Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus
Key result
Type-2 diabetes mellitus was independently associated with a significantly higher prevalence of obstructive coronary artery disease (37% vs 18%, OR 2.44) compared to nondiabetic patients.
Why the study?
Does type-2 diabetes increase coronary atherosclerotic burden as assessed by CTCA in patients without a history of CAD?
Population
1,126 patients without a history of coronary artery disease, comprising 147 with type-2 diabetes and 979…
Comparison
CT Coronary Angiography and Coronary calcium… vs CTCA and CCS in patients without diabetes
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Supports greater CAD burden on CTCA in diabetics; leaves open whether screening alters outcomes.
Study Design
Type
Cross-Sectional (n=1,126)
Blinding
Single-blind
Multicenter
No
Structured PICO
Does type-2 diabetes increase coronary atherosclerotic burden as assessed by CTCA in patients without a history of CAD?
P
Population
1,126 patients (mean age 61.4 years, 42% female) with suspected coronary artery disease but no prior history of CAD who underwent CT coronary angiography.
E
Exposure
CT Coronary Angiography (CTCA) and Coronary calcium scoring (CCS) in patients with type-2 diabetes
C
Comparator
CTCA and CCS in patients without diabetes
O
Outcome
Coronary atherosclerotic burden (per-patient number of diseased coronary segments, presence of obstructive lesions >50%, and coronary calcium score)surrogate
Main Result
Odds Ratio: 2.44 (95% CI 1.62–3.68)
Absolute Event Rate: 37% vs 18%
p-value: p=<0.0001
Type-2 diabetes is associated with a significantly higher coronary plaque burden, and the absence of coronary calcification does not reliably exclude obstructive CAD in diabetic patients.
Limitations
- Registry data with potential patient selection bias
- CTCA findings were not routinely confirmed by invasive coronary angiography or intra-coronary imaging techniques
- Detailed information concerning metabolic control, secondary organ damage, or autonomic dysfunction was unavailable
- Plaque morphology and composition were not evaluated
Cite This Study
Maffei et al. (2010) conducted a cross-sectional in Suspected coronary artery disease (n=1,126). Type-2 diabetes mellitus vs. Nondiabetic patients was evaluated on Obstructive coronary artery disease (>50% luminal narrowing) (OR 2.44, 95% CI 1.62-3.68, p=<0.0001). Type-2 diabetes mellitus was independently associated with a significantly higher prevalence of obstructive coronary artery disease (37% vs 18%, OR 2.44) compared to nondiabetic patients.