Incidence of myocardial infarction or stroke or death at 47-month follow-up in patients with diabetes and a predicted exercise capacity <or=85% vs >85% during an exercise treadmill sestamibi stress test.
A treadmill exercise sestamibi stress test (TESST) was performed in 609 consecutive diabetic persons with a mean age of 70 years and no history of coronary artery disease (CAD) who were referred for a TESST because of chest pain or dyspnea. Of 609 patients, 301 (49%) had a predicted exercise capacity <or=85% (group A) and 308 (51%) had a predicted exercise capacity >85% (group B). Group A patients had a higher prevalence of myocardial ischemia (43% vs 30%, P=.0005), 2- or 3-vessel obstructive CAD (38% vs 18%, P=.001), myocardial infarction (17% vs 9%, P=.004), death (10% vs 4%, P=.008), and myocardial infarction or stroke or death at 47-month follow-up (21% vs 12%, P=.001). Stepwise Cox regression analysis showed that the only significant independent predictor for the time to development of myocardial infarction or stroke or death was a predicted exercise capacity >85% (hazard ratio, 0.52; 95% confidence interval, 0.34-0.78; P=.002). Diabetic persons with a predicted exercise capacity >85% had a 48% lower chance of myocardial infarction, stroke, or death than those with a predicted exercise capacity <or=85%.
Pierre-Louis
Bredy
B
Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
Aronow
Wilbert S
WS
Yoon
Joo H
JH
Ahn
Chul
C
DeLuca
Albert J
AJ
Weiss
Melvin B
MB
Kalapatapu
Kumar
K
Pucillo
Anthony L
AL
Monsen
Craig E
CE
D000368:Aged; D002637:Chest Pain; D003324:Coronary Artery Disease; D048909:Diabetes Complications / Q000453:epidemiology* / Q000401:mortality; D004417:Dyspnea; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D017202:Myocardial Ischemia; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology