TY - JOUR
T1 - Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk
AU - Nasti, Rodolfo
AU - Carbonara, Ornella
AU - Di Santo Stefano, Maria L.Mangoni
AU - Auriemma, Roberta
AU - Esposito, Sabato
AU - Picardi, Giuseppe
AU - Lascar, Nadia
AU - Pagano, Antonio
AU - Ruggiero, Roberto
AU - Torella, Roberto
AU - Sasso, Ferdinando C.
N1 - Funding Information:
Grant from Italian Ministry of University and Research (PRIN).
PY - 2012/1
Y1 - 2012/1
N2 - Objective: Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography. Methods: In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥50% lumen narrowing), patients were sent to conventional coronary angiography (CCA).Results: Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥75% and were submitted to the revascularisation procedure.Conclusion: MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy.
AB - Objective: Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography. Methods: In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥50% lumen narrowing), patients were sent to conventional coronary angiography (CCA).Results: Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥75% and were submitted to the revascularisation procedure.Conclusion: MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy.
KW - CAD
KW - diabetes
KW - imaging
KW - nephropathy
UR - http://www.scopus.com/inward/record.url?scp=83455172642&partnerID=8YFLogxK
UR - https://journals.sagepub.com/doi/10.1177/1479164111426439
U2 - 10.1177/1479164111426439
DO - 10.1177/1479164111426439
M3 - Article
C2 - 22064696
AN - SCOPUS:83455172642
SN - 1479-1641
VL - 9
SP - 10
EP - 17
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
IS - 1
ER -