How important is screening angiography for CAS in diabetic patients awaiting transplant? A cardiologist's view
Michael E Farkouh
Correspondence Cardiovascular Institute, Mount Sinai School of Medicine, One Gustave L Levy Place, Box 1074, New York, NY 10029, USA
Email michael.farkouh@mssm.edu
This article has no abstract so we have provided the first paragraph of the full text.
Despite strong evidence supporting routine screening for coronary heart disease (CHD) in renal transplant candidates, the pretransplant evaluation of patients with end-stage renal disease remains a challenge. Diabetic patients being evaluated for renal or renal–pancreatic transplantation are likely to be asymptomatic,1 but with typically a more than 20-year history of diabetes by the time they require transplantation. These patients have about a 50% likelihood of also having severe CHD. There is, however, a paucity of randomized trial evidence demonstrating that revascularization strategies in these asymptomatic patients are superior to contemporary aggressive medical management alone. Hence, the most effective strategy to evaluate these patients has remained elusive.
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