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Diabetes: prognostic value of CT coronary angiography--comparison with a nondiabetic population

Jacob M Van Werkhoven1, Filippo Cademartiri, Sara Seitun

  • 1Departments of Cardiology and Radiology, Leiden University Medical Center, Leiden, the Netherlands.

Radiology
|June 25, 2010
PubMed

Insights

Multidetector CT coronary angiography effectively predicts cardiac events in patients with and without diabetes. Absence of coronary artery disease on CT angiography indicates an excellent prognosis for both groups.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Preventive Cardiology

Background:

  • Coronary artery disease (CAD) poses a significant risk, particularly in individuals with diabetes mellitus (DM).
  • Accurate risk stratification is crucial for managing patients with suspected or known CAD.

Purpose of the Study:

  • To assess the prognostic capability of multidetector computed tomographic (CT) coronary angiography in diabetic patients compared to non-diabetic individuals.
  • To determine if CT coronary angiography improves risk stratification in diabetic populations.

Main Methods:

  • 313 patients with type 2 DM and 303 without DM underwent 64-detector row CT coronary angiography.
  • CT angiograms were categorized by the presence and severity of CAD (normal, nonobstructive, or obstructive).
  • Major adverse cardiac events and total events were tracked during a mean 20-month follow-up.

Main Results:

  • Patients with DM had a higher prevalence of obstructive CAD (51% vs. 37%) and more diseased segments.
  • Diabetes mellitus and obstructive CAD were independent predictors of adverse outcomes.
  • The event rate was 0% in patients without obstructive CAD, regardless of DM status.
  • Patients with obstructive CAD had higher event rates (36% without DM, 47% with DM).

Conclusions:

  • Multidetector CT coronary angiography provides valuable prognostic information beyond clinical variables for both diabetic and non-diabetic patients.
  • The absence of atherosclerosis on CT coronary angiography signifies an excellent prognosis.
  • CT coronary angiography is a potentially useful tool for enhancing risk stratification in diverse patient groups.
Abstract

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