Veillet-Chowdhury Mahdi, Blankstein Ron
Brigham and Women's Hospital, 75 Francis Street, Shapiro Cardiovascular Center, Boston, MA 02115, USA.
Expert Rev Cardiovasc Ther. 2015 Jun;13(6):589-91. doi: 10.1586/14779072.2015.1047764. Epub 2015 May 15.
Coronary artery disease (CAD) remains a leading cause of death among patients with diabetes mellitus. However, many patients with diabetes and CAD are asymptomatic and may sustain a myocardial infarction as their presenting symptom of CAD. Non-invasive cardiovascular imaging offers an opportunity to detect the presence and severity of CAD, or its hemodynamic consequences. The Detection of Ischemia in Asymptomatic Diabetics study and the FACTOR-64 study examined the utility of non-invasive imaging tests to evaluate asymptomatic individuals with diabetes mellitus. The results of these trials may have been negative with regard to promoting CAD screening of asymptomatic diabetic patients, but they do strengthen the position of optimal medical management in reducing cardiovascular events. However, performing a trial to include true high-risk patients who have CAD and are more likely to have silent ischemia could lead to prognostically beneficial coronary revascularizations.
冠状动脉疾病（CAD）仍然是糖尿病患者死亡的主要原因。然而，许多糖尿病合并CAD患者并无症状，可能以心肌梗死作为CAD的首发症状。无创心血管成像为检测CAD的存在、严重程度或其血流动力学后果提供了契机。无症状糖尿病患者缺血检测研究和FACTOR - 64研究探讨了无创成像检查在评估无症状糖尿病个体中的效用。这些试验的结果在促进无症状糖尿病患者的CAD筛查方面可能是阴性的，但它们确实强化了优化药物治疗在减少心血管事件方面的地位。然而，开展一项纳入真正患有CAD且更可能存在无症状性心肌缺血的高危患者的试验，可能会带来对预后有益的冠状动脉血运重建。
