|First Author (Ref. #)||Primary Outcome||Patients||Main Results||Additional notes|
|Acampa et al. (76)||Nonfatal myocardial infarction and cardiac death in symptomatic and asymptomatic diabetic patients submitted to MPI||Meta-analysis of 14 studies involving 13,493 diabetic patients. Average follow-up 36.2 months||Annual event rate in patients with a negative MPI averaged 1.6%||Reported annual event rate with negative MPI in nondiabetic patients <1%|
|Giri et al. (77)||Death, nonfatal myocardial infarction, and revascularization||Prospective observational study of 929 diabetic and 3,826 nondiabetic patients. Mean follow-up 2.5 years||Event rate in diabetes patients 8.6% vs. 4.5% in nondiabetic patients. Diabetic patients with reversible defects had the highest risk of myocardial infarction, and those with fixed perfusion defects had the highest risk of death||In the presence of a normal MPI, the risk of event started climbing in diabetic patients after 2 years from imaging|
|Wackers et al. (80) (DIAD study)||Prevalence of silent ischemia in asymptomatic type 2 diabetic patients||522 patients 50–75 years of age submitted to adenosine stress MPI||113 (22%) had inducible ischemic changes; 33 (6%) had moderate-to-large ischemia on MPI||American Diabetic Association guidelines would have missed 41% of patients with silent ischemia|
|Zellweger et al. (82)||Prevalence, progression, and outcome of silent coronary artery disease in diabetes mellitus||400 patients with type 2 diabetes mellitus submitted to baseline and repeat MPI after 2 years||Baseline MPI was abnormal in 22% of patients. Patients with abnormal MPI experienced more cardiac deaths, myocardial infarctions, and revascularizations (9.8% vs. 2.9%) than patients with normal MPI.||Ischemia or new scar appeared in 3.2% and 34.2% of patients with normal and abnormal baseline MPI, respectively. Patients randomized to revascularization had similar rates of major adverse cardiovascular events but lower rates of asymptomatic CAD (more ischemia or new scar) progression|
Abbreviations as in Table 1.