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Diabetes

Does screening for inducible ischemia improve outcomes?

The DIAD trial investigators have demonstrated that screening for inducible myocardial ischemia did not improve overall clinical outcome in a contemporary cohort of patients with asymptomatic type 2 diabetes, most of whom were receiving excellent medical management and few of whom underwent revascularization. Future studies should be designed to evaluate the clinical value and cost effectiveness of unconditional treatment versus screening using techniques to detect atherosclerotic and ischemic burden, coupled with therapeutic interventions, risk-factor management, and selective use of revascularization in high-risk patients.

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References

  1. Wild, S., Roglic, G., Green, A., Sicree R. & King, H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27, 1047–1053 (2004).

    Article  Google Scholar 

  2. Haffner, S. M., Lehto, S., Ronnemaa, T., Pyorala, K. & Laakso, M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N. Engl. J. Med. 339, 229–234 (1998).

    Article  CAS  Google Scholar 

  3. Grundy, S. M. et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation 100, 1134–1146 (1999).

    Article  CAS  Google Scholar 

  4. Buse, J. B. et al. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 115, 114–126 (2007).

    Article  Google Scholar 

  5. Young, L. H. et al. Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial. JAMA 301, 1547–1555 (2009).

    Article  CAS  Google Scholar 

  6. Falk, E., Shah, P. K. & Fuster, V. Coronary plaque disruption. Circulation 92, 657–671 (1995).

    Article  CAS  Google Scholar 

  7. Raggi, P., Shaw, L. J., Berman, D. S. & Callister, T. Q. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J. Am. Coll. Cardiol. 43, 1663–1669 (2004).

    Article  CAS  Google Scholar 

  8. Diamond, G. A., Kaul S. & Shah, P. K. Screen testing cardiovascular prevention in asymptomatic diabetic patients. J. Am. Coll. Cardiol. 49, 1915–1917 (2007).

    Article  Google Scholar 

  9. Hachamovitch, R. et al. Predicting therapeutic benefit from myocardial revascularization procedures: are measurements of both resting left ventricular ejection fraction and stress-induced myocardial ischemia necessary? J. Nucl. Cardiol. 13, 768–778 (2006).

    Article  Google Scholar 

  10. Bypass Angioplasty Revascularization Investigation 2 Diabetes Study Group. Baseline characteristics of patients with diabetes and coronary artery disease enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial. Am. Heart J. 156, 528–536 (2008).

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Correspondence to Prediman K. Shah.

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The author declares no competing financial interests.

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Shah, P. Does screening for inducible ischemia improve outcomes?. Nat Rev Cardiol 6, 452–453 (2009). https://doi.org/10.1038/nrcardio.2009.95

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