Subclinical cardiovascular disease in type 2 diabetes mellitus: To screen or not to screen

Table 1 Clinical characteristics of diabetic patients with increased risk of coronary heart disease

Evidence of other atherosclerotic vascular disease

Renal disease

Abnormal resting electrocardiogram

Diabetes complications including autonomic neuropathy

Age > 45 yr

Male sex

Traditional risk factors

Blood pressure

Dyslipidemia

Smoking

Inactivity

Abdominal obesity

Novel cardiac risk factors

C-reactive protein

Homocysteine

Lipoprotein(a)

Table 2 Key messages

Cardiovascular disease is the leading cause of mortality in patients with T2DM

Control of cardiovascular risk factors has been shown to significantly reduce the incidence of cardiovascular disease in T2DM patients

Control level of cardiovascular risk factors in patients with T2DM in clinical practice is poor

Systematic screening of cardiovascular disease has not been shown to improve the prognosis of patients with T2DM

In patients with atypical symptoms or ECG abnormalities, cardiovascular disease screening is warranted

T2DM: Type 2 diabetes mellitus; ECG: Electrocardiogram.