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In Reply As Dr Potier and colleagues note, a major difference between FACTOR-64 and the DIAD study1 was that FACTOR-64 provided recommendations for potentially more aggressive medical and procedural management of the care of asymptomatic patients with diabetes who were found at screening to have evidence of atherosclerotic CAD. It was believed that for screening to be helpful, it must result in some change in treatment that may provide clinical benefit to the patient. When designing FACTOR-64, our goal was to provide recommendations that were as aggressive as safely possible and also more aggressive than was already recommended for patients with diabetes.
Muhlestein JB, Lappe DL, Anderson JL. Coronary Artery Disease Screening Using Coronary Computed Tomography Angiography—Reply. JAMA. 2015;313(12):1267-1268. doi:10.1001/jama.2015.1435