title: Holter monitoring for the screening of cardiac disease in diabetes mellitus: The non-invasive Holter monitoring observation of new cardiac events in diabetics study.
abstract: We investigated the usefulness of Holter monitoring to detect cardiac disease and predict future cardiovascular risk in asymptomatic diabetic patients. This is a multi-centre, prospective study in 406 asymptomatic diabetic patients. They were categorized into three groups based on findings of Holter monitoring. A total of 377 met inclusion criteria and were classified as low (n = 172), moderate (n = 136) and high risk (n = 69). In total, 86 in moderate and 53 in high risk receive further evaluation. In total, 29 in moderate and 25 in high risk were diagnosed as cardiac disease and 12 required additional treatment, including coronary intervention. Over 1.8 years of mean follow-up, 11 (16.5 per 1000 person-years) experienced cardiovascular events. The cumulative incidence in moderate and high risk was higher than that in low risk (p = 0.029 and p = 0.014, respectively). Our study suggests that Holter monitoring may be a useful screening tool to detect cardiac disease and predict future cardiovascular risk in asymptomatic diabetic patients.
authors.affiliation: Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Yoko M
authors.initials: YM
authors.lastname: Nakao
authors.affiliation: Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan ueshima.kenji.5m@kyoto-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ueshima
authors.affiliation: The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Nohara
authors.affiliation: Mizunuma Medical Clinic, Morioka, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Mizunuma
authors.affiliation: Diabetes Center, Kitakami-Chuo Clinic, Kitakami, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Segawa
authors.affiliation: Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka-Mizuno
authors.affiliation: Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yasuno
authors.affiliation: Medical Innovation Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
authors.affiliation: Morioh Co. Ltd, Morioka, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Hiramori
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000175:diagnosis*; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Diabetes mellitus; Holter monitoring; cardiac disease; silent myocardial ischemia