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Old March 4th, 2010, 10:40 AM   #1
Sysop
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Default Prognostic Value of Coronary Computed Tomographic Angiography in Diabetic Patients wi

AbstractObjective:Diabetic patients have a high prevalence of coronary artery disease (CAD), but timely diagnosis of CAD remains challenging. We assessed the ability of coronary CT angiography (CCTA) to detect CAD in diabetic patients and to predict subsequent cardiac events.
Methods:We analyzed 140 diabetic patients without known CAD undergoing CCTA. 1782 patients without diabetes were used as control group. Besides calcium scoring and the degree of the most severe stenosis, the atherosclerotic burden score counting the number of segments having either a nonstenotic plaque or a stenosis was recorded. The primary endpoint was a composite of hard cardiac events defined as all cause death, nonfatal myocardial infarction or unstable angina requiring hospitalization.
Results:
During a mean follow-up of 33 months, there were 7 events in the diabetes group and 24 events in the control group. The best predictor in diabetic patients was the atherosclerotic burden score: the annual event rate ranged from 0.5% for patients with less than 5 lesions to 9.6% for patients with more than 9 lesions resulting in a hazard ratio of 1.3 (95% CI 1.1 to 1.7) for each additional lesion (p=0.005). For comparison, in nondiabetic patients the annual event rate ranged from 0.3% to 2.2% respectively resulting in a hazard ratio of 1.2 (95%CI 1.1 to 1.3, p
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