The Limited Usefulness of the Treadmill Test or a Risk-guided Approach in Screening for Asymptomatic Coronary Heart Disease in Japanese Patients with Type 2 Diabetes
スポンサーリンク
概要
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Objective We prospectively investigated the efficacy of the screening methods for asymptomatic coronary heart disease (CHD) in Japanese patients with type 2 diabetes using the treadmill tolerance test (TTT) as a first-line test or the American Diabetes Association (ADA) guidelines. Methods The subjects included consecutive inpatients with type 2 diabetes (n=331) assessed with both electrocardiogram (ECG) at rest and TTT. Subjects with abnormal TTT findings were evaluated using stress myocardial perfusion scintigraphy (MPS). Results A total of 60 out of 69 subjects with positive TTT findings underwent MPS, among whom a total of 22 subjects (6.6% of the total number of subjects) had positive MPS results. Among those with positive MPS results, a total of 14 subjects underwent coronary angiography, eight of whom were determined to have significant coronary artery stenosis. The prevalence rates of hypertension and micro/macroalbuminuria were significantly higher in the MPS-positive group (77.3% and 54.5%, respectively) than in the TTT-negative group (44.7% and 27.1%, respectively). Among the subjects with positive MPS results, 68.2% met the 1998 ADA criteria. Conclusion Neither the TTT as a first-line test nor the ADA guidelines are sufficiently adequate screening methods to detect asymptomatic CHD in Japanese subjects with type 2 diabetes. Conducting routine screening for asymptomatic CHD in Japanese patients with type 2 diabetes may therefore not be very useful.
著者
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Koshiyama Hiroyuki
Center For Diabetes & Endocrinology The Tazuke Kofukai Foundation Medical Research Institute Kit
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HAMAMOTO Yoshiyuki
Center for Diabetes & Endocrinology, The Tazuke Kofukai Foundation Medical Research Institute Kitano
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HONJO Sachiko
Center for Diabetes & Endocrinology, The Tazuke Kofukai Foundation Medical Research Institute Kitano
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IKEDA Hiroki
Center for Diabetes & Endocrinology, The Tazuke Kofukai Foundation Medical Research Institute Kitano
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Nohara Ryuji
Cardiovascular Center Kitano Hospital The Tazuke Kofukai Medical Research Institute
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Ikeda Hiroki
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Kawasaki-Ogita Yukiko
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Iwasaki Yorihiro
Center for Diabetes and Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Wada Yoshiharu
Center for Diabetes and Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Nomura Kazuhiro
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Iwasaki Yorihiro
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Honjo Sachiko
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Koshiyama Hiroyuki
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Wada Yoshiharu
Center for Diabetes & Endocrinology, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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Nohara Ryuji
Cardiovascular Center, Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
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