Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Diabetes Care Publish Ahead of Print published online ahead of print May 13, 2008
DOI: 10.2337/dc08-0616
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
dc08-0616v1
dc08-0616v2    most recent
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Ho, P. M.
Right arrow Articles by Magid, D. J.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ho, P. M.
Right arrow Articles by Magid, D. J.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Original Research

Impaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts Future Cardiovascular Events

P. Michael Ho, MD, PhD1,,2,,3, Thomas M. Maddox, MD1,,2,,3, SM Colleen Ross, MS3, John S. Rumsfeld, MD, PhD1,,2,,3 and David J. Magid, MD, MPH2,,3

1Denver VA Medical Center
2University of Colorado Denver
3Institute for Health Research, Kaiser Permanente of Colorado

Michael.ho{at}uchsc.edu

ABSTRACT

Objectives: To assess the association between impaired chronotropic response (CR) and adverse events among patients with diabetes referred for exercise treadmill testing (ETT).

Research design and methods: Impaired CR was defined as achievement of less than 80% of a patient's heart rate reserve. Multivariable Cox proportional hazards regression assessed the independent association between impaired CR and adverse outcomes adjusting for demographics, co-morbidities and treadmill variables including the Duke Treadmill score.

Results: Of 1,341 patients with diabetes, 35.7% (n=479) demonstrated impaired CR during ETT. Patients with impaired CR were at increased risk of all-cause mortality, myocardial infarction, or coronary revascularization procedures. In multivariable analyses, impaired CR remained significantly associated with adverse outcomes (HR 1.53; 95% CI 1.10-2.14).

Conclusions: Among patients with diabetes, impaired CR is common during ETT and is associated with adverse outcomes. Impaired CR can be used as another non-invasive tool to risk stratify patients with diabetes following ETT.


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2008 by the American Diabetes Association.