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Subject Area

Cardiology and Vascular Medicine

Article Type

Original Study

Abstract

Objectives To study the prognostic value of coronary computed tomography (CT) angiography in asymptomatic diabetic patients. Background Diabetic patients have a higher prevalence of coronary artery disease (CAD) and are more likely to have silent myocardial ischemia and myocardial infarction than nondiabetics and are characterized by multivessel disease and calcified, diffuse, and distal lesions. CT coronary angiography is a safe, accurate, and reliable technique of high ability to detect CAD and estimate the degree of obstruction, number of affected arteries, and the pattern of their affection and a reliable modality for exclusion of CAD. Patients and methods This study was conducted on 99 patients with type 2 diabetes mellitus without symptoms of CAD. Patients were referred for multislice CT angiography, for diagnosis of CAD and to detect patients with obstructive coronary lesions, and then patients were followed up for 1 year for cardiac events (cardiac death, nonfatal myocardial infarction, unstable angina, or late coronary revascularization). Results Of the 99 patients, 58 (58.6%) had normal coronaries, 15 (15.2%) patients had nonobstructive, whereas the remaining 26 (26.3%) had obstructive coronary lesions, and of these 26 patients, three (3.03%) patients had moderate stenosis and the remaining 23 (23.3%) patients had severe stenosis. Those with severe stenosis were further classified into one-vessel disease (13 patients, 13.1%) and multivessel disease (10 patients, 10.1%). There were no cases of unstable angina, myocardial infarctions, cardiac deaths, and late coronary revascularization during the follow-up period. Conclusion Asymptomatic type 2 diabetic patients with normal coronary arteries and nonobstructive CAD on coronary CT angiography show excellent clinical outcomes over a 1-year follow-up.

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