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Asymptomatic ischemia is a frequently encountered problem in patients with diabetes mellitus. However it is presently unclear what clinical characteristics may predict an abnormal stress myocardial perfusion study in asymptomatic diabetes patients. In the present study Scholte et al (1) studied 120 asymptomatic patients with adenosine MIBI SPECT. In line of previous studies they report an abnormal stress study in 33% including abnormal perfusion in 25%. Importantly and in contrast to earlier studies, current smoking, duration of diabetes and the cholesterol/HDL ratio were identified as independent predictors of an abnormal study. Further studies are needed to evaluate whether these clinical variables may allow better risk stratification and selection for noninvasive imaging in asymptomatic diabetes patients.
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