Heart Rate Response During Positive Exercise Stress Test Predicts Coronary Artery Disease and Its Severity in High- Risk Type 2 Diabetic Patients With Silent Ischemia
- Simonetta Bacci, MD1,
- Tommaso Iangialonga, MD1,
- Massimo Villella, MD1,
- Anna Rauseo, MD1,
- Raffaele Fanelli, MD1 and
- Vincenzo Trischitta, MD12
- 1Department of Cardiovascular and Endocrine and Metabolic diseases, Scientific Institute “Casa Sollievo della Sofferenza,” San Giovanni Rotondo, Italy
- 2Department of Clinical Sciences, University “La Sapienza,” Rome, Italy
- Address correspondence to Dr. Simonetta Bacci, Unit of Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza,” Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy. E-mail: endocrino{at}operapadrepio.it
Diagnosis of coronary artery disease (CAD) before symptoms appear can reduce mortality in diabetes (1). ST depression at exercise stress test (EST) independent of angina is a hallmark of CAD (2); however, if a positive EST is characterized by the lack of angina, a second test to better stratify the risk of ischemia is recommended (3). Heart rate response at EST with ST depression can improve risk stratification in the general population (4), but no such data are available in diabetic patients.
We studied the relationship between heart rate response and CAD in 33 consecutive patients with type 2 diabetes and silent ischemia at EST (i.e., horizontal or downsloping ST depression ≥1 mm at 0.08 s after J point, without angina). Patients (22 men and …
