| Intensive cardiovascular risk factors therapy and prevalence of silent myocardial ischaemia in patients with type 2 diabetes. | |
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MedLine Citation:
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PMID: 19041838 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Screening for silent myocardial ischaemia (SMI) is a controversial strategy undergoing intensive risk factor therapy. AIMS: To assess the prevalence of SMI and coronary artery disease (CAD) in asymptomatic type 2 diabetic patients at high cardiovascular risk (two additional risk factors or more) and undergoing long-term intensive risk factor therapy and tight glycaemic control. METHODS: SMI screening, using isotopic or echographic stress tests, was carried out in 122 asymptomatic type 2 diabetic patients at high cardiovascular risk and undergoing long-term intensive risk factor therapy. Coronary angiography was proposed if SMI was detected. Long-term follow-up data on death, myocardial infarction and revascularization were obtained by telephone call or clinical review. RESULTS: The mean age was 65+/-6 years and 74% of patients were men. The mean duration of diabetes was 15+/-9 years. The mean number of additional risk factors was 2.9, 32% of patients had microalbuminuria and 12% had peripheral arterial disease. SMI was detected in 20 (16%) patients. Seven (6%) patients had significant CAD treated successfully by angioplasty (n=6) or bypass surgery (n=1). The positive predictive value of the non-invasive screening test for the diagnosis of significant CAD (stenosis>50%) was 39%. The event rate was very low (1.6%) at 2-year follow-up. CONCLUSION: Long-term intensive risk factor therapy in high-risk patients with type 2 diabetes is associated with low prevalence of SMI and detected CAD. Optimal medical therapy and revascularization of significant CAD are associated with a low cardiovascular event rate at two years. |
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Authors:
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Olivier Barthelemy; Sophie Jacqueminet; Francois Rouzet; Richard Isnard; Anissa Bouzamondo; Dominique Le Guludec; André Grimaldi; Jean-Philippe Metzger; Claude Le Feuvre |
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Publication Detail:
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Type: Journal Article Date: 2008-09-23 |
Journal Detail:
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Title: Archives of cardiovascular diseases Volume: 101 ISSN: 1875-2136 ISO Abbreviation: Arch Cardiovasc Dis Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-12-01 Completed Date: 2009-01-30 Revised Date: 2011-04-25 |
Medline Journal Info:
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Nlm Unique ID: 101465655 Medline TA: Arch Cardiovasc Dis Country: Netherlands |
Other Details:
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Languages: eng Pagination: 539-46 Citation Subset: IM |
Affiliation:
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Département de cardiologie médicale, institut de cardiologie, groupe hospitalo-universitaire Pitié-Salpêtrière, 47 et 83, boulevard de l'Hôpital, 75651 , Paris cedex 13, France. Olivier.barthelemy@psl.aphp.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography Coronary Angiography Coronary Artery Disease / epidemiology*, etiology, pathology, therapy Diabetes Complications / epidemiology*, etiology, pathology Diabetes Mellitus, Type 2 / complications, drug therapy, epidemiology*, pathology Echocardiography, Stress Female Humans Male Middle Aged Myocardial Ischemia / epidemiology*, etiology, pathology, prevention & control Practice Guidelines as Topic Predictive Value of Tests Prevalence Prospective Studies Risk Factors Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Arch Cardiovasc Dis. 2008 Sep;101(9):509-11
[PMID:
19041833
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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