Impact of Cardiovascular Screening Tests in Patients with Type 2 Diabetes Mellitus without Previous Histories of Cardiovascular Disease: 5-year Clinical Outcomes.

Abstract

Background We previously reported that, among the asymptomatic patients with type 2 diabetes mellitus (T2DM) without history of cardiovascular disease (CVD), up to 19% of the patients with myocardial ischemia were detected by cardiovascular screening tests (CVSTs). We concluded that the CVSTs in patients with T2DM may be one of the most effective strategies to find CVD in those patients. Thus, the aim of the study was to assess the long-term clinical outcomes of CVSTs in patients with T2DM without previous histories of CVD. Methods Six hundred fifty-seven out-patients with T2DM who received CVSTs at least more than one time or not at all from April in 2014 to March in 2019 were defined as the S group or NS group, respectively. The data in 2104 and 2018 were collected from the medical records, and compared between the S and NS groups. Results This study revealed that, in the out-patients with T2DM in our hospital over those 5 years; 1) the frequency of receiving CVSTs was significantly increasing, 2) in accordance with that increase, the frequency of the internal use for CVD of statins, anti-platelets, and renin-angiotensin system inhibitors, which are well-known as medications for preventing CVD, was significantly increasing, 3) however, there was only a small increase in the internal use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptors, which are well-known to suppress cardiovascular events in patients with T2DM, 4) LDL-cholesterol and triglycerides significantly improved more in the S group than the NS group, 5) highly sensitive C-protein, which is one of the strongest predictors of CVD, was significantly suppressed by CVSTs, 6) the progression of renal dysfunction was significantly more suppressed in the S group than the NS group, 7) in an inverse proportion to the CVST increase, the frequency of acute coronary syndrome, cerebral infarctions, 4-point major adverse cardiovascular events, and admissions due to heart failure were significantly decreasing, and 8) finally, the frequency of all-cause mortality was significantly suppressed during those 5 years. Conclusions Thus, it may be important to continue CVSTs in out-patients with T2DM without a previous history of CVD for several years.