Identification of coronary heart disease in asymptomatic individuals with diabetes mellitus: to screen or not to screen
Fuente:
Redalyc
Saved in:
| Main Author: | |
|---|---|
| Format: | Artículo científico |
| Language: | en |
| Published: |
Universidad del Valle
2015
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1876471676981477376 |
|---|---|
| author | Paco E. Bravo |
| author_facet | Paco E. Bravo |
| contents | Identification of coronary heart disease in asymptomatic individuals with diabetes mellitus: to screen or not to screen Paco E. Bravo Bruce M. Psaty Marcelo F. Di Carli Kelley R. Branch Medicina diabetes Screening coronary heart disease Coronary heart disease (CHD) is highly prevalent in patients with diabetes mellitus (DM), and remains the single most common cause of death among this population. Regrettably, a significant percentage of diabetics fail to perceive the classic symptoms associated with myocardial ischemia. Among asymptomatic diabetics, the prevalence of abnormal cardiac testing appears to be high, raging between 10% and 62%, and mortality is significantly higher in those with abnormal scans. Hence, the potential use of screening for CHD detection among asymptomatic DM individuals is appealing and has been recommended in certain circumstances. However, it was not until recently, that this question was addressed in clinical trials. Two studies randomized a total of 2,023 asymptomatic diabetics to screening or not using cardiac imaging with a mean follow up of 4.4 ±1.4 yrs. In combination, both trials showed lower than expected annual event rates, and failed to reduce major cardiovascular events in the screened group compared to the standard of care alone. The results of these trials do not currently support the use of screening tools for CHD detection in asymptomatic DM individuals. However, these studies have important limitations, and potential explanations for their negative results that are discussed in this manuscript. 2015 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28338620007 https://www.redalyc.org/journal/283/28338620007/ https://www.redalyc.org/journal/283/28338620007/html/ https://www.redalyc.org/journal/283/28338620007/28338620007.epub https://www.redalyc.org/journal/283/28338620007/movil en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.1 Vol.46 |
| format | Artículo científico |
| id | redalyc_28338620007 |
| institution | Redalyc |
| language | en |
| publishDate | 2015 |
| publisher | Universidad del Valle |
| spellingShingle | Identification of coronary heart disease in asymptomatic individuals with diabetes mellitus: to screen or not to screen Paco E. Bravo Medicina diabetes Screening coronary heart disease Identification of coronary heart disease in asymptomatic individuals with diabetes mellitus: to screen or not to screen Paco E. Bravo Bruce M. Psaty Marcelo F. Di Carli Kelley R. Branch Medicina diabetes Screening coronary heart disease Coronary heart disease (CHD) is highly prevalent in patients with diabetes mellitus (DM), and remains the single most common cause of death among this population. Regrettably, a significant percentage of diabetics fail to perceive the classic symptoms associated with myocardial ischemia. Among asymptomatic diabetics, the prevalence of abnormal cardiac testing appears to be high, raging between 10% and 62%, and mortality is significantly higher in those with abnormal scans. Hence, the potential use of screening for CHD detection among asymptomatic DM individuals is appealing and has been recommended in certain circumstances. However, it was not until recently, that this question was addressed in clinical trials. Two studies randomized a total of 2,023 asymptomatic diabetics to screening or not using cardiac imaging with a mean follow up of 4.4 ±1.4 yrs. In combination, both trials showed lower than expected annual event rates, and failed to reduce major cardiovascular events in the screened group compared to the standard of care alone. The results of these trials do not currently support the use of screening tools for CHD detection in asymptomatic DM individuals. However, these studies have important limitations, and potential explanations for their negative results that are discussed in this manuscript. 2015 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28338620007 https://www.redalyc.org/journal/283/28338620007/ https://www.redalyc.org/journal/283/28338620007/html/ https://www.redalyc.org/journal/283/28338620007/28338620007.epub https://www.redalyc.org/journal/283/28338620007/movil en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.1 Vol.46 |
| title | Identification of coronary heart disease in asymptomatic individuals with diabetes mellitus: to screen or not to screen |
| topic | Medicina diabetes Screening coronary heart disease |
| url | https://www.redalyc.org/articulo.oa?id=28338620007 https://www.redalyc.org/journal/283/28338620007/ https://www.redalyc.org/journal/283/28338620007/html/ https://www.redalyc.org/journal/283/28338620007/28338620007.epub https://www.redalyc.org/journal/283/28338620007/movil |