Current Cardiology Reports

, Volume 12, Issue 2, pp 140–146 | Cite as

Screening Asymptomatic Patients with Type 2 Diabetes Mellitus for Coronary Artery Disease: Does It Improve Patient Outcome?

Article

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

ADVANCE

Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation

BARI-2D

Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics Trial

DCCT

Diabetes Control and Complications Trial

DIAD

Detection of Ischemia in Asymptomatic Diabetics

MERIDIAN

Multicenter Trial of Elective Revascularization in Patients With Diabetes Mellitus and Mild Anginal Complaints

MiSAD

Milan Study on Atherosclerosis and Diabetes

NHANES

National Health and Nutrition Examination Survey

UKPDS

United Kingdom Prospective Diabetes Study

VADT

Veterans Affairs Diabetes Trial

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of CardiologyGeisinger Medical CenterDanvilleUSA
  2. 2.Department of Diagnostic Radiology and Nuclear MedicineThe University of Maryland Hospital and School of MedicineBaltimoreUSA

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