Riccardo Marano1, Dario Pitocco2, Enrico Di Stasio3, Giancarlo Savino4, Biagio Merlino4, Carlo Trani5, Federica Pirro4, Claudia Rutigliano4, Carolina Santangelo4, Aurelian Costin Minoiu4, Luigi Natale4, Lorenzo Bonomo4. 1. Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy. riccardo.marano@rm.unicatt.it. 2. Department of Internal Medicine, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy. 3. Department of Clinical Biochemistry, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy. 4. Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy. 5. Department of Cardiovascular Medicine - Institute of Cardiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
Abstract
OBJECTIVES: To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). METHODS: Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. RESULTS: CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87%. CONCLUSIONS: These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. KEY POINTS: Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.
OBJECTIVES: To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabeticpatients with and without Charcot-neuroarthropathy (CN). METHODS: Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. RESULTS: CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87%. CONCLUSIONS: These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabeticpatients with autonomic-neuropathy. KEY POINTS: Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.
Authors: O Gaddi; G Tortorella; E Picano; M Pantaleoni; E Manicardi; A Varga; I Moneta; U Guiducci Journal: Diabet Med Date: 1999-09 Impact factor: 4.359
Authors: H C Gerstein; J F Mann; Q Yi; B Zinman; S F Dinneen; B Hoogwerf; J P Hallé; J Young; A Rashkow; C Joyce; S Nawaz; S Yusuf Journal: JAMA Date: 2001-07-25 Impact factor: 56.272
Authors: J l Ritchie; T M Bateman; R O Bonow; M H Crawford; R J Gibbons; R J Hall; R A O'Rourke; A F Parisi; M S Verani Journal: Circulation Date: 1995-02-15 Impact factor: 29.690