[Input of coronary artery calcium score assessed by computed tomography in the screening of diabetic coronaropathy].
The poor prognosis of coronary artery disease along with the inaccuracy of available testing methods have favoured the development of new screening techniques. One such innovation involves measuring the coronary artery calcium score (CAC). Through computed tomography, this test quantifies the amount of calcium deposited in coronary arteries, itself a reflection of the degree of atherosclerosis. This investigation is a prospective study of 48 diabetic subjects comparing the performance of CAC score with the gold standard testing methods. The results of our study showed that, due to its high negative predictive value, 5 invasive tests were performed needlessly as these subjects had very low CAC scores. At this time, the CAC score is not recommended for every patient but rather on a case-by-case basis. However, it may soon emerge as the next step after the ECG in the evaluation of coronary artery disease. This would alleviate the need for more invasive tests in those patients for whom such investigations are deemed unnecessary. The CAC score, when matched for age, sex and other variables, could also serve as an indication for prescribing medications such as statins, along with other therapeutic interventions. Diabetologists, cardiologists and radiologists must work together in order to gain a better understanding of these new techniques. This may facilitate the emergence of a new approach to the treatment of coronary artery disease.
Dupuy
O
O
Service d'Endocrinologie, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France. Olivier-Dupuy2@wanadoo.fr
Hauret
L
L
Bonnevie
L
L
Bordier
L
L
Mayaudon
H
H
Bauduceau
B
B
D002118:Calcium / Q000378:metabolism*; D003331:Coronary Vessels / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
D002118:Calcium