Do You Need to Assess Myocardial Ischemia in Type 2 Diabetes (DYNAMIT)
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Purpose
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.
| Condition | Intervention |
|---|---|
|
Type 2 Diabetes |
Other: a bicycle exercise test |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Randomized Strategy Trial Comparing Detection of Silent Ischemia With no Detection of Silent Ischemia in Asymptomatic Patients With Type 2 Diabetes Mellitus. Effects on Cardiovascular Events. |
- 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
- Unstable angina requiring hospitalization Coronary events Coronary revascularization
| Enrollment: | 642 |
| Study Start Date: | December 2000 |
| Estimated Study Completion Date: | July 2005 |
| Estimated Primary Completion Date: | July 2005 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Intervention
Patients are referred to a cardiologist for a systematic detection of silent ischemia by a bicycle exercise test performed according to the French Society of Cardiology protocol after washout of cardiovascular medications likely to interfere with the test. Dipyridamole Single Photon Emission Computed Tomography (SPECT) is used in patients unable to perform the exercise test, with a sub-maximal negative exercise test result or with electrocardiographic abnormalities impairing the interpretation of the exercise test. Subsequent investigations (such as coronary angiography) and treatments (such as revascularization procedures) are left at the cardiologist's decision.
|
Other: a bicycle exercise test |
|
No Intervention: Control
Patients are treated according current guidelines but are not referred to a cardiologist
|
Eligibility| Ages Eligible for Study: | 55 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations
More Information
No publications provided by Hospices Civils de Lyon
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | PLATTNER, MD, HOSPICES CIVILS DE LYON |
| ClinicalTrials.gov Identifier: | NCT00627783 History of Changes |
| Other Study ID Numbers: | 2000.217 |
| Study First Received: | February 22, 2008 |
| Last Updated: | February 29, 2008 |
| Health Authority: | France: Direction Générale de la Santé |
Additional relevant MeSH terms:
|
Myocardial Ischemia Diabetes Mellitus Diabetes Mellitus, Type 2 Ischemia Heart Diseases Cardiovascular Diseases |
Vascular Diseases Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 21, 2013