TREATMENT OF MYOCARDIAL ISCHEMIA IN ASYMPTOMATIC PATIENTS WITH DIABETES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this study is to evaluate risk factors which might prospectively identify patients with type 2 diabetes with silent heart disease. The ability of clinical profiles to predict either myocardial perfusion abnormalities (hemodynamically significant CAD) or subsequent clinical cardiac events over a 2-3 year period will be evaluated. The prevalence of demonstrable stress-induced myocardial ischemia by radionuclide stress myocardial perfusion imaging in asymptomatic patients with diabetes will be defined. The negative predictive value of normal perfusion imaging in type 2 diabetes will be defined. Evidence-based guidelines for diagnostic stress testing in asymptomatic patients with diabetes will then be developed. This is the first phase of a two-phase study: the current Phase I portion being a background observational study; Phase II will be a randomized treatment study evaluating the outcome of treatment of patients with silent heart disease.