Key result
Routine CHD screening fails to improve outcomes in asymptomatic diabetes despite aiding risk reclassification.
Why the study?
Routine screening for coronary heart disease has not improved outcomes in asymptomatic diabetes mellitus patients on intensive medical therapy, but guidelines recommend selected imaging for risk reclassification.
Do cardiovascular screening tests (electrocardiography, coronary calcium score, carotid ultrasonography) improve clinical outcomes or risk reclassification in asymptomatic patients with diabetes mellitus?
Do cardiovascular screening tests (electrocardiography, coronary calcium score, carotid ultrasonography) improve clinical outcomes or risk reclassification in asymptomatic patients with diabetes mellitus?
While routine coronary heart disease screening is not recommended for asymptomatic diabetic patients, targeted use of coronary calcium scoring and carotid ultrasonography can aid in risk reclassification and guide treatment intensification.
Supports avoiding routine CHD screening in asymptomatic diabetes on intensive therapy; leaves open targeted CAC and carotid US for risk reclassification.
Diabetes mellitus (DM) per se confers a two-fold excess risk of vascular outcomes, but the risk is subject to wide variation depending on the population and contemporary prophylactic medical therapy. Although patients with DM have a high rate of asymptomatic coronary heart disease (CHD), routine screening for CHD has not been shown to improve clinical outcomes in asymptomatic DM patients being treated with intensive medical therapy for cardiovascular risk factors. Therefore, professional societies do not recommend routine screening for CHD in asymptomatic patients. However, they recommend additional imaging such as coronary calcium score or carotid ultrasonography to provide risk reclassification and reason for treatment intensification. In this review, we provide recent guidelines regarding screening for cardiovascular disease in asymptomatic DM patients and updated the discussion of the role of electrocardiography, coronary calcium score, and carotid ultrasonography.
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Mok et al. (2023) conducted a review in Diabetes mellitus with asymptomatic cardiovascular disease. Cardiovascular disease screening (ECG, coronary calcium score, carotid ultrasonography) was evaluated. Routine screening for coronary heart disease does not improve clinical outcomes in asymptomatic patients with diabetes receiving intensive medical therapy, though coronary calcium scoring and carotid ultrasonography can aid in risk reclassification.
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