Key result
A predicted exercise capacity >85% during stress testing in diabetic patients was associated with a lower risk of myocardial infarction, stroke, or death compared to ≤85% (HR 0.52; 95% CI 0.34-0.78).
Why the study?
Does a predicted exercise capacity >85% during treadmill stress testing predict a lower risk of myocardial infarction, stroke, or death in diabetic patients without known CAD?
Cohort (n=609)
Does a predicted exercise capacity >85% during treadmill stress testing predict a lower risk of myocardial infarction, stroke, or death in diabetic patients without known CAD?
In diabetic patients without known CAD, achieving a predicted exercise capacity >85% during treadmill stress testing is associated with a 48% lower risk of MI, stroke, or death over 47 months.
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%.
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Pierre-Louis et al. (2009) conducted a cohort in Diabetes (n=609). Predicted exercise capacity >85% vs. Predicted exercise capacity ≤85% was evaluated on Myocardial infarction or stroke or death (HR 0.52, 95% CI 0.34-0.78, p=0.002). A predicted exercise capacity >85% during stress testing in diabetic patients was associated with a lower risk of myocardial infarction, stroke, or death compared to ≤85% (HR 0.52; 95% CI 0.34-0.78).
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