[Silent myocardial ischemia in diabetic patients: to screen or not to screen?].
Cardiovascular diseases are the leading cause of death in patients with diabetes and silent myocardial ischemia occurs more frequently in diabetics than non-diabetics. Thus American Diabetes Association guidelines recommend screening for coronary artery disease in high-risk, asymptomatic diabetic patients. However these recommendations are the result of expert consensus panels instead of being evidence-based. The selection criteria for patients who should be included in screenings programs and the most appropriate treatment of silent ischemia in diabetics have to be clarified. In particular further studies are necessary to assess if myocardial revascularization is more beneficial than full medication alone. Screening of silent ischemia should be more individualized rather than systematic.
Meyer
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Service d'endocrinologie, diabétologie et nutrition, Département de médecine interne, Hôpitaux universitaires de Genève, 1211 Genève 14. Patrick.Meyer@hcuge.ch
D003327:Coronary Disease / Q000150:complications; D048909:Diabetes Complications / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D017410:Practice Guidelines as Topic