DOC News October 1, 2004
Volume 1 Number 2 p. 22
© 2004 American Diabetes Association
Aggressive CAD Evaluations for Diabetes
Coronary artery disease (CAD) is the leading cause of death in diabetes
patients and is often in advanced stages before it is detected. To help combat
this common problem a group of researchers at Yale University studied 1,123
patients with type 2 diabetes to assess the prevalence of asymptomatic
coronary artery disease. Researchers also tested the effectiveness of the
American Diabetes Association's current screening process.
Patients, age 50–75 years, with no known history of CAD, were
randomly assigned to both a stress test and 5-year follow-up or follow-up
only.
Results showed that 22% of the patients had silent ischemia. According to
the study, selecting only patients who met American Diabetes Association
guidelines would have failed to identify 41% of the patients with CAD. The
strongest predictors of abnormal tests were abnormal Valsalva, male sex, and
diabetes duration.
Researchers concluded that patients with type 2 diabetes should be treated
with aggressive risk factor modification to prevent the development and
progression of CAD.
Wackers FJT, et al: Detection of silent myocardial ischemia
in asymptomatic diabetic subjects. Diabetes Care 27: 1954–1961, 2004.[Abstract/Free Full Text]
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