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Prognostic value of coronary computed tomographic angiography in symptomatic diabetic/non-diabetic patients without history of myocardial infarction

Session Poster session 1

Speaker

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : A Shalaeva (Tashkent,UZ), N Dadabaeva (Tashkent,UZ), E Shalaeva (Tashkent,UZ)

Authors:
A. Shalaeva1 , N. Dadabaeva1 , E. Shalaeva1 , 1Tashkent Medical Academy, Cardiology - Tashkent - Uzbekistan ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 202-203

The aim of the study was to evaluate the prognostic value of coronary computed tomographic angiography (CCTA) and coronary artery calcium score (CACS) in symptomatic patients with/without type 2 diabetes (T2D) during 3 years of follow-up.

Methods: In this cohort study, in the year 2013, we included 270 consecutive pts (149 male and 121 female) with symptomatic coronary artery disease (CAD) without contraindications to CCTA and no history of major adverse cardiovascular events (MACE). 145 pts (58.1±5.7 years old) had T2D, 135 pts (57.4±6.0 years old) were without T2D. Follow-up examination was every 3 months during 3 years.

Results: There were no significant differences in baseline characteristics in regard to age, gender, the severity of clinical CAD between the two groups. All pts had dyslipidemia, more severe in T2D group. 68 (46.9%) diabetic vs. 62 (49.6%) non-diabetic pts were current smokers, 132 (91%) vs. 101 (80.8%) suffered from arterial hypertension, 49 (33.7%) vs. 42 (33.6%) had congestive heart failure, 92 (63.4%) vs. 57 (45.6%) were obese. During 3-years follow-up 34 diabetic pts (23.4%) suffered from myocardial infarction (MI), 3 of them were fatal, compare to 13 cases (10.4%) without T2D (p=0.0059) (Table).16 diabetic and 18 non-diabetic pts underwent heart revascularization. The incidence rate of MACE increased in T2D pts from 5.3% with non-obstructive to 93.3% with multi-vessels obstructive CAD; in pts without diabetes from 0% to 71.4% (p=0.0001), from 25.9% to 100% with increasing CACS score from 400 to 1000 in diabetic and from 5.2% to 75% in non-diabetic pts (p=0.0001).

Conclusion: CCTA and CACS may be considered a valuable tool for detection of CAD severity, intensive preventive treatment, and early revascularization to decrease an incidence of MACE.

CCTA and CACS for myocardial infarction
No. of events/No. of total patients (event rate %)Type 2 diabetesWithout diabetes
n=145n=125
No CAD0/2 (0)
Non-obs CAD2/38 (5.3)0/42 (0)
1-vessels obs CAD5/41 (9.7)1/50 (2)
2-vessels obs CAD13/39 (33.3)7/26 (26.9)
3-vessels obs CAD14/15 (93.3)5/7 (71.4)
CACS=00/2 (0)
CACS 1–990/18 (0)0/11 (0)
CACS 100–3996/40 (15.0)0/25 (0)
CACS 400–99920/77 (25.9)4/77 (5.2)
CACS >10008/8 (100)9/12 (75)
CAD, coronary artery disease; obs, obstructive.

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