1st Cardiology Department, Hippokration Hospital, Athens Medical School, Greece.
1st Cardiology Department, Hippokration Hospital, Athens Medical School, Greece.
Hellenic J Cardiol. 2017 Nov-Dec;58(6):419-424. doi: 10.1016/j.hjc.2017.04.004. Epub 2017 Apr 22.
Dobutamine stress contrast echo (DSCE) has a well-established prognostic value in the context of coronary artery disease (CAD). However, data regarding its prognostic capability separately in men and women are scarce. The aim of the current study was to assess gender-related differences in the prognostic performance of DSCE.
DSCE was performed in 2645 consecutive patients, who were classified into two groups depending on gender. Follow-up lasted 57.1±10.1 months. End points included all-cause mortality, cardiac death, late revascularization, and hospitalizations. Survival analysis was performed comparing men and women.
Of the 2645 patients (59.3±8.7 years), 69.1% were men. DSCE was positive in 23.4% of male patients, while in females, the respective percentage was 14.3%. There was statistically significant difference between the two groups with regard to end point occurrence (11.6% vs. 6.1%, p<0.05). Multivariate analysis revealed that the DSCE response was the strongest predictor of adverse outcomes (Exp(B)=51.9, p<0.05) in both groups. The predictive model including DSCE results along with clinical data performed well without significant differences between males and females (C-index 0.93 vs. 0.87 respectively, p=NS).
DSCE has a strong prognostic value for patients with known or suspected CAD, regardless of patient gender. This makes DSCE an attractive screening option for women in whom CAD assessment can be challenging.
多巴酚丁胺负荷超声心动图（DSCE）在冠心病（CAD）背景下具有明确的预后价值。然而，关于其在男性和女性中的单独预后能力的数据却很少。本研究旨在评估 DSCE 在性别方面的预后性能差异。
对 2645 例连续患者进行了 DSCE，根据性别将患者分为两组。随访时间为 57.1±10.1 个月。终点包括全因死亡率、心源性死亡率、晚期血运重建和住院。对男性和女性进行生存分析比较。
在 2645 例患者中（59.3±8.7 岁），男性占 69.1%。男性患者中 DSCE 阳性的比例为 23.4%，而女性分别为 14.3%。两组之间在终点事件发生率方面存在统计学显著差异（11.6%比 6.1%，p<0.05）。多变量分析显示，DSCE 反应是两组不良预后的最强预测因素（Exp(B)=51.9，p<0.05）。包括 DSCE 结果和临床数据的预测模型在男性和女性之间没有显著差异（C 指数分别为 0.93 和 0.87，p=NS）。
无论患者性别如何，DSCE 对已知或疑似 CAD 的患者均具有很强的预后价值。这使得 DSCE 成为一种有吸引力的筛查选择，适用于 CAD 评估具有挑战性的女性。
