Performance of the 2019 ESC/EASD guideline strategy for the screening of silent coronary artery disease in patients with diabetes
Authors' conclusion
The ESC-EASD guidelines suggesting SMI screening in asymptomatic patients with very high risk assessed by severe TOD or high CAC score appears effective and could identify all the patients with stenoses eligible for revascularization.
Study context
- Population
- Asymptomatic patients with DM, no history of coronary disease, with target organ damage (TOD) or ≥ 3 risk factors in addition to DM
- Participants
- 385 patients
- Comparison
- Strategies to select patients with DM for silent myocardial ischemia (SMI) screening, incl. 2019 European Society of Cardiology and European Association for the Study of Diabetes (ESC-EASD) strategy (severe TOD or coronary artery calcium (CAC) ≥ 100 Agatston units (AU))
- Outcome
- Validity of the 2019 ESC-EASD screening strategy for SMI (stress myocardial scintigraphy, angiography if SMI)
Performance
As reported in the abstract
Most effective strategy: scintigraphy in severe TOD and, in those without severe TOD, in CAC ≥ 100 AU
Sensitivity for SMI diagnosis
82%
Further findings
CAC score ≥ 100 AU
- Patients with CAC ≥ 100 AU
- 175 (45.5%)
SMI and angiography findings
- SMI present
- 39 (10.1%)
- Underwent angiography
- 30
- Coronary stenoses among those with angiography
- 15
- Revascularization
- 12
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Performance of the 2019 ESC/EASD guideline strategy for the screening of silent coronary artery disease in patients with diabetes. Cardiovasc Diabetol. Published 15 February 2023. doi:10.
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