Diagnosis of Coronary Artery Disease in Persons with Diabetes Mellitus

Division of Cardiology, Department of Medicine, University of California-Irvine, 333 City Boulevard West, Orange, CA 92868-3298, USA.
Current Diabetes Reports (Impact Factor: 3.08). 04/2012; 12(3):286-93. DOI: 10.1007/s11892-012-0273-8
Source: PubMed


Coronary heart disease (CHD) is the leading cause of morbidity and mortality in patients with diabetes. Asymptomatic CHD in these patients is elusive and carries a poor prognosis given the fact that an unheralded acute myocardial infarction or sudden cardiac death frequently constitutes its first presentation. Because effective screening for asymptomatic patients with type 2 diabetes for both the presence and severity of CHD is intuitively appealing, we have summarized the utility and prognostic value of various diagnostic modalities (both functionally and anatomically) in enhancing risk stratification and leading to improved and more aggressive management of the risk factors. There exist some evidence and recommendations for screening of asymptomatic persons with diabetes using certain modalities. More research is needed to define potential subsets of patients with diabetes who may benefit from additional testing for asymptomatic CHD.

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    • "Should every diabetic undergo a diagnostic test? The answer is most probably no even if the question is still open [3]. Let's use a Bayesian approach: according to the UKPDS risk calculator , my pre-test probability fell in the range of 20–25%; almost the same results were obtained using the Mayo Clinic instrument which purported similar results (I had a score of 18, therefore falling at the border between average and elevated risk) [4]. "

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