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Prognostic value of coronary CT angiography in diabetic patients: a 5-year follow up study

Jonathan Nadjiri1, Jörg Hausleiter2, Simon Deseive2

  • 1Institut für Radiologie und Nuklearmedizin, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, 80636, Munich, Germany. j.nadjiri@gmx.net.

The International Journal of Cardiovascular Imaging
|October 12, 2015
PubMed

Insights

Coronary computed tomography angiography (CCTA) effectively predicts cardiac events in diabetic patients with few symptoms. Segment involvement score (SIS) and segment stenosis score (SSS) from CCTA improve risk assessment for these high-risk individuals.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diabetology

Background:

  • Coronary artery disease (CAD) is highly prevalent in diabetic patients.
  • Early diagnosis of CAD in diabetic individuals presents significant challenges.
  • Coronary computed tomography angiography (CCTA) offers potential for risk stratification.

Purpose of the Study:

  • To evaluate the prognostic value of CCTA in predicting long-term cardiac events in oligosymptomatic diabetic patients.
  • To compare the predictive capabilities of CCTA-derived scores (CACS, SIS, SSS) against traditional risk scores.
  • To assess the incremental prognostic value of CCTA beyond established risk factors.

Main Methods:

  • A cohort study including 108 diabetic patients and 1379 non-diabetic controls.
  • All patients underwent CCTA for assessment of coronary artery disease.
  • Coronary artery calcium score (CACS), segment involvement score (SIS), and segment stenosis score (SSS) were documented.
  • Follow-up for a composite endpoint of cardiac events (death, myocardial infarction, unstable angina) over 66 months.

Main Results:

  • Diabetic patients had a higher annual cardiac event rate (1.74%) compared to non-diabetic patients (0.64%).
  • In diabetic patients, SIS and SSS demonstrated significant prognostic value over the Framingham Score (HR 2.98 and 4.47, respectively).
  • CACS did not add significant prognostic value in the diabetic cohort; patients with SIS=0 had 0% event rate, while SIS≥8 had 3.9%.

Conclusions:

  • CCTA, particularly SIS and SSS, significantly improves long-term cardiac event risk prediction in oligosymptomatic diabetic patients.
  • CCTA provides valuable prognostic information beyond traditional risk scores for this population.
  • CCTA can aid in identifying diabetic patients at higher risk for future cardiac events.

Keywords:
Coronary artery diseaseCoronary computed tomographic angiographyDiabetic patientsPlaque loadPrognostic value

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