RT Journal
A1 Chikamori T
T1 SCreening for asymptomatic coronary artery disease in patients with type 2 diabetes
JF JAMA
JO JAMA
YR 2009
FD August 19
VO 302
IS 7
SP 735
OP 737
DO 10.1001/jama.2009.1187
UL http://dx.doi.org/10.1001/jama.2009.1187
AB 
To the Editor:  Dr Young and colleagues1 reported the results of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. This trial addressed whether routine screening of patients with asymptomatic type 2 diabetes for coronary artery disease (CAD) with myocardial perfusion imaging (MPI) is warranted. Among 1123 patients, the primary outcome of cardiac death or nonfatal myocardial infarction occurred in 15 patients in the screening group and in 17 patients in the no-screening group during the mean follow-up of 4.8 years (P = .73). The low-risk nature of the study population is one possible explanation for the negative results of the DIAD study, which had a low rate of high-risk MPI results and low cardiac event rates. However, in a clinical practice setting the presence of advanced CAD in asymptomatic diabetic patients is common, and the prognosis of patients with type 2 diabetes is poor.2