Feature | December 05, 2014

Study Presented at RSNA Says Even Mild Coronary Artery Disease Puts Diabetic Patients at Risk

Researchers evaluated long-term prognostic value of CCTA in diabetic patients

December 5, 2014 — According to a new long-term study, diabetic patients with even mild coronary artery disease face the same relative risk for a heart attack or other major adverse heart events as diabetics with serious single-vessel obstructive disease. Results of the study were presented at RSNA 2014.

Researchers at the University of British Columbia and St. Paul's Hospital in Vancouver analyzed data from the Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter (CONFIRM) Registry, which was developed to examine the prognostic value of cardiac computed tomography angiography (CCTA) for predicting adverse cardiac events related to coronary artery disease. The registry, which has CCTA data on 40,000 patients from 17 centers around the world, now has five-year follow-up data on 14,000 patients.

The researchers analyzed data on 1,823 diabetic patients who underwent CCTA to detect and determine the extent of coronary artery disease, in which a waxy substance called plaque builds up inside the arteries of the heart. This plaque buildup causes the artery wall to thicken, which limits or, in some cases, completely obstructs blood flow.

Men and women (median age 61.7) in the study were categorized as having no coronary artery disease, mild disease (less than 50 percent of coronary artery narrowed), or obstructive disease (more than 50 percent artery obstruction). Over a 5.2-year follow-up period, there were 246 deaths, representing 13.5 percent of the total study group.

Major adverse cardiovascular event (MACE) data was available on 973 patients. During the follow-up period, 295 (30.3 percent) of the patients experienced a MACE, such as heart attack or a procedure to re-open an obstructed artery called a coronary revascularization.

The researchers found that both obstructive and mild, or non-obstructive, coronary artery disease as determined by CCTA were related to patient deaths and MACE. The study found that the relative risk for death or MACE for a patient with mild coronary artery disease was comparable to that of patients with single vessel obstructive disease.

"Until now, two-year follow-up studies suggested that a diabetic patient with mild or non-obstructive coronary artery disease had a lower risk of major adverse cardiovascular events and death than patients with obstructive disease," said co-author Philipp Blanke, M.D., radiologist at the University of British Columbia and St. Paul's Hospital. "Our five-year follow-up data suggests that non-obstructive and obstructive coronary artery disease as detected by cardiac CTA in diabetic patients are both associated with higher rates of mortality."

Study observers say that researchers need a better understanding of the evolution of plaque in the arteries and patient response to therapies.

Researchers say that cardiac CT angiography is helpful for identifying diabetic patients who are at higher risk for heart events, who may benefit from more aggressive therapy to help modify that risk.

Co-authors on the study include Bruce Precious, M.D., Sasi R Ganga Raju, M.B.Ch.B.m Iksung Cho, M.S., Hyuk-Jae Chang, M.D., Fay Lin, M.D., Stephan Achenbach, M.D., Daniel S. Berman, M.D., Matthew J. Budoff, M.D., Tracy Q. Callister, M.D., Mouaz Al-Mallah, M.D., Filippo Cademartiri, M.D., Ph.D., Kavitha M. Chinnaiyan, M.D., Benjamin Chow, M.D., Allison Dunning, M.S., Augustin Delago, M.D., Todd C. Villines, M.D., Martin Hadamitzky, M.D., Jorg Hausleiter, M.D., Leslee Shaw, Ph.D., Philipp A. Kaufmann, M.D., Ricardo C. Cury, M.D., Gudrun Feuchtner, M.D., Yong-Jin Kim, M.D., Erica Maffei, M.D., Gilbert Raff, M.D., Gianluca Pontone, M.D., Daniele Andreini, M.D., Hugo M. Marques, M.D., Ronen Rubinshtein, M.D., Millie Gomez, M.D. and James K. Min, M.D.

For more information: www.rsna.org

Related Content

Siemens Healthineers Announces First U.S. Install of Somatom go.Top CT
News | Computed Tomography (CT) | September 17, 2018
September 17, 2018 — The Ohio State University Wexner Medical Center in Columbus recently became the first healthcare
Key Patient Preparations for a CT Scan
News | Computed Tomography (CT) | September 05, 2018
The Center for Diagnostic Imaging (CDI) in Miami recently released a list of important preparations patients should...
Videos | Computed Tomography (CT) | July 25, 2018
A discussion with Patricia Dickson, LRT(CT), director of imaging and outpatient services, Capital Cardiology Associat
Videos | Computed Tomography (CT) | July 23, 2018
Ed Nicol, M.D., FSCCT, MBA, head of cardiac CT, Royal Brompton Hospital, London, and chair of the Society of Cardiova
Videos | Computed Tomography (CT) | July 17, 2018
An interview with Patrick Serruys, M.D., Ph.D., Imperial College London, principal investigator of the SYNTAX III Tri
Zebra Medical Vision Announces FDA 510(k) Clearance of Coronary Calcium Algorithm
Technology | Computed Tomography (CT) | July 12, 2018
Zebra Medical Vision has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Coronary...
IAC Awards First CT Accreditation for a Mobile Stroke Unit
News | Computed Tomography (CT) | July 09, 2018
The Intersocietal Accreditation Commission (IAC) recently recognized the University of Tennessee Health Science Center...
FFR-CT may soon replace invasive angiography for coronary lesion assessment. #EuroPCR 

Anexample of a clinical case of CT-FFR, which can derive the FFR numbers for their entire coronary tree using a noninvasive CT scan.

Feature | Computed Tomography (CT) | May 29, 2018
May 29, 2018 — Results from the innovative SYNTAX III Revolution Trial [1] underline the effectiveness of evolving no
James Min Named Editor-in-Chief of Journal of Cardiovascular Computed Tomography
News | Computed Tomography (CT) | May 01, 2018
James K. Min, M.D., FSCCT, has been selected for a five-year term as the new editor-in-chief of the Journal of...
FDA Clears Siemens' Somatom go.All, go.Top CT Scanners
Technology | Computed Tomography (CT) | April 18, 2018
April 18, 2018 — The U.S.
Overlay Init