Why the study?
Rapid management of diabetic patients presenting to the emergency department with chest pain is important, leading researchers to evaluate computed tomography coronary angiography for predicting CAD in type-2 diabetics with typical chest pain and normal initial cardiac investigations.
Does multislice computed tomography-coronary angiography accurately predict coronary artery disease in type-2 diabetic patients presenting with typical chest pain and normal initial investigations?
Does multislice computed tomography-coronary angiography accurately predict coronary artery disease in type-2 diabetic patients presenting with typical chest pain and normal initial investigations?
Early CT coronary angiography is highly specific and accurate for predicting coronary artery disease in diabetic patients presenting to the emergency department with chest pain.
May aid ED risk stratification in diabetics; leaves open need for validation before any practice change.
Background and aim Diabetes mellitus is a metabolic disorder affecting a wide range of the population all over the world. Microvascular and macrovascular complications are very common in diabetic patients with high incidence of affection of the coronary arteries. Rapid and efficient management in cases (especially diabetics) complaining of chest pain at the emergency department is a matter of great importance to decrease the incidence of subsequent complications. Our aim was to predict coronary artery diseases in type-2 diabetic patients with typical chest pain with normal initial cardiac investigations at the emergency room by using computed tomography (CT) coronary angiography. Patients and methods A total number of 100 patients were included in this study and classified into two groups: 80 patients with diabetes mellitus (group A) and 20 nondiabetic patients (group B) presented with chest pain. Complete history was taken from the cases with performing of complete physical examination, and routine laboratory and radiological investigations. Additionally, echocardiography and multislice CT-coronary angiography (coronary computed tomography angiography) were done for all cases. Also, calcium score was calculated. Results CT angiography revealed affection in 19 (23.8%) cases of the cases in group A with no affected cases in group B with a statistically significant difference between the two groups. There was a high statistically significant agreement between the findings of the CT angiography and coronary angiography results ( P <0.001). CT angiography had sensitivity of 70.37%, specificity of 100%, positive predictive value 100%, negative predictive value 86.89%, and accuracy of 90%. Conclusion An early coronary computed tomography angiography strategy has revealed high sensitivity in prediction of coronary artery disease affection as compared with ordinary coronary angiography in cases presented with chest pain to emergency department.
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Habour et al. (2022) studied this question.
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