Abstract Body (Do not enter title and authors here): Background:
Stress testing is a well-established non-invasive method commonly used in clinical practice for patients with angina. However, its benefit in diabetic patients after coronary intervention remains unclear. This systematic review aims to address this knowledge gap by evaluating the impact of routine stress testing in this specific patient population.
Research Question:
Does routine stress testing improve outcomes in diabetic patients with prior revascularization?

Goals:
We aimed to perform a systematic review and meta-analysis of studies that evaluated death, MACE and repeated revascularization episodes in diabetic patients who have prior coronary intervention.

Methods:
We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCT) and cohort studies evaluating diabetic patients who underwent cardiac revascularization and reporting the following outcomes: (1) Myocardial Infarction (MI) and Cardiovascular Death; (2) Ischemia; and (3) Repeat Revascularization. Statistical analysis was performed using Open Meta and heterogeneity was assessed with I² statistical.

Results:
We included 16924 patients from 16 studies, of which 15 were observational cohort studies and 1 was a RCT. All patients were diabetics and had a history of revascularization. Follow-up ranged from 1 to 5.2 years. The mean patient age was 60.8±9.5 years and 75% were male. MI and cardiovascular death was found in 9.8% (95% CI; range 6.8-12.8%; p<0.01; (figure 1A), ischemia was found in 36.5% (95% CI; range 28.7-44.3%; p<0.01; (figure 1B) and revascularization was repeated in 16.3% (95% CI; range 4.9-27.7%; p<0.01; (figure 1C).

Conclusion:
Routine stress testing in diabetic patients with prior coronary intervention may not significantly alter the outcomes. These findings suggest that, while routine stress testing is a common practice for monitoring heart diseases in diabetic patients, its impact on improving clinical outcomes requires further investigation through controlled studies.