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Prognostic significance of asymptomatic coronary artery disease in patients with diabetes and need for early revascularization therapy

Cited 19 time in Web of Science Cited 20 time in Scopus
Authors
Choi, E-K; Koo, B-K; Kim, H-S; Cho, Y-M; Kang, H-J; Cho, Y-S; Chung, W-Y; Chae, I-H; Choi, D-J; Oh, B-H; Park, Y-B; Choi, Y-S
Issue Date
2007-05-19
Publisher
Wiley-Blackwell
Citation
Diabet Med. 2007 Sep;24(9):1003-11. Epub 2007 May 17.
Keywords
AgedCoronary Angiography/*methodsCoronary Artery Disease/*diagnosis/surgeryDiabetic Angiopathies/*diagnosis/surgeryFemaleFibrinolytic Agents/*therapeutic useFollow-Up StudiesHumansMaleMiddle AgedMyocardial Infarction/*prevention & controlMyocardial Revascularization/*methods/mortalityPrognosis
Abstract
AIMS: Information on the clinical outcome of patients with diabetes with silent myocardial ischaemia is limited. We compared the clinical and angiographic characteristics, and the clinical outcomes of diabetic patients with asymptomatic or symptomatic coronary artery disease (CAD). METHODS: Three hundred and ten consecutive diabetic patients with CAD were divided into two groups according to the presence of angina and followed for a mean of 5 years. Fifty-six asymptomatic patients with a positive stress test and CAD on coronary angiography were compared with 254 symptomatic patients, 167 with unstable angina and 87 with chronic stable angina. RESULTS: Although the severity of coronary atherosclerosis was similar in asymptomatic and symptomatic patients, revascularization therapy was performed less frequently in the asymptomatic than the symptomatic patients (26.8 vs. 62.0%; P < 0.001). Asymptomatic patients experienced a similar number of major adverse cardiac events (MACEs; death, non-fatal myocardial infarction, and revascularization; 32 vs. 28%; P = 0.57), but had higher cardiac mortality than symptomatic patients (26 vs. 9%; P < 0.001). However, patients who underwent revascularization therapy at the time of CAD diagnosis in these two groups showed similar MACE and cardiac mortality (20.0 vs. 22.5%, 6.7 vs. 5.3%, respectively; all P > 0.05). CONCLUSIONS: This study suggests that diabetic patients with asymptomatic CAD have a higher cardiac mortality risk than those with symptomatic CAD, and that lack of revascularization therapy may be responsible for the poorer survival.
ISSN
0742-3071 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17509072

http://hdl.handle.net/10371/22156
DOI
https://doi.org/10.1111/j.1464-5491.2007.02182.x
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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