Non ST ergometric variables in the diabetic patient and their prognostic significance

Background. Recent research based on large number of patients has demonstrated that there are strong exercise predictors of cardiovascular events other than ST-segment behaviour. Studies focused on non-ST segment variables in exercise testing (exercise capacity, chronotropic and pressure response, heart rate recovery) in diabetics are lacking. The aim of our study is to find out differences in the exercise- testing variables between diabetics and non and to evaluate their prognostic role. Methods. We analyzed non ST-variables in 1172 patients undergoing exercise testing with Bruce protocol:diabetics vs non diabetics: n=83 (7%) vs n=1089 (93%); mean age: 64.37±8.44 vs 60.44±11.44; males: n=56 (67.47%) vs n=665 (61.06%). Mean follow-up was 13,5±4 months. Results. Follow-up data were available in 74 diabetics (89%), 14 (18,9%) presented cardiac events (death, infarction, coronaric revascularization, heart failure). Diabetics with events showed significantly worse 1st min Heart Rate (HR) and 3rd min Systolic Blood Pressure (SBP) recovery. Conclusions. Preliminary results highlight that non-ST variables (exercise time, chronotropic response, heart rate and blood pressure recovery) are significantly different in diabetics. Abnormal HR and SBP recovery identify a subgroup of diabetics at higher risk of cardiac events in the follow-up.