糖尿病患者在运动平板西司他比负荷试验中预测运动能力≤85%与＞85%时，47个月随访期内心肌梗死、中风或死亡的发生率。

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.

作者信息

Pierre-Louis Bredy, Aronow Wilbert S, Yoon Joo H, Ahn Chul, DeLuca Albert J, Weiss Melvin B, Kalapatapu Kumar, Pucillo Anthony L, Monsen Craig E

机构信息

Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.

出版信息

Prev Cardiol. 2010 Winter;13(1):14-7. doi: 10.1111/j.1751-7141.2009.00051.x.

DOI:10.1111/j.1751-7141.2009.00051.x

PMID:20021621

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%.

摘要

对609例连续的糖尿病患者进行了平板运动锝-甲氧基异丁基异腈负荷试验（TESST），这些患者平均年龄70岁，无冠状动脉疾病（CAD）病史，因胸痛或呼吸困难而接受TESST检查。在609例患者中，301例（49%）的预测运动能力≤85%（A组），308例（51%）的预测运动能力>85%（B组）。A组患者心肌缺血的患病率更高（43%对30%，P = 0.0005），2支或3支血管阻塞性CAD的患病率更高（38%对18%，P = 0.001），心肌梗死的患病率更高（17%对9%，P = 0.004），死亡率更高（10%对4%，P = 0.008），在47个月随访时心肌梗死或中风或死亡的发生率更高（21%对12%，P = 0.001）。逐步Cox回归分析显示，心肌梗死或中风或死亡发生时间的唯一显著独立预测因素是预测运动能力>85%（风险比，0.52；95%置信区间，0.34 - 0.78；P = 0.002）。预测运动能力>85%的糖尿病患者发生心肌梗死、中风或死亡的几率比预测运动能力≤85%的患者低48%。