Recent Advances in Diagnosis of Coronary Artery Disease in Diabetes

With better control of infective and metabolic complications, diabetes has emerged as a cardiovascular disease. The ATP III recognizes it as a CHD equivalent and the American Diabetes Association has categorized it as a cardiovascular disease. Unlike microvascular disease, which gets clicked with onset of diabetes, macrovascular disease, particularly coronary artery disease (CAD) predates the diagnosis of diabetes by several years. The mortality of diabetic infarct is very high compared to a nondiabetic infarct. The diagnosis of CAD in diabetic should be made at the earliest preferably in prediabetic state to minimize the high morbidity and mortality associated with it. The diagnosis of CAD with stable plaques with hemodynamically stenosis is simple but documentation of vulnerable plaque, the dangerous subset of CAD with high propensity to develop an acute coronary syndrome, still poses a very challenging problem.