Screen testing - Cardiovascular prevention in asymptomatic diabetic patients

It has recently been proposed that asymptomatic diabetic patients undergo routine screening for subclinical atherosclerotic disease using myocardial perfusion scintigraphy. We herein analyze the expected cost and benefit associated with such a conditional test-treatment strategy (scintigraphic testing followed by statin treatment in positive test responders) in comparison to an unconditional treatment strategy (no testing and statin treatment in all). This analysis shows that unconditional treatment is the dominant strategy, costing 24% less ($3.2 billion) and preventing 25% more (16,800) atherosclerotic events annually on a national basis. (J Am Coll Cardiol 2007;49:1915-7) (C) 2007 by the American College of Cardiology Foundation