title: MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy.
abstract: OBJECTIVE
  To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN).
  
  
  METHODS
  Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment.
  
  
  RESULTS
  CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87%.
  
  
  CONCLUSIONS
  These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy.
  
  
  CONCLUSIONS
  Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy. riccardo.marano@rm.unicatt.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Marano
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Pitocco
authors.affiliation: Department of Clinical Biochemistry, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Savino
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Merlino
authors.affiliation: Department of Cardiovascular Medicine - Institute of Cardiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Pirro
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rutigliano
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Santangelo
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Aurelian Costin
authors.initials: AC
authors.lastname: Minoiu
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Natale
authors.affiliation: Department of Radiological Sciences - Institute of Radiology, Catholic University of Rome, "A. Gemelli" University Hospital, L.go Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging; D003929:Diabetic Neuropathies / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: CT coronary angiography; Charcot neuro-arthropathy; Coronary artery calcium score; Diabetes mellitus; Prevention