title: Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk.
abstract: OBJECTIVE
  Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography.
  
  
  METHODS
  In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥ 50% lumen narrowing), patients were sent to conventional coronary angiography (CCA).
  
  
  RESULTS
  Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥ 50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥ 75% and were submitted to the revascularisation procedure.
  
  
  CONCLUSIONS
  MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy.
authors: Department of Experimental and Internal Medicine Lanzara-Magrassi, Center of Cardiovascular Excellence, Second University of Naples, Via F. Petrarca, 64, I-80122, Naples, Italy.
authors: Rodolfo
authors: R
authors: Nasti
authors: Ornella
authors: O
authors: Carbonara
authors: Maria L Mangoni
authors: ML
authors: di Santo Stefano
authors: Roberta
authors: R
authors: Auriemma
authors: Sabato
authors: S
authors: Esposito
authors: Giuseppe
authors: G
authors: Picardi
authors: Nadia
authors: N
authors: Lascar
authors: Antonio
authors: A
authors: Pagano
authors: Roberto
authors: R
authors: Ruggiero
authors: Roberto
authors: R
authors: Torella
authors: Ferdinando C
authors: FC
authors: Sasso
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed