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

Autor: Caminiti Maurizio, Curci Vincenzo, Mattioli Roberto, Quarantiello Antonella, Mantero Manuela, Morabito Alberto, Gino Michela, Ezio Faglia
Rok vydání: 2005
Předmět:
Zdroj: American heart journal. 149(2)
ISSN: 1097-6744
Popis: 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.One hundred forty-one subjects with type 2 diabetes mellitus without known cardiac disease and asymptomatic, aged45 to76 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, stenosesor =50% of vessel diameter were present in 9 patients, of these 4 underwent coronary artery bypass grafting and 4 underwent percutaneous transluminal coronary angioplasty. Stenoses50% of vessel diameter were present in 5 patients.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).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.
Databáze: OpenAIRE
Externí odkaz: