Abstract 17791: Yield of Different Approaches for Screening for Cardiovascular Disease in Asymptomatic Diabetics

Introduction: While diabetes has long been considered a coronary heart disease equivalent, there is increasing evidence to suggest that not all individuals with diabetes have cardiovascular disease, and it is unclear how best to risk stratify this population. We sought to compare the yield of testing for pre-clinical atherosclerosis with various approaches. Methods: A group of 98 asymptomatic subjects with type 2 diabetes mellitus (T2DM) without known coronary artery disease (CAD) were enrolled in a prospective study and underwent carotid ultrasound, exercise treadmill testing (ETT), coronary artery calcium (CAC) scoring, and coronary computed tomography angiography (CTA). CTA was used as the reference standard for CAD. Results: Of 98 subjects (average age 55±6, 64% female, 22 on insulin, mean A1c 7.3%), 43 (44%) had coronary plaque detectable on CTA, and 38 (39%) had CAC score > 0. By CTA, 16 (16%) had coronary stenosis ≥ 50%, including 3 subjects with CAC=0. Subjects with coronary plaque had greater pre...