Results: ETT was positive in 19 patients (7.25%), 17 accepted to undergo an- giography, 5 (29.4%) had no critical stenosis. Percutaneous revascularization was.
From physical activity to exercise training
P3390 | BEDSIDE Screening diabetic patients for unknown coronary disease. An open-label randomized trial comparing exercise testing aimed at revascularization with management based on best medical therapy F. Turrini 1 , R. Messora 1 , P. Giovanardi 1 , S. Scarlini 1 , P. Magnavacchi 2 , V. Evandri 3 , A. Zanasi 3 , R. Cavani 4 , S. Tondi 2 , M. Bondi 1 . 1 Cardiovascular Medicine - AUSL Modena, Modena, Italy; 2 Cardiology - Department of Cardiovascular Disease, Modena, Italy; 3 Unit of Geriatrics - Department of Internal Medicine, Endocrinology, Metabolism and Geriatrics, Modena, Italy; 4 Diabetology Service, Modena, Italy Purpose: To evaluate efficacy of screening and treatment of asymptomatic coronary disease in diabetic patients. Screening was achieved by exercise tolerance testing (ETT) aimed at revascularization, surgical or percutaneous. Methods: From Sep 2007 to May 2012, 523 consecutive patients were enrolled (F 110-21.0%; age 61.9±4.9). Inclusion criteria were: a) T2 diabetes b) age 50 to 70y c) CV risk score ≥10% d) no symptoms or known ischemic disease or heart failure (HF) e) no ECG signs of ischemia f) GFR ≥40 ml/min. Patients were randomized according to age, sex and CV risk to screening by ETT (262) or follow up (261). Angiography has been proposed to patients with a positive ETT. Critical coronary lesions were treated by stenting or surgery. Primary end point was combined reduction of cardiac death and myocardial infarction (MI); secondary end point was prevention of HF. Results: ETT was positive in 19 patients (7.25%), 17 accepted to undergo angiography, 5 (29.4%) had no critical stenosis. Percutaneous revascularization was performed in 7 patients (58.3%) while 5 underwent surgery. One patient who underwent angioplasty had subacute MI. After a mean follow up of 3 years overall cardiac event rate was 1.27%/y. The occurrence of primary endpoint did not differ between screening and follow up (4.20 vs 3.45% Log Rank P.65). The occurrence of a first HF episode was similar in both groups (1.14 vs 1.92% Log Rank P.41). Subgroup analysis revealed in screening group a lower number of cardiac death if ≥60y (p.044) and HF if CV Risk
