2015
Autonomic dysfunction independently predicts poor cardiovascular outcomes in asymptomatic individuals with type 2 diabetes in the DIAD study
Chyun DA, Wackers FJ, Inzucchi SE, Jose P, Weiss C, Davey JA, Heller GV, Iskandrian AE, Young LH, Investigators F. Autonomic dysfunction independently predicts poor cardiovascular outcomes in asymptomatic individuals with type 2 diabetes in the DIAD study. SAGE Open Medicine 2015, 3: 2050312114568476. PMID: 26770763, PMCID: PMC4679226, DOI: 10.1177/2050312114568476.Peer-Reviewed Original ResearchCardiac autonomic neuropathyHeart rate ratioAdverse cardiac outcomesHigher pulse pressureAutonomic neuropathyType 2 diabetesCardiac outcomesNon-Black ethnicityHeart rate variabilityInsulin useAsymptomatic individualsPulse pressureCardiac diseaseHeart rateRate ratioGreater systolic blood pressure decreasePower spectral analysisSystolic blood pressure decreaseRate variabilityAsymptomatic Diabetics (DIAD) studyAsymptomatic type 2Composite clinical outcomeHigher glycated hemoglobinPoor cardiac outcomesPoor cardiovascular outcomes
2012
The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes
Hage FG, Wackers FJ, Bansal S, Chyun DA, Young LH, Inzucchi SE, Iskandrian AE. The heart rate response to adenosine: A simple predictor of adverse cardiac outcomes in asymptomatic patients with type 2 diabetes. International Journal Of Cardiology 2012, 167: 2952-2957. PMID: 22981277, PMCID: PMC3723723, DOI: 10.1016/j.ijcard.2012.08.011.Peer-Reviewed Original ResearchConceptsAbnormal myocardial perfusion imagingMyocardial perfusion imagingHeart rate responseCardiac eventsMPI abnormalitiesAsymptomatic patientsAdenosine myocardial perfusion imagingHard cardiac event rateCardiovascular risk factor managementCox proportional regression modelType 2 diabetes mellitusAsymptomatic Diabetics (DIAD) studyCardiac event rateNonfatal myocardial infarctionCardiac autonomic neuropathyRate responseRisk factor managementYears of followAdverse cardiac outcomesProportional regression modelHigh cardiac riskType 2 diabetesDetection of ischemiaAbnormal HRRAutonomic neuropathyTHE HEART RATE RESPONSE TO ADENOSINE AS A PREDICTOR OF ADVERSE CARDIAC OUTCOMES IN THE DETECTION OF ISCHEMIA IN ASYMPTOMATIC DIABETICS STUDY
Hage F, Wackers F, Bansal S, Chyun D, Young L, Inzucchi S, Iskandrian A. THE HEART RATE RESPONSE TO ADENOSINE AS A PREDICTOR OF ADVERSE CARDIAC OUTCOMES IN THE DETECTION OF ISCHEMIA IN ASYMPTOMATIC DIABETICS STUDY. Journal Of The American College Of Cardiology 2012, 59: e1162. DOI: 10.1016/s0735-1097(12)61163-2.Peer-Reviewed Original ResearchGender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study
Tandon S, Wackers F, Inzucchi SE, Bansal S, Staib LH, Chyun DA, Davey JA, Young LH. Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study. Diabetes And Vascular Disease Research 2012, 9: 124-130. PMID: 22228772, DOI: 10.1177/1479164111431470.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsymptomatic DiseasesCanadaCardiovascular DiseasesDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansIncidenceKaplan-Meier EstimateMaleMass ScreeningMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsSex FactorsTime FactorsUnited StatesConceptsType 2 diabetesMyocardial perfusion imagingCardiovascular outcomesStress myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyBetter cardiac outcomesHigh-risk womenCoronary artery diseaseHigh-risk menDetection of ischemiaMPI abnormalitiesAsymptomatic patientsAsymptomatic menCardiac eventsCardiac outcomesArtery diseaseAsymptomatic womenAbnormal screeningDiabetic studyPerfusion imagingDIAD studyWomenMenDiabetesOutcomes
2011
SCREENING ASYMPTOMATIC PATIENTS WITH TYPE 2 DIABETES FOR SILENT MYOCARDIAL ISCHEMIA: IMPORTANT GENDER DIFFERENCES FROM THE DETECTION OF ISCHEMIA IN ASYMPTOMATIC DIABETICS (DIAD) STUDY
Tandon S, Bansal S, Inzucchi S, Staib L, Davey J, Chyun D, Young L, Wackers F. SCREENING ASYMPTOMATIC PATIENTS WITH TYPE 2 DIABETES FOR SILENT MYOCARDIAL ISCHEMIA: IMPORTANT GENDER DIFFERENCES FROM THE DETECTION OF ISCHEMIA IN ASYMPTOMATIC DIABETICS (DIAD) STUDY. Journal Of The American College Of Cardiology 2011, 57: e745. DOI: 10.1016/s0735-1097(11)60745-6.Peer-Reviewed Original Research
2010
Five-Year Outcomes in High-Risk Participants in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study A post hoc analysis
Bansal S, Wackers FJ, Inzucchi SE, Chyun DA, Davey JA, Staib LH, Young LH, . Five-Year Outcomes in High-Risk Participants in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study A post hoc analysis. Diabetes Care 2010, 34: 204-209. PMID: 20929989, PMCID: PMC3005488, DOI: 10.2337/dc10-1194.Peer-Reviewed Original ResearchConceptsCardiac event rateBaseline cardiovascular riskAnnual cardiac event rateHigh cardiovascular riskCardiovascular riskHigh-risk participantsDetection of ischemiaEvent ratesInducible ischemiaRisk engineUK Prospective Diabetes Study risk engineHigh baseline cardiovascular riskAsymptomatic Diabetics (DIAD) studyFive-year outcomesUKPDS risk engineLow-risk groupRisk stratification approachStudy of DiabetesLow-risk participantsAsymptomatic diabeticsCardiac eventsFramingham scoreMetabolic syndromeRisk groupsDiabetic studyCARDIAC OUTCOMES AFTER SCREENING FOR ASYMPTOMATIC CORONARY ARTERY DISEASE IN PATIENTS WITH METABOLIC SYNDROME: POST-HOC ANALYSIS OF THE DIAD TRIAL
Bansal S, Wackers F, Inzucchi S, Young L, Chyun D. CARDIAC OUTCOMES AFTER SCREENING FOR ASYMPTOMATIC CORONARY ARTERY DISEASE IN PATIENTS WITH METABOLIC SYNDROME: POST-HOC ANALYSIS OF THE DIAD TRIAL. Journal Of The American College Of Cardiology 2010, 55: a141.e1325. DOI: 10.1016/s0735-1097(10)61326-5.Peer-Reviewed Original Research
2009
Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes—Reply
Wackers F, Young L. Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes—Reply. JAMA 2009, 302: 735-737. DOI: 10.1001/jama.2009.1190.Peer-Reviewed Original ResearchLessons learned from the detection of ischemia in asymptomatic diabetics (DIAD) study
Wackers FJ, Young LH. Lessons learned from the detection of ischemia in asymptomatic diabetics (DIAD) study. Journal Of Nuclear Cardiology 2009, 16: 855-859. PMID: 19685266, DOI: 10.1007/s12350-009-9138-1.Commentaries, Editorials and LettersCardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial
Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Heller GV, Iskandrian AE, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE, Investigators F. Cardiac Outcomes After Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes : The DIAD Study: A Randomized Controlled Trial. JAMA 2009, 301: 1547-1555. PMID: 19366774, PMCID: PMC2895332, DOI: 10.1001/jama.2009.476.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseType 2 diabetesNonfatal myocardial infarctionAsymptomatic coronary artery diseaseMyocardial perfusion imagingCardiac event rateMyocardial infarctionCardiac deathMPI defectsCardiac outcomesEvent ratesScreened groupArtery diseaseSymptoms of CADRadionuclide myocardial perfusion imagingAsymptomatic Diabetics (DIAD) studyHigh cardiac riskLow event ratesPositive predictive valueDetection of ischemiaPrimary medical preventionCoronary revascularizationDiabetes clinicIdentifies patientsControlled Trials
2007
Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study
Wackers FJ, Chyun DA, Young LH, Heller GV, Iskandrian AE, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE. Resolution of Asymptomatic Myocardial Ischemia in Patients With Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study. Diabetes Care 2007, 30: 2892-2898. PMID: 17682123, DOI: 10.2337/dc07-1250.Peer-Reviewed Original ResearchConceptsResolution of ischemiaType 2 diabetesDetection of ischemiaNew ischemiaAsymptomatic Diabetics (DIAD) studyCardiovascular risk factorsAsymptomatic myocardial ischemiaAdenosine stress myocardial perfusionRepeat stressIschemia increasesAsymptomatic patientsCardiac eventsMore patientsACE inhibitorsMyocardial ischemiaRisk factorsIntensive treatmentDiabetic studyIschemiaMyocardial perfusionPatientsMedical treatmentDiabetesInitial evaluationGreater increase
2006
Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging
Papaioannou GI, Kasapis C, Seip RL, Grey NJ, Katten D, Wackers FJ, Inzucchi SE, Engel S, Taylor A, Young LH, Chyun DA, Davey JA, Iskandrian AE, Ratner RE, Robinson EC, Carolan S, Heller GV. Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging. Journal Of Nuclear Cardiology 2006, 13: 362-368. PMID: 16750781, DOI: 10.1016/j.nuclcard.2006.01.022.Peer-Reviewed Original ResearchConceptsEndothelium-dependent vasodilationEndothelium-independent vasodilationCoronary artery diseaseMyocardial perfusion imagingRelative myocardial ischemiaAsymptomatic patientsEndothelial functionNegative predictive valueMyocardial ischemiaAsymptomatic type 2 diabetic patientsExclusion of CADPredictive valueAdenosine myocardial perfusion imagingPeripheral vascular endothelial functionType 2 diabetic patientsType 2 diabetes mellitusHigh negative predictive valueAsymptomatic Diabetics (DIAD) studyBrachial artery ultrasonographyVascular endothelial functionDetection of ischemiaEDV responseRelative ischemiaEndothelial dysfunctionOvert atherosclerosis
2005
Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects
Wackers F, Young L, Inzucchi S, Chyun D. Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects. Diabetes Care 2005, 28: 232-233. DOI: 10.2337/diacare.28.1.232.Peer-Reviewed Original Research
2004
Screening for coronary artery disease in diabetic patients: The DIAD study
Inzucchi S, Young L, Chyun D, Wackers F. Screening for coronary artery disease in diabetic patients: The DIAD study. British Journal Of Diabetes 2004, 4: 317-319. DOI: 10.1177/14746514040040050501.Peer-Reviewed Original ResearchBrachial artery reactivity in asymptomatic patients with type 2 diabetes mellitus and microalbuminuria (from the Detection of Ischemia in Asymptomatic Diabetics–Brachial Artery Reactivity study)
Papaioannou GI, Seip RL, Grey NJ, Katten D, Taylor A, Inzucchi SE, Young LH, Chyun DA, Davey JA, Wackers FJ, Iskandrian AE, Ratner RE, Robinson EC, Carolan S, Engel S, Heller GV. Brachial artery reactivity in asymptomatic patients with type 2 diabetes mellitus and microalbuminuria (from the Detection of Ischemia in Asymptomatic Diabetics–Brachial Artery Reactivity study). The American Journal Of Cardiology 2004, 94: 294-299. PMID: 15276091, DOI: 10.1016/j.amjcard.2004.04.022.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAlbuminuriaBrachial ArteryCoronary Artery DiseaseC-Reactive ProteinDiabetes Mellitus, Type 2Diabetic AngiopathiesEndothelium, VascularFemaleHumansLinear ModelsMaleMiddle AgedMultivariate AnalysisProspective StudiesReference ValuesRisk AssessmentSensitivity and SpecificitySeverity of Illness IndexSex FactorsUltrasonography, DopplerVasoconstrictionVasodilationConceptsEndothelium-independent vasodilationEndothelium-dependent vasodilationBrachial artery reactivityType 2 diabetes mellitusHormone replacement therapyDiabetes mellitusC-reactive proteinSystemic inflammationAsymptomatic patientsEndothelial dysfunctionIndependent predictorsReplacement therapyNovel atherosclerotic risk factorAsymptomatic Diabetics (DIAD) studyAtherosclerotic risk factorsPresence of microalbuminuriaFuture cardiovascular eventsSimilar baseline characteristicsDetection of ischemiaCardiovascular eventsBaseline characteristicsBrachial arteryVascular dysfunctionEntire cohortRisk factorsAbnormal heart rate response to adenosine infusion is associated with silent myocardial ischemia in asymptomatic patients with diabetes mellitus
Sudhakar S, Chyun D, Young L, Inzucchi S, Davey J, Wackers F. Abnormal heart rate response to adenosine infusion is associated with silent myocardial ischemia in asymptomatic patients with diabetes mellitus. Journal Of Nuclear Cardiology 2004, 11: s20. DOI: 10.1016/j.nuclcard.2004.06.064.Peer-Reviewed Original ResearchHeart rate responseSilent myocardial ischemiaLarge myocardial perfusion defectsMyocardial perfusion defectsLarger perfusion abnormalityAsymptomatic patientsNegative predictive valuePerfusion abnormalitiesMyocardial ischemiaPerfusion defectsAdenosine infusionRate responsePredictive valueAbnormal heart rate responseBlunted heart rate responseHigh negative predictive valueLower heart rate responseCoronary artery diseaseMyocardial perfusion abnormalitiesDetection of ischemiaMales 53Autonomic neuropathyArtery diseaseDiabetes mellitusPoor outcomeCardiac Abnormalities in Diabetic Patients With Neuropathy
Johnson BF, Nesto RW, Pfeifer MA, Slater WR, Vinik AI, Chyun DA, Law G, Wackers FJ, Young LH. Cardiac Abnormalities in Diabetic Patients With Neuropathy. Diabetes Care 2004, 27: 448-454. PMID: 14747227, DOI: 10.2337/diacare.27.2.448.Peer-Reviewed Original ResearchMeSH KeywordsAldehyde ReductaseBenzothiazolesCardiac OutputDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic NeuropathiesDouble-Blind MethodEnzyme InhibitorsExercise TestFemaleHeartHeart Conduction SystemHeart RateHumansMaleMiddle AgedPhthalazinesPlacebosStroke VolumeThiazolesVentricular Function, LeftConceptsLeft ventricular ejection fractionDiabetic patientsARI treatmentCardiac outputStroke volumeCardiac abnormalitiesAldose reductase inhibitorExercise left ventricular ejection fractionAbnormal heart rate variabilityDiastolic peak filling rateAsymptomatic cardiac abnormalitiesGated radionuclide ventriculographyMaximal bicycle exercisePlacebo-treated subjectsDiastolic filling rateVentricular ejection fractionCoronary artery diseaseValvular heart diseasePeak filling rateExercise cardiac outputLV stroke volumeHeart rate variabilityBlinded treatmentInsulin useArtery disease
2003
Detection of ischemia in asymptomatic diabetics: Preliminary results of the DIAD study
Wackers F, Young L, Inzucchi S, Chyun D, Davey J. Detection of ischemia in asymptomatic diabetics: Preliminary results of the DIAD study. Journal Of The American College Of Cardiology 2003, 41: 409. DOI: 10.1016/s0735-1097(03)81197-x.Peer-Reviewed Original Research
2002
Correlation of myocardial p-(123)I-iodophenylpentadecanoic acid retention with (18)F-FDG accumulation during experimental low-flow ischemia.
Shi CQ, Young LH, Daher E, DiBella EV, Liu YH, Heller EN, Zoghbi S, Wackers FJ, Soufer R, Sinusas AJ. Correlation of myocardial p-(123)I-iodophenylpentadecanoic acid retention with (18)F-FDG accumulation during experimental low-flow ischemia. Journal Of Nuclear Medicine 2002, 43: 421-31. PMID: 11884504.Peer-Reviewed Original Research
2001
Cardiac responses to insulin-induced hypoglycemia in nondiabetic and intensively treated type 1 diabetic patients
Russell R, Chyun D, Song S, Sherwin R, Tamborlane W, Lee F, Pfeifer M, Rife F, Wackers F, Young L. Cardiac responses to insulin-induced hypoglycemia in nondiabetic and intensively treated type 1 diabetic patients. AJP Endocrinology And Metabolism 2001, 281: e1029-e1036. PMID: 11595660, DOI: 10.1152/ajpendo.2001.281.5.e1029.Peer-Reviewed Original ResearchMeSH KeywordsAdultCardiac OutputCatecholaminesChemical PrecipitationDiabetes Mellitus, Type 1DiastoleEpinephrineFatty Acids, NonesterifiedFemaleGlucagonGlucose Clamp TechniqueHeartHeart RateHumansHydrocortisoneHypoglycemiaInsulinLactic AcidMaleNorepinephrinePolyethylene GlycolsStroke VolumeSystoleVentricular Function, LeftConceptsType 1 diabetic patientsInsulin-induced hypoglycemiaNondiabetic groupType 1 diabetesDiabetic subjectsEuglycemic hyperinsulinemiaDiabetic patientsNondiabetic subjectsCardiac responseLeft ventricular systolicHealthy nondiabetic subjectsEquilibrium radionuclide angiographyDiabetic groupDiastolic functionVentricular systolicCardiovascular consequencesVentricular functionBlunted increaseCardiac outputGlucagon concentrationsPlasma catecholaminesRadionuclide angiographyInsulin infusionEuglycemic conditionsHypoglycemia