Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study

Wackers, Frans J. Th.; Chyun, Deborah A.; Young, Lawrence H.; Heller, Gary V.; Iskandrian, Ami E.; Davey, Janice A.; Barrett, Eugene J.; Taillefer, Raymond; Wittlin, Steven D.; Filipchuk, Neil; Ratner, Robert E.; Inzucchi, Silvio E.; for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Investigators

doi:10.2337/dc07-1250

Cited by 137Cardiac Imaging and DiagnosticsCardiovascular Function and Risk FactorsDiabetes, Cardiovascular Risks, and Lipoproteins

Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study

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Wackers, Frans J. Th., Chyun, Deborah A., Young, Lawrence H., Heller, Gary V., Iskandrian, Ami E., Davey, Janice A., Barrett, Eugene J., Taillefer, Raymond +5 more·2007·Diabetes Care

DOI 10.2337/dc07-1250

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Abstract

OBJECTIVE—The purpose of this study was to assess whether the prevalence of inducible myocardial ischemia increases over time in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—Participants enrolled in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study underwent repeat adenosine-stress myocardial perfusion imaging 3 years after initial evaluation. Patients with intervening cardiac events or revascularization and those who were unable or unwilling to repeat stress imaging were excluded. RESULTS—Of the initial 522 DIAD patients, 358 had repeat stress imaging (DIAD-2), of whom 71 (20%) had ischemia at enrollment (DIAD-1). Of 287 patients with normal DIAD-1 studies, 259 (90%) remained normal in DIAD-2, whereas 28 (10%) developed new ischemia in DIAD-2. Of the 71 patients with abnormal DIAD-1 studies, 56 (79%) demonstrated resolution of ischemia, whereas 15 (21%) remained abnormal. During this 3-year interval, medical treatment was intensified, with more patients using statins, aspirin, and ACE inhibitors than at baseline. Patients with resolution of ischemia had significantly greater increases in these medications than patients who developed new ischemia (P = 0.04). CONCLUSIONS—Thus, the majority of asymptomatic patients with type 2 diabetes demonstrated resolution of ischemia upon repeat stress imaging after 3 years. This resolution was associated with more intensive treatment of cardiovascular risk factors.

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Silent ischemia may reverse over time.
“There is also some evidence that silent ischemia may reverse over time, adding to the controversy concerning aggressive screening strategies (174).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2023 (2023) · cites this paper as [174]
There is recent preliminary evidence that silent myocardial ischemia may reverse over time.
“There is also recent preliminary evidence that silent myocardial ischemia may reverse over time, adding to the controversy concerning aggressive screening strategies (223).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [223]

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Myocardial perfusion imaging findings and 2-year outcomes in clinically referred asymptomatic patients with type 2 diabetes
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FOR THE DETECTION OF ISCHEMIA IN
Wackers, F. J. T., Young, L. H., Inzucchi, S. E., Chyun, D. A., Davey, J. A., Barrett, E. J., Taillefer, R., Wittlin, S. D., Heller, G. V., Md, N. F., et al. (2015)
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Authors: Wackers, F. J. T., Chyun, D. A., Young, L. H., Heller, G. V., Iskandrian, A. E., Davey, J. A., Barrett, E. J., Taillefer, R., Wittlin, S. D., Filipchuk, N., Ratner, R. E., Inzucchi, S. E., & for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Investigators
Affiliations: Yale University (US)
Hartford Hospital (US)
University of Alabama at Birmingham (US)
University of Virginia (US)
Université de Montréal (CA)
University of Rochester (US)
Cardiology Consultants, Calgary, Alberta, Canada
MedStar Health Research Institute (US)
ORCID: Chyun, Deborah A.
Young, Lawrence H.
Barrett, Eugene J.
Wittlin, Steven D.
Inzucchi, Silvio E.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2007-11-01
Volume: 30
Issue: 11
Pages: 2892-2898
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc07-1250
OpenAlex: W2071539914
Cited by: 137
References: 25
Citations by year: 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 3 · 2015: 13 · 2014: 10 · 2013: 15 · 2012: 10
FWCI: 9.75
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: Astellas Pharma US
Yale University
Tulane University
University of Rochester
Mylan
Astellas Pharma
Bracco Diagnostics
National Center for Research Resources (5-M01-RR-00044, M01RR000125, 5 M01 RR05096, M01 RR-00125, M01RR000044, M01RR000847, M01RR005096, M01-RR 00847)
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: silent myocardial ischemia, type 2 diabetes, inducible myocardial ischemia, statins, aspirin, ACE inhibitors
MeSH terms: Adenosine, Aged, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Electrocardiography, Exercise Test, Female, Humans, Male, Middle Aged, Reproducibility of Results, Tomography, Emission-Computed, Single-Photon, Prevalence, Myocardial Ischemia, Technetium Tc 99m Sestamibi, Radiopharmaceuticals, Racial Groups

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Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study

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