Predictors of coronary heart disease in Japanese patients with type 2 diabetes: Screening for coronary artery stenosis using multidetector computed tomography.
Aims/Introduction:  Multidetector computed tomography (MDCT) coronary angiography has been applied as a tool for non-invasive evaluation of the coronary arteries. The purpose of the present study was to evaluate the effectiveness of MDCT in screening for coronary artery disease (CAD), and to identify the indications for screening in diabetes patients with CAD.


METHODS
The study population consisted of 52 Japanese type 2 diabetes patients who underwent examination with a 64-slice MDCT scanner, electrocardiogram (ECG), echocardiography and ultrasonographic scanning of the carotid arteries. Regression analysis was carried out to assess the correlation between MDCT results and CAD risk factors.


RESULTS
Stenosis of the coronary artery was detected in 19/52 patients. Of the 19 patients, 7 patients had no symptoms, including chest pain, and no ischemic changes in ECG. Significant differences between patients with stenosis and those without stenosis were detected by mean IMT (1.21 vs 0.95 mm), and duration of diabetes (20 vs 13 years). Two-tailed χ(2)-test showed that a duration of diabetes of more than 20 years (odds ratio 6.222) and more than 1.1 mm of mean-IMT (odds ratio 4.600) significantly correlated with the stenosis.


CONCLUSIONS
It was shown that MDCT is useful in detecting coronary artery stenosis in diabetic patients without symptoms of CAD or ECG abnormality, and the predictors of CAD are mean IMT and duration of diabetes. It is recommended that patients with more than 1.1 mm mean IMT at the carotid artery and/or more than 20 years duration of diabetes should be screened for CAD by carrying out MDCT.
Departments of Metabolic Medicine.
Hiroko
H
Nishioka
Departments of Metabolic Medicine.
Noboru
N
Furukawa
Departments of Metabolic Medicine.
Seiya
S
Shimoda
Departments of Metabolic Medicine.
Kenro
K
Nishida
Diagnostic Radiology, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Takeshi
T
Nakaura
Departments of Metabolic Medicine.
Takako
T
Maeda
Departments of Metabolic Medicine.
Rieko
R
Goto
Departments of Metabolic Medicine.
Nobuhiro
N
Miyamura
Diagnostic Radiology, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Kazuo
K
Awai
Diagnostic Radiology, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
Yasuyuki
Y
Yamashita
Departments of Metabolic Medicine.
Eiichi
E
Araki
Cronary artery disease; Multidetector computed tomography; Silent myocardial ischemia