2014
Predictors of Physical Inactivity in Men and Women With Type 2 Diabetes From the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study
McCarthy M, Davey J, Wackers F, Chyun D. Predictors of Physical Inactivity in Men and Women With Type 2 Diabetes From the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Study. The Science Of Diabetes Self-Management And Care 2014, 40: 678-687. PMID: 24942531, PMCID: PMC4169341, DOI: 10.1177/0145721714540055.Peer-Reviewed Original ResearchMeSH KeywordsCanadaDiabetes Mellitus, Type 2Diabetic AngiopathiesExerciseFemaleFollow-Up StudiesHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMotor ActivityMyocardial IschemiaPeripheral Nervous System DiseasesPredictive Value of TestsPrevalenceProspective StudiesRisk FactorsSedentary BehaviorTime FactorsUnited StatesConceptsAsymptomatic Diabetics (DIAD) studyPhysical inactivityType 2 diabetesDetection of ischemiaDiabetic studyOverweight/obesityPrimary care practicesPhysical activity dataGender-related differencesAsymptomatic patientsAutonomic neuropathySilent ischemiaSecondary data analysisCare practicesType 2Secondary analysisIschemiaDiabetesTime pointsInactivityBaselineWomenMenGender differencesYears
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 neuropathyGender-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
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 ResearchMeSH KeywordsAgedCardiovascular DiseasesDiabetes Mellitus, Type 2FemaleHumansMaleMetabolic SyndromeMiddle AgedConceptsCardiac 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 study
2009
Cardiac 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
2008
Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus
Scholte A, Schuijf J, Kharagjitsingh A, Dibbets-Schneider P, Stokkel M, Jukema J, van der Wall E, Bax J, Wackers F. Different manifestations of coronary artery disease by stress SPECT myocardial perfusion imaging, coronary calcium scoring, and multislice CT coronary angiography in asymptomatic patients with type 2 diabetes mellitus. Journal Of Nuclear Cardiology 2008, 15: 503-509. PMID: 18674717, DOI: 10.1016/j.nuclcard.2008.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2FemaleHumansIncidenceMaleMiddle AgedNetherlandsReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificityTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedVentricular Dysfunction, LeftConceptsType 2 diabetes mellitusCoronary artery diseaseMSCT coronary angiographyAsymptomatic patientsCoronary angiographyDiabetes mellitusPositive CAC scoreMyocardial perfusion imagingCAC scoreCoronary atherosclerosisArtery diseaseCAC scoringCalcium scoringPerfusion imagingAbnormal diagnostic test resultsSilent coronary artery diseaseStress single-photon emissionCoronary artery calcium scoringMultislice CT coronary angiographyTomography myocardial perfusion imagingStress SPECT myocardial perfusion imagingSilent coronary atherosclerosisSPECT myocardial perfusion imagingRelative prognostic valueTomographic coronary angiography
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
Screening Asymptomatic Diabetic Patients for Coronary Artery Disease Why Not?
Miller T, Redberg R, Wackers F. Screening Asymptomatic Diabetic Patients for Coronary Artery Disease Why Not? Journal Of The American College Of Cardiology 2006, 48: 761-764. PMID: 16904546, DOI: 10.1016/j.jacc.2006.04.076.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseAsymptomatic diabetic patientsDiabetic patientsArtery diseaseSilent coronary artery diseaseStress single-photon emissionImportant coronary artery diseaseAnti-ischemic medicationNon-diabetic patientsClinical scoring systemAbnormal SPECT imagesSingle photon emissionCardiovascular eventsAggressive treatmentDiabetes statusPatient subsetsHigh prevalenceScreening programElevated riskHigh riskPatientsConsensus documentTrue prevalenceScoring systemDIAD studyValue 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 atherosclerosisThe Association of Psychological Factors, Physical Activity, Neuropathy, and Quality of Life in Type 2 Diabetes
Chyun DA, Melkus GD, Katten DM, Price WJ, Davey JA, Grey N, Heller G, Wackers FJ. The Association of Psychological Factors, Physical Activity, Neuropathy, and Quality of Life in Type 2 Diabetes. Biological Research For Nursing 2006, 7: 279-288. PMID: 16581898, DOI: 10.1177/1099800405285748.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnxietyAttitude to HealthConnecticutCoronary DiseaseCross-Sectional StudiesDepressionDiabetes Mellitus, Type 2Diabetic NeuropathiesFemaleHostilityHumansLinear ModelsMaleMiddle AgedMotor ActivityMultivariate AnalysisQuality of LifeRisk FactorsSocioeconomic FactorsSurveys and QuestionnairesVirginiaConceptsQuality of lifeBody mass indexDepressive symptomsMass indexPhysical inactivityMedical Outcomes Study Short Form-36Diabetes-related microvascular complicationsHigher body mass indexPoor QOLAsymptomatic Diabetics (DIAD) studyCardiac risk factorsDiabetes-related factorsShort Form-36Type 2 diabetesPsychological factorsDetection of ischemiaMicrovascular complicationsForm-36Diabetes QualityFemale sexRisk factorsAncillary studiesDiabetic studyPhysical activityType 2The Impact of Screening for Asymptomatic Myocardial Ischemia in Individuals With Type 2 Diabetes
Chyun DA, Katten DM, Melkus GD, Talley S, Davey JA, Wackers FJ. The Impact of Screening for Asymptomatic Myocardial Ischemia in Individuals With Type 2 Diabetes. The Journal Of Cardiovascular Nursing 2006, 21: e1-e7. PMID: 16601520, DOI: 10.1097/00005082-200603000-00015.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAntihypertensive AgentsAnxietyAspirinDepressionDiabetes Mellitus, Type 2EmotionsFemaleFibrinolytic AgentsFollow-Up StudiesHealth BehaviorHumansHypolipidemic AgentsMaleMass ScreeningMiddle AgedMotor ActivityMultivariate AnalysisMyocardial IschemiaPersonal AutonomyProspective StudiesQuality of LifeRisk AssessmentSocioeconomic FactorsConceptsCoronary artery diseaseType 2 diabetesAsymptomatic coronary artery diseasePoor emotional outcomesAsymptomatic myocardial ischemiaRisk factor behaviorsImpact of screeningSelf-administered questionnaireAggressive screeningArtery diseaseProspective studyStudy baselineMyocardial ischemiaScreening TrialMyocardial perfusionEmotional outcomesOutcomesDiabetesBehavior outcomesLaboratory testsLow levelsScreeningHigh levelsIschemiaPerfusionScreening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring
Scholte A, Bax J, Wackers F. Screening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease: Combined use of stress myocardial perfusion imaging and coronary calcium scoring. Journal Of Nuclear Cardiology 2006, 13: 11-18. PMID: 16464712, DOI: 10.1016/j.nuclcard.2005.11.002.Peer-Reviewed Original ResearchMeSH KeywordsAlgorithmsCalcinosisComorbidityCoronary Artery DiseaseDiabetes Mellitus, Type 2Diagnosis, Computer-AssistedExercise TestHumansIncidenceMass ScreeningPrognosisRadionuclide ImagingReproducibility of ResultsRisk AssessmentRisk FactorsSensitivity and SpecificitySurvival RateVentricular Dysfunction, LeftConceptsSilent coronary artery diseaseCoronary artery diseaseCoronary calcium scoringType 2 diabetes mellitusMyocardial perfusion imagingArtery diseaseDiabetes mellitusCalcium scoringPerfusion imagingAsymptomatic individualsStress myocardial perfusion imagingRadionuclide myocardial perfusion imagingEarly appropriate treatmentRecent prospective studiesRates of morbidityAsymptomatic patientsCardiovascular complicationsProspective studyOverall prevalenceClinical combinationAppropriate treatmentClinical investigationMellitusClinical importanceDisease
2004
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)
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 factorsCardiac 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