Abstract 17119: Clinical Usefulness of Coronary Computed Tomographic Angiography in Asymptomatic Patients with Type 2 Diabetic Mellitus

Abstract

Background: Little is known regarding the role of coronary computed tomographic angiography (CCTA) in asymptomatic type 2 diabetic mellitus. To address these issues, we evaluated the clinical usefulness of CCTA in asymptomatic patients with type 2 diabetic mellitus.

Method: We retrospectively enrolled 557 asymptomatic patients with type 2 diabetes who underwent CCTA. Cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or revascularization.

Results: Of the 557 patients with type 2 diabetes, 392 (70.4%) had atherosclerotic plaques and 170 (30.5%) showed significant coronary artery disease (CAD) on CCTA. During the follow-up period (30.7±12.0 months), a total of 61 cardiac events occurred: 5 cardiac deaths, 1 nonfatal myocardial infarction, 6 unstable anginas, and 58 revascularizations. There were more cardiac events in patients with significant CAD compared to those without (34.7% [59/170] versus 0.5% [2/387], p<0.001). In 68 patients with only noncalcified plaques, 22 had significant CAD and 6 of them had cardiac events. Furthermore, in 211 patients with zero Agaston score, 17 had significant CAD and 2 of them had cardiac events. On multivariate analysis, longer diabetic duration, family history of premature CAD, previous history of stroke, higher Framingham risk scores, and neuropathy were the independent clinical predictors of significant CAD (figure).

Conclusion: About one third of asymptomatic type 2 diabetes was associated with significant CAD on CCTA with subsequent high risk for cardiac events. These findings suggest that CCTA may become a useful screening tool in high risk group of asymptomatic type 2 diabetes.