TREATMENT OF MYOCARDIAL ISCHEMIA IN ASYMPTOMATIC PATIENTS WITH DIABETES

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。本研究的目的是评估可能前瞻性识别2型糖尿病合并无症状性心脏病患者的危险因素。将评价临床特征预测2-3年期间心肌灌注异常（血流动力学显著CAD）或后续临床心脏事件的能力。通过放射性核素负荷心肌灌注成像，确定无症状糖尿病患者中可证实的负荷诱导心肌缺血的患病率。将定义2型糖尿病灌注成像正常的阴性预测值。然后将制定无症状糖尿病患者诊断压力测试的循证指南。这是一项两阶段研究的第一阶段：目前的I期部分是一项背景观察性研究; II期将是一项随机治疗研究，评价无症状性心脏病患者的治疗结局。

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.