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A new study at Intermountain Medical Center's Heart Institute finds that less is more when it comes to diabetic patients.
It turns out that excellent diabetes management — diet, exercise, medication — is better than expensive heart screenings in the prevention of heart attacks, said Brent Muhlestein, director of cardiovascular research at the institute in Murray.
Muhlestein was the lead researcher of a study that looked into whether routine heart-imaging screenings could help diabetics avoid heart attacks or other serious heart problems.
"We were hoping to find that it did," he said from Chicago, where he delivered a report about the study Monday to the 2014 American Heart Association Scientific Sessions. Results also are being published in JAMA, the Journal of the American Medical Association.
Intermountain Healthcare's researchers are presenting 21 studies at the conference, the highest number of reports from any institution in the country, said spokesman Jess Gomez.
In the heart-screening study, IMC researchers randomly assigned 900 diabetic patients from various Intermountain Healthcare clinics to undergo screenings or pursue standard diabetes management through their regular physicians.
Among patients who were screened and found to have silent heart disease, aggressive treatment was recommended. Of those, 6 percent had stents installed to open clogged arteries and 3 percent had bypass surgery, Muhlestein said. There was a modest increase in the use of cholesterol-lowering statin drugs.
After four years of follow-up, however, the number of deaths, heart attacks and episodes of unstable angina did not differ significantly between those who were screened and those who were not. Of those screened, 6.2 percent had such problems, while 7.6 percent of the unscreened had them.
Those numbers were not statistically significant, although some of the individuals who were treated more aggressively benefited from the treatments, Muhlestein said.
Heart screenings, he said, are not cost effective. "We need a better way to identify those most at risk."
One wrench — a good wrench — was thrown into the study when Intermountain Healthcare began more aggressively treating its patients with diabetes throughout its system of hospitals and clinics, Muhlestein said. That may be one reason those who were not screened did as well as those who had heart screenings. Both groups did better than expected.
The change in patients' treatment began about the same time as the study started in 2007, he said.
Diabetes is the most important risk factor for heart disease and many patients with diabetes develop heart disease without any symptoms, according to an IMC news release. In fact, asymptomatic heart disease is the most common cause of death in patients with diabetes.
Twitter: @KristenMoulton