Screening Strategies for Silent Myocardial Ischemia in Individuals With Diabetes Without Known Coronary Artery Disease: Systematic Review and Meta-Analysis.
Vanessa Del Carmen Romero Martínez, Juan Pablo Tobón Cuenca, Paula Alejandra Longas García et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of routine screening for silent myocardial ischemia in asymptomatic adults with diabetes and no known coronary artery disease. Analyzing five randomized trials with 3315 participants, the study found that screening did not significantly reduce major adverse cardiovascular events (MACE) compared to usual care, with a pooled hazard ratio of 0.76 (95% CI 0.48-1.19).
Key findings
- Screening did not significantly reduce MACE in the pooled analysis (pooled HR/RR 0.76; 95% CI 0.48-1.19).
- Five randomized trials were included, with a total of 3315 participants.
- Reporting of false-positive results and procedure-related harms was incomplete and heterogeneous.
- Routine screening did not demonstrate a reduction in cardiovascular mortality or all-cause mortality.
Why it matters
The findings suggest that routine screening for silent myocardial ischemia in asymptomatic diabetic patients may not improve cardiovascular outcomes, highlighting the need for selective testing based on individual risk factors.