CAD screening reduces CV mortality, morbidity in Type 2 diabetics
MedWire News: Research indicates that screening for asymptomatic coronary artery disease (CAD) helps reduce cardiovascular (CV) mortality and morbidity in patients with Type 2 diabetes.
Carmine Gazzaruso (Clinical Institute ''Beato Matteo'' ICBM, Vigevano, Pavia, Italy) and colleagues assessed the 4.3-year incidence of major adverse cardiac events (MACE) in 921 Type 2 diabetes patients who were screened for asymptomatic CAD and 268 who were not.
No patients had CAD prior to study enrollment. Following angiography, 386 of the screened group were found to have silent or asymptomatic CAD.
During the follow-up period, 130 patients in the overall cohort had a MACE; defined as CAD death, myocardial infarction, death due to congestive heart failure, unstable angina, repeat revascularization, stroke, transient ischemic attack, or symptomatic peripheral artery disease. The incidence of MACE was significantly higher in the unscreened rather than the screened group, at 22.0% versus 7.7%.
The researchers found that the unscreened group had a similar risk for MACE to that of the screened CAD group, and that the screened individuals found to be CAD-free had a significantly better prognosis than the unscreened individuals.
Multivariate analysis showed that screening with angiography significantly reduced the risk for MACE by 80% in patients with Type 2 diabetes compared with no screening.
Gazzaruso and co-authors explain that the reduction in risk for MACE seen in the screened group is likely to be due to the timely application of anti-CAD treatment, such as anti-ischemic therapies or revascularization, in patients found to have silent CAD.
"This strict cardiologic control in addition to diabetes control may contribute to the improvement in the cardiovascular prognosis," they suggest.
The results of this study are published in the journal Internal Emergency Medicine.
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By Helen Albert