title: 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.
abstract: 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%.
authors.affiliation: Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
authors.forename: Bredy
authors.initials: B
authors.lastname: Pierre-Louis
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.forename: Joo H
authors.initials: JH
authors.lastname: Yoon
authors.forename: Chul
authors.initials: C
authors.lastname: Ahn
authors.forename: Albert J
authors.initials: AJ
authors.lastname: DeLuca
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Weiss
authors.forename: Kumar
authors.initials: K
authors.lastname: Kalapatapu
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Pucillo
authors.forename: Craig E
authors.initials: CE
authors.lastname: Monsen
mesh_terms: 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