S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Assessment of Subclinical Coronary Atherosclerosis in Asymptomatic Patients With Type 2 Diabetes Mellitus With Single Photon Emission Computed Tomography and Coronary Computed Tomography Angiography
- Choi, Eue-Keun; Chun, Eun Ju; Choi, Sang-Il; Chang, Sung-A; Lim, Soo; Nasir, Khurram; Jang, Hak-Chul; Chang, Hyuk-Jae; Blumenthal, Roger S.; Rivera, Juan J.; Choi, Sung-Hee
- Issue Date
- EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
- AMERICAN JOURNAL OF CARDIOLOGY; Vol.104 7; 890-896
- We evaluated the characteristics of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus (DM) using single photon emission computed tomography (SPECT) and coronary computed tomographic angiography (CCTA). A total of 116 patients with DM without abnormal electrocardiographic findings or evidence of peripheral arterial disease (number of risk factors >= 2; 62 +/- 7 years, 59% men) underwent CCTA and SPECT. Of the 116 patients with DM, 88 (76%) had a normal single photon emission computed tomographic findings, and 28 (24%) had abnormal perfusion defects. Of the 116 patients, 92 (79%) had atherosclerotic plaques (2 +/- 2 segments per subject), and 20 (17%) had significant stenosis seen on CCTA. Patients with DM and normal findings on SPECT had a similar prevalence of atherosclerotic plaque (78% vs 82% significant stenosis (15% vs 25%), severe stenosis (7% vs 7% and calcified (40% vs 43% mixed (49% vs 57% and noncalcified plaques (26% vs 29%) and a high (> 100) coronary artery calcium score (32% vs 29%; all p >0.05) compared to those with abnormal findings on SPECT. During the mid-term follow-up (24 +/- 4 months), 5 cardiac events occurred in patients with DM and normal findings on SPECT, only in those with occult CAD on CCTA: 1 sudden cardiac death and 4 revascularization procedures. In conclusion, a significant percentage of patients with DM and normal eletrocardiographic findings, no peripheral arterial disease, and normal findings on SPECT have evidence of occult CAD on CCTA. Furthermore, a small percentage had had a cardiac event by mid-term follow-up. SPECT showed limited capability to differentiate the coronary risks between patients with DM and no coronary plaque and from those with a certain degree of disease; 2 circumstances that represent different coronary risks. (C) 2009 Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104:890-896)
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