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Screening Reduces Cardiac Events

Researchers conducted a prospective study of 141 people with type 2diabetes. All of the patients had been admitted to the hospital for treatmentof diabetes and had at least two of the following conditions:

1. Total cholesterol 240 mg/dl, HDL cholesterol 35 mg/dl, or drugtreatment;
   
2. Systolic blood pressure >140 mm Hg, diastolic pressure >90 mm Hg, ordrug treatment;
   
3. Active smoking;
   
4. Albumin excretion >30 mg per 24 hours; and
   
5. Family history of coronary artery disease.
   

Seventy-one patients were randomized into a screening group, while 70participants received their usual care as a control group. Those who underwentscreening for coronary artery disease had an exercise electrocardiogram andechocardiography and, if indicated, were referred for angiography andtreatment. Participants were followed for an average of 4.5 years, whichincluded an average of three diabetes evaluations per year.

Screening was positive in 15 participants (21.4%). Nine patients hadnarrowing of coronary arteries, which was treated by bypass grafting in fourpatients and with percutaneous angioplasty in four patients. Some diseasedcoronary arteries did not need treatment.

During the follow-up period, there were three cases of angina and one heartattack among the screening group, compared with four cases of angina and 11heart attacks in the control group.

Although the study population was small, the data show that screening iseffective in preventing cardiac events among high-risk patients with type 2diabetes.

Faglia E, Manuela M, Antonella Q, et al.: Risk reduction ofcardiac events by screening of unknown asymptomatic coronary artery disease insubjects with type 2 diabetes mellitus at high cardiovascular risk: Anopen-label randomized pilot study. Am Heart J 149: 283.e1–283.e6, 2005.

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Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Social Bookmarking                What's this?