PHILADELPHIA — In this Endocrine Today video perspective, Michael H. Davidson, MD, professor and director of preventive cardiology at the University of Chicago Pritzker School of Medicine, and Matthew J. Budoff, MD, professor of medicine at David Geffen School of Medicine at UCLA, debate whether biomarkers or imaging are a better predictor of cardiovascular risk in patients with diabetes.
Davidson, who was tasked with proving that biomarkers are the better option, told Endocrine Today: “It's not that they're better at risk prediction, per se, because I don't think anything really trumps coronary calcium. However, what biomarkers provide is a better utilization of how to address residual risk in the diabetic patient population because LDL cholesterol is not a good risk predictor of targeting therapy.”
Budoff who argued in defense of imaging said physicians still must do some risk stratification.
“Coronary calcium provides us with a robust way of identifying the diabetic patient at risk,” he said. “We can intensify therapy and, maybe, improve adherence at the same time, which I think is still a problem, especially in the diabetic patient who has not two or three, but maybe seven or eight medicines to take every day, and that gets more and more complex with each passing year and each new drug that's demonstrated to be beneficial.”