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Prognostic value of coronary CT angiography in diabetic patients: a 5-year follow up study

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Abstract

Prevalence of coronary artery disease (CAD) is high in diabetic patients while diagnosis of early stage of CAD remains demanding. This study evaluates prognostic value of coronary computed tomography angiography (CCTA) for long-term outcome to predict cardiac events in oligosymptomatic diabetic patients. A cohort of 108 consecutive diabetic patients without angina pectoris or known CAD, undergoing CCTA was included. 1379 consecutive patients without diabetes were defined as a control group. Coronary artery calcium score (CACS), segment involvement score (SIS) and the segment stenosis score (SSS) were documented. The end point was a composite of cardiac events defined as all-cause death, nonfatal myocardial infarction, or unstable angina requiring hospitalization. Follow up period was 66.0 ± 14.2 month. 98 % of initially enrolled patient were followed. During follow-up period 10 cardiac events within the diabetic cohort and 48 within the non-diabetic cohort were observed. Annual event rate in diabetic and non-diabetic patients was 1.74 and 0.64 % respectively. In diabetic patients a multivariate analysis showed significant prognostic value over Framingham Score for SIS with a hazard ratio (HR) of 2.98 (95 % CI 1.02, 8.72; p = 0.047) and SSS (HR 4.47, 95 % CI 1.21, 16.49; p = 0.025), while CACS did not add prognostic value in this cohort. Annual event rate was 0 % in diabetic patients with SIS = 0 and 3.9 % in diabetic patients with SIS ≥ 8. CCTA allows for improved risk prediction for subsequent cardiac events in oligosymptomatic diabetic patients.

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Acknowledgments

We are indebted to the medical and technical staff members of the computer tomography laboratory for their invaluable contribution.

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Authors and Affiliations

  1. Institut für Radiologie und Nuklearmedizin, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, 80636, Munich, Germany

    Jonathan Nadjiri, Albrecht Will, Eva Hendrich, Stefan Martinoff & Martin Hadamitzky

  2. Medizinische Klinik und Poliklinik I, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany

    Jörg Hausleiter & Simon Deseive

Authors
  1. Jonathan Nadjiri
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  2. Jörg Hausleiter
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  3. Simon Deseive
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  4. Albrecht Will
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  5. Eva Hendrich
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  6. Stefan Martinoff
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  7. Martin Hadamitzky
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Corresponding author

Correspondence to Jonathan Nadjiri.

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Conflict of interest

Dr. Hadamitzky and Dr. Martinoff report receiving unrestricted institutional research grants from Siemens Healthcare. Dr. Hausleiter reports receiving speaker honoraria from Edwards Lifesciences and Abbott Vascular (not related to the current manuscript). The other authors have nothing to disclose. This is an investigator driven study; there is no involvement from outside the departments.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study design was approved by the local ethics committee.

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All patients gave written informed consent before examination.

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Nadjiri, J., Hausleiter, J., Deseive, S. et al. Prognostic value of coronary CT angiography in diabetic patients: a 5-year follow up study. Int J Cardiovasc Imaging 32, 483–491 (2016). https://doi.org/10.1007/s10554-015-0785-9

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  • DOI: https://doi.org/10.1007/s10554-015-0785-9

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