Assessing prognosis in patients with diabetes mellitus--the Achilles' heel of cardiac stress imaging tests?
The prognostic utility of stress imaging studies has been validated in numerous studies and, in general, patients with a normal imaging study have annual cardiac ischemic event rates of <1%. However, this predictive value of a normal stress imaging study does not appear to be applicable to subjects with diabetes. In this editorial, we summarize the current available data on prognostic utility of stress imaging studies in subjects with diabetes and provide insights into how to interpret and integrate these data for daily clinical practice. In conclusion, currently available data suggest that the prognostic value of stress imaging studies in subjects with diabetes differs from those without diabetes and should be interpreted as such.
Kamalesh
Masoor
M
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA. masoor.kamalesh@med.va.gov
Feigenbaum
Harvey
H
Sawada
Stephen
S
D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D048909:Diabetes Complications / Q000175:diagnosis* / Q000503:physiopathology; D003952:Diagnostic Imaging; D005080:Exercise Test; D006801:Humans; D011379:Prognosis; D018570:Risk Assessment