UR Among 7 Centers To Study No. 1 Killer of Americans with Diabetes
First Study of its Kind Seeks to Detect "Silent" Heart Disease
September 07, 2000
Researchers at Strong Memorial Hospital of the University of Rochester Medical Center have begun enrolling patients in the first multi-center study designed to detect "silent" ischemia (heart disease) in patients with diabetes. The study - Detection of Ischemia in Asymptomatic Diabetics (DIAD) - is designed to evaluate the potential role of a nuclear cardiac-imaging procedure in screening these at-risk patients for heart disease, with the hope of developing an approach that may save many from premature heart attack or death.
Heart disease is the leading silent killer of the nearly 16 million Americans with diabetes, whose risk is two to four times that of the general population. Identifying coronary artery disease in these patients is difficult because many have no apparent chest pain symptoms. This so-called silent ischemia may go undiagnosed until symptoms of late-stage heart disease occur, including heart attack or cardiac death.
"Heart disease among patients with diabetes has not received adequate attention despite the fact that it is the leading cause of the reduced life expectancy among these patients," Steven Wittlin, M.D., clinical director of the Endocrine/Metabolism Unit and a co-investigator on the study. "We hope that this study will shed light on whether nuclear cardiac imaging may help to improve patient outcomes in this high-risk patient population which is disproportionately affected by this silent but potentially life-threatening cardiac condition."
Yale University School of Medicine will serve as the study's lead investigation site. In addition to the University of Rochester, other sites are: Soundview Research Associates, Norwalk, Conn.; Tulane University, New Orleans; University of Alabama, Birmingham; University of Chicago; and University of Virginia, Charlottesville.
The DIAD study will enroll a total of 1,000 patients. Eligible patients must be adults, age 50 to 75, with known diabetes but no symptoms of heart disease. Those interested in enrolling in the New York state area may call (716) 273-3972 or (716) 275-2901.
"Current strategies are not sophisticated enough to detect heart disease at its earliest stages in patients with diabetes, so we need to evaluate promising approaches to improve detection and outcomes in this high-risk group," says cardiologist Ronald Schwartz, M.D. "We're excited to be part of this groundbreaking study."
DIAD study participants will be randomized into two groups - a control group receiving usual care and a second group receiving a non-invasive heart-imaging test. Notably, study results presented at the American College of Cardiology annual scientific meeting in March suggest this nuclear imaging technique to be an accurate predictor of major cardiac events in patients with diabetes known to have heart disease. The study is sponsored by DuPont Pharmaceuticals and Fujisawa Healthcare Inc.