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
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
2007
Screening for Coronary Artery Disease in Patients With Diabetes
Bax JJ, Young LH, Frye RL, Bonow RO, Steinberg HO, Barrett EJ. Screening for Coronary Artery Disease in Patients With Diabetes. Diabetes Care 2007, 30: 2729-2736. PMID: 17901530, DOI: 10.2337/dc07-9927.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsCoronary artery diseaseArtery diseaseCardiovascular diseaseHigh-risk coronary artery diseaseStable coronary artery diseaseCoronary artery calcium scoringAdditive survival benefitIntensive medical managementRecognition of diabetesCVD risk reductionPercutaneous coronary revascularizationStrong clinical suspicionAmerican Diabetes AssociationType 2 diabetesClinical trial resultsCost of diabetesAsymptomatic patientsAtherosclerotic burdenCoronary revascularizationCardiac eventsClinical suspicionCoronary atherosclerosisDiabetic populationSurvival benefitAsymptomatic atherosclerosisResolution 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
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 factorsDetection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects
Wackers FJ, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Heller GV, Filipchuk N, Engel S, Ratner RE, Iskandrian AE. Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects. Diabetes Care 2004, 27: 1954-1961. PMID: 15277423, DOI: 10.2337/diacare.27.8.1954.Peer-Reviewed Original ResearchConceptsSilent myocardial ischemiaType 2 diabetesCardiac risk factorsMyocardial ischemiaAsymptomatic patientsSilent ischemiaNormal perfusionRisk factorsTraditional cardiac risk factorsAmerican Diabetes Association guidelinesTomography myocardial perfusion imagingRegional myocardial perfusion abnormalitiesAbnormal stress testAsymptomatic diabetic subjectsAsymptomatic Diabetics (DIAD) studyCurrent American Diabetes AssociationPrevalence of ischemiaCardiac autonomic dysfunctionLarge perfusion defectsST-segment depressionCoronary artery diseaseAmerican Diabetes AssociationMyocardial perfusion abnormalitiesMyocardial perfusion imagingStrongest predictorAbnormal 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 outcome
2003
Diagnosis of CAD in patients with diabetes: Who to evaluate
Young LH, Jose P, Chyun D. Diagnosis of CAD in patients with diabetes: Who to evaluate. Current Diabetes Reports 2003, 3: 19-27. PMID: 12643142, DOI: 10.1007/s11892-003-0048-3.BooksConceptsCoronary artery diseaseCardiac testingDiabetic patientsDiagnosis of CADNoninvasive cardiac testingManagement of patientsCAD screeningAsymptomatic ischemiaAsymptomatic patientsSymptomatic patientsArtery diseaseCardiac catheterizationRisk stratificationPatientsAccurate diagnosisDiagnosisAppropriate useDiabetesEffective diagnosisCurrent controversiesRecent informationRevascularizationCatheterizationIschemiaClinicians