Screening for Coronary Artery Disease
University of South Carolina
Welcome to this month’s
Diabetes Care newsletter. Our topic is
heart screening may not be beneficial for people with type 2 diabetes. Routine screening for coronary artery disease
appears to be of no value for adults with diabetes who have no symptoms of
heart problems. The study was reported
in the Journal of the American Medical Association. The study of more than 1,100 people with type
2 diabetes, who had no symptoms of heart disease, didn’t identify those at high
risk for developing cardiac problems.
Lead researcher Dr.
Lawrence Young says there’s no question that coronary artery disease is still a
major concern in patients with type 2 diabetes.
But the findings imply that a typical patient who is doing well, is
taking their heart medications and is managing their diabetes doesn’t need this
testing. Dr. Young stresses, however,
that people who have any symptoms of heart disease need to be screened.
The study had two groups,
those who received the nuclear stress test, and those who did not. In a follow-up period, averaging five years,
nearly three percent of the people in the screened group had heart attacks or died
of cardiac disease compared with 2.7 percent of those who weren’t
screened. Many of the people in the
study had well known risk factors for heart disease, explains Dr. Young. He says most of the patients in the study
were overweight. Many had other risk
factors, such as high blood pressure and high cholesterol. He adds that people with type 2 diabetes who
have a family history of heart disease or have symptoms should be screened. He says the symptoms may include chest pain,
or angina, a feeling of tightness or heaviness in the chest, and unexplained
shortness of breath on exertion.
Another member of the
study group, Dr. Stephen Whitland (?), says that over the years, since the
study began, many people have started taking aspirin and newer blood pressure
medication. This may account for the low
rate of cardiac events and death in the study participants. There are two major findings from the study,
says Dr. Whitland. People with type 2
diabetes, who are middle-aged and have a positive stress test, have an
increased risk of a cardiac event.
However, the event rate was low enough so that it doesn’t appear to be
cost effective to routinely screen patients with a nuclear stress test.
information, always consult your doctor.
Thank you for listening. Please
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