Screening for asymptomatic coronary artery disease in patients with type 2 diabetes mellitus

Abstract

Diabetes is a very frequent disease and it is estimated that its prevalence will continuously increase during the next two decades. The arteriosclerotic process in diabetic patients progresses earlier and more diffusely, and it is more accelerated in the diabetic patient than in the overall population. In diabetic subjects, acute myocardial infarction (AMI) and stroke are the leading causes of death, but the presence of arterial disease is not always detected before the development of the acute arterial event. Several times, AMI is asymptomatic or present nonspecific symptoms, and it is the initial form of presentation of coronary artery disease causing an important delay in initiating cardiovascular treatment in these patients. The purpose of this review article is to discuss how to screen and early diagnose the presence of coronary artery disease in asymptomatic diabetic patients, based on new available diagnostic resources. Currently, the most recommended technique used for screening coronary artery disease in these patients is myocardial perfusion scintigraphy or stress echocardiography because of greater sensitivity and specificity in relation to the exercise test. However, technological advances have enabled the development of new imaging diagnostic methods that are less invasive than conventional coronary angiography, and which gradually gain importance in the diagnosis of coronary artery disease as they show higher effectiveness with lower invasiveness and risk. Arch Endocrinol Metab. 2016;60(2):143-51

Assessment of electrocardiogram abnormality and associated factors among apparently healthy adult type 2 diabetic patients on follow-up at Jimma Medical Center, Southwest Ethiopia: Cross-sectional study

“…A resting 12-lead electrocardiogram is frequently used in evaluating patients with suspected cardiovascular disease [ 17 ]. Usually, physicians do not routinely screen diabetic patients for arteriosclerotic unless the disease is suspected [ 18 ]. The presence of major ECG abnormality is associated with an increased risk of CVDs in diabetic patients [ 19 ].…”

Diagnostic value of carotid artery ultrasound and hypersensitive C-reactive protein in Type 2 diabetes mellitus patients with acute myocardial infarction in Chinese population

“…[ 2 ] Atherosclerosis (AS) is the main pathogenesis of AMI as well as the primary target vessel lesion of T2DM. [ 3 ] C-reactive protein is a glycosylated polyprotein, which is the main index to reflect the changes of inflammation. Recently interest has been focused on simple biochemical marker for high-sensitivity C-reactive protein (hs-CRP) have been shown to be especially promising.…”

Impact of Diabetes Duration on the Extent and Severity of Coronary Atheroma Burden in Type 2 Diabetic Patients : Evaluation by Coronary CT Angiography

“…Tavars et al [24] used different noninvasive imaging techniques, in order to screen for asymptomatic coronary artery disease in patients with type 2 diabetes mellitus. Impact of diabetes duration was clearly found to be significant regarding the presence of CAD, a result which is accordance with our study.…”