{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:53:30Z","timestamp":1761058410091},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,2,13]],"date-time":"2006-02-13T00:00:00Z","timestamp":1139788800000},"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":[[2006,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> To assess the association between abnormal stress myocardial perfusion imaging (MPI) and cardiac events (CE) in asymptomatic patients with diabetes and with \u2265\u00a01 additional risk factor. Predictors of abnormal stress MPI were also evaluated.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Four hundred and forty\u2010seven consecutive patients who underwent stress MPI were prospectively followed for 2.1 [0.5\u20134.1] years for the subsequent occurrence of hard CE (myocardial infarction and sudden or coronary death) and soft CE (unstable angina and ischaemic heart failure requiring hospitalization). Re\u2010vascularization procedures performed as a result of the screening protocol were not included in the analysis.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Follow\u2010up was successful in 419 of 447 patients (94%), of whom 71 had abnormal MPI at baseline. Medical therapy was intensified in all subjects and especially in those with abnormal MPI. Twenty\u2010three patients with abnormal MPI underwent a re\u2010vascularization procedure. CEs occurred in 14 patients, including six of 71 patients (8.5%) with abnormal MPI and eight of 348 patients (2.3%) with normal MPI (<jats:italic>P\u00a0&lt;<\/jats:italic>\u00a00.005). Only two patients developed a hard CE and 12 a soft CE. In multivariate analysis, abnormal MPI was the strongest predictor for CEs [odds ratio (OR) (95% CI)\u00a0=\u00a05.6 (1.7\u201318.5)]. Low\u2010density lipoprotein cholesterol \u2265\u00a03.35\u00a0mmol\/l [OR (95% CI)\u00a0=\u00a07.3; 1.5\u201334.7] and age\u00a0&gt;\u00a0median [OR (95% CI)\u00a0=\u00a06.0 (1.2\u201328.6)] were additional independent predictors for CE. The independent predictors for abnormal MPI were male gender, plasma triglycerides \u2265\u00a01.70\u00a0mmol\/l, creatinine clearance &lt;\u00a060\u00a0ml\/min and HbA<jats:sub>1c<\/jats:sub>\u00a0&gt;\u00a08%, with male gender the strongest [OR (95% CI)\u00a0=\u00a04.0 (1.8\u20138.8)].<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Asymptomatic patients with diabetes in this study had a very low hard cardiac event rate over an intermediate period. This could be explained by the effects of intervention or by the low event rate in the background population. Randomized studies of cardiac heart disease screening are required in asymptomatic subjects with diabetes to determine the effectiveness of this intervention.<\/jats:p><jats:p>Diabet. Med. 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