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Stress Tests for Ischemia Compared in Diabetes Patients
Exercise stress tests with myocardial perfusion imaging show more ischemia than ECGs

THURSDAY, June 20 (HealthDay News) -- Silent ischemia is more often detected by exercise myocardial perfusion imaging (MPI) than by electrocardiogram (ECG) in patients with diabetes mellitus, according to research published in the July 1 issue of The American Journal of Cardiology.

Fadi G. Hage, M.D., of the University of Alabama at Birmingham, and colleagues conducted the Ischemia Assessment with Exercise imaging in Asymptomatic Diabetes (IAEA Diabetes) study in developing countries to determine the prevalence of ischemia detected by exercise ECG and MPI in asymptomatic patients with diabetes mellitus. This prospective study involved 392 patients with diabetes mellitus who were matched in a 2:1 ratio by age and gender to 205 control participants without diabetes mellitus who had at least one risk factor for coronary artery disease.

The researchers found that, among patients receiving diagnostic ECGs, ischemia was detected at a similar rate in patients with diabetes (15 percent) and controls (12 percent). MPI abnormalities were detected at a significantly greater rate in patients with diabetes (26 percent) than in controls (14 percent). Ischemia by ECG was found in 17 percent of those with ischemia by MPI and in 10 percent of those without ischemia by MPI. Women were significantly less likely than men to have ischemia by MPI (10 versus 30 percent).

"In conclusion, in this large prospective study, asymptomatic DM participants had (1) more ischemia by exercise MPI than ECG, (2) more ischemia by MPI but not ECG than control group, and (3) ischemia by MPI was less in women than men," the authors write.

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