Jin-Jin Kim1, Byung-Hee Hwang1, Ik Jun Choi2, Eun-Ho Choo3, Sungmin Lim4, Jae-Kyung Kim3, Yoon-Seok Koh5, Dong-Bin Kim1, Sung-Won Jang1, Eun Joo Cho1, Jong Min Lee3, Pum-Joon Kim5, Jae-Hyoung Cho6, Jung Im Jung7, Ki-Bae Seung5, James K Min8, Kiyuk Chang9. 1. Cardiovascular Center and Cardiology Division, St Paul's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. 2. Cardiovascular Center and Cardiology Division, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea. 3. Cardiovascular Center and Cardiology Division, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea. 4. Cardiovascular Center and Cardiology Division, Bucheon St Mary's Hospital, The Catholic University of Korea, Bucheon, Republic of Korea. 5. Cardiovascular Center and Cardiology Division, Seoul St Mary's Hospital, The Catholic University of Korea, 505 Banpodong, Seochogu, Seoul 137-701, Republic of Korea. 6. Division of Endocrinology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. 7. Department of Radiology, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. 8. Department of Radiology, Weill Cornell Medical College and the New York Presbyterian Hospital, New York, NY, USA. 9. Cardiovascular Center and Cardiology Division, Seoul St Mary's Hospital, The Catholic University of Korea, 505 Banpodong, Seochogu, Seoul 137-701, Republic of Korea kiyuk@catholic.ac.kr.
Abstract
AIMS: We investigated the association between diabetes duration and the extent and severity of coronary artery disease (CAD) as well as long-term clinical outcomes using coronary computed tomography angiography (CCTA) in asymptomatic type 2 diabetic patients. METHODS AND RESULTS: We analysed 933 asymptomatic type 2 diabetic patients without known CAD who underwent CCTA. Patients were divided into three groups according to the duration of diabetes: <5 years, 5-10 years, and ≥10 years. Stenosis by CCTA was scored as none (0%), non-obstructive (1-49%), or obstructive (≥50%) for each coronary artery segment. For these patients, we compared the prevalence, extent, and severity of CAD, including coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS), and segment stenosis score (SSS). Major adverse cardiac and cerebrovascular events (MACCE), including all-cause mortality, non-fatal myocardial infarction, and stroke, within a follow-up period were also compared.Patients with longer duration of diabetes possessed higher rates of obstructive CAD (P < 0.001). Patients with longer duration of diabetes also manifested greater degree of CACS, ABOS, SIS, and SSS (P < 0.001 for all) with associated higher rate of MACCE (P = 0.025). Presence of obstructive CAD as assessed by CCTA was an independent predictor of MACCE after adjusting for confounding risk factors (hazard ratio: 1.979, confidence interval: 1.178-3.327, P = 0.010). CONCLUSION: In asymptomatic diabetic patients, longer diabetes duration is associated with a higher prevalence, extent, and severity of CAD as well as risk of MACCE. Moreover, greater CAD burden increases the risk of MACCE independent of co-existing CAD risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: We investigated the association between diabetes duration and the extent and severity of coronary artery disease (CAD) as well as long-term clinical outcomes using coronary computed tomography angiography (CCTA) in asymptomatic type 2 diabeticpatients. METHODS AND RESULTS: We analysed 933 asymptomatic type 2 diabeticpatients without known CAD who underwent CCTA. Patients were divided into three groups according to the duration of diabetes: <5 years, 5-10 years, and ≥10 years. Stenosis by CCTA was scored as none (0%), non-obstructive (1-49%), or obstructive (≥50%) for each coronary artery segment. For these patients, we compared the prevalence, extent, and severity of CAD, including coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS), and segment stenosis score (SSS). Major adverse cardiac and cerebrovascular events (MACCE), including all-cause mortality, non-fatal myocardial infarction, and stroke, within a follow-up period were also compared.Patients with longer duration of diabetes possessed higher rates of obstructive CAD (P < 0.001). Patients with longer duration of diabetes also manifested greater degree of CACS, ABOS, SIS, and SSS (P < 0.001 for all) with associated higher rate of MACCE (P = 0.025). Presence of obstructive CAD as assessed by CCTA was an independent predictor of MACCE after adjusting for confounding risk factors (hazard ratio: 1.979, confidence interval: 1.178-3.327, P = 0.010). CONCLUSION: In asymptomatic diabeticpatients, longer diabetes duration is associated with a higher prevalence, extent, and severity of CAD as well as risk of MACCE. Moreover, greater CAD burden increases the risk of MACCE independent of co-existing CAD risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Jared P Reis; Norrina B Allen; Michael P Bancks; J Jeffrey Carr; Cora E Lewis; Joao A Lima; Jamal S Rana; Samuel S Gidding; Pamela J Schreiner Journal: Diabetes Care Date: 2018-01-09 Impact factor: 17.152
Authors: Andrea Igoren Guaricci; Delia De Santis; Mariangela Carbone; Giuseppe Muscogiuri; Marco Guglielmo; Andrea Baggiano; Gaetano Serviddio; Gianluca Pontone Journal: Biomed Res Int Date: 2018-01-15 Impact factor: 3.411