Sudden death and diabetes mellitus: the role of parental antecedents in the Paris prospective study I

Jouven, Xavier; Balkau, Beverley; Andujar, Ludivine; Desnos, Michel; Guérot, C; Ducimetière, Pierre

doi:10.1016/s0735-1097(02)81472-3

Journal of the American College of Cardiology

2002

DOI: 10.1016/s0735-1097(02)81472-3

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Sudden death and diabetes mellitus: the role of parental antecedents in the Paris prospective study I

Xavier Jouven¹,

Beverley Balkau²,

Ludivine Andujar³

et al.

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The changing costs and benefits of screening for asymptomatic coronary heart disease in patients with diabetes

Rutter

Nesto

2007

Nat Rev Endocrinol

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Aggressive medical therapy can be justified in most patients with diabetes, but there may be some higher-risk asymptomatic patients who could benefit from revascularization and/or medical therapy for myocardial ischemia. Silent myocardial ischemia (SMI) might be used to identify these high-risk individuals. In this Review we define SMI as objective evidence of ischemia from any noninvasive test occurring in an asymptomatic patient. We outline what is known about asymptomatic coronary heart disease (CHD) in diabetes and how this relates to SMI. We examine how SMI predicts angiographic CHD and CHD events, and we describe the changing role of CHD screening as reflected by various guidelines. We identify the recent research suggesting that there may be substantial numbers of high-risk asymptomatic patients who have diabetes with undiagnosed CHD and who could benefit from more-active intervention; however, with the recent advances in medical therapy, and the uncertain benefits of screening, current guidelines strongly discourage this practice, except in limited clinical situations, such as before major surgery. Carefully conducted clinical trails using state-of-the-art investigations and therapy in well-characterized patients with diabetes are urgently required to inform physicians on when and how to intervene.

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The changing costs and benefits of screening for asymptomatic coronary heart disease in patients with diabetes

Rutter

Nesto

2007

Nat Rev Endocrinol

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Sudden death and diabetes mellitus: the role of parental antecedents in the Paris prospective study I

Cited by 1 publication

References 0 publications

The changing costs and benefits of screening for asymptomatic coronary heart disease in patients with diabetes

The changing costs and benefits of screening for asymptomatic coronary heart disease in patients with diabetes

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