Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient The Imaging Council of the American College of Cardiology
Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient The Imaging Council of the American College of Cardiology
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DOI：
10.1016/j.jcmg.2015.11.011
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发表时间：
2016-02-01
影响因子：
14
通讯作者：
Soman, Prem
中科院分区：
文献类型：
--
作者：
Budoff, Matthew J.;Raggi, Paolo;Soman, Prem
2型糖尿病患者心血管疾病发病率和死亡率增加已得到充分证实；糖尿病与患冠心病的风险增加至少两倍有关。糖尿病患者中大约三分之二的死亡与心血管疾病有关。以前，糖尿病被认为是“冠状动脉风险等同”，这意味着每个糖尿病患者10年的心血管风险都很高。根据Haffner等人的原始研究。，来自不同队列的多项研究对糖尿病患者冠状动脉风险等效概念的有效性提供了不同的结论。新的指南已经开始承认风险的异质性，并包括对没有其他风险因素的糖尿病患者的不同治疗建议，这些患者被认为处于较低风险。此外，指南还建议在普遍治疗前对糖尿病患者进行进一步的风险分层。美国心脏病学会影像委员会系统地回顾了糖尿病患者风险分层常用的所有模式，并总结了数据和建议。本文回顾了关于使用无创检测对无症状糖尿病患者进行冠心病风险分层的证据，并基于现有数据开发了一种筛查算法。(C) 2016年由美国心脏病学会基金会发布。
Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a "coronary risk equivalent," implying a high 10-year cardiovascular risk for every diabetes patient. Following the original study by Haffner et at., multiple studies from different cohorts provided varying conclusions on the validity of the concept of coronary risk equivalency in patients with diabetes. New guidelines have started to acknowledge the heterogeneity in risk and include different treatment recommendations for diabetic patients without other risk factors who are considered to be at Lower risk. Furthermore, guidelines have suggested that further risk stratification in patients with diabetes is warranted before universal treatment. The Imaging Council of the American College of Cardiology systematically reviewed all modalities commonly used for risk stratification in persons with diabetes mellitus and summarized the data and recommendations. This document reviews the evidence regarding the use of noninvasive testing to stratify asymptomatic patients with diabetes with regard to coronary heart disease risk and develops an algorithm for screening based on available data. (C) 2016 by the American College of Cardiology Foundation.