OBJECTIVE: Ischemic heart disease is a pivotal complication for diabetic patients. Electron-beam computed tomography (EBCT) represents the only noninvasive method that allows for accurate quantification of coronary artery calcification that reflects underlying atherosclerotic disease. Although coronary calcium score (CCS) cut points that predict the presence of angiographic stenosis have been established in nondiabetic individuals, it is not known whether coronary calcifications in diabetic patients are associated with the presence of significant coronary stenoses. In this study, we evaluated the relationship between coronary calcifications and angiographic stenosis in symptomatic patients with or without type 2 diabetes. RESEARCH DESIGN AND METHODS: In this study, 282 patients (204 men and 78 women) with chest pain, including 101 diabetic patients and 181 nondiabetic patients (mean age 63 +/- 9.6 years), underwent coronary angiography and EBCT with determination of CCS using Agatston's method. Luminal stenosis >or= 50% was defined as significant coronary stenosis. RESULTS: Angiography identified 205 patients with significant stenoses (89 of 101 diabetic patients, 114 of 181 nondiabetic patients). The sensitivity and specificity of EBCT to detect significant coronary stenosis were not significantly different between diabetic and nondiabetic patients. In diabetic patients, a CCS >or=90 was associated with 75% sensitivity and 75% specificity, whereas a CCS >or=200 was associated with 64% sensitivity and 83% specificity. CONCLUSIONS: We demonstrated that calcification of the coronary arteries in symptomatic diabetic patients is well associated with severity of coronary stenosis, as in nondiabetic patients.
OBJECTIVE: Ischemic heart disease is a pivotal complication for diabeticpatients. Electron-beam computed tomography (EBCT) represents the only noninvasive method that allows for accurate quantification of coronary artery calcification that reflects underlying atherosclerotic disease. Although coronary calcium score (CCS) cut points that predict the presence of angiographic stenosis have been established in nondiabetic individuals, it is not known whether coronary calcifications in diabeticpatients are associated with the presence of significant coronary stenoses. In this study, we evaluated the relationship between coronary calcifications and angiographic stenosis in symptomatic patients with or without type 2 diabetes. RESEARCH DESIGN AND METHODS: In this study, 282 patients (204 men and 78 women) with chest pain, including 101 diabeticpatients and 181 nondiabeticpatients (mean age 63 +/- 9.6 years), underwent coronary angiography and EBCT with determination of CCS using Agatston's method. Luminal stenosis >or= 50% was defined as significant coronary stenosis. RESULTS: Angiography identified 205 patients with significant stenoses (89 of 101 diabeticpatients, 114 of 181 nondiabeticpatients). The sensitivity and specificity of EBCT to detect significant coronary stenosis were not significantly different between diabetic and nondiabeticpatients. In diabeticpatients, a CCS >or=90 was associated with 75% sensitivity and 75% specificity, whereas a CCS >or=200 was associated with 64% sensitivity and 83% specificity. CONCLUSIONS: We demonstrated that calcification of the coronary arteries in symptomatic diabeticpatients is well associated with severity of coronary stenosis, as in nondiabeticpatients.
Authors: Victor K Goh; Chu-Pak Lau; Stefan Mohlenkamp; John A Rumberger; Stephan Achenbach; Matthew J Budoff Journal: Cardiovasc Ultrasound Date: 2010-03-12 Impact factor: 2.062
Authors: Alisha N Wade; Sean Fedyna; Nehal N Mehta; Caitlin St Clair; Naeema Ginwala; Rama K Krishna; Atif N Qasim; Seth Braunstein; Nayyar Iqbal; Mark H Schutta; Muredach P Reilly Journal: Diabetes Res Clin Pract Date: 2010-11-09 Impact factor: 5.602
Authors: Susan Sam; Steven Haffner; Michael H Davidson; Ralph B D'Agostino; Steven Feinstein; George Kondos; Alfonso Perez; Theodore Mazzone Journal: Diabetes Care Date: 2009-07-10 Impact factor: 19.112