Do You Need to Assess Myocardial Ischemia in Type 2 Diabetes

Hospices Civils de Lyon642 enrolled

Overview

DYNAMIT is a prospective, randomized, multicenter, open strategy trial run in 45 French hospitals. Diabetic patients with no evidence of coronary artery disease and at least 2 additional cardiovascular risk factors are randomized to screening for silent ischemia using a bicycle exercise test or Dipyridamole Single Photon Emission Computed Tomography (N=316), or follow-up without screening (N=315). All have access to cardiovascular prevention according current guidelines. The main end point is time to death from all causes, non-fatal myocardial infarction, non-fatal stroke, or heart failure requiring hospitalization or emergency service intervention.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

642

Conditions

Type 2 Diabetes

Interventions

Eligibility

Sex: ALLMin age: 55 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients 55 to 75 years old had type-2 diabetes and at least two of the following cardiovascular risk factors: * urinary albumin excretion \> 30 mg/L or \> 30 mg/24 hours, * treated or untreated hypertension, * treated or untreated lipid abnormality, * peripheral arterial disease, * history of transient ischemic accident, * tobacco consumption * familial history of premature cardiovascular disease. Exclusion Criteria: * History of myocardial infarction, coronary artery disease, or stroke, * Previous positive stress test or myocardial perfusion imaging, * Negative stress test or myocardial perfusion imaging within the last three years

Outcomes

Primary Outcomes

Death from all causes, non-fatal myocardial infarction, non-fatal stroke, or heart failure requiring hospitalization or emergency service intervention, measured after a minimum follow-up of 2 years

Secondary Outcomes

Unstable angina requiring hospitalization Coronary events Coronary revascularization