PMID- 32367320
OWN - NLM
STAT- MEDLINE
DCOM- 20201119
LR  - 20201119
IS  - 1826-6983 (Electronic)
IS  - 0033-8362 (Linking)
VI  - 125
IP  - 12
DP  - 2020 Dec
TI  - Coronary artery disease (CAD) extension-derived risk stratification for 
      asymptomatic diabetic patients: usefulness of low-dose coronary computed 
      tomography angiography (CCTA) in detecting high-risk profile patients.
PG  - 1249-1259
LID - 10.1007/s11547-020-01204-z [doi]
AB  - BACKGROUND: As one of the most frequent risk factors for cardiovascular disease, 
      type 2 diabetes mellitus (T2DM) is one of the largest causes of death. However, 
      an acute cardiac presentation is not uncommon in diabetic patients, and the 
      current investigative approach remains often inadequate. The aim of our study was 
      to retrospectively stratify the risk of asymptomatic T2DM patients using low-dose 
      640-slice coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: 
      CCTA examinations of 62 patients (mean age, 65 years) with previous diagnosis of 
      type 2 diabetes and without cardiac symptoms were analyzed. Image acquisition was 
      performed using a 640-slice CT. Per-patient, per-vessel and per-plaque analyses 
      were performed. Stratification risk was evaluated according to the ESC 
      guidelines. The patients were followed up after 2.21 +/- 0.56 years from CCTA 
      examination. RESULTS: Coronary artery disease (CAD) was found in 58 patients 
      (93.55%) presenting 290 plaques. Analysis of all samples showed 
      severe-to-occlusive atherosclerosis in 24 patients (38.7% of cases). However, 
      over the degree of stenosis, 23 patients were evaluated at high risk considering 
      the extension of CAD. Good agreement was shown by the correlation of CAD 
      extension/risk estimation and MACE incidence, according to a Kaplan-Meier 
      survival analysis (p value = 0.001), with a 7.25-fold increased risk (HR 7.25 CI 
      2.13-24.7; p value = 0.002). CONCLUSION: Our study confirms the high capability 
      of CCTA to properly stratify the CV risk of asymptomatic T2DM patients. Its use 
      could be recommended if we consider how current investigative strategies to 
      correctly assess these patients often seem inadequate.
FAU - Palumbo, Pierpaolo
AU  - Palumbo P
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy. palumbopierpaolo89@gmail.com.
FAU - Cannizzaro, Ester
AU  - Cannizzaro E
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Bruno, Federico
AU  - Bruno F
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Schicchi, Nicolo
AU  - Schicchi N
AD  - Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Via 
      Conca 71, 60126, Ancona, Italy.
FAU - Fogante, Marco
AU  - Fogante M
AD  - Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Via 
      Conca 71, 60126, Ancona, Italy.
FAU - Agostini, Andrea
AU  - Agostini A
AD  - Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Via 
      Conca 71, 60126, Ancona, Italy.
FAU - De Donato, Maria Carmela
AU  - De Donato MC
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - De Cataldo, Camilla
AU  - De Cataldo C
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Giovagnoni, Andrea
AU  - Giovagnoni A
AD  - Radiology Department, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Via 
      Conca 71, 60126, Ancona, Italy.
FAU - Barile, Antonio
AU  - Barile A
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Splendiani, Alessandra
AU  - Splendiani A
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Masciocchi, Carlo
AU  - Masciocchi C
AD  - Department of Biotechnological and Applied Clinical Sciences, University of 
      L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
FAU - Di Cesare, Ernesto
AU  - Di Cesare E
AD  - Department of Life, Health and Environmental Sciences, University of L'Aquila, 
      Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Italy.
LA  - eng
PT  - Journal Article
DEP - 20200504
PL  - Italy
TA  - Radiol Med
JT  - La Radiologia medica
JID - 0177625
SB  - IM
MH  - Aged
MH  - *Asymptomatic Diseases
MH  - Computed Tomography Angiography
MH  - Coronary Angiography/*methods
MH  - Coronary Artery Disease/*diagnostic imaging/etiology
MH  - Coronary Stenosis/diagnostic imaging
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multidetector Computed Tomography/methods
MH  - Plaque, Atherosclerotic/*diagnostic imaging/etiology
MH  - Radiation Dosage
MH  - Retrospective Studies
MH  - Risk Assessment
OTO - NOTNLM
OT  - Asymptomatic
OT  - CCTA
OT  - Low-dose
OT  - Risk stratification
OT  - Type-2 diabetes mellitus
EDAT- 2020/05/06 06:00
MHDA- 2020/11/20 06:00
CRDT- 2020/05/06 06:00
PHST- 2019/10/21 00:00 [received]
PHST- 2020/04/16 00:00 [accepted]
PHST- 2020/05/06 06:00 [pubmed]
PHST- 2020/11/20 06:00 [medline]
PHST- 2020/05/06 06:00 [entrez]
AID - 10.1007/s11547-020-01204-z [pii]
AID - 10.1007/s11547-020-01204-z [doi]
PST - ppublish
SO  - Radiol Med. 2020 Dec;125(12):1249-1259. doi: 10.1007/s11547-020-01204-z. Epub 
      2020 May 4.