Presence, Characteristics, and Volumes of Coronary Plaque Determined by Computed Tomography Angiography in Young Type 2 Diabetes Mellitus

Nezarat, Negin; Budoff, Matthew J.; Luo, Yun; Darabian, Sirous; Nakanishi, Rine; Dong, Li; Sheidaee, Nasim; Kim, Michael; Alani, Anas; Matsumoto, Suguru; Rahmani, Sina; Kanisawa, Mitsuru; Čeponienė, Indrė; Osawa, Kazuhiro; Qi, Hong; Hamal, Sajad; Kitslaar, Pieter H.; Broersen, Alexander; Flores, Ferdinand; Ipp, Eli; Khazai, Bahram

doi:10.1016/j.amjcard.2017.02.023

Cited by 25 publications

(16 citation statements)

References 30 publications

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“…Notably, in this study CTCA identified a high prevalence (nearly 40%) of occult CAD in an asymptomatic sample of patients with T2DM, which is consistent with other studies reporting a prevalence of CAD in patients with T2DM ranging from 64 to 80%, including significant, obstructive plaques being observed in 26–37% of subjects [15–18]. In contrast, < 10% of a general population may be expected to present with similar plaques [18, 19]. Furthermore, the prevalence of CAD in this study was observed in the context of a population that was optimally treated for hypertension and dyslipidaemia, with mean values being well within the recommended national guidelines [20].…”

Section: Discussionsupporting

confidence: 91%

“…CTCA offers an alternative to invasive catheter angiography for screening for CAD and has very high sensitivity (95–99%) [14]. Notably, in this study CTCA identified a high prevalence (nearly 40%) of occult CAD in an asymptomatic sample of patients with T2DM, which is consistent with other studies reporting a prevalence of CAD in patients with T2DM ranging from 64 to 80%, including significant, obstructive plaques being observed in 26–37% of subjects [15–18]. In contrast, < 10% of a general population may be expected to present with similar plaques [18, 19].…”

Section: Discussionsupporting

confidence: 89%

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Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Venuraju

Lahiri

Jeevarethinam

et al. 2019

Cardiovasc Diabetol

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Background Evidence from imaging studies suggests a high prevalence of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, there are no criteria for initiating screening for CAD in this population. The current study investigated whether clinical and demographic characteristics can be used to predict significant CAD in patients with T2DM. Methods Computed tomography coronary angiography (CTCA) and laboratory assessments were performed in 259 patients diagnosed with T2DM attending clinics in Northwest London, UK. Coronary artery calcium (CAC) was calculated during CTCA. Significant plaque was defined as one causing more than 50% luminal stenosis. Associations between groups and variables were evaluated using Student’s t test, Chi-square tests and univariate and multivariate regression analysis. P < 0.05 was considered statistically significant. Results Among patients with a median duration of T2DM of 13 years and a mean age of 62.0 years, median CAC score was 105.91 Agatston Units. In a multivariate analyses, duration of diabetes, CAC score and the presence and number of coronary artery plaques and presence of significant plaque were significant predictors of cardiovascular adverse events. Systolic blood pressure (SBP) had borderline significance as a predictor of cardiovascular events (p = 0.05). In a receiver operating characteristic curve (ROC) analysis, duration of diabetes of > 10.5 years predicted significant CAD (sensitivity, 75.3%; specificity 48.2%). Area under the ROC curve was 0.67 when combining duration of T2DM > 10.5 years and SBP of > 139 mm Hg. Adverse cardiovascular events after a median follow-up of 22.8 months were also significantly higher in those with duration of T2DM > 10.5 years and SBP > 140 mm Hg (log rank p = 0.02 and 0.009, respectively). Conclusions Routine screening for CAD using CTCA should be considered for patients with a diagnosis of T2DM for > 10.5 years and SBP > 140 mm Hg. Trial registration Clinicaltrials.gov identifier: NCT02109835, 10 April 2014 (retrospectively registered)

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Venuraju

Lahiri

Jeevarethinam

et al. 2019

Cardiovasc Diabetol

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show abstract

“…According to the clinical outcome, type 2 diabetic patients are prone to developing CAD more often and with greater extent, depending on the type of atheromatic plaques, compared to non-diabetic individuals of matched-age. As a result, computed tomography angiography may be used as a detector of subclinical atherosclerosis in this group (44).…”

Section: Imaging Methods As Predictors For Cadmentioning

confidence: 99%

Screening and Risk Assessment of Coronary Artery Disease in Patients With Type 2 Diabetes: An Updated Review

Patsouras

Farmaki

Garmpi

et al. 2019

In Vivo

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Current literature indicates that there is a strong correlation between coronary artery disease (CAD) and type 2 diabetes. The arteriosclerotic progression occurs earlier and in a greater extent in the diabetic than in the non-diabetic population. In diabetic subjects, the detection of arterial disease does not always precede the development of an acute arterial incident. Herein, we reviewed studies published within the last 5 years in order to reveal the risk factors for coronary artery disease in patients with type 2 diabetes. In addition, we aimed to discuss how to diagnose in an early stage or even screen the presence of coronary artery disease in asymptomatic diabetic patients. Possible blood markers as predictors of CAD, which are mostly related to the lipidemic profile of subjects, are included in this review. Less invasive imaging methods than conventional coronary angiography, included in the article, are gradually used more in the diagnosis of CAD and show high effectiveness. Data from 23 articles with 22,350 patients having type 2 diabetes were summarized and presented descriptively. The rates of diabetes are increasing worldwide. The scientific community estimates that the number of people living with diabetes will rise dramatically the following years and will reach the number of 592 million by 2035 (1). Diabetes mellitus has a wide range of complications which includes both microvascular (renal, retinal, and neuropathic disease) and macrovascular complications [vascular disease and coronary artery disease (CAD)] (2). The main system affected by diabetes, causing death, is the cardiovascular one. As a result, patients suffering from diabetes are prone to more severe cardiovascular diseases and have greater complication rates than non-diabetic patients (3). Inflammatory elements, vascular smooth muscle cell proliferation and endothelial dysfunction, which characterize atherosclerosis, result in atherosclerotic plaque instability and progression (4-10). Atherosclerosis leading to CAD results in restriction of blood flow to the heart (11). It is common knowledge that the degree of stenosis varies among patients. Therefore, the clinical presentation of patients also varies from asymptomatic to stable angina and acute coronary syndrome (ACS), which includes unstable angina, stemi and non-stemi myocardial infraction (12). Diabetes is regarded as a CAD risk equivalent. This means that diabetic patients are at risk of having coronary events alike non-diabetic patients, who previously had one (13). Many factors contribute to the appearance of CAD in diabetes type 2 patients and only 25% of these are already known (14). As CAD constitutes a challenging task among practitioners, the aim of our review is to present the correlation between type 2 diabetes mellitus and CAD, according to current scientific reports, and to reveal possible 1039 This article is freely accessible online.

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“…16 Arterial thickening/hardening of the arteries or plaque makes the blood flow reduction , reducing the supply of oxygen and nutrients to the leg muscles. [17][18][19][20] Tissue necrosis can occur due to reduced blood flow, hypoxia, so that infection and gangrene can occur and that may lead to amputation. 21…”

Section: Itemsmentioning

confidence: 99%

Relationship of visual impairment and peripheral artery disease with the occurrence of diabetic foot ulcers in Dr. Moewardi Hospital

Purwanti

Yetti

Herawati

2019

Frontiers of Nursing

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Objective: One of the diabetes mellitus (DM) complications is foot ulcers. Foot ulcers are influenced by many factors. DM puts patients at risk of injury because of visual impairment. Hyperglycemia can damage blood vessels, which results in peripheral artery disease (PAD). The purpose of this study was to find the relationship of visual impairment and PAD with diabetic foot ulcers. Methods: This research used observational analytic study with case-control methods. It used purposive sampling in 34 DM patients with foot ulcers and 34 DM patients without foot ulcers. The research instruments were an interview guide to assess visual impairment, physical examination to assess PAD, and documentation study, which was used to know the incidence of diabetic ulcers. Results: The results showed that the respondents who experienced ulcers with visual impairment were 44.1% and the respondents who had foot ulcers with PAD were 73.5%. The results of statistical tests showed that there was no relationship between visual impairment and the incidence of ulcers (P = 0.166). The respondents with PAD will have a chance to suffer from foot ulcers 5.808 times higher than those who do not have PAD. Conclusions:There is no relationship between visual impairment and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital, but there is relationship between PAD and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital. Suggestions of this study are to do foot screening and educate about the importance of foot care to prevent the occurrence of diabetic ulcers.

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Presence, Characteristics, and Volumes of Coronary Plaque Determined by Computed Tomography Angiography in Young Type 2 Diabetes Mellitus

Cited by 25 publications

References 30 publications

Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Screening and Risk Assessment of Coronary Artery Disease in Patients With Type 2 Diabetes: An Updated Review

Relationship of visual impairment and peripheral artery disease with the occurrence of diabetic foot ulcers in Dr. Moewardi Hospital

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