Screening Asymptomatic Patients with Type 2 Diabetes Mellitus for Coronary Artery Disease: Does It Improve Patient Outcome?
First Online: 23 February 2010 DOI:
10.1007/s11886-010-0091-z Cite this article as: Shirani, J. & Dilsizian, V. Curr Cardiol Rep (2010) 12: 140. doi:10.1007/s11886-010-0091-z Abstract
The increasing global burden, the reported high prevalence of rapidly progressive coronary artery disease (CAD), and the atypical nature of CAD presentation in type 2 diabetes mellitus have encouraged development of strategies for detecting occult CAD in this population. Several recent prospective studies have addressed the value of screening for CAD in asymptomatic diabetic patients. The overall message of these studies is that despite detection of silent ischemia in a notable proportion of these patients, the dynamic nature of myocardial ischemia, the prohibitive cost of screening all asymptomatic patients, and the proven efficacy of primary preventive strategies would mandate implementation of better clinical risk stratification strategies for identifying at-risk individuals. Questions still remain as to what best strategy would allow proper patient selection through logical stepwise approaches to screening and whether that would alter patients’ outcome when added to rigorously implemented primary preventive measures.
Keywords Coronary artery disease Diabetes mellitus Detection of ischemia in asymptomatic diabetes (DIAD) Myocardial perfusion imaging Screening Prognosis Clinical Trial Acronyms ACCORD
Action to Control Cardiovascular Risk in Diabetes
Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation
Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics Trial
Diabetes Control and Complications Trial
Detection of Ischemia in Asymptomatic Diabetics
Multicenter Trial of Elective Revascularization in Patients With Diabetes Mellitus and Mild Anginal Complaints
Milan Study on Atherosclerosis and Diabetes
National Health and Nutrition Examination Survey
United Kingdom Prospective Diabetes Study
Veterans Affairs Diabetes Trial
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