Integrating Biomarkers and Imaging for Cardiovascular Disease Risk Assessment in Diabetes.
Cardiovascular disease (CVD) risk assessment has changed substantially in recent years. While older guidelines considered diabetes a coronary disease risk equivalent, more recent guidelines recommend risk stratification on the basis of global risk scoring to target intensity of therapy. While patients with diabetes as a whole are at greater risk for CVD events, these patients may also benefit from risk stratification based on circulating biomarkers like high-sensitivity C-reactive protein, high-sensitivity cardiac troponin T, and N-terminal pro-B-type natriuretic peptide, as well as newer imaging modalities (coronary artery calcium, carotid intima-media thickness, and myocardial perfusion imaging). The addition of these CVD risk assessment modalities could play an important role for deciding how aggressive a physician should be with pharmacological therapy. Here, we discuss many of the current recommendations of CVD risk assessment in patients with diabetes including newer modalities for CVD risk assessment.
Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA.
David M
DM
Tehrani
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA. ndwong@uci.edu.
Nathan D
ND
Wong
D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D020107:Troponin T / Q000378:metabolism
D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D002118:Calcium
C-reactive protein; Cardiovascular disease; Carotid intima-media thickness; Coronary artery calcium; Diabetes; Myocardial perfusion imaging