Tags

Type your tag names separated by a space and hit enter

Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus.
Am J Cardiol. 2016 Mar 15; 117(6):887-93.AJ

Abstract

Aspirin use for primary prevention in patients at high risk with diabetes mellitus (DM) is often recommended under the assumption that most patients with DM have coronary artery disease (CAD). However, not all patients may have CAD. The present study evaluated, in 425 patients at high risk with DM (without chest pain syndrome or a history of cardiac disease), the prevalence of CAD on coronary computed tomography angiography (CTA). Moreover, the association between the presence and number of traditional cardiovascular (CV) risk factors and CAD (on coronary CTA) was evaluated. The median coronary artery calcium score was 29 (interquartile range 0 to 298). On coronary CTA, 116 patients (27%) had no CAD (defined as <30% stenosis). Of the 309 patients (73%) with any CAD (≥30% stenosis), 35% had obstructive CAD (≥50% stenosis). The number of traditional CV risk factors was not associated with the presence of any CAD (≥30% stenosis; p = 0.18) or obstructive CAD (≥50% stenosis; p = 0.13). Hypertension was the only traditional CV risk factor associated with a higher frequency of any CAD (≥30% stenosis; odds ratio = 2.21, 95% CI 1.43 to 3.41, p <0.001) and obstructive CAD (≥50% stenosis; odds ratio 2.03, 95% CI 1.33 to 3.11, p = 0.001). In conclusion, in patients at high risk with DM without chest pain syndrome, any CAD was ruled out by coronary CTA in 27%, whereas 65% of the patients did not have obstructive CAD. The number of CV risk factors was not associated with the presence of CAD. Hypertension was the only traditional CV risk factor that was associated with a higher frequency of CAD. These observations support potential use of coronary CTA to tailor aspirin therapy in patients at high risk with DM.

Authors+Show Affiliations

Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.c.dimitriu-leen@lumc.nl.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Internal Medicine, Medical Center Haaglanden, The Hague, The Netherlands; Division of Endocrinology, Department of Medicine, Leiden University Medical Center, The Netherlands.Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.Turku Positron Emission Tomography Centre, Turku University Hospital, University of Turku, Turku, Finland.Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26803383

Citation

Dimitriu-Leen, Aukelien C., et al. "Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus." The American Journal of Cardiology, vol. 117, no. 6, 2016, pp. 887-93.
Dimitriu-Leen AC, Scholte AJ, van Rosendael AR, et al. Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus. Am J Cardiol. 2016;117(6):887-93.
Dimitriu-Leen, A. C., Scholte, A. J., van Rosendael, A. R., van den Hoogen, I. J., Kharagjitsingh, A. V., Wolterbeek, R., Knuuti, J., Kroft, L. J., Delgado, V., Jukema, J. W., de Graaf, M. A., & Bax, J. J. (2016). Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus. The American Journal of Cardiology, 117(6), 887-93. https://doi.org/10.1016/j.amjcard.2015.12.023
Dimitriu-Leen AC, et al. Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus. Am J Cardiol. 2016 Mar 15;117(6):887-93. PubMed PMID: 26803383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Value of Coronary Computed Tomography Angiography in Tailoring Aspirin Therapy for Primary Prevention of Atherosclerotic Events in Patients at High Risk With Diabetes Mellitus. AU - Dimitriu-Leen,Aukelien C, AU - Scholte,Arthur J H A, AU - van Rosendael,Alexander R, AU - van den Hoogen,Inge J, AU - Kharagjitsingh,Aantje V, AU - Wolterbeek,Ron, AU - Knuuti,Juhani, AU - Kroft,Lucia J M, AU - Delgado,Victoria, AU - Jukema,J Wouter, AU - de Graaf,Michiel A, AU - Bax,Jeroen J, Y1 - 2015/12/30/ PY - 2015/11/03/received PY - 2015/12/16/revised PY - 2015/12/16/accepted PY - 2016/1/25/entrez PY - 2016/1/25/pubmed PY - 2016/7/12/medline SP - 887 EP - 93 JF - The American journal of cardiology JO - Am J Cardiol VL - 117 IS - 6 N2 - Aspirin use for primary prevention in patients at high risk with diabetes mellitus (DM) is often recommended under the assumption that most patients with DM have coronary artery disease (CAD). However, not all patients may have CAD. The present study evaluated, in 425 patients at high risk with DM (without chest pain syndrome or a history of cardiac disease), the prevalence of CAD on coronary computed tomography angiography (CTA). Moreover, the association between the presence and number of traditional cardiovascular (CV) risk factors and CAD (on coronary CTA) was evaluated. The median coronary artery calcium score was 29 (interquartile range 0 to 298). On coronary CTA, 116 patients (27%) had no CAD (defined as <30% stenosis). Of the 309 patients (73%) with any CAD (≥30% stenosis), 35% had obstructive CAD (≥50% stenosis). The number of traditional CV risk factors was not associated with the presence of any CAD (≥30% stenosis; p = 0.18) or obstructive CAD (≥50% stenosis; p = 0.13). Hypertension was the only traditional CV risk factor associated with a higher frequency of any CAD (≥30% stenosis; odds ratio = 2.21, 95% CI 1.43 to 3.41, p <0.001) and obstructive CAD (≥50% stenosis; odds ratio 2.03, 95% CI 1.33 to 3.11, p = 0.001). In conclusion, in patients at high risk with DM without chest pain syndrome, any CAD was ruled out by coronary CTA in 27%, whereas 65% of the patients did not have obstructive CAD. The number of CV risk factors was not associated with the presence of CAD. Hypertension was the only traditional CV risk factor that was associated with a higher frequency of CAD. These observations support potential use of coronary CTA to tailor aspirin therapy in patients at high risk with DM. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/26803383/Value_of_Coronary_Computed_Tomography_Angiography_in_Tailoring_Aspirin_Therapy_for_Primary_Prevention_of_Atherosclerotic_Events_in_Patients_at_High_Risk_With_Diabetes_Mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(15)30068-0 DB - PRIME DP - Unbound Medicine ER -