Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects
Response to Bhalodkar and Blum
- Frans J.Th. Wackers, MD1,
- Lawrence H. Young, MD1,
- Silvio E. Inzucchi, MD2,
- Deborah A. Chyun, PhD3 and
- for the DIAD Investigators
- 1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- 2Section of Endocrinology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- 3Yale University School of Nursing, New Haven, Connecticut
- Address correspondence to Frans J.Th. Wackers, MD, Yale University School of Medicine, 333 Cedar St., Fitkin-3, New Haven, CT 06520. E-mail: frans.wackers{at}yale.edu
The DIAD study was designed to investigate the prevalence and predictors of silent ischemia, specifically in asymptomatic patients with type 2 diabetes (1), who often present with advanced coronary artery disease (CAD) without prior angina. The DIAD study did not compare the prevalence of asymptomatic CAD in diabetic and nondiabetic patients. Although the relative prevalence of asymptomatic CAD in nondiabetic patients otherwise well-matched for cardiac risk factors is of interest, it will require a much larger study.
Bhalodkar and Blum (2) express concern that the prevalence of silent ischemia in DIAD might be overestimated. We believe this to be unlikely. All single-photon emission–computed tomography …
