Prediction of mortality by stress echocardiography in 2835 diabetic and 11 305 nondiabetic patients

To compare the capability by stress echocardiography results to predict overall mortality in a large unselected cohort of diabetic and nondiabetic patients. The study group comprised 14 140 patients (2835 diabetics and 11 305 nondiabetics) who underwent stress echocardiography for evaluation of known (n=5671) or suspected (n=8469) coronary artery disease. Ischemia at stress echocardiography was observed in 768 (27%) diabetics and 2644 (23%) nondiabetics. During a median follow-up of 30 months (first quartile, 9; third quartile, 63), 1213 patients died. In diabetics, multivariable indicators of mortality were age (hazard ratio [HR], 1.07, 95% confidence interval [CI], 1.06-1.09), rest wall motion abnormality (HR, 2.43; 95% CI, 1.83-3.22), and ischemia at stress echocardiography (HR, 1.71; 95% CI, 1.34-2.18). In nondiabetics, multivariable indicators of mortality were age (HR, 1.07; 95% CI, 1.06-1.08), rest wall motion abnormality (HR, 2.19; 95% CI, 1.86-2.57), male sex (HR, 1.65; 95% CI, 1.41-1.93), ischemia at stress echocardiography (HR, 1.54; 95% CI, 1.32-1.80), and antischemic therapy at the time of test (HR, 1.15; 95% CI, 1.00-1.32). In stress echo negative subjects for ischemia, antischemic therapy showed increased annual mortality in nondiabetic patients with (3.8% versus 3.1%; P=0.04) or without rest wall motion abnormality (1.6% versus 0.9%; P