April 14, 2009 / 4:20 PM / 10 years ago

Screening does not lower heart risks for diabetics

CHICAGO (Reuters) - Screening patients with type 2 diabetes for coronary artery disease did little to lower their rate of heart attacks or death compared with diabetics who got routine care, U.S. researchers said on Tuesday.

The study suggests routine screening tests of diabetics for heart problems would not be worth the enormous additional cost of such a screening program.

“I do not recommend blanket screening,” Dr. Frans Wackers of Yale University School of Medicine in New Haven, Connecticut, whose study appears in the Journal of the American Medical Association, told a news briefing.

He said routine care in which diabetics are closely followed by their doctors for any signs of heart trouble was just as effective at catching heart disease, and a whole lot cheaper.

People with type 2 diabetes, which is closely linked with obesity, have a far greater risk of heart disease and some had expected that scanning these patients to check for clogged arteries would help identify dangerously blocked arteries just waiting to cause trouble.

To test this, Dr. Wackers and colleagues studied 1,123 patients with type 2 diabetes who had no symptoms of heart disease. About half of them were assigned to be screened for coronary artery disease with a non-invasive imaging method and the rest were followed closely by their doctors.

After an average follow-up of about 5 years, the team found only 2.9 percent of people in both groups had heart attacks or died from heart events, much lower than expected.

Rates of heart problems were about the same: 15 in the screening group and 17 in the group that was not screened.

The overall rate of procedures to open blocked arteries was also low in both groups: 5.5 percent in the screened group and 7.8 percent in the unscreened group.

Wackers said people in both groups got significantly more preventive medications over the course of the study, including aspirin, statins and angiotension-converting enzyme or ACE inhibitors, which treat high blood pressure.

“Rather than considering this as a negative study, I think there is a positive side to this,” Wackers told the briefing.

He said while the study showed routine screening strategy made no difference, the study did show how well current drugs work at protecting diabetics from heart risks.

Government figures released last year found heart disease deaths in the United States have fallen 30 percent in the past decade, helped by better control of cholesterol and blood pressure, declining smoking rates and better medical treatments.

Some 23.6 million Americans have diabetes, according to the American Diabetes Association.

Editing by Michael Conlon

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