In Reply: Dr Chikamori suggests that the lack of beneficial effect of screening was due in part to the low-risk nature of the DIAD participants. We excluded patients who had symptoms of angina, a history of CAD, a recent stress test, or an abnormal rest electrocardiogram. Those patients are indeed at high risk and require diagnostic cardiac evaluation. However, DIAD focused on asymptomatic diabetic patients and addressed the efficacy of screening these patients for inducible ischemia.
Wackers FJT, Young LH. Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes—Reply. JAMA. 2009;302(7):735-737. doi:10.1001/jama.2009.1190