Diabetic Patients and Cardiac Risk: What Works, and What Doesn't?

Two studies in 2009 shed light on whether screening for ischemia in asymptomatic patients with diabetes is useful, and which treatment regimens for diabetic patients with documented coronary disease work best.

In the DIAD study, researchers randomized 1123 North American patients (mean age, 60) with type 2 diabetes to stress myocardial perfusion imaging (MPI) or no testing. All patients received standard medical care for diabetes. Interestingly, more unscreened patients than screened patients (44 vs. 31) underwent revascularization during the 5-year study. Overall, adverse cardiac event rates were similar in both groups. Within the screened group, the event rate was much higher in those with large perfusion defects than in those with small o…