Trial reportInternational journal of cardiology2013
The heart rate response to adenosine: a simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes.
Trial report in International journal of cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Prognostic value of normal stress myocardial perfusion imaging in diabetic patients: a meta-analysis.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Pooled it
- Prognostic value of heart rate response during regadenoson stress myocardial perfusion imaging in patients with end stage renal disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Trial
- Fractional flow reserve versus angiography in guiding management to optimize outcomes in non-ST-elevation myocardial infarction (FAMOUS-NSTEMI): rationale and design of a randomized controlled clinical trial.American heart journal · 2013Trial
- Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis.Communications medicine · 2024Article
- Relationship between heart rate response and cardiac innervation in patients with suspected or known coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Heart rate and 123I-MIBG in heart failure with preserved ejection fraction: More variability and slower washout-A secret recipe for better survival.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- The prognostic value of heart rate response during vasodilator stress myocardial perfusion imaging in patients with end-stage renal disease undergoing renal transplantation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Article
- Adverse effects associated with regadenoson myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- The heart rate response to regadenoson in patients with atrial fibrillation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- The reproducibility and prognostic value of serial measurements of heart rate response to regadenoson during myocardial perfusion imaging.European journal of nuclear medicine and molecular imaging · 2016Article
- Heart rate response to regadenoson: Making the case for its value in clinical practice.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Article
- The prognostic value of non-perfusion variables obtained during vasodilator stress myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2016Review
- Cardiac purinergic signalling in health and disease.Purinergic signalling · 2015Review
- Autonomic dysfunction independently predicts poor cardiovascular outcomes in asymptomatic individuals with type 2 diabetes in the DIAD study.SAGE open medicine · 2015Article
- The importance of heart rate response during myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Article
- Cardiac autonomic neuropathy in patients with diabetes mellitus.World journal of diabetes · 2014 · on this mapReview
- Prognostic Value of Normal Perfusion but Impaired Left Ventricular Function in the Diabetic Heart on Quantitative Gated Myocardial Perfusion SPECT.Nuclear medicine and molecular imaging · 2013Article
- Risk assessment in the era of high-speed myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe Detection of Ischemia in Asymptomatic Diabetics (DIAD) study demonstrated a low 5-year hard cardiac event rate. We hypothesized that a blunted heart rate response (HRR, maximum percent change) to adenosine, a simple marker of cardiac autonomic neuropathy, will identify a cohort at higher cardiac risk.
methodsIn DIAD, 518 participants were randomized to screening adenosine myocardial perfusion imaging (MPI) and had available data. HRR <20% was considered abnormal. The primary endpoint was a composite of nonfatal myocardial infarction and cardiac death.
resultsDuring 4.7 ± 0.9 years of follow-up 15 (3%) participants experienced the primary outcome. Participants with lower HRR experienced more events than those with higher HRR (8%, 3%, 1%, for HRR <20% (n=79), 20-39% (n=182) and ≥ 40% (n=257), respectively, p=0.01). In a Cox proportional regression model that included MPI abnormalities and HRR, both were independently associated with cardiac events (p for model <0.001). HRR <20% was associated with 9-fold increased risk (p=0.007) and moderate/large abnormal MPI was associated with 6-fold increased risk (p=0.004). Participants with both abnormal MPI and HRR (n=8) were at highest risk for cardiac events (38%) whereas those with HRR ≥ 40%, irrespective of MPI abnormalities (n=234), were at extremely low risk (≤1%, log-rank p<0.001).
conclusionsIn DIAD, abnormal HRR to adenosine infusion is an independent predictor of cardiac events. This easily obtained marker of cardiac autonomic neuropathy identifies asymptomatic patients with type 2 diabetes mellitus at increased risk, particularly when associated with abnormal MPI, who may warrant further testing and more aggressive cardiovascular risk factor management.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.