A new study by Intermountain Health has concluded that proactively screening patients with diabetes for coronary heart disease (CHD) does not improve long-term survival rates or reduce the risk of heart attacks and strokes. The findings, presented at the American Heart Association’s 2024 Scientific Sessions in Chicago, challenge the routine use of coronary computed tomography angiography (CCTA) for diabetes patients without symptoms of heart disease.
The study, led by Dr. J. Brent Muhlestein, co-director of cardiovascular research at Intermountain Health, found that despite the common co-occurrence of coronary heart disease and diabetes, the presence of diabetes alone does not indicate a higher likelihood of undiagnosed heart disease in patients.
“Our research demonstrates that screening patients who show no symptoms of heart disease does not affect long-term mortality rates or the likelihood of suffering a heart attack or stroke,” said Dr. Muhlestein. “Instead, this study reinforces the importance of focusing on established interventions—such as medication management, diet, and exercise—to improve the overall health and longevity of diabetes patients.”
The study analyzed data from the FACTOR-64 trial, a randomized clinical trial that tracked 900 individuals with type 1 or type 2 diabetes over several years. Participants in the study had been living with diabetes for at least three to five years and showed no symptoms of coronary artery disease. Of these, 452 were screened using CCTA, a diagnostic tool that uses advanced X-ray imaging to produce detailed 3D images of the heart. The remaining 448 participants received standard diabetes care following established guidelines.
The research team followed up with participants over several years, starting in 2007, with a final analysis in May 2024. The results showed that CCTA screening did not significantly impact the rates of all-cause mortality or the occurrence of non-fatal heart incidents like heart attacks and strokes. These findings were consistent even after a follow-up period of 12 years.
Dr. Muhlestein cautioned against the use of CCTA screening for asymptomatic diabetes patients, stating that such screenings should not replace critical health management practices. “While our study demonstrated that CCTA screenings do not provide significant benefits, it highlighted that patients who effectively manage their diabetes can live nearly as long as those without the condition,” he said.
The study underscores the importance of focusing on proven strategies such as optimizing diabetes care to improve long-term health outcomes, rather than relying on advanced screenings that have not shown a substantial impact on survival or cardiovascular events in the diabetes population.
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