Author + information
- Received October 5, 2015
- Accepted November 6, 2015
- Published online February 1, 2016.
- Matthew J. Budoff, MD, Chaira,∗ (, )
- Paolo Raggi, MDb,
- George A. Beller, MDc,
- Daniel S. Berman, MDd,
- Regina S. Druz, MDe,
- Shaista Malik, MD, PhDf,
- Vera H. Rigolin, MDg,
- Wm. Guy Weigold, MDh,
- Prem Soman, MD, PhDi,
- Imaging Council of the American College of Cardiology
- aDepartment of Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California
- bMazankowski Alberta Heart Institute, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- cDepartment of Medicine, University of Virginia, Charlottesville, Virginia
- dDepartments of Imaging and Medicine, Cedars-Sinai Medical Center and the Cedars-Sinai Heart Institute, Los Angeles, California
- eDepartment of Cardiology, Hofstra North Shore-LIJ School of Medicine, Uniondale, New York
- fDepartment of Medicine, University of California, Irvine, California
- gDepartment of Medicine/Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- hCardiology Division, MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC
- iDivision of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- ↵∗Reprint requests and correspondence:
Dr. Matthew Budoff, 1124 West Carson Street, Torrance, California 90502.
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 al., 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.
Dr. Budoff has received grant support from General Electric. Dr. Soman has received grant funding and consultant fees from Astellas. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 5, 2015.
- Accepted November 6, 2015.
- American College of Cardiology Foundation
- 1 Role of Exercise Stress Testing
- 2 Carotid Intima-Media Thickness
- 3 Coronary Artery Calcium
- 4 Echocardiography in Patients With DM
- 5 Radionuclide Imaging of the High-Risk Asymptomatic Diabetic Patient
- 6 Coronary CTA for Risk Stratification of the Asymptomatic Diabetic Patient
- 7 Cardiac Magnetic Resonance Imaging
- 8 Gender Differences in Patients With DM
- 9 Diabetes and CKD
- 10 Guidelines and Appropriate Use Criteria
- 11 Clinical Implications