Diabetics Show Improvements in Ischemia Over Three Years

Resolution of ischemia associated with use of statins, aspirin, ACE inhibitors

MONDAY, Oct. 29 (HealthDay News) -- In a majority of people with type 2 diabetes and myocardial ischemia, the ischemia resolved during a three-year span, which was an unexpected development associated with intensive treatment, according to study findings reported in the November issue of Diabetes Care.

Frans J. Th. Wackers, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues analyzed data from 522 participants in the earlier Detection of Ischemia in Asymptomatic Diabetics (DIAD) study, who underwent adenosine-stress single photon emission computerized tomography myocardial perfusion imaging. All were type 2 diabetics with no indication of coronary artery disease.

Out of this group, 358 participated in repeat imaging after three years. Seventy-one of these subjects showed abnormal findings at the original screening, but at the follow-up, 56 of them (79 percent) demonstrated resolution of ischemia. Patients whose ischemia resolved had significantly increased use of statins, aspirin and ACE inhibitors during the three-year interim than the 28 patients who developed new ischemia from the group of 287 with normal findings at the first screening.

"More aggressive treatment of cardiac risk factors might have been driven by increasingly stringent practice guidelines that had an impact on the care of patients with type 2 diabetes," the authors write. "However, the DIAD study was not designed as a treatment trial, and the association of resolution of ischemia and intensification of medical treatment does not prove a causal relationship between the two."

This study received funding and support from Bristol Myers-Squibb Medical Imaging and Astellas Pharma. The lead author has received grants and honoraria from various pharmaceutical and imaging companies, including Bristol Myers-Squibb Imaging and Astellas Pharma.

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