Abstract 1703: Incidence of Myocardial Infarction or Stroke or Death at 47-Month Follow-up in Patients With Diabetes and a Predicted Exercise Capacity Less Than 85% versus Greater Than 85% During an Exercise Treadmill Sestamibi Stress Test
Purpose: To investigate the effect of predicted exercise capacity on the long-term incidence of myocardial infarction or stroke or death in diabetics without a history of coronary artery disease (CAD) undergoing a treamill exercise sestamibi stress test (TESST).
Methods: A TESST was performed in 609 consecutive diabetics without a history of CAD referred for a TESST because of chest pain or dyspnea. Follow-up for the incidence of myocardial infarction or stroke or death was 47 months.
Results: Of 609 patients, 301 (49%) had a predicted exercise capacity less than 85% (group A), and 308 (51%) had a predicted exercise capacity greater than 85% (group B). Group A patients had a higher prevalence of myocardial ischemia (43% versus 30%, p = 0.0005), 2- or 3-vessel obstructive CAD (38% versus 18%, p = 0.001), myocardial infarction (17% versus 9%, p = 0.004), death (10% versus 4%, p = 0.008), and myocardial infarction or stroke or death at 47-month follow-up (21% versus 12%, p = 0.001). 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 greater than 85% (hazard ratio = 0.52; 95% CI, 0.34, 0.78; p = 0.002).
Conclusions: Diabetics with a predicted exercise capacity greater than 85% had a 48% less chance of developing myocardial infarction, stroke, or death than those with a predicted exercise capacity less than 85%.