Purpose of Review

The study aims to describe methods for detecting subclinical coronary artery disease (CAD) and their potential implications in asymptomatic patients with diabetes.

Recent Findings

Imaging tools can assess non-invasively the presence and severity of CAD, based on myocardial ischemia, coronary artery calcium score, and coronary computed tomography coronary angiography. Subclinical CAD is common in the general population ageing 50 to 64 years with any coronary atherosclerosis present in 42.1% and obstructive CAD in 5.2%. In patients with diabetes, an even higher prevalence has been noted. The presence of myocardial ischemia, obstructive CAD, and the extent of coronary atherosclerosis provide powerful risk stratification regarding the risk of cardiovascular events. However, randomized trials evaluating systematic screening in the general population or patients with diabetes have demonstrated only moderate impact on management and no significant impact on patient outcomes.

Summary

Despite providing improved risk stratification, systematic screening of CAD is not recommended in patients with diabetes.

中文翻译：

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糖尿病患者的冠状动脉疾病筛查

审查目的

该研究旨在描述检测亚临床冠状动脉疾病（CAD）的方法及其对无症状糖尿病患者的潜在影响。

最近的发现

成像工具可以根据心肌缺血、冠状动脉钙化评分和冠状动脉计算机断层扫描冠状动脉造影，无创地评估 CAD 的存在和严重程度。亚临床 CAD 在 50 至 64 岁的一般人群中很常见，其中 42.1% 存在冠状动脉粥样硬化，5.2% 存在阻塞性 CAD。在糖尿病患者中，患病率甚至更高。心肌缺血、阻塞性 CAD 和冠状动脉粥样硬化的程度为心血管事件的风险提供了强有力的风险分层。然而，评估一般人群或糖尿病患者系统筛查的随机试验表明，对管理的影响只有中等，对患者的治疗结果没有显着影响。

概括

尽管提供了改进的风险分层，但不建议对糖尿病患者进行系统的 CAD 筛查。