Screening Test for Evaluation of Cardiovascular Disease in Patients with Diabetes

Abstract

Diabetes mellitus (DM) per se confers a two-fold excess risk of vascular outcomes, but the risk is subject to wide variation depending on the population and contemporary prophylactic medical therapy. Although patients with DM have a high rate of asymptomatic coronary heart disease (CHD), routine screening for CHD has not been shown to improve clinical outcomes in asymptomatic DM patients being treated with intensive medical therapy for cardiovascular risk factors. Therefore, professional societies do not recommend routine screening for CHD in asymptomatic patients. However, they recommend additional imaging such as coronary calcium score or carotid ultrasonography to provide risk reclassification and reason for treatment intensification. In this review, we provide recent guidelines regarding screening for cardiovascular disease in asymptomatic DM patients and updated the discussion of the role of electrocardiography, coronary calcium score, and carotid ultrasonography.