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Screening for Ischemia in Asymptomatic Patients With Type 2 Diabetes: Five- Year Outcomes in the DIAD Study
Date:9/13/2008

Study Shows Systematic Screening May Not Be Necessary For Diabetic Patients

BOSTON, Sept. 13 /PRNewswire-USNewswire/ -- There are 21 million patients with Type 2 diabetes in the United States alone. Coronary artery disease (CAD) is a major cause of morbidity in patients with diabetes. Silent myocardial ischemia is common, and cardiac death or myocardial infarction may be the first manifestation of CAD.

Data from the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study, presented today at the American Society of Nuclear Cardiology Annual Scientific Session, seeks to assess the prevalence of silent myocardial ischemia and discern whether CAD screening should be offered to all people with type 2 diabetes. According to the most recent information from the study, screening does not provide a significant benefit to this patient population.

"The DIAD study is the first large prospective study addressing the issue of whether a strategy of systematic screening for silent coronary artery disease alters cardiac outcome," said Dr. Frans Wackers, who will present results from the study at today's meeting.

Overall, 1,123 diabetic patients without symptomatic or previously diagnosed CAD were randomized to either screening with myocardial perfusion imaging or standard care without screening. After an average 5-year follow- up, researchers found a low overall cardiac event rate and no difference between the two groups. Thus, unexpectedly, diabetic patients without known CAD have an overall highly favorable five-year prognosis with contemporary therapy, such as aspirin, statins, and ACE-inhibitors.

"Systematic screening cannot be recommended in asymptomatic patients with diabetes," commented Dr. Wackers. "However, targeted screening, involving close clinical follow-up and clinically driven diagnostic testing, is appropriate. Using the latter approach, about 30% of initially asymptomatic patients had stress myocardial perfusion imaging in
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SOURCE American Society of Nuclear Cardiology
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