Key result
In asymptomatic patients with type 2 diabetes, the presence of obstructive coronary artery disease on CTA was associated with a increased risk of cardiac events compared to normal coronary arteries.
Why the study?
The study was conducted to investigate the prognostic value of coronary CTA results for asymptomatic patients with CAD in type 2 diabetes mellitus.
Does coronary computed tomography angiography (CTA) predict long-term cardiac events in asymptomatic patients with type 2 diabetes mellitus?
Cohort (n=164)
No
Does coronary computed tomography angiography (CTA) predict long-term cardiac events in asymptomatic patients with type 2 diabetes mellitus?
Answers are grounded in this paper and cite their sources.
CTA may refine risk assessment in asymptomatic T2DM; hypothesis-generating and requires prospective trials before practice change.
The present study was performed to investigate the prognostic value of coronary computed tomography angiography (CTA) results for asymptomatic patients with coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM). A total of 164 asymptomatic patients with T2DM were enrolled at Weifang Traditional Chinese Hospital (Weifang, China). Coronary plaques and stenosis severity were evaluated after CTA. Structures >1 mm2 adjacent to or within the coronary artery lumen that could be clearly separated from the vessel lumen, was scored as a coronary plaque. Stenosis of ≥50% was considered as being obstructive. CAD was defined as the presence of any coronary plaque or a coronary artery calcium (CAC) score of >0. A CAC score of 0 and no coronary plaques was considered to indicate the absence of CAD. A 5‑year follow‑up was performed to determine the impact of the CTA findings and various clinicopathological characteristics on the prognosis of all participants. The primary end‑point was any cardiac event. Event‑free survival curves were plotted using the Kaplan‑Meier method and compared using the log‑rank test. Based on the coronary CTA results, the patients were classified into 3 groups according to the extent of stenosis: Normal coronary arteries, obstructive CAD and non‑obstructive CAD. Significant differences in 5‑year event‑free survival were identified among the groups with normal coronary arteries, non‑obstructive CAD and obstructive CAD (P=0.026). Further analysis indicated that the event‑free survival rate of patients with 1‑vessel CAD was 94.11%, that of patients with 2‑vessel CAD was 73.68% and that associated with 3‑vessel CAD was 61.54%. Multivariate Cox regression analysis revealed that non‑obstructive as well as obstructive CAD diagnosed by coronary CTA are prognostic indicators for asymptomatic T2DM patients [hazard ratio (HR)=11.132, 95% confidence interval (CI): 1.857‑66.742, P=0.008; HR=7.792, 95% CI: 1.750‑34.698, P=0.007, respectively]. In conclusion, the present study suggests that coronary CTA may predict the prognosis of asymptomatic patients with T2DM.
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Tian et al. (2019) conducted a cohort in Type 2 diabetes mellitus (asymptomatic for coronary artery disease) (n=164). Obstructive coronary artery disease on CTA vs. Normal coronary arteries (no CAD) was evaluated on Any cardiac event (composite of non-fatal myocardial infarction, unstable angina requiring hospitalization, cardiac death and late coronary revascularization) (HR 7.792, 95% CI 1.750-34.698, p=0.007). In asymptomatic patients with type 2 diabetes, the presence of obstructive coronary artery disease on CTA was associated with a increased risk of cardiac events compared to normal coronary arteries.
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