Why the study?
The review aimed to describe methods for detecting subclinical coronary artery disease and their potential implications in asymptomatic patients with diabetes.
Does systematic screening for subclinical coronary artery disease improve outcomes in asymptomatic patients with diabetes?
Does systematic screening for subclinical coronary artery disease improve outcomes in asymptomatic patients with diabetes?
Despite providing improved risk stratification, systematic screening for coronary artery disease is not recommended in asymptomatic patients with diabetes due to a lack of outcome benefit.
Answers are grounded in this paper and cite their sources.
Imaging detects common subclinical CAD in asymptomatic diabetes; leaves open effects on outcomes and management.
PURPOSE OF REVIEW: The study aims to describe methods for detecting subclinical coronary artery disease (CAD) and their potential implications in asymptomatic patients with diabetes. RECENT FINDINGS: Imaging tools can assess non-invasively the presence and severity of CAD, based on myocardial ischemia, coronary artery calcium score, and coronary computed tomography coronary angiography. Subclinical CAD is common in the general population ageing 50 to 64 years with any coronary atherosclerosis present in 42.1% and obstructive CAD in 5.2%. In patients with diabetes, an even higher prevalence has been noted. The presence of myocardial ischemia, obstructive CAD, and the extent of coronary atherosclerosis provide powerful risk stratification regarding the risk of cardiovascular events. However, randomized trials evaluating systematic screening in the general population or patients with diabetes have demonstrated only moderate impact on management and no significant impact on patient outcomes. Despite providing improved risk stratification, systematic screening of CAD is not recommended in patients with diabetes.
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Saraste et al. (2023) studied this question.
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