CCTA imaging useful for predicting future CV events in diabetics
MedWire News: Coronary computed tomography angiography (CCTA) imaging helps predict cardiovascular (CV) event risk in patients with diabetes, but no known coronary artery disease (CAD).
CCTA has emerged as an effective and widely used imaging technique for detecting or excluding obstructive CAD and as a prognostic tool for predicting subsequent cardiac events, say researchers.
In this study, Martin Hadamitsky (Technical University of Munich, Germany) and colleagues tested the efficacy of CCTA for predicting CAD and future CV events in 140 patients with diabetes and no prior history of CAD and 1782 controls without diabetes or CAD, aged 61.7 years on average.
Calcium score, degree of the most severe stenosis, and the atherosclerotic burden score (number of segments with a nonstenotic plaque or stenosis) were all recorded by the researchers.
The participants were then followed-up for a mean period of 33 months for a composite of CV events defined as all-cause death, nonfatal myocardial infarction, or unstable angina requiring hospitalization.
As reported in the journal Diabetes Care, 67 (48%) diabetics and 457 (26%) nondiabetics were diagnosed as having obstructive CAD using CCTA.
Seven CV events occurred in the diabetic group and 24 in the control group over the follow-up period. The annual event rate ranged from 0.5–9.6% in diabetics and from 0.3–2.2% in controls in those with less than five to more than nine atherosclerotic lesions.
Atherosclerotic burden score was the best predictor for CV events in diabetics and nondiabetics with an increase in relative risk of 30% and 20%, respectively, for each additional lesion.
The team concludes that the prevalence of previously undiagnosed CAD in this study was significantly higher in diabetics than nondiabetics leading to a higher rate of subsequent CV events.
The researchers add that CCTA was shown to improve CV risk prediction both in diabetic and nondiabetic patients.
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By Helen Albert