Prognostic Value of Dobutamine Echocardiography in Patients with Intermediate Coronary Lesions at Angiography

The prognostic value of dobutamine echocardiography (DOBU‐ECHO) in patients with intermediate coronary lesions has not been described in the literature. The aim of this study was to determine the prognostic value of DOBU‐ECHO in patients presenting with coronary lesions smaller than 50% at angiography. Ninety‐four consecutive patients were analyzed and followed‐up for 64 ± 7 months (range: 12 to 75 months). All patients presented with coronary lesions between ≥ 30% and < 50% of the luminal diameter of at least one major epicardial vessel. The patient population was divided into two groups: Those with a positive DOBU‐ECHO (n = 23) and those with a negative DOBU‐ECHO (n = 71). The number of coronary lesions did not differ between the two groups. The patients with a positive DOBU‐ECHO result were more likely than those in the negative group to have a family history of coronary artery disease or suffer from hypertension or a dyslipidemia. During the follow‐up period, 13 cardiac events occurred (1 cardiac death, 5 myocardial infarctions, 2 unstable anginas, and 5 myocardial revascularizations), 11 (47.8%) of which occurred in patients with positive DOBU‐ECHO. The annual incidence for a cardiac event was 7.9% per year in the positive DOBUECHO group and 0.5% per year in the negative DOBU‐ECHO group (P < 0.001). This incidence remained significant for spontaneous cardiac events, such as cardiac death, myocardial infarction, and unstable angina (5.8% per year vs 0.2% per year; P < 0.001). Conclusions. In patients with angiographically confirmed intermediate coronary lesions, a positive DOBU‐ECHO is an additional risk factor for the onset of a cardiac event, whereas a negative DOBU‐ECHO can be used to define patients with a low cardiac risk.