Assessing Cardiovascular Risk in Asymptomatic Diabetes: The DIAD Study

Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Heller GV, Filipchuk N, Engel S, Ratner RE, Iskandrian AE, the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Investigators: Detection of silent myocardial ischemia in asymptomatic diabetic subjects. Diabetes Care27 : 1954-1961,2004[OpenUrl][1][Abstract/FREE Full Text][2]Objective. To determine the prevalence and severity of inducible myocardial ischemia in asymptomatic patients with type 2 diabetes, aged 50-75 years, with normal electrocardiograms (ECGs), using adenosine-stress single photon emission-computed tomography (SPECT) myocardial perfusion imaging along with clinical and laboratory predictors of abnormal test results.Design. A randomized, open, prospective, clinical trial following patients for a period of 5 years to determine the prevalence and predictors of silent myocardial ischemia (SMI) in people with type 2 diabetes with no history of known coronary artery disease (CAD) and no cardiac symptoms. Approximately half of the subjects were randomized to adenosine-stress perfusion imaging at baseline and follow-up, and half were randomized to follow-up without imaging screening.End points. Prevalence, severity, and predictors of patients with SMI as defined by perfusion abnormalities on pharmacological stress perfusion imaging (adenosine-sestamibi SPECT).Results. Of 1,123 patients with type 2 diabetes aged 50-75 years without known or suspected CAD, 113 (22%) had silent ischemia. Eighty-three had regional myocardial perfusion abnormalities, and 30 had normal perfusion with other abnormalities. Moderate and large perfusion defects were present in 33 patients (6% of the screened cohort). Of those with perfusion abnormalities, 96% had some degree of reversibility indicative of ischemia. The strongest predictors … [1]: {openurl}?query=rft.jtitle%253DDiabetes%2BCare%26rft.stitle%253DDiabetes%2BCare%26rft.issn%253D0149-5992%26rft.aulast%253DWackers%26rft.auinit1%253DF.%2BJ.Th.%26rft.volume%253D27%26rft.issue%253D8%26rft.spage%253D1954%26rft.epage%253D1961%26rft.atitle%253DDetection%2Bof%2BSilent%2BMyocardial%2BIschemia%2Bin%2BAsymptomatic%2BDiabetic%2BSubjects%253A%2BThe%2BDIAD%2Bstudy%26rft_id%253Dinfo%253Adoi%252F10.2337%252Fdiacare.27.8.1954%26rft_id%253Dinfo%253Apmid%252F15277423%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=diacare&resid=27/8/1954&atom=%2Fdiaclin%2F23%2F3%2F126.atom