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Stress Testing Predicts Risk of Cardiac Events in Diabetics

Ischemia an additional predictive factor

THURSDAY, Jan. 3 (HealthDay News) -- Stress echocardiography can predict the risk of adverse events such as death and heart attack in diabetic and non-diabetic patients, with the presence of ischemia being an additional predictive factor, according to a study published in the Dec. 15 issue of the American Journal of Cardiology.

Lauro Cortigiani, M.D., from Lucca Hospital in Lucca, Italy, and colleagues examined the prognostic value of pharmacologic stress echocardiography and intermediate- to high-threshold positive exercise electrocardiography in 935 patients with chest pain (131 diabetics).

During a median follow-up of 26 months, the researchers observed 158 adverse events (deaths, myocardial infarctions or late revascularizations), which were significantly more common in diabetic patients (26 versus 15 percent). Events were independently predicted by age, diabetes, high cholesterol, smoking, anti-anginal therapy at the time of testing, and ischemia at stress echocardiography. There were significantly more events in patients with ischemia (46 versus 7 percent). A lack of ischemia predicted no events in six months and a 2 percent rate of events at one year in both diabetic and non-diabetic patients.

"In conclusion, stress echocardiography was effective in risk stratifying diabetic and non-diabetic patients with intermediate- to high-threshold ischemic exercise electrocardiographic results," Cortigiani and colleagues write. "However, major event rates associated with a non-ischemic test result were similar in diabetic and non-diabetic patients during the first year of follow-up and markedly increased in the former thereafter."

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