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Park, Gyung-Min, MD; Lee, Seung-Whan, MD; Cho, Young-Rak, MD; Kim, Chan Joon, MD; Cho, Jung Sun, MD; Park, Mahn-Won, MD; Her, Sung Ho, MD; Ahn, Jung-Min, MD; Lee, Jong-Young, MD; Park, Duk-Woo, MD; Kang, Soo-Jin, MD; Kim, Young-Hak, MD; Lee, Cheol Whan, MD; Koh, Eun Hee, MD; Lee, Woo Je, MD; Kim, Min-Seon, MD; Lee, Ki-Up, MD; Kang, Joon-Won, MD; Lim, Tae-Hwan, MD; Park, Seong-Wook, MD; Park, Seung-Jung, MD; Park, Joong-Yeol, MD
The American journal of cardiology, 03/2014, Letnik: 113, Številka: 5Journal Article
There are limited data regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic patients with type 2 diabetes mellitus. We analyzed 557 asymptomatic type 2 diabetic patients who underwent CCTA. Cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome requiring hospitalization, or late revascularization. Atherosclerotic plaques were observed in 395 patients (70.9%), and 170 patients (30.5%) showed significant coronary artery disease (CAD) on CCTA. Ninety-two patients (16.5%) were associated with a significant stenosis in the left main or proximal left anterior descending artery. During the follow-up period (33.7 ± 7.8 months), although an excellent prognosis was observed in patients without significant CAD on CCTA, those with significant CAD showed more cardiac events (7.1% vs 0.5%) and lower 3-year event-free survival rates (99.2 ± 0.6% vs 90.9 ± 2.6%, p <0.001). Furthermore, in group with significant CAD, patients with significant CAD in the left main or proximal left anterior descending artery had more cardiac events (10.9% vs 2.6%) and lower 3-year event-free survival rates (97.4 ± 1.8% vs 86.1 ± 4.2%, p = 0.049). On multivariate analysis, family history of premature CAD, previous history of stroke, higher UK Prospective Diabetes Study 10-year risk scores, neuropathy, and retinopathy were independent clinical predictors of having significant CAD and left main or proximal left anterior descending artery significant CAD on CCTA. In conclusion, about 1/3 of asymptomatic type 2 diabetic patients had significant CAD on CCTA with a subsequent high risk for cardiac events. These findings suggest that CCTA may have a potential role in identifying patients with high cardiovascular risks in asymptomatic type 2 diabetes.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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