Comparison of Cardiac Events and Survival Between Asymptomatic Diabetic and Nondiabetic Patients: Coronary CT Study

Fig. 1. Study design. CACS = coronary artery calcium scores, CCTA = coronary computed tomography angiography, MDCT = multi-detector computed tomography, PCI = percutaneous coronary intervention, CABG = coronary artery bypass grafting, ESCORT = Evaluation of Subclinical Coronary atherosclerosis for Risk Stratification Using the Coronary Computed Tomography Angiography, T2DM = patients with type 2 diabetes mellitus, non-DM = patients without diabetes mellitus, CT = computed tomography, MI = myocardial infarction, MACE = major adverse cardiac events.

Fig. 2. Coronary computed tomography angiography imaging in a 48-year-old man with diabetes. (A) A curved multiplanar reconstructed image of the LAD reveals an obstructive stenosis of 60% stenosis in the proximal LAD (arrows), with a high-risk plaque characterized by LAP of less than 30 HU and positive remodeling. (B) The short-axis image more clearly demonstrates the concentric luminal narrowing of the LAD surrounding the LAP with positive remodeling (arrows). (C) A magnified short-axis image with region of interest measurement confirms LAP, with a mean attenuation of 3.50 HU. LAD = left anterior descending coronary artery, LAP = low-attenuation plaque, HU = Hounsfield Units.

Fig. 3. Distribution of cardiac events. The prevalence of MACE and TCE was significantly higher in T2DMs than in non-DMs (all P < 0.05). MACE = major adverse cardiac events, TCE = total cardiac events, T2DMs = patients with type 2 diabetes mellitus, non-DMs = patients without diabetes mellitus, MI = myocardial infarction, UA = unstable angina. *P < 0.05.

Fig. 4. Kaplan–Meier survival curve according to the grade of coronary stenosis and the presence or absence of T2DM. The cumulative survival rates for MACE (A) and TCE (B) were inversely related to the degree of stenosis. Adding T2DM significantly affected survival rates in patients with obstructive stenosis (P < 0.05), but not in those with non-obstructive or no stenosis. Obstructive stenosis with T2DM showed the lowest survival, followed by obstructive stenosis without T2DM, and non-obstructive stenosis with or without T2DM; no stenosis had the highest survival, irrespective of T2DM. T2DM = type 2 diabetes mellitus, MACE = major adverse cardiac events, TCE = total cardiac events.