Gender-based divergence of cardiovascular outcomes in asymptomatic patients with type 2 diabetes: Results from the DIAD study

• Published in: Diabetes & vascular disease research Vol. 9; no. 2; pp. 124 - 130
• Main Authors: Tandon, Suman, Wackers, Frans JT, Inzucchi, Silvio E, Bansal, Shanti, Staib, Lawrence H, Chyun, Deborah A, Davey, Janice A, Young, Lawrence H
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2012
• Subjects: Aged; Asymptomatic Diseases; Canada - epidemiology; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Diabetes Complications - diagnosis; Diabetes Complications - epidemiology; Diabetes Complications - mortality; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - mortality; Female; Humans; Incidence; Kaplan-Meier Estimate; Male; Mass Screening - methods; Middle Aged; Myocardial Perfusion Imaging; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Risk Factors; Sex Factors; Time Factors; United States - epidemiology; Canada; United States; Cardiovascular outcomes; type 2 diabetes mellitus; stress myocardial perfusion imaging; screening; gender differences; silent coronary artery disease
• ISSN: 1479-1641; 1752-8984
• DOI: 10.1177/1479164111431470

Gender differences in cardiovascular outcomes were compared in asymptomatic men and women with type 2 diabetes (T2DM) in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. Of 1123 participants, 290 men and 271 women were randomised to screening with stress myocardial perfusion imaging (MPI); 311 men and 251 women were randomised to no screening. Follow-up was 4.8±0.9 years for the occurrence of cardiac events (CE; cardiac death or non-fatal myocardial infarction). The frequency of abnormal screening was similar in men (24%) and women (19%), (p=0.2), although women trended to have smaller MPI abnormalities. CE rates were lower in women than men (1.7% vs. 3.8%, p=0.04). No CEs occurred in 17 high-risk (UKPDS risk engine) women, whereas 14 (11.2%) occurred in 125 high-risk men. Asymptomatic women with T2DM have significantly better cardiac outcomes than their male counterparts and represent a subgroup for which screening for coronary artery disease does not appear warranted.