Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros
Diabetes mellitus is associated with an increased risk of coronary heart disease (CHD) morbidity and mortality. Although it frequently coexists with other cardiovascular disease (CVD) risk factors, it confers an increased risk for CVD events on its own. Coronary atherosclerosis is generally more agg...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2017/8927473 |
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| _version_ | 1832559098744274944 |
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| author | Konstantinos Makrilakis Stavros Liatis |
| author_facet | Konstantinos Makrilakis Stavros Liatis |
| author_sort | Konstantinos Makrilakis |
| collection | DOAJ |
| description | Diabetes mellitus is associated with an increased risk of coronary heart disease (CHD) morbidity and mortality. Although it frequently coexists with other cardiovascular disease (CVD) risk factors, it confers an increased risk for CVD events on its own. Coronary atherosclerosis is generally more aggressive and widespread in people with diabetes (PWD) and is frequently asymptomatic. Screening for silent myocardial ischaemia can be applied in a wide variety of ways. In nearly all asymptomatic PWD, however, the results of screening will generally not change medical therapy, since aggressive preventive measures, such as control of blood pressure and lipids, would have been already indicated, and above all, invasive revascularization procedures (either with percutaneous coronary intervention or coronary artery bypass grafting) have not been shown in randomized clinical trials to confer any benefit on morbidity and mortality. Still, unresolved issues remain regarding the extent of the underlying ischaemia that might affect the risk and the benefit of revascularization (on top of optimal medical therapy) in ameliorating this risk in patients with moderate to severe ischaemia. The issues related to the detection of coronary atherosclerosis and ischaemia, as well as the studies related to management of CHD in asymptomatic PWD, will be reviewed here. |
| format | Article |
| id | doaj-art-c8264051296d413f861bfb07d3f9928a |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-c8264051296d413f861bfb07d3f9928a2025-02-03T01:30:56ZengWileyJournal of Diabetes Research2314-67452314-67532017-01-01201710.1155/2017/89274738927473Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than ProsKonstantinos Makrilakis0Stavros Liatis1First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, GreeceFirst Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, GreeceDiabetes mellitus is associated with an increased risk of coronary heart disease (CHD) morbidity and mortality. Although it frequently coexists with other cardiovascular disease (CVD) risk factors, it confers an increased risk for CVD events on its own. Coronary atherosclerosis is generally more aggressive and widespread in people with diabetes (PWD) and is frequently asymptomatic. Screening for silent myocardial ischaemia can be applied in a wide variety of ways. In nearly all asymptomatic PWD, however, the results of screening will generally not change medical therapy, since aggressive preventive measures, such as control of blood pressure and lipids, would have been already indicated, and above all, invasive revascularization procedures (either with percutaneous coronary intervention or coronary artery bypass grafting) have not been shown in randomized clinical trials to confer any benefit on morbidity and mortality. Still, unresolved issues remain regarding the extent of the underlying ischaemia that might affect the risk and the benefit of revascularization (on top of optimal medical therapy) in ameliorating this risk in patients with moderate to severe ischaemia. The issues related to the detection of coronary atherosclerosis and ischaemia, as well as the studies related to management of CHD in asymptomatic PWD, will be reviewed here.http://dx.doi.org/10.1155/2017/8927473 |
| spellingShingle | Konstantinos Makrilakis Stavros Liatis Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros Journal of Diabetes Research |
| title | Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros |
| title_full | Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros |
| title_fullStr | Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros |
| title_full_unstemmed | Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros |
| title_short | Cardiovascular Screening for the Asymptomatic Patient with Diabetes: More Cons Than Pros |
| title_sort | cardiovascular screening for the asymptomatic patient with diabetes more cons than pros |
| url | http://dx.doi.org/10.1155/2017/8927473 |
| work_keys_str_mv | AT konstantinosmakrilakis cardiovascularscreeningfortheasymptomaticpatientwithdiabetesmoreconsthanpros AT stavrosliatis cardiovascularscreeningfortheasymptomaticpatientwithdiabetesmoreconsthanpros |