{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T23:35:16Z","timestamp":1769816116928,"version":"3.49.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The impact of diabetes mellitus on the clinical presentation and noninvasive test (\n              <jats:styled-content style=\"fixed-case\">NIT<\/jats:styled-content>\n              ) results among stable outpatients presenting with symptoms suggestive of coronary artery disease (\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              ) has not been well described.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial enrolled 10\u00a0003 patients with known diabetic status, of whom 8966 were tested as randomized and had interpretable\n              <jats:styled-content style=\"fixed-case\">NIT<\/jats:styled-content>\n              results (1908 with diabetes mellitus, 21%). Differences in symptoms and\n              <jats:styled-content style=\"fixed-case\">NIT<\/jats:styled-content>\n              results were evaluated using logistic regression. Patients with diabetes mellitus (versus without) were similar in age (median 61 versus 60\u00a0years) and sex (female 54% versus 52%), had a greater burden of cardiovascular comorbidities, and had a similar likelihood of nonchest pain symptoms (29% versus 27%). The Diamond\u2010Forrester\/Coronary Artery Surgery Study score predicted that patients with diabetes mellitus (versus without) had similar likelihood of obstructive\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              (low 1.8% versus 2.7%; intermediate 92.3% versus 92.6%; high 5.9% versus 4.7%). Physicians estimated patients with diabetes mellitus to have a higher likelihood of obstructive\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              (low to very low: 28.3% versus 40.1%; intermediate 63.9% versus 55.9%; high to very high 7.8% versus 4.0%). Patients with diabetes mellitus (versus without) were more likely to have a positive\n              <jats:styled-content style=\"fixed-case\">NIT<\/jats:styled-content>\n              result (15% versus 11%; adjusted odds ratio, 1.23;\n              <jats:italic>P<\/jats:italic>\n              =0.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Stable chest pain patients with and without diabetes mellitus have similar presentation and pretest likelihood of obstructive\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              ; however, physicians perceive that patients with diabetes mellitus have a higher pretest likelihood of obstructive\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              , an assessment supported by increased risk of a positive\n              <jats:styled-content style=\"fixed-case\">NIT<\/jats:styled-content>\n              . Further evaluation of diabetes mellitus's influence on\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              assessment is required.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01174550.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.007019","type":"journal-article","created":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:10:42Z","timestamp":1509495042000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of Diabetes Mellitus on the Evaluation of Stable Chest Pain Patients: Insights From the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) Trial"],"prefix":"10.1161","volume":"6","author":[{"given":"Abhinav","family":"Sharma","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishant K.","family":"Sekaran","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Coles","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha J.","family":"Pagidipati","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udo","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel 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