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

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 ...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Rationale: Peripheral arterial diseases (PADs) is defined as a systemic arterial disorders involving the lower extremity arteries, iliac, and carotid, which is developed more common in patients with chronic kidney disease (CKD) than individual with normal renal function. Concurrence of mesenteric artery disease and lower extremity artery disease (LEAD) is rare. The presence of PADs in patients receiving hemodialysis leads to a dramatic increase in risk of cardiovascular mortality. However, the early diagnosis of PADs in patient with CKD remains a challenge to nephrologists, which adds an adverse effect on prognosis. Pat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract BACKGROUND: Diabetes mellitus (DM) causes macro- and microvasculopathy, but data on cardiac microvascular changes in large animals are scarce. We sought to determine the effect of DM on macro- and microvascular changes in diabetic pigs and humans. METHODS: Eight domestic pigs (4 with type I diabetes and 4 controls) underwent coronary angiography with optical coherence tomography (OCT; at baseline and 1 and 2 months), coronary computed tomography angiography, cardiac magnet resonance (CMR) imaging, and histologic examination. RESULTS: The diabetic pigs had more irregular capillaries with acellula...
Source: J Korean Med Sci - Category: General Medicine Authors: Tags: J Korean Med Sci Source Type: research
Recent evidence suggests plaque morphology evaluated on coronary computed tomography angiography (CTA) has prognostic implications. East Asians have a lower prevalence of myocardial infarction and cardiovascular mortality compared with European-origin Caucasians. We aimed to compare coronary atherosclerotic burden and plaque composition in a matched cohort of Caucasian and East Asians patients with stable chest pain who underwent CTA. Two-hundred symptomatic patients (age 58.8 ±7.9, male 51%) were matched for age, gender, body mass index (BMI) and diabetes (100 each ethnic group).
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
A patient with DM presented with acute chest pain.Here was his ED ECG:There isLVH in limb leads, with a 17 mm R-wave in aVL, and deep S-wave in inferior leads.With this much voltage, one expects some repolarization abnormalities.Indeed, there is a bit of ST depression in aVL (discordant to the tall R-wave) that does not appear to be out of proportion.There is inferior ST Elevation, but the S-waves are also of high voltage.Is this an inferior STEMI?  Or is the LVH with expected repolarization abnormalities? There is also some ST depression in V2.  Possible posterior involvement?CommentTo me, the inferior ST E...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Congestive heart failure caused by silent ischemia and silent myocardial infarction : Diagnostic challenge in type 2 diabetes. Herz. 2019 Mar 21;: Authors: Valensi P, Meune C Abstract In asymptomatic patients with type 2 diabetes (T2D), the prevalence of silent myocardial infarction on routine electrocardiograms is about 4% while for silent myocardial ischemia it is 20-30%. Some studies showed that silent myocardial infarction is associated with an increased risk of incident heart failure (HF), whereas no prospective study has ever reported such a risk in patients with silent myocardial ...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
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Source: Mass Device - Category: Medical Devices Authors: Tags: Cardiac Assist Devices Cardiovascular Clinical Trials Featured Patient Monitoring ReCor Medical Source Type: news
Abstract Objectives of the study were to examine the long-term prognostic power of coronary computed tomography angiography (CCTA) to predict death or myocardial infarction in patients with diabetes mellitus (DM). The prognostic value of CCTA in diabetic patients has been confirmed for short- and intermediate follow-up durations. The slowly progressing nature of coronary artery disease (CAD), however, underlines the necessity to validate CCTA for longer observation periods in this high-risk population. A total of 132 patients with DM and 1781 without DM were examined by CCTA and followed for a median duration of 9...
Source: Nuklearmedizin - Category: Radiology Authors: Tags: Heart Vessels Source Type: research
AbstractObjectives of the study were to examine the long-term prognostic power of coronary computed tomography angiography (CCTA) to predict death or myocardial infarction in patients with diabetes mellitus (DM). The prognostic value of CCTA in diabetic patients has been confirmed for short- and intermediate follow-up durations. The slowly progressing nature of coronary artery disease (CAD), however, underlines the necessity to validate CCTA for longer observation periods in this high-risk population. A total of 132 patients with DM and 1781 without DM were examined by CCTA and followed for a median duration of 9.7 (IQR 6....
Source: Heart and Vessels - Category: Cardiology Source Type: research
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