Abstract
Background: The value of cardiac computed tomography (CT) for screening and risk stratification in patients with type 2 diabetes mellitus (DM) who are at a higher cardiovascular risk is unclear. Thus, this study aim s to investigate the efficacy of cardiac CT in predicting long-term cardiovascular events (CVEVs) in this subset of patients. Methods: Type 2 diabetic with a higher cardiovascular risk who underwent cardiac CT between 2012 and 2014 were included in this study. Cardiac CT was performed, and coronary artery calcium score, location and extent of lesion, stenosis severity, plaque composition, and epicardial adipose tissue (EAT) volume were assessed. The endpoints were a composite of CVEVs (cardiac death, non-fatal myocardial infarction, or coronary revascularization,non-fatal stroke, hospitalization for unstable angina, and hospitalization for congestive heart failure). Potential predictors of CVEVs were identified. Predictive models were created and compared. Results: CVEVs occurred in 26.8% of the patients. Independent predictors of CVEVs included diabetes duration (odds ratio [OR]=10.003), mean creatinine level (OR=3.845), hypertension (OR=3.844), atheroma burden obstructive score (OR=14.060), segment stenosis score (OR=7.912), and EAT volume (OR=7.947). The model including cardiac CT data and clinical parameters improved the prediction of CVEVs, with an area under the receiver operating characteristic curve of 0.912 (95% confidence interval 0.829–0.963; p<0.05) for the prediction of the study endpoints. Conclusion: Cardiac CT showed a great value in risk stratification for patients with diabetes with higher cardiovascular risk. Cardiac CT data may help predict CVEVs and potentially improve outcomes.
Usefulness of QT-interval parameters for cardiovascular risk stratification in type 2 diabetic patients with arterial hypertension
