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Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries.
Diabetes Care. 2013 Jul; 36(7):1834-41.DC

Abstract

OBJECTIVE

To assess the prognostic role of multidetector computed tomography coronary angiography (MDCT-CA) in patients with diabetes with suspected coronary artery disease (CAD). Use of MDCT-CA is increasing in patients with suspected CAD. However, data supporting its prognostic value in patients with diabetes are limited.

RESEARCH DESIGN AND METHODS

Between January 2006 and September 2007, 429 consecutive diabetic patients were prospectively studied with MDCT-CA for detecting the presence and assessing the extent of CAD (disease extension and coronary plaque scores). Patients were classified according to the presence of normal coronary arteries and nonobstructive (<50%) and obstructive (≥50%) coronary lesions. The composite rates of hard cardiac events (cardiac death, nonfatal myocardial infarction, unstable angina) and all cardiac events (including revascularization) were the end points of the study.

RESULTS

Twenty-four patients were excluded because MDCT-CA data were not able to be interpreted. Of the remaining 405 patients, clinical follow-up (mean 62 ± 9 months) was obtained in 390 (98%). Multivariate analysis showed that predictors of hard and all events were obstructive CAD, three-vessel CAD, and left main coronary artery (LMCA) disease. Cumulative event-free survival was 100% for hard and all events in patients with normal coronary arteries, 78% for hard events and 56% for all events in patients with nonobstructive CAD, and 60% for hard events and 16% for all events in patients with obstructive CAD. Three-vessel CAD and LMCA disease were associated with a higher rate of hard cardiac events.

CONCLUSIONS

MDCT-CA provides long-term prognostic information for patients with diabetes with suspected CAD, showing excellent prognosis when there is no evidence of atherosclerosis and allowing risk stratification when CAD is present.

Authors+Show Affiliations

Centro Cardiologico Monzino, Istituto Di Ricovero e Cura a Carattere Scientifico, Milan, Italy. daniele.andreini@ccfm.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23801796

Citation

Andreini, Daniele, et al. "Prognostic Value of Multidetector Computed Tomography Coronary Angiography in Diabetes: Excellent Long-term Prognosis in Patients With Normal Coronary Arteries." Diabetes Care, vol. 36, no. 7, 2013, pp. 1834-41.
Andreini D, Pontone G, Mushtaq S, et al. Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries. Diabetes Care. 2013;36(7):1834-41.
Andreini, D., Pontone, G., Mushtaq, S., Bertella, E., Conte, E., Baggiano, A., Veglia, F., Agostoni, P., Annoni, A., Formenti, A., Montorsi, P., Ballerini, G., Bartorelli, A. L., Fiorentini, C., & Pepi, M. (2013). Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries. Diabetes Care, 36(7), 1834-41. https://doi.org/10.2337/dc12-2123
Andreini D, et al. Prognostic Value of Multidetector Computed Tomography Coronary Angiography in Diabetes: Excellent Long-term Prognosis in Patients With Normal Coronary Arteries. Diabetes Care. 2013;36(7):1834-41. PubMed PMID: 23801796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries. AU - Andreini,Daniele, AU - Pontone,Gianluca, AU - Mushtaq,Saima, AU - Bertella,Erika, AU - Conte,Edoardo, AU - Baggiano,Andrea, AU - Veglia,Fabrizio, AU - Agostoni,Piergiuseppe, AU - Annoni,Andrea, AU - Formenti,Alberto, AU - Montorsi,Piero, AU - Ballerini,Giovanni, AU - Bartorelli,Antonio L, AU - Fiorentini,Cesare, AU - Pepi,Mauro, PY - 2013/6/27/entrez PY - 2013/6/27/pubmed PY - 2014/2/4/medline SP - 1834 EP - 41 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 7 N2 - OBJECTIVE: To assess the prognostic role of multidetector computed tomography coronary angiography (MDCT-CA) in patients with diabetes with suspected coronary artery disease (CAD). Use of MDCT-CA is increasing in patients with suspected CAD. However, data supporting its prognostic value in patients with diabetes are limited. RESEARCH DESIGN AND METHODS: Between January 2006 and September 2007, 429 consecutive diabetic patients were prospectively studied with MDCT-CA for detecting the presence and assessing the extent of CAD (disease extension and coronary plaque scores). Patients were classified according to the presence of normal coronary arteries and nonobstructive (<50%) and obstructive (≥50%) coronary lesions. The composite rates of hard cardiac events (cardiac death, nonfatal myocardial infarction, unstable angina) and all cardiac events (including revascularization) were the end points of the study. RESULTS: Twenty-four patients were excluded because MDCT-CA data were not able to be interpreted. Of the remaining 405 patients, clinical follow-up (mean 62 ± 9 months) was obtained in 390 (98%). Multivariate analysis showed that predictors of hard and all events were obstructive CAD, three-vessel CAD, and left main coronary artery (LMCA) disease. Cumulative event-free survival was 100% for hard and all events in patients with normal coronary arteries, 78% for hard events and 56% for all events in patients with nonobstructive CAD, and 60% for hard events and 16% for all events in patients with obstructive CAD. Three-vessel CAD and LMCA disease were associated with a higher rate of hard cardiac events. CONCLUSIONS: MDCT-CA provides long-term prognostic information for patients with diabetes with suspected CAD, showing excellent prognosis when there is no evidence of atherosclerosis and allowing risk stratification when CAD is present. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/23801796/Prognostic_value_of_multidetector_computed_tomography_coronary_angiography_in_diabetes:_excellent_long_term_prognosis_in_patients_with_normal_coronary_arteries_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=23801796 DB - PRIME DP - Unbound Medicine ER -