Long-Term Prognostic Value of Coronary CT Angiography in Asymptomatic Type 2 Diabetes Mellitus

被引：66

作者：

Kang, Se Hun ^{[1
]}

Park, Gyung-Min ^{[2
]}

Lee, Seung-Whan ^{[1
]}

Yun, Sung-Cheol ^{[3
]}

Kim, Young-Hak ^{[1
,4
]}

Cho, Young-Rak

Park, Hyun Woo ^{[5
]}

Suh, Jon ^{[5
]}

Yang, Dong Hyun ^{[6
]}

Kang, Joon-Won ^{[6
]}

Lim, Tae-Hwan ^{[6
]}

Jung, Chang Hee ^{[7
]}

Koh, Eun Hee ^{[7
]}

Lee, Woo Je ^{[7
]}

Kim, Min-Seon ^{[7
]}

Lee, Ki-Up ^{[7
]}

Park, Joong-Yeol ^{[7
]}

机构：

[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Cardiol, 43gil 88 Olympicro, Seoul, South Korea

[2] Univ Ulsan, Coll Med, Ulsan Univ Hosp, Dept Cardiol, Ulsan, South Korea

[3] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Biostat, Seoul, South Korea

[4] Dong A Univ Hosp, Dept Cardiol, Busan, South Korea

[5] Soon Chun Hyang Univ Hosp Bucheon, Dept Cardiol, Bucheon, South Korea

[6] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea

[7] Univ Ulsan, Coll Med, Asan Med Ctr, Diabet Ctr, Seoul, South Korea

来源：

JACC-CARDIOVASCULAR IMAGING | 2016年 / 9卷 / 11期

关键词：

atherosclerosis; coronary artery disease; coronary computed tomography angiography; diabetes mellitus; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; INTERNATIONAL MULTICENTER REGISTRY; ALL-CAUSE MORTALITY; ARTERY-DISEASE; CLINICAL-OUTCOMES; FOLLOW-UP; RISK; PREVALENCE; CONFIRM; INDIVIDUALS;

D O I：

10.1016/j.jcmg.2016.01.040

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES This study sought to evaluate the long-term prognostic value of coronary computed tomography angiography (CTA) in asymptomatic patients with type 2 diabetes mellitus. BACKGROUND There are limited data on the long-term prognostic impact of coronary CTA in asymptomatic patients with type 2 diabetes mellitus. METHODS This study analyzed clinical outcomes of 591 consecutive asymptomatic patients with type 2 diabetes mellitus who underwent coronary CTA (mean age 62.2 +/- 8.3 years and 352 men [59.6%]). A cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or late coronary revascularization. Patients were categorized into 3 groups according to severity of coronary artery disease (CAD) on coronary CTA: normal coronary arteries, nonobstructive CAD (<50%), and obstructive CAD (>= 50%). RESULTS One hundred sixty-eight patients (28.4%) had normal coronary arteries, whereas 236 (39.9%) patients had nonobstructive CAD and 187 (31.6%) had obstructive CAD. During the follow-up period (median 5.3 years [interquartile range: 4.7 to 5.8 years]), 37 cardiac events occurred in 29 patents: 10 cardiac deaths, 2 nonfatal myocardial infarctions, 8 cases of unstable angina, and 17 late coronary revascularizations. The 6-year event-free survival rates were 99.3 +/- 0.7% in patients with normal coronary arteries, 96.7 +/- 1.2% in patients with nonobstructive CAD, and 86.2 +/- 3.0% in patients with obstructive CAD (log-rank p < 0.001). CONCLUSIONS Asymptomatic patients with type 2 diabetes mellitus with normal coronary arteries or nonobstructive CAD on coronary CTA show excellent clinical outcomes over a follow-up period of more than 5 years, whereas prognosis is worse in patients with obstructive CAD. These findings suggest long-term prognostic value of coronary CTA for asymptomatic type 2 diabetes mellitus. (C) 2016 by the American College of Cardiology Foundation.

引用

页码：1292 / 1300

页数：9

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