Diagnosis of CAD in patients with diabetes: who to evaluate.
Effective diagnosis and treatment of coronary artery disease (CAD) are key to the management of patients with diabetes. Although the use of specialized cardiac testing for CAD screening in asymptomatic patients varies widely and is the source of current controversy, evidence is emerging on the prevalence and predictors of asymptomatic ischemia in diabetic patients. Accurate diagnosis and risk stratification are essential in symptomatic patients with known or suspected CAD. Noninvasive cardiac testing has an important role in these patients, although evaluation for revascularization with cardiac catheterization is warranted in high-risk circumstances. This article reviews recent information that may help guide the clinician in the appropriate use of cardiac testing in diabetic patients.
Young
Lawrence H
LH
Department of Internal Medicine (Section of Cardiovascular Medicine), Yale University School of Medicine, 333 Cedar Street, 3 FMP, New Haven, CT 06520, USA. lawrence.young@yale.edu
Jose
Powell
P
Chyun
Deborah
D
D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis*; D048909:Diabetes Complications; D006334:Heart Function Tests; D006801:Humans; D008403:Mass Screening; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D012307:Risk Factors