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Prognostic value of 64-slice coronary angiography in diabetes mellitus patients with known or suspected coronary artery disease compared with a nondiabetic population

Valore prognostico della coronarografia-TC a 64 strati nei pazienti diabetici con cardiopatia ischemica nota o sospetta a confronto con la popolazione non diabetica

  • Cardiac Radiology/Cardioradiologia
  • Published:
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Abstract

Purpose

This study aimed to determine the prognostic value of coronary angiography with multislice computed tomography (MSCT) in a population of diabetic subjects with known or suspected ischaemic heart disease compared with a nondiabetic control population.

Materials and methods

Forty-nine patients with type 2 diabetes mellitus (DM) [group 1; mean age 67.7±8.8 years; 32 men; mean body mass index (BMI) 28±3.9] and 49 patients without DM (group 2, with similar demographic and clinical characteristics) were studied with MSCT coronary angiography to exclude the presence of ischaemic coronary artery disease (CAD). Each group comprised 26 patients (53%) with no history of ischaemic coronary disease and 23 patients (47%) with a history of myocardial infarction and/or myocardial revascularisation. Clinical follow-up was performed by analysing correlations between the rate of cumulative cardiac events (cardiac death, nonfatal myocardial infarction, unstable angina, and myocardial revascularisation), the severity of CAD identified on MSCT, and the presence of DM as a cardiovascular risk factor.

Results

At mean follow-up of 20 months, univariate analysis of survival showed significant differences between the two groups (group 1 vs. group 2, p=0.046). Moreover, the cumulative cardiac event rate correlated significantly with the presence of significant CAD (>50% stenosis) in both groups (group 1: p=0.003; group 2: p=0.0004).

Conclusions

Event-free survival is significantly lower in the diabetic population compared with the normal control population (p=0.046) and is closely correlated with the presence of significant CAD. MSCT is an effective method for stratifying such risk and, together with high diagnostic accuracy, provides additional prognostic value.

Riassunto

Obiettivo

Studiare il valore prognostico della angiografia coronarica mediante TC multistrato (TCMS) in una popolazione di pazienti diabetici con nota o sospetta cardiopatia ischemica e in una popolazione non diabetica di confronto.

Materiali e metodi

Quarantanove pazienti con diabete mellito tipo-2 (DM), gruppo I, (età media: 67,7±8,8 anni; maschi 32; BMI medio: 28±3,9) e 49 pazienti senza DM, gruppo II, con sovrapponibili caratteristiche demografiche e cliniche, sono stati sottoposti a studio coronarografico con TCMS per escludere la presenza di coronaropatia ischemica. Relativamente ad ogni gruppo, 26 pazienti (53%) erano senza storia di cardiopatia ischemica, mentre 23 (47%) avevano storia di pregresso infarto miocardico e/o rivascolarizzazione miocardica. Abbiamo condotto un follow-up clinico analizzando la correlazione fra il tasso di eventi cardiaci cumulativi (morte cardiaca, infarto miocardico non fatale, angina instabile e rivascolarizzazioni miocardiche) e la severità della coronaropatia riscontrata alla TCMS e la presenza del DM come fattore di rischio cardiovascolare.

Risultati

Al follow-up medio di 20 mesi, l’analisi univariata della sopravvivenza ha mostrato differenze significative nel confronto fra i gruppi (gruppo I vs. gruppo II, p=0,046). Inoltre, il tasso di eventi cardiaci cumulativi è risultato significativamente correlato alla presenza di malattia significativa (stenosi >50%) in entrambi i gruppi (gruppo I: p=0,003; gruppo II: p=0,0004).

Conclusioni

La sopravvivenza libera da eventi cardiaci è significativamente più bassa nella popolazione diabetica rispetto alla popolazione normale di controllo (p=0,046) ed è strettamente correlata alla presenza di malattia significativa. La TCMS è una metodica efficace nella stratificazione del rischio e, insieme all’accuratezza diagnostica, offre un valore prognostico aggiunto.

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Authors and Affiliations

  1. Erasmus Medical Center, Dipartimento di Radiologia e Cardiologia, Rotterdam, The Netherlands

    F. Cademartiri, A. Palumbo & R. Malagò

  2. Dipartimento di Radiologia e Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    F. Cademartiri, S. Seitun, M. Romano, E. Maffei, M. Fusaro, A. Palumbo & A. Aldrovandi

  3. Dipartimento di Radiologia, Università degli Studi di Napoli, Napoli, Italy

    G. Messalli

  4. Dipartimento di Radiologia, Università degli Studi di Milano, Milano, Italy

    S. Tresoldi

  5. Dipartimento di Radiologia, Università degli Studi di Verona, Verona, Italy

    R. Malagò

  6. Unità di Riabilitazione Cardiovascolare, Fondazione Don Gnocchi ONLUS, Parma, Italy

    V. Brambilla

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  1. F. Cademartiri
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  2. S. Seitun
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  4. E. Maffei
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  6. A. Palumbo
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  7. A. Aldrovandi
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  8. G. Messalli
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  9. S. Tresoldi
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  10. R. Malagò
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  11. V. Brambilla
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Correspondence to F. Cademartiri.

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Cademartiri, F., Seitun, S., Romano, M. et al. Prognostic value of 64-slice coronary angiography in diabetes mellitus patients with known or suspected coronary artery disease compared with a nondiabetic population. Radiol med 113, 627–643 (2008). https://doi.org/10.1007/s11547-008-0268-3

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  • DOI: https://doi.org/10.1007/s11547-008-0268-3

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