{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T12:43:45Z","timestamp":1772196225249,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2004,3,22]],"date-time":"2004-03-22T00:00:00Z","timestamp":1079913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> To determine whether performing a myocardial scintigraphy immediately after a maximal electrocardiogram (ECG) stress test is effective in detecting silent coronary stenoses and predicting cardiovascular events.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold> Asymptomatic patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a0262) aged 57.6\u00a0\u00b1\u00a08.8\u00a0years, with diabetes for 12.0\u00a0years (5\u201339) [median (range)] and no history of a cardiac event, underwent a maximal ECG stress test followed by a myocardial scintigraphy. The patients with an abnormal ECG stress test or abnormal imaging underwent a coronary angiography. Cardiac events were assessed in 250 (95.4%) patients followed for 37.8\u00a0months (3\u2013101).<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> The ECG stress test was abnormal in 54 patients. Among them, 18 had coronary stenoses and seven had a cardiac event. Despite a normal ECG stress test, the myocardial scintigraphy was abnormal in 42 additional patients, including 16 patients with coronary stenoses. Four of these 42 patients experienced a cardiac event. Follow\u2010up showed a poor prognosis in subjects who were abnormal on the two tests. Univariate predictors of the 15 cardiac events were the ECG stress test [odds ratio (OR) 3.9, 95% confidence interval (CI) 1.3, 11.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008], myocardial scintigraphy (OR 3.8, 95% CI 1.3, 11.0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009), coronary stenoses (OR 26.6, 95% CI 7.6, 90.7, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and peripheral or carotid occlusive arterial disease (OR 9.5, 95% CI 2.1, 42.5, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> In the asymptomatic patients with diabetes, combining a myocardial scintigraphy with a maximal ECG stress test is effective in detecting more patients with coronary stenoses and predicting cardiovascular events. However, the ECG stress test has a good negative predictive value for cardiac events (97%), is cheaper, and should therefore be proposed first.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2004.01157.x","type":"journal-article","created":{"date-parts":[[2004,3,22]],"date-time":"2004-03-22T14:14:10Z","timestamp":1079964850000},"page":"342-348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Detecting silent coronary stenoses and stratifying cardiac risk in patients with diabetes: ECG stress test or exercise myocardial scintigraphy?"],"prefix":"10.1111","volume":"21","author":[{"given":"E.","family":"Cosson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Paycha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Paries","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Cattan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Ramadan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Meddah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u2010R.","family":"Attali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Valensi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,3,22]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807233390404"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.301.6743.92"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(92)90745-H"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.63.1.7"},{"key":"e_1_2_7_6_2","first-page":"409","article-title":"Silent myocardial ischaemia and left ventricle hypertrophy in diabetic patients","volume":"23","author":"Valensi P","year":"1997","journal-title":"Diabetes Metab"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.9.1396"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.2.339"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(99)00102-3"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01910-1"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90343-2"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.11.2032"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.1.19"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.11.1797"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2001.00599.x"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.9.1551"},{"key":"e_1_2_7_17_2","first-page":"446","article-title":"Coronaires et diab\u00e8te","volume":"21","author":"Passa Ph","year":"1995","journal-title":"Diabetes Metab"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/14.7.969"},{"key":"e_1_2_7_19_2","first-page":"1","volume-title":"Society of Nuclear Medicine ed. 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