In the TIBET (Total Ischemic Burden European Trial) study group, which comprised 682 patients with stable angina and positive exercise ECG tests, adverse outcome was predicted by time to ischemia during exercise, prior infarction or prior CABG, ECG evidence for LV hypertrophy, and LV enlargement by echocardiography.58 Easily available clinical characteristics have been the strongest predictors of risk during follow-up of patients with SIHD in other studies. The Euro Heart Survey found that a score based on the cumulative presence of comorbidity, diabetes mellitus, severity of angina, onset of recurrent symptoms ,6 months previously, abnormal ven- tricular function, and resting ECG repolarization abnormali- ties was associated with an increase in the 1-year risk of death or nonfatal infarction that ranged nearly 100-fold (from 0.5% to 47%) among .3000 outpatients.57 The ACTION (A Coronary Disease Trial Investigating Outcome with Nifedi- pine Gastrointestinal Therapeutic System) trial derived a clinical risk score that separated 5-year risk of death, MI, or stroke from 4% to 35% in .7300 patients with stable angina on the basis of commonly available clinical variables. In order of decreasing importance, the variables included age, LVEF, smoking, white blood cell count, presence of diabetes mellitus, casual (any time of day without regard to time since the last meal) blood glucose concentration, creatinine, prior stroke, frequent angina, findings at coronary angiography, lipid-lowering treatment, QT interval on the resting ECG, systolic hypertension, number of drugs used for angina, prior infarction, and sex.1216 Because the populations enrolled in these studies varied and the results have not been indepen- dently validated, additional prospective studies of patients with established SIHD are required to establish appropriate follow-up evaluation strategies and to establish efficient time intervals for evaluation in stable patients.307,320,1223,1224 6.2. 