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Grant number (RSD 1716).\nDepartment of Diagnostic Radiology, University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong \n Department of Medical Imaging, University of Hong Kong, Shenzhen Hospital, Shenzhen, China \n Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong \n Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, Hong Kong \n Department of Cardiology, University of Hong Kong, Shenzhen Hospital, Shenzhen, China \n Departments of Medicine and Medical Imaging, St. Michael's Hospital, Toronto, Canada \n University of Toronto, Toronto, Canada \n Department of Medicine, Tung Wah Hospital, Hong Kong, Hong Kong \n Department of Medical Imaging, University of Toronto, Toronto, Canada \n Department of Medical Imaging, University Health Network, Toronto, Canada \n Export Date: 22 June 2020 \n CODEN: CDAIA \n Correspondence Address: Ng, M.-Y.; Department of Diagnostic Radiology, University of Hong Kong, 102 Pokfulam Road, Hong Kong; email: myng2@hku.hk\nDepartment of Diagnostic Radiology, University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong \n Department of Medical Imaging, University of Hong Kong, Shenzhen Hospital, Shenzhen, China \n Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong \n Department of Family Medicine and Primary Care, University of Hong Kong, Hong Kong, Hong Kong \n Department of Cardiology, University of Hong Kong, Shenzhen Hospital, Shenzhen, China \n Departments of Medicine and Medical Imaging, St. Michael's Hospital, Toronto, Canada \n University of Toronto, Toronto, Canada \n Department of Medicine, Tung Wah Hospital, Hong Kong, Hong Kong \n Department of Medical Imaging, University of Toronto, Toronto, Canada \n Department of Medical Imaging, University Health Network, Toronto, Canada \n Cited By :3 \n Export Date: 9 July 2021 \n CODEN: CDAIA \n Correspondence Address: Ng, M.-Y.; Department of Diagnostic Radiology, 102 Pokfulam Road, Hong Kong; email: 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asymptomatic high risk patients with type 2 diabetes mellitus (DM) has never been performed, and its effectiveness is unknown. Our aim was to determine the feasibility of a screening programme using stress CMR by obtaining preliminary data on the prevalence of silent ischaemia caused by obstructive coronary artery disease (CAD) and quantify myocardial perfusion in asymptomatic high risk patients with type 2 diabetes. Methods In this prospective cohort study, we recruited 63 asymptomatic DM patients (mean age 66 years +/- 4.4 years; 77.8% male); with Framingham risk score >= 20% from 3 sites from June 2017 to August 2018. Normal volunteers were recruited to determine normal global myocardial perfusion reserve index (MPRI). Adenosine stress CMR and global MPRI was performed and measured in all subjects. Positive stress CMR cases were referred for catheter coronary angiography (CCA) with/without fractional flow reserve (FFR) measurements. Positive CCA was defined as an FFR <= 0.8 or coronary narrowing >= 70%. Patients were followed up for major adverse cardiovascular events. Prevalence is presented as patient numbers and percentage. Mann-Whitney U test was used to compare global MPRI between patients and normal volunteers. Results 13 patients had positive stress CMR with positive CCA (20.6% of patient population), while 9 patients with positive stress CMR examinations had a negative CCA. 5 patients (7.9%) had infarcts detected of which 2 patients had no stress perfusion defects. 12 patients had coronary artery stents inserted, whilst 1 patient declined stent placement. DM patients had lower global MPRI than normal volunteers (n = 7) (1.43 +/- 0.27 vs 1.83 +/- 0.31 respectively; p < 0.01). After a median follow-up of 653 days, there was no death, heart failure, acute coronary syndrome hospitalisation or stroke. Conclusion 20.6% of asymptomatic DM patients (with Framingham risk >= 20%) had silent obstructive CAD. Furthermore, asymptomatic patients have reduced global MPRI than normal volunteers. 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