Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0240-6 · Published: September 18, 2019
The authors express concern that several central recommendations in the 2018 Guideline for the Identification and Management of Cardiometabolic Risk after Spinal Cord Injury (SCI) have been offered prematurely. They argue that in some instances, the guideline inappropriately applies data from studies of people without SCI to support SCI-specific suggestions. The authors also question the recommendation to employ tests whose usefulness and clinical relevance have yet to be demonstrated among people living with injuries.
The lack of data underpinning several of the guideline's central recommendations underscores the inadequacy of research in this area and provides a roadmap for future investigative efforts.
Prior to adopting the current guideline, it is important to answer questions regarding the clinical significance of postprandial glucose spikes and which screening tests best correlate with vascular complications.
Given the uncertainty over which screening tests and pharmacological interventions may help reduce CV morbidity and mortality among people with SCI, further research is needed to determine the effectiveness of statin therapy and identify tests that can predict atherosclerotic disease.