title: Coronary computed tomographic angiographic findings in asymptomatic patients with type 2 diabetes mellitus.
abstract: There are limited data regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic patients with type 2 diabetes mellitus. We analyzed 557 asymptomatic type 2 diabetic patients who underwent CCTA. Cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome requiring hospitalization, or late revascularization. Atherosclerotic plaques were observed in 395 patients (70.9%), and 170 patients (30.5%) showed significant coronary artery disease (CAD) on CCTA. Ninety-two patients (16.5%) were associated with a significant stenosis in the left main or proximal left anterior descending artery. During the follow-up period (33.7 ± 7.8 months), although an excellent prognosis was observed in patients without significant CAD on CCTA, those with significant CAD showed more cardiac events (7.1% vs 0.5%) and lower 3-year event-free survival rates (99.2 ± 0.6% vs 90.9 ± 2.6%, p <0.001). Furthermore, in group with significant CAD, patients with significant CAD in the left main or proximal left anterior descending artery had more cardiac events (10.9% vs 2.6%) and lower 3-year event-free survival rates (97.4 ± 1.8% vs 86.1 ± 4.2%, p = 0.049). On multivariate analysis, family history of premature CAD, previous history of stroke, higher UK Prospective Diabetes Study 10-year risk scores, neuropathy, and retinopathy were independent clinical predictors of having significant CAD and left main or proximal left anterior descending artery significant CAD on CCTA. In conclusion, about 1/3 of asymptomatic type 2 diabetic patients had significant CAD on CCTA with a subsequent high risk for cardiac events. These findings suggest that CCTA may have a potential role in identifying patients with high cardiovascular risks in asymptomatic type 2 diabetes.
authors: Department of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Gyung-Min
authors: GM
authors: Park
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: seungwlee@amc.seoul.kr.
authors: Seung-Whan
authors: SW
authors: Lee
authors: Department of Cardiology, Dong-A University Hospital, Busan, Korea.
authors: Young-Rak
authors: YR
authors: Cho
authors: Department of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Chan Joon
authors: CJ
authors: Kim
authors: Department of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Jung Sun
authors: JS
authors: Cho
authors: Department of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Mahn-Won
authors: MW
authors: Park
authors: Department of Cardiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
authors: Sung Ho
authors: SH
authors: Her
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jung-Min
authors: JM
authors: Ahn
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jong-Young
authors: JY
authors: Lee
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Duk-Woo
authors: DW
authors: Park
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Soo-Jin
authors: SJ
authors: Kang
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Young-Hak
authors: YH
authors: Kim
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Cheol Whan
authors: CW
authors: Lee
authors: Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Eun Hee
authors: EH
authors: Koh
authors: Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Woo Je
authors: WJ
authors: Lee
authors: Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Min-Seon
authors: MS
authors: Kim
authors: Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Ki-Up
authors: KU
authors: Lee
authors: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Joon-Won
authors: JW
authors: Kang
authors: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Tae-Hwan
authors: TH
authors: Lim
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Seong-Wook
authors: SW
authors: Park
authors: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Seung-Jung
authors: SJ
authors: Park
authors: Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Joong-Yeol
authors: JY
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*