Document Detail

Clinical utility of the exercise ECG in patients with diabetes and chest pain.
MedLine Citation:
PMID:  11348969     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to determine the characteristics of exercise treadmill testing in diabetic patients presenting with chest pain. BACKGROUND: The diagnosis of coronary artery disease (CAD) in diabetic patients is confounded by different manifestations of coronary disease than are seen in the general population. Because of the association of diabetes with accelerated CAD, it is critical to assess the diagnostic utility of the standard exercise test in diabetic patients with chest pain. METHODS: This study was a retrospective analysis of standard exercise test results in 1,282 male patients without prior myocardial infarction who had undergone coronary angiography and were being evaluated for possible CAD at two Veterans' Administration institutions. RESULTS: In patients with diabetes, 38% had an abnormal exercise test result, and the prevalence of angiographic CAD was 69%; the sensitivity of the exercise test was 47% (95% confidence interval [CI], 41 to 58), and specificity was 81% (95% CI, 68 to 89). In patients without diabetes, 38% had an abnormal exercise test result, and the prevalence of angiographic CAD was 58%; the sensitivity of the exercise test was 52% (95% CI, 48 to 56), and specificity was 80% (95% CI, 76 to 83). The receiver operating characteristic curves were also similar in both diabetic and nondiabetic patients (0.67 and 0.68, respectively). CONCLUSION: These data demonstrate that the standard exercise test has similar diagnostic characteristics in diabetic as in nondiabetic patients.
D P Lee; W F Fearon; V F Froelicher
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  119     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-11     Completed Date:  2001-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1576-81     Citation Subset:  AIM; IM    
Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford 94305-5406, USA.
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MeSH Terms
Chest Pain / etiology*
Coronary Disease / complications*,  diagnosis*
Diabetes Complications*
Exercise Test*
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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