Comparison of Coronary Computed Tomographic Angiographic Findings in Asymptomatic Subjects With Versus Without Diabetes Mellitus.

Autor: Park GM; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Lee JH; Department of Cardiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea., Lee SW; Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: seungwlee@amc.seoul.kr., Yun SC; Department of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Kim YH; Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Cho YR; Department of Cardiology, Dong-A University Hospital, Busan, Korea., Gil EH; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Kim TS; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Kim CJ; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Cho JS; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Park MW; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Her SH; Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea., Yang DH; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Kang JW; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Lim TH; Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Koh EH; Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Lee WJ; Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Kim MS; Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Lee KU; Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Kim HK; The Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Choe J; The Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea., Park JY; Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2015 Aug 01; Vol. 116 (3), pp. 372-8. Date of Electronic Publication: 2015 May 08.
DOI: 10.1016/j.amjcard.2015.04.046
Abstrakt: There are limited data on the impact of diabetes mellitus (DM) on the risk of subclinical atherosclerosis. Therefore, we sought to investigate the impact of DM on the risk of subclinical atherosclerosis in asymptomatic subjects. We analyzed 2,034 propensity score-matched asymptomatic subjects who underwent coronary computed tomographic angiography (mean age 55.9 ± 8.2 years; men 1,725 [84.8%]). Coronary artery calcium score, degree and extent of coronary artery disease (CAD), and clinical outcomes were assessed. High-risk CAD was defined as at least 2-vessel coronary disease with proximal left anterior descending artery involvement, 3-vessel disease, or left main disease. Compared with subjects without DM, those matched with DM had higher coronary artery calcium score (89.9 ± 240.4 vs 62.8 ± 179.5, p = 0.004) and more significant CAD (≥50% diameter stenosis, 15.2% vs 10.2%, p = 0.001), largely in the form of 1-vessel disease (10.8% vs 7.3%, p = 0.007). However, there were no significant differences between matched pairs in significant CAD in the left main or proximal left anterior descending artery (5.3% vs 3.8%, p = 0.138), multivessel disease (4.4% vs 2.9%, p = 0.101), and high-risk CAD (4.3% vs 2.7%, p = 0.058). During the follow-up period (median 21.8, interquartile range 15.2 to 33.4 months), there was no significant difference in the composite of all-cause death, myocardial infarction, acute coronary syndrome, and coronary revascularization between 2 groups (hazard ratio 1.438, 95% confidence interval 0.844 to 2.449, p = 0.181). In asymptomatic subjects, those matched with DM have more subclinical atherosclerosis, mainly confined to non-high-risk CAD, than those matched without DM, and there are no differences in high-risk CAD and clinical outcomes.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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