Predictors of coronary heart disease in Japanese patients with type 2 diabetes: Screening for coronary artery stenosis using multidetector computed tomography

Abstract

Aims/Introduction: Multidetector computed tomography (MDCT) coronary angiography has been applied as a tool for non‐invasive evaluation of the coronary arteries. The purpose of the present study was to evaluate the effectiveness of MDCT in screening for coronary artery disease (CAD), and to identify the indications for screening in diabetes patients with CAD.Materials and Methods: The study population consisted of 52 Japanese type 2 diabetes patients who underwent examination with a 64‐slice MDCT scanner, electrocardiogram (ECG), echocardiography and ultrasonographic scanning of the carotid arteries. Regression analysis was carried out to assess the correlation between MDCT results and CAD risk factors.Results: Stenosis of the coronary artery was detected in 19/52 patients. Of the 19 patients, 7 patients had no symptoms, including chest pain, and no ischemic changes in ECG. Significant differences between patients with stenosis and those without stenosis were detected by mean IMT (1.21 vs 0.95 mm), and duration of diabetes (20 vs 13 years). Two‐tailed χ2‐test showed that a duration of diabetes of more than 20 years (odds ratio 6.222) and more than 1.1 mm of mean‐IMT (odds ratio 4.600) significantly correlated with the stenosis.Conclusions: It was shown that MDCT is useful in detecting coronary artery stenosis in diabetic patients without symptoms of CAD or ECG abnormality, and the predictors of CAD are mean IMT and duration of diabetes. It is recommended that patients with more than 1.1 mm mean IMT at the carotid artery and/or more than 20 years duration of diabetes should be screened for CAD by carrying out MDCT.

Lack of association of tumor necrosis factor superfamily member 4 (TNFSF4) gene polymorphisms (rs3850641 and rs17568) with coronary heart disease and stroke: A systematic review and meta-analysis

“…( 3 ) We could not conduct subgroup analysis of ethnicity, source of control, and genotyping method. ( 4 ) All studies included were conducted in the Asian and Caucasian populations; therefore, the conclusions may not be applicable to other populations. Therefore, further studies on other ethnic groups are required.…”

“…The included studies were required to meet the following criteria: ( 1 ) the study was used to assess the association between TNFSF4 polymorphisms and the risk of CHD and stroke; ( 2 ) the study was a case-control study; ( 3 ) the study provided odds ratio (OR) with 95% confidence interval (CI) or other sufficient data to calculate OR and CI for demonstrating the association between TNFSF4 polymorphisms and the risk of CHD and stroke; ( 4 ) when multiple publications reported on the same or overlapping data, the most recent article or the article based on the largest study population was selected. Studies satisfying the following criteria were excluded: conference abstracts and investigations without raw data available for retrieval, republished data, duplicate studies, reviews, animal studies, not a case-control study, and editorials.…”

“…Coronary heart disease (CHD), one of the most prevalent cardiovascular diseases caused by ischemia and hypoxia of the coronary artery, remains the leading cause of human death throughout the world ( 1 - 4 ). In general, CHD is referred to angina pectoris, myocardial infarction, ischemic cardiomyopathy, and sudden death ( 5 ).…”

Relation Between Erectile Dysfunction and Silent Myocardial Ischemia in Diabetic Patients: A Multidetector Computed Tomographic Coronary Angiographic Study

“…MDCT-CA has been used to screen patients with asymptomatic diabetes for SMI, 24 providing long-term prognostic value 25 . Some studies have used MDCT-CA to screen for SMI in patients with ED 26, 27, 28.…”

“…MDCT coronary angiography (MDCT-CA) has become a reliable non-invasive imaging modality with high specificity and sensitivity for the evaluation of CAD. 22 , 23 MDCT-CA has been used to screen patients with asymptomatic diabetes for SMI, 24 providing long-term prognostic value. 25 Some studies have used MDCT-CA to screen for SMI in patients with ED.…”