Secondary prevention of coronary artery disease in high-risk diabetic patients

2003 ◽  
Vol 13 (4) ◽  
pp. 238-243 ◽  
Author(s):  
C. Giorda ◽  
M. Maggini ◽  
S. Spila Alegiani ◽  
S. Turco ◽  
R. Raschetti
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Secondary Prevention ◽  
Diabetic Patients ◽  
Artery Disease

scholarly journals Prognostic Value of Atherosclerotic Extent in Diabetic Patients with Nonobstructive Coronary Artery Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yipu Ding ◽  
Zinuan Liu ◽  
Guanhua Dou ◽  
Xia Yang ◽  
Xi Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Prognostic Value ◽  
Risk Scores ◽  
Plaque Burden ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Nonobstructive Coronary Artery Disease ◽  
Artery Disease

Background and Objective. Atherosclerotic extent was proved to be associated with adverse cardiac events. Risk scores derived by coronary computed tomography angiography (CCTA) could identify high-risk group among patients with nonobstructive coronary artery disease (CAD), but the ability is still uncertain in the presence of diabetes mellitus (DM). The purpose of this study was to investigate the prognostic value of the atherosclerotic extent shown by CCTA in diabetic patients with nonobstructive CAD. Methods and Results. 813 DM patients (mean age 58.9 ± 9.9 years, 48.1% male) referred for CCTA due to suspected CAD in 2015-2017 were consecutively included. During a median follow-up of 31.77 months, 50 major adverse cardiovascular events (MACEs) (6.15%) were experienced, including 2 cardiovascular deaths, 14 nonfatal myocardial infarctions, 27 unstable anginas requiring hospitalization, and 7 strokes. Three groups were defined based on coronary stenosis combined with Leiden score as normal, nonobstructive Leiden < 5 , and nonobstructive Leiden ≥ 5 . Cox models were used to assess the prognosis of plaque burden within these groups. An incremental incidence of MACE rates was observed. After adjustment for age, gender, and presence of high-risk plaque, the group of Leiden ≥ 5 showed a higher risk than Leiden < 5 (HR: 1.88, 95% CI: 1.03-3.42, p = 0.039 ). Similar results were observed when segment involvement score (SIS) was used for sensitivity analysis. Conclusion. Atherosclerotic extent was associated with the prognosis of DM patients with nonobstructive coronary artery disease, highlighting the importance of better risk stratification and management.

scholarly journals Improved Survival in Asymptomatic Diabetic Patients With High-Risk Spect Imaging Treated With Coronary Artery Bypass Grafting

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Paul Sorajja ◽  
Panithaya Chareonthaitawee ◽  
Navin Rajagopalan ◽  
Todd D. Miller ◽  
Robert L. Frye ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
High Risk ◽  
Artery Bypass ◽  
Survival Advantage ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Artery Disease ◽  
Bypass Angioplasty Revascularization Investigation

Background— The Bypass Angioplasty Revascularization Investigation trial demonstrated that symptomatic diabetics with multivessel coronary artery disease had a survival advantage with initial coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI). No published study has examined different treatments and outcome in asymptomatic diabetics. Methods and Results— This study group consisted of 826 asymptomatic diabetics (age 62±12 years; 76% men) without known coronary artery disease who had abnormal myocardial perfusion during stress single photon emission computed tomography (SPECT). SPECT images were classified as low-, intermediate-, and high-risk. Early revascularization (CABG or PCI ≤4 months after SPECT) was performed in 76 patients. Survival (follow-up, 5.3±3.3 years) was compared in patients treated with CABG, PCI, or medical therapy. Revascularization (CABG or PCI) was performed in 54 of 261 patients with high-risk scans and was independently associated with improved survival (χ 2 =4.55; P =0.03 after multivariate adjustment). Subset analysis demonstrated that the survival advantage was confined to patients treated with CABG (n =39), with a 5-year survival CABG at 85%, PCI at 72%, and medical therapy at 67% ( P =0.02 for 3 groups). Although CABG was associated with better survival, mortality remained high (3% per year). There was no survival advantage by treatment for patients with less-severe SPECT abnormalities. Conclusions— These nonrandomized data suggest that CABG improves survival in asymptomatic diabetic patients with high-risk SPECT, although revascularization was performed infrequently in these patients. These results parallel those of the Bypass Angioplasty Revascularization Investigation trial in symptomatic diabetic patients.

scholarly journals Prognostic Value of Atherosclerotic Extent in Diabetic Patients with Non-Obstructive Coronary Artery Disease

2021 ◽  
Author(s):  
Yipu Ding ◽  
Zinuan Liu ◽  
Guanhua Dou ◽  
Xia Yang ◽  
Xi Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Prognostic Value ◽  
Obstructive Coronary Artery Disease ◽  
High Risk Group ◽  
Plaque Burden ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Artery Disease

Abstract Background and Objective: Atherosclerotic extent was approved to be associated with adverse cardiac events. Risk score derived by coronary computed tomography angiography (CCTA) could identify high-risk group among patients with non-obstructive coronary artery disease (CAD) but its ability is still uncertain in the presence of diabetes mellitus (DM). The purpose of this study was to investigate the prognostic value of the plaque burden shown by CCTA in diabetic patients with non-obstructive CAD.Methods and Results: 813 DM patients (age 58.9±9.9 years, 48.1% male) referred for CCTA due to suspect CAD in 2015-2017 were consecutively included. During a median follow-up of 31.77 months, 50 MACEs (6.15%) were experienced, including 2 cardiovascular deaths, 14 non-fatal myocardial infarction, 27 unstable angina requiring hospitalization and 7 strokes. 3 groups were defined based on coronary stenosis combined with Leidon score, as normal, non-obstructive Leidon<5, and non-obstructive Leidon≥5. Cox models was used to assess the prognosis of plaque burden within these groups. An incremental incidence of outcome event rates was observed. After adjustment for age, gender, and presence of high-risk plaque, the group of Leidon≥5 showed a higher risk than Leidon<5 in non-obstructive CAD (HR:1.88 95%CI:1.03-3.42, p＝0.039). Similar results were illustrated when segment involvement score was used for sensitivity analysis.Conclusion: Atherosclerotic extent was associated with the prognosis of DM patients with non-obstructive coronary disease, highlighting the importance of better risk stratification and management.

scholarly journals NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

2012 ◽  
Vol 11 (1) ◽  
pp. 19 ◽  
Author(s):  
Henrik Reinhard ◽  
Peter R Hansen ◽  
Niels Wiinberg ◽  
Andreas Kjær ◽  
Claus L Petersen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
High Risk Type ◽  
Artery Disease ◽  
Type 2 Diabetic

Obstructive coronary artery disease in high-risk diabetic patients with and without atrial fibrillation

2009 ◽  
Vol 20 (2) ◽  
pp. 91-93 ◽  
Author(s):  
Bredy Pierre-Louis ◽  
Wilbert S. Aronow ◽  
Chandrasekar Palaniswamy ◽  
Tarunjit Singh ◽  
Melvin B. Weiss ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Obstructive Coronary Artery Disease ◽  
Diabetic Patients ◽  
Artery Disease

scholarly journals Dual Antiplatelet or Dual Antithrombotic Therapy for Secondary Prevention in High-Risk Patients with Stable Coronary Artery Disease?

2019 ◽  
Vol 119 (10) ◽  
pp. 1583-1589 ◽  
Author(s):  
Wael Sumaya ◽  
Tobias Geisler ◽  
Steen D. Kristensen ◽  
Robert F. Storey
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Secondary Prevention ◽  
Dual Antiplatelet Therapy ◽  
Stable Coronary Artery Disease ◽  
Risk Patients ◽  
History Of ◽  
Artery Disease

AbstractAntithrombotic treatment is a key component of secondary prevention following acute coronary syndromes (ACS). Although dual antiplatelet therapy is standard therapy post-ACS, duration of treatment is the subject of ongoing debate. Prolonged dual antiplatelet therapy in high-risk patients with history of myocardial infarction reduced the risk of recurrent myocardial infarction, stroke or cardiovascular death. Similarly, in patients with stable coronary artery disease, two-thirds of whom had a history of myocardial infarction, dual antithrombotic therapy with very-low-dose rivaroxaban and aspirin also resulted in improved ischaemic outcomes. In the absence of head-to-head comparison, choosing the most appropriate treatment strategy can be challenging, particularly when it comes to balancing the risks of ischaemia and bleeding. We aim to review the evidence for currently available antithrombotic treatments and provide a practical algorithm to aid the decision-making process.

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