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Patients with diabetes are twice as likely to have heart disease, which makes screening crucial. Risk factors for ASCVD and HF should be assessed annually, with the 10-year risk of of a first ASCVD event used to guide interventions.
- • Use a prognostic tool such as the ASCVD Risk Calculator to determine 10-year risk.
- • Testing is indicated for typical/atypical chest pain, signs/symptoms of other vascular disease, or an abnormal ECG.
- • Exercise testing with/without echocardiography is the recommended initial test. Pharmacologic stress echo or nuclear imaging is indicated for those who are unable to exercise or have significant resting ECG abnormalities.
- • Routine screening for ASCVD with CT calcium scores/CT angiography in asymptomatic high risk patients is not recommended as it would not change management. CT Calcium scoring is indicated for CV risk assessment in asymptomatic adults =40 years of age at intermediate risk (7.5 to 19.9 percent 10-year ASCVD risk) by the American College of Cardiology/American Heart Association (ACC/AHA) pooled cohort risk calculators [1].
[1] 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
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