Recommendations: Coronary Heart Disease Screening
Recommendations for coronary heart disease (CHD) screening1 is summarized on this slide In asymptomatic patients, routine screening for coronary artery disease (CAD) is not recommended, as it does not improve outcomes as long as cardiovascular disease (CVD) risk factors are treated (A) Screening for CAD is reviewed in a recently updated consensus statement2 To identify the presence of CAD in diabetic patients without clear or suggestive symptoms, a risk factor-based approach to the initial diagnostic evaluation and subsequent follow-up has intuitive appeal However, recent studies concluded that using this approach fails to identify which patients with type 2 diabetes will have silent ischemia on screening tests3,484References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S34. Bax JJ, Young LH, Frye RL, Bonow RO, Steinberg HO, Barrett EJ; ADA. Screening for coronary artery disease in patients with diabetes. Diabetes Care 2007;30:2729-2736. Wackers FJ, Young LH, Inzucchi SE, et al for the Detection of Ischemia in Asymptomatic Diabetics Investigators. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care 2004;27:1954-1961. Scognamiglio R, Negut C, Ramondo A, Tiengo A, Avogaro A. Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus. J Am Coll Cardiol 2006;47:65-71.