Evidence mapPaperPMID 15309331Full record

Trial reportEuropean journal of nuclear medicine and molecular imaging2005

Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy.

John O Prior, David Monbaron, Melanie Koehli, Maria-Lucia Calcagni, Juan Ruiz, Angelika Bischof Delaloye

Open access · bronzeAbstract readClinical TrialControlled Clinical Trial
PubMed Publisher
In one paragraph

Trial report in European journal of nuclear medicine and molecular imaging, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
2.2field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 35 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
  6. Cardiovascular risk stratification in diabetic patients: is all in METS?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014
    Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Asymptomatic patients with diabetes mellitus should be screened for coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2006
    Article
  13. Lessons learned from the detection of ischemia in asymptomatic diabetics (DIAD) study.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
    Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

John O PriorDivision of Nuclear Medicine, Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), 1011, Lausanne, Switzerland. john.prior@chuv.hospvd.ch
David Monbaron
Melanie Koehli
Maria-Lucia Calcagni
Juan Ruiz
Angelika Bischof Delaloye
University Hospital of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSilent myocardial ischaemia--as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain--is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion.

methodsThe patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, (99m)Tc-sestamibi, 201Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS).

resultsAbnormal MPS (SSS> or =4) was observed in 49 (37%) patients (SSS=4.9+/-8.4, SDS=2.4+/-4.7), reversible perfusion defects (SDS> or =2) in 40 (30%) patients [SSS=13.3+/-10.9; SDS=8.0+/-5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9+/-11.3; SDS=7.4+/-1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress [odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02).

conclusionSilent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify these patients with a potentially increased risk of cardiovascular events.

Indexed as

Technetium Tc 99m SestamibiAdultAgedAged, 80 and overCausalityComorbidityCoronary Artery DiseaseDiabetes MellitusExercise TestFemaleHumansIncidenceMaleMiddle AgedMyocardial IschemiaPrevalenceRadiopharmaceuticalsTechnetium Tc 99m Sestamibi

Identifiers

PMID15309331
OpenAlexW1966680242

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.