The Particulars: Coronary artery disease (CAD) has been shown to be a major cause of cardiovascular morbidity and mortality in patients with diabetes. However, CAD is often asymptomatic prior to patients suffering a myocardial infarction (MI) and coronary death. Routine CAD screening with coronary CT angiography (CCTA) in patients with diabetes who are at high cardiac risk and subsequently using CCTA-direct therapy may reduce the risk of death and non-fatal coronary outcomes.
Data Breakdown: For a study, patients with diabetes and no symptoms of CAD were randomized to CAD screening with CCTA or to standard optimal diabetes care based on national guideline recommendations. At an average of 4 years follow-up, the composite rates of all-cause mortality, non-fatal MI, or unstable angina requiring hospitalization were not significantly different between the two groups. Rates of ischemic major adverse cardiovascular events also did not differ between the groups.
Take Home Pearl: Among asymptomatic patients with diabetes, use of CCTA to screen for CAD does not appear to reduce the rate of all-cause mortality, non-fatal MI, or unstable angina requiring hospitalization at 4 years when compared with standard optimal care.