title: Association of coronary artery stenosis with carotid atherosclerosis in asymptomatic type 2 diabetic patients.
abstract: OBJECTIVE
  Carotid atherosclerosis assessed by ultrasound is an established surrogate marker for systemic atherosclerosis. This study aimed to evaluate the association between coronary artery stenosis assessed by coronary computed tomography angiography (CCTA) and intima-media thickness (IMT) in asymptomatic type 2 diabetic patients.
  
  
  METHODS
  In a cross-sectional study, carotid IMT was measured by ultrasound and CCTA in 169 asymptomatic type 2 diabetic patients.
  
  
  RESULTS
  Among 169 patients, 77 (46%) had coronary artery stenosis on CCTA. Multivariate logistic regression analysis revealed four independent predictors of coronary artery stenosis: diabetes duration (OR 4.07, 95%CI 2.34-7.12; p< 0.001), gender (OR 1.66, 95% CI 1.05-2.61; p=0.029), dyslipidemia (OR 2.07, 95%CI 1.34-3.18; p=0.001), and max-IMT (OR 2.71, 95%CI 1.70-4.33; p< 0.001). By ROC curve analyses, the area under the curve (AUC) for max-IMT was 0.73 (95%CI 0.66-0.81; p< 0.001) and mean-IMT was 0.64 (95%CI 0.56-0.73; p=0.001). The cut-off level for the greatest sensitivity and specificity for max-IMT was 1.55 mm (sensitivity 0.90, specificity 0.46), and mean-IMT was 1.05 mm (sensitivity 0.55, specificity 0.72).
  
  
  CONCLUSIONS
  Carotid IMT was associated with coronary artery stenosis assessed by CCTA in asymptomatic type 2 diabetic patients. Measurement of both mean- and max-carotid IMT is useful for selecting asymptomatic type 2 diabetic patients who should undergo CCTA screening.
authors.affiliation: Osaka Police Hospital, 10-31 Kitayama-cho, Osaka, Japan. chibikko1978no1@yahoo.co.jp
authors.forename: Yoko
authors.initials: Y
authors.lastname: Irie
authors.forename: Kenya
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Kubo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okusu
authors.forename: Takashi
authors.initials: T
authors.lastname: Katura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Umayahara
authors.forename: Naoto
authors.initials: N
authors.lastname: Katakami
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneto
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kashiyama
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kosugi
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011859:Radiography; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography