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Risk reduction of cardiac events by screening of unknown asymptomatic coronary artery disease in subjects with type 2 diabetes mellitus at high cardiovascular risk: an open-label randomized pilot study.
Am Heart J 2005; 149(2):e1-6AH

Abstract

BACKGROUND

Evaluated the efficacy of reducing the risk of cardiac events by a preclinical diagnosis of CAD in subjects with type 2 diabetes mellitus with 2 or more cardiovascular risk factors.

METHODS

One hundred forty-one subjects with type 2 diabetes mellitus without known cardiac disease and asymptomatic, aged >45 to <76 years, were randomized into the screening arm for CAD (71 patients) or to the control arm (70 patients). The screening consisted in performing an exercise electrocardiogram test and dipyridamole stress echocardiography; if 1 test was abnormal, coronary angiography is done. Screening was positive in 15 subjects (21.4%). At coronary angiography, which was performed in 14 of 15 patients, stenoses > or =50% of vessel diameter were present in 9 patients, of these 4 underwent coronary artery bypass grafting and 4 underwent percutaneous transluminal coronary angioplasty. Stenoses <50% of vessel diameter were present in 5 patients.

RESULTS

Mean follow-up was 53.5 months (range, 42-54 months). During this period, 1 major (myocardial infarction) and 3 minor events (angina) occurred in the screening arm. Eleven major and 4 minor events occurred in the control arm. In the screened arm, the proportion of all events was significantly less (P = .018) (RR .226, 95% CI 0.707-0.719, P = .012); the proportion of major to minor events was significantly less (P = .006) (RR .07, 95% CI 0.0087-0.565, P = .013).

CONCLUSIONS

The preclinical diagnosis of CAD is effective in reducing the risk of cardiac events, especially major events, in subjects with type 2 diabetes mellitus at high cardiovascular risk.

Authors+Show Affiliations

Internal Medicine Unit, Diabetology Center, Policlinico Multimedica, Sesto San Giovanni, Milan, Italy. ezio.faglia@multimedica.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15846252

Citation

Faglia, Ezio, et al. "Risk Reduction of Cardiac Events By Screening of Unknown Asymptomatic Coronary Artery Disease in Subjects With Type 2 Diabetes Mellitus at High Cardiovascular Risk: an Open-label Randomized Pilot Study." American Heart Journal, vol. 149, no. 2, 2005, pp. e1-6.
Faglia E, Manuela M, Antonella Q, et al. Risk reduction of cardiac events by screening of unknown asymptomatic coronary artery disease in subjects with type 2 diabetes mellitus at high cardiovascular risk: an open-label randomized pilot study. Am Heart J. 2005;149(2):e1-6.
Faglia, E., Manuela, M., Antonella, Q., Michela, G., Vincenzo, C., Maurizio, C., ... Alberto, M. (2005). Risk reduction of cardiac events by screening of unknown asymptomatic coronary artery disease in subjects with type 2 diabetes mellitus at high cardiovascular risk: an open-label randomized pilot study. American Heart Journal, 149(2), pp. e1-6.
Faglia E, et al. Risk Reduction of Cardiac Events By Screening of Unknown Asymptomatic Coronary Artery Disease in Subjects With Type 2 Diabetes Mellitus at High Cardiovascular Risk: an Open-label Randomized Pilot Study. Am Heart J. 2005;149(2):e1-6. PubMed PMID: 15846252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk reduction of cardiac events by screening of unknown asymptomatic coronary artery disease in subjects with type 2 diabetes mellitus at high cardiovascular risk: an open-label randomized pilot study. AU - Faglia,Ezio, AU - Manuela,Mantero, AU - Antonella,Quarantiello, AU - Michela,Gino, AU - Vincenzo,Curci, AU - Maurizio,Caminiti, AU - Roberto,Mattioli, AU - Alberto,Morabito, PY - 2005/4/23/pubmed PY - 2005/9/24/medline PY - 2005/4/23/entrez SP - e1 EP - 6 JF - American heart journal JO - Am. Heart J. VL - 149 IS - 2 N2 - BACKGROUND: Evaluated the efficacy of reducing the risk of cardiac events by a preclinical diagnosis of CAD in subjects with type 2 diabetes mellitus with 2 or more cardiovascular risk factors. METHODS: One hundred forty-one subjects with type 2 diabetes mellitus without known cardiac disease and asymptomatic, aged >45 to <76 years, were randomized into the screening arm for CAD (71 patients) or to the control arm (70 patients). The screening consisted in performing an exercise electrocardiogram test and dipyridamole stress echocardiography; if 1 test was abnormal, coronary angiography is done. Screening was positive in 15 subjects (21.4%). At coronary angiography, which was performed in 14 of 15 patients, stenoses > or =50% of vessel diameter were present in 9 patients, of these 4 underwent coronary artery bypass grafting and 4 underwent percutaneous transluminal coronary angioplasty. Stenoses <50% of vessel diameter were present in 5 patients. RESULTS: Mean follow-up was 53.5 months (range, 42-54 months). During this period, 1 major (myocardial infarction) and 3 minor events (angina) occurred in the screening arm. Eleven major and 4 minor events occurred in the control arm. In the screened arm, the proportion of all events was significantly less (P = .018) (RR .226, 95% CI 0.707-0.719, P = .012); the proportion of major to minor events was significantly less (P = .006) (RR .07, 95% CI 0.0087-0.565, P = .013). CONCLUSIONS: The preclinical diagnosis of CAD is effective in reducing the risk of cardiac events, especially major events, in subjects with type 2 diabetes mellitus at high cardiovascular risk. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/15846252/Risk_reduction_of_cardiac_events_by_screening_of_unknown_asymptomatic_coronary_artery_disease_in_subjects_with_type_2_diabetes_mellitus_at_high_cardiovascular_risk:_an_open_label_randomized_pilot_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002870304004946 DB - PRIME DP - Unbound Medicine ER -