title: Risk score model for the assessment of coronary artery disease in asymptomatic patients with type 2 diabetes.
abstract: No model has been developed to predict significant coronary artery disease (CAD) on coronary computed tomographic angiography (CCTA) in asymptomatic type 2 diabetes. Therefore, we sought to develop a model for the prediction of significant CAD on CCTA in these patients. We analyzed 607 asymptomatic patients with type 2 diabetes who underwent CCTA. The cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome, and coronary revascularization. Significant CAD (diameter stenosis ≥50%) in at least one coronary artery on CCTA was observed in 188 (31.0%). During the follow-up period (median 4.3 [interquartile range, 3.7-4.8] years), 71 patients had 83 cardiac events. Clinical risk factors for significant CAD were age, male gender, duration of diabetes, hypertension, current smoking, family history of premature CAD, previous history of stroke, ratio of total cholesterol to high-density lipoprotein cholesterol, and neuropathy. Using these variables, we formulated a risk score model, and the scores ranged from 0 to 17 (area under the curve = 0.727, 95% confidence interval = 0.714-0.739, P < 0.001). Patients were categorized into low (≤3), intermediate (4-6), or high (≥7) risk group. There were significant differences between the risk groups in the probability of significant CAD (12.6% vs 29.4% vs 57.7%, P for all < 0.001) and 5-year cardiac event-free survival rate (96.6% ± 1.5% vs 88.9% ± 1.8% vs 73.8% ± 4.1%, log-rank P for trend < 0.001). This model predicts significant CAD on CCTA and has the potential to identify asymptomatic type 2 diabetes with high risk.
authors: From the Department of Cardiology (G-MP, EHG, SHH), Daejeon St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Daejeon; Department of Biostatistics (HA), College of Medicine, Korea University; Departments of Cardiology (S-WL, Y-HK, CWL, S-WP, S-JP); Endocrinology (EHK, WJL, M-SK, K-UL, J-YP); Radiology (J-WK, T-HL), Asan Medical Center, College of Medicine, University of Ulsan, Seoul; and Department of Cardiology (Y-RC), Dong-A University hospital, Busan, Korea.
authors: Gyung-Min
authors: GM
authors: Park
authors: Hyonggin
authors: H
authors: An
authors: Seung-Whan
authors: SW
authors: Lee
authors: Young-Rak
authors: YR
authors: Cho
authors: Eun Ha
authors: EH
authors: Gil
authors: Sung Ho
authors: SH
authors: Her
authors: Young-Hak
authors: YH
authors: Kim
authors: Cheol Whan
authors: CW
authors: Lee
authors: Eun Hee
authors: EH
authors: Koh
authors: Woo Je
authors: WJ
authors: Lee
authors: Min-Seon
authors: MS
authors: Kim
authors: Ki-Up
authors: KU
authors: Lee
authors: Joon-Won
authors: JW
authors: Kang
authors: Tae-Hwan
authors: TH
authors: Lim
authors: Seong-Wook
authors: SW
authors: Park
authors: Seung-Jung
authors: SJ
authors: Park
authors: Joong-Yeol
authors: JY
authors: Park
mesh_terms: D000367:Age Factors; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009203:Myocardial Infarction / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol
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