Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? The DADDY-D trial. Screening diabetic patients for unknown coronary disease

Turrini, Fabrizio; Scarlini, Stefania; Mannucci, Caterina; Messora, Roberto; Giovanardi, Paolo; Magnavacchi, Paolo; Cappelli, Carlo; Evandri, Valeria; Zanasi, Andrea; Romano, Stefania; Cavani, R; Ghidoni, Italo; Tondi, Stefano; Bondi, Mario

doi:10.1016/j.ejim.2015.05.006

Cited by 29 publications

(28 citation statements)

References 32 publications

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“…The Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? (DADDY) study main finding reported that screening for CAD and revascularization did not affect the occurrence of a first cardiac event in people with diabetes (12). These results are in line with the Detection of Ischemia in Asymptomatic Diabetes (DIAD), COURAGE and BARI 2D studies and confirm that to date there is no proven indication, in daily practice, to search for ischemia in people with diabetes without symptoms.…”

Section: Introductionsupporting

confidence: 70%

Screening for the Presence of Cardiovascular Disease

Poirier¹,

Bertrand²,

Leipsic³

et al. 2018

Canadian Journal of Diabetes

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Section: Introductionsupporting

confidence: 70%

Screening for the Presence of Cardiovascular Disease

Poirier¹,

Bertrand²,

Leipsic³

et al. 2018

Canadian Journal of Diabetes

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“…trial. They found silent ischemia in 7.6% of patients and concluded that screening and revascularization of silent CAD in patients with diabetes failed to demonstrate a significant reduction in cardiac events and HF episodes (22). …”

Section: Role Of Exercise Stress Testingmentioning

confidence: 99%

Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient

Budoff

Raggi

Beller

et al. 2016

JACC: Cardiovascular Imaging

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Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a “coronary risk equivalent,” implying a high 10-year cardiovascular risk for every diabetes patient. Following the original study by Haffner et al., multiple studies from different cohorts provided varying conclusions on the validity of the concept of coronary risk equivalency in patients with diabetes. New guidelines have started to acknowledge the heterogeneity in risk and include different treatment recommendations for diabetic patients without other risk factors who are considered to be at lower risk. Furthermore, guidelines have suggested that further risk stratification in patients with diabetes is warranted before universal treatment. The Imaging Council of the American College of Cardiology systematically reviewed all modalities commonly used for risk stratification in persons with diabetes mellitus and summarized the data and recommendations. This document reviews the evidence regarding the use of noninvasive testing to stratify asymptomatic patients with diabetes with regard to coronary heart disease risk and develops an algorithm for screening based on available data.

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“…(DYNAMIT) study [ 13 ], the FACTOR-64 study [ 14 ], and the Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? (DADDY-D) study [ 11 ]. The search procedure was repeated in ScienceDirect and ISI Web of Knowledge; we found no additional studies that met our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Although DIAD was a breakthrough study with rapid incorporation into the guidelines, it was acknowledged that, due to the low rate of events overall, the power of the study to exclude a difference in outcome was limited. Since then, several other studies randomizing screening strategies in diabetic populations have been published, including very recently [ 11 ]. In the present paper, our aim was to perform a systematic review and meta-analysis of randomized trials that addressed this question.…”

Section: Introductionmentioning

confidence: 99%

Screening for asymptomatic coronary artery disease in patients with diabetes mellitus: A systematic review and meta-analysis of randomized trials

Bauters

Lemesle

2016

BMC Cardiovasc Disord

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BackgroundScreening diabetic patients for the presence of asymptomatic coronary artery disease (CAD) may potentially impact therapeutic management and outcome. We performed a systematic review and meta-analysis of randomized trials addressing this question.MethodsWe searched the PubMed database for studies reporting a randomized comparison of systematic screening for CAD in diabetic patients versus no systematic screening. The screening protocols were variable with the use of exercise electrocardiogram test, or stress echocardiography, or nuclear test, or coronary computed tomography angiography.ResultsThe final analysis included 5 randomized studies and 3,314 patients altogether. The screening strategy had no detectable impact on outcome with odds ratios (OR) [95 % confidence interval (CI)] of 1.00 [0.67–1.50], 0.72 [0.33–1.57], 0.71 [0.40–1.27], and 0.60 [0.23–1.52] for all-cause death, cardiovascular death, non-fatal myocardial infarction, and the composite cardiovascular death or non-fatal myocardial infarction, respectively. Protocol-related coronary procedures were relatively infrequent in screened patients: coronary angiography was performed in 8 % of the cases, percutaneous coronary intervention in 2.5 %, and coronary artery bypass surgery in 1.5 %. There was no evidence for an effect of screening on the use of statins (OR = 1.19 [0.94–1.51]), aspirin (OR = 1.02 [0.83–1.25]), or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (OR = 0.97 [0.79–1.19]).ConclusionThe present analysis shows no evidence for a benefit of screening diabetic patients for the presence of asymptomatic CAD. The proportion of patients who undergo myocardial revascularization as a consequence of screening was low.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0256-9) contains supplementary material, which is available to authorized users.

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Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? The DADDY-D trial. Screening diabetic patients for unknown coronary disease

Cited by 29 publications

References 32 publications

Screening for the Presence of Cardiovascular Disease

Screening for the Presence of Cardiovascular Disease

Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient

Screening for asymptomatic coronary artery disease in patients with diabetes mellitus: A systematic review and meta-analysis of randomized trials

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