Trial reportJournal of the American College of Cardiology2019
Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease.
Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01174550 (PROspective Multicenter Imaging Study for Evaluation of Chest Pain - The PROMISE Trial), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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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.
PROspective Multicenter Imaging Study for Evaluation of Chest Pain - The PROMISE Trial
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association.Circulation · 2020Guideline
- SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography.Journal of cardiovascular computed tomographyGuideline
- Prognostic Value of Coronary CT Angiography Among Patients With and Without Diabetes: The Mass General Brigham CCTA registry.Cardiovascular diabetology · 2026Article
- SCORE2-diabetes for predicting coronary artery disease: a cardiac CT study in a diabetic moderate-risk region population.Cardiovascular diabetology · 2025Article
- Coronary Artery Disease and Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Review
- The Role of Coronary Computed Tomography Angiography in the Diagnosis, Risk Stratification, and Management of Patients with Diabetes and Chest Pain.Reviews in cardiovascular medicine · 2024Review
- Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study.European heart journal. Digital health · 2024Article
- Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease.Diabetes care · 2023Article
- Machine learning in precision diabetes care and cardiovascular risk prediction.Cardiovascular diabetology · 2023Review
- Recent clinical trials support continued emphasis on patient-first over modality-first approaches to initial test selection in patients with stable ischemic heart disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- The role of coronary computed tomography angiography in low- and intermediate-risk patients with chest pain: a paradigm shift in modern cardiology.Internal and emergency medicine · 2023Review
- Invasive versus Conservative Management in Coronary Artery Disease.Clinical medicine & research · 2023Review
- Impact of Family History of Premature Coronary Artery Disease on Noninvasive Testing in Stable Chest Pain.Journal of the American Heart Association · 2023Article
- Cardiovascular Magnetic Resonance Imaging as an Adjunct to the Evaluation of Cardiovascular Involvement in Diabetes Mellitus.Journal of personalized medicine · 2023Review
- Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement.International journal of heart failure · 2023Review
- Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement.Diabetes & metabolism journal · 2023Review
- Editorial: Old habits die hard: from risk calculators and stenosis evaluation to phenotyping coronary atherosclerosis using cardiac CT.Frontiers in cardiovascular medicine · 2023Article
- Preventive cardiology advances in the 2021 AHA/ACC chest pain guideline.American journal of preventive cardiology · 2022Article
- Atherosclerotic plaque characteristics on quantitative coronary computed tomography angiography associated with ischemia on positron emission tomography in diabetic patients.The international journal of cardiovascular imaging · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe optimal noninvasive test (NIT) for patients with diabetes and stable symptoms of coronary artery disease (CAD) is unknown.
objectivesThe purpose of this study was to assess whether a diagnostic strategy based on coronary computed tomographic angiography (CTA) is superior to functional stress testing in reducing adverse cardiovascular (CV) outcomes (CV death or myocardial infarction [MI]) among symptomatic patients with diabetes.
methodsPROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) was a randomized trial evaluating an initial strategy of CTA versus functional testing in stable outpatients with symptoms suggestive of CAD. The study compared CV outcomes in patients with diabetes (n = 1,908 [21%]) and without diabetes (n = 7,058 [79%]) based on their randomization to CTA or functional testing.
resultsPatients with diabetes (vs. without) were similar in age (median 61 years vs. 60 years) and sex (female 54% vs. 52%) but had a greater burden of CV comorbidities. Patients with diabetes who underwent CTA had a lower risk of CV death/MI compared with functional stress testing (CTA: 1.1% [10 of 936] vs. stress testing: 2.6% [25 of 972]; adjusted hazard ratio: 0.38; 95% confidence interval: 0.18 to 0.79; p = 0.01). There was no significant difference in nondiabetic patients (CTA: 1.4% [50 of 3,564] vs. stress testing: 1.3% [45 of 3,494]; adjusted hazard ratio: 1.03; 95% confidence interval: 0.69 to 1.54; p = 0.887; interaction term for diabetes p value = 0.02).
conclusionsIn diabetic patients presenting with stable chest pain, a CTA strategy resulted in fewer adverse CV outcomes than a functional testing strategy. CTA may be considered as the initial diagnostic strategy in this subgroup. (PROspective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]; NCT01174550).
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Registered trials
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.