Use of imaging and clinical data to screen for cardiovascular disease in asymptomatic diabetics

Autor: Carlos H Rassi, Bernardo Léo Wajchenberg, Carlos E. Rochitte, Ron Blankstein, Fabricia P Rassi, Márcio Sommer Bittencourt, Timothy W. Churchill, Augusto Hiroshi Uchida, Carlos A. Tavares, A. C. Lerario, Mateus G Fahel, Edward Hulten, Khurram Nasir
Rok vydání: 2015
Předmět:
Carotid Artery Diseases
Male
Endocrinology
Diabetes and Metabolism
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Carotid Intima-Media Thickness
Coronary artery disease
0302 clinical medicine
Prevalence
Mass Screening
Prospective Studies
Prospective cohort study
Original Investigation
Middle Aged
Prognosis
Coronary Vessels
Plaque
Atherosclerotic
Cardiology
cardiovascular system
Female
Radiology
medicine.symptom
Cardiology and Cardiovascular Medicine
Brazil
Adult
Diagnostic Imaging
medicine.medical_specialty
030209 endocrinology & metabolism
Asymptomatic
03 medical and health sciences
Predictive Value of Tests
Internal medicine
Diabetes mellitus
Type 2 diabetes mellitus
medicine
Humans
Coronary computed tomography angiography
cardiovascular diseases
Vascular Calcification
Angiology
Aged
business.industry
Coronary Stenosis
Type 2 Diabetes Mellitus
Reproducibility of Results
medicine.disease
Stenosis
Intima-media thickness
Diabetes Mellitus
Type 2
Asymptomatic Diseases
Exercise Test
business
Tomography
X-Ray Computed
Zdroj: Cardiovascular Diabetology
ISSN: 1475-2840
Popis: Background There is increasing evidence to suggest that not all individuals with type 2 diabetes mellitus (T2DM) have equal risk for developing cardiovascular disease. We sought to compare the yield of testing for pre-clinical atherosclerosis with various approaches. Methods 98 asymptomatic individuals with T2DM without known coronary artery disease (CAD) were enrolled in a prospective study and underwent carotid ultrasound, exercise treadmill testing (ETT), coronary artery calcium (CAC) scoring, and coronary computed tomography angiography (CTA). Results Of 98 subjects (average age 55 ± 6, 64 % female), 43 (44 %) had coronary plaque detectable on CTA, and 38 (39 %) had CAC score >0. By CTA, 16 (16 %) had coronary stenosis ≥50 %, including three subjects with CAC = 0. Subjects with coronary plaque had greater prevalence of carotid plaque (58 % vs. 38 %, p = 0.01) and greater carotid intima media thickness (0.80 ± 0.20 mm vs. 0.70 ± 0.11 mm, p = 0.02). Notably, 18 of 55 subjects (33 %) with normal CTA had carotid plaque. Eight subjects had a positive ETT, of whom five had ≥ 50 % coronary stenosis, two had
Databáze: OpenAIRE
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