Non-invasive imaging for coronary artery disease in diabetes

Abstract

Diabetic patients are at greater risk of cardiovascular disease than non-diabetic individuals, coronary artery disease (CAD) has a less favourable prognosis and is more likely to be silent in diabetic than in non-diabetic patients. Thus, screening is an integral component of risk-reduction strategies for such patients. The available non-invasive testing options include exercise tolerance testing (ETT), stress echocardiography, and stress myocardial perfusion imaging (MPI) with or without gated single-photon emission computed tomography (SPECT). Calcium scoring with electron beam computed tomography (EBCT) and magnetic resonance imaging (MRI) are promising techniques, requiring further validation. Stress MPI with gated SPECT enables assessment of myocardial ischaemia, viability, and function, and allows for risk stratification to improve clinical management in diabetic patients.