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Usefulness of a systematic screening of carotid atherosclerosis in asymptomatic people with type 2 diabetes for cardiovascular risk reclassification.
- Source :
-
Annales d'endocrinologie [Ann Endocrinol (Paris)] 2017 Feb; Vol. 78 (1), pp. 14-19. Date of Electronic Publication: 2017 Feb 07. - Publication Year :
- 2017
-
Abstract
- Aims: Routine screening of carotid atherosclerosis lesions is frequently suggested for people with type 2 diabetes, the presence of a carotid lesion being associated with a significant increase risk for vascular events. However, the impact of this strategy on medical management is not validated. We herein question the usefulness of such screening.<br />Methods: We assessed the prevalence and severity of carotid lesions in 337 consecutive people with type 2 diabetes without known cardiovascular disease who underwent a systematic carotid duplex ultrasonography. We analyzed whether the results of duplex ultrasonography allowed reclassification of cardiovascular risk level relative to the most recent international recommendations on diabetes and modified therapy.<br />Results: We found that 35.9% of people had no atherosclerotic lesion. Prevalence of carotid stenosis<20%, between 20 and 50% and ≥50% were 32.9%, 28.4% and 2.7% respectively. Regarding the use of statins and LDL-C target, the result of carotid duplex ultrasonography allowed to reclassify respectively 11.8% to 55.2% of the cohort in a higher cardiovascular risk level. For the indication of antiplatelet agent, reclassification in a higher risk level concerned 6.8% of the patients. No subject had an indication of carotid revascularization.<br />Conclusions: Carotid atherosclerosis is frequent in asymptomatic people with type 2 diabetes in primary cardiovascular prevention. Screening for carotid atherosclerosis by duplex ultrasonography seems useful to redefine the level of cardiovascular risk.<br /> (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adult
Aged
Asymptomatic Diseases
Cardiovascular Diseases classification
Cardiovascular Diseases complications
Cardiovascular Diseases diagnosis
Cardiovascular Diseases epidemiology
Carotid Artery Diseases complications
Carotid Artery Diseases epidemiology
Diabetes Mellitus, Type 2 epidemiology
Diabetic Angiopathies epidemiology
Early Diagnosis
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prevalence
Risk Factors
Ultrasonography, Doppler, Duplex
Carotid Artery Diseases diagnosis
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 diagnosis
Diabetic Angiopathies diagnosis
Mass Screening methods
Subjects
Details
- Language :
- English
- ISSN :
- 2213-3941
- Volume :
- 78
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annales d'endocrinologie
- Publication Type :
- Academic Journal
- Accession number :
- 28185650
- Full Text :
- https://doi.org/10.1016/j.ando.2016.12.001