Prognostic Value of Dobutamine Stress Echocardiography in Predicting Major Cardiac Events in Patients with Metabolic...

The metabolic syndrome increases cardiovascular mortality. We report the mid-term prognostic value of dobutamine echocardiography for metabolic syndrome.

A dobutamine echocardiography protocol was performed in patients aged 18 years of age or older who suffered from chest pain and who were followed-up for two years. The patients were divided in two groups, with and without metabolic syndrome. Statistical analyses were performed using ROC curves and survival analysis; the Begg-Greenes method was used to correct for verification bias. We included 128 patients, 66 with metabolic syndrome and 62 without.

Forty-one patients with metabolic syndrome and 36 without had positive dobutamine echocardiography test results (p = 0.77). Coronary artery disease was found in 27 patients with metabolic syndrome and in 29 without metabolic syndrome; percutaneous revascularization was required in 24 and 26 patients, respectively (p = 0.29). Cardiovascular events occurred in 28 patients during follow-up (19 in metabolic syndrome vs. 9 in non-metabolic syndrome; p = 0.17). The odds ratio of major cardiovascular events in the metabolic syndrome group was 5.8 (95% CI: 1.74-19.60); in the control group it was 8.6 (95% CI: 2.53-29.59).

Dobutamine echocardiography for metabolic syndrome has high sensitivity but is not a determining factor for mid-term prognosis.