scholarly journals Prognostic Utility of Coronary CT Angiography-derived Plaque Information on Long-Term Outcome in Patients With and Without Diabetes mellitus

2021 ◽  
Author(s):  
Christian Tesche ◽  
Moritz Baquet ◽  
Maximilian Bauer ◽  
Florian Straube ◽  
Stefan Hartl ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Ct Angiography ◽  
Risk Scores ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Coronary Ct ◽  
Adverse Cardiac Events ◽  
Patients With Diabetes ◽  
Low Attenuation Plaque

Abstract PurposeTo investigate the long-term prognostic value of coronary CT angiography (cCTA)-derived plaque information on major adverse cardiac events (MACE) in patients with and without diabetes mellitus. Methods64 patients with diabetes (63.3±10.1 years, 66% male) and suspected coronary artery disease (CAD) who underwent cCTA were matched with 297 patients without diabetes according to age, sex, cardiovascular risk factors, statin and antithrombotic therapy. Major adverse cardiac events (MACE) were recorded. cCTA-derived risk scores and plaque measures were assessed. The discriminatory power to identify MACE was evaluated using multivariable regression analysis and concordance indices (CIs).ResultsAfter a median follow-up of 5.4 years, MACE occurred in 31 patients (8.6%). In patients with diabetes, cCTA risk scores and plaque measures were significantly higher compared to non-diabetic patients (all p<0.05). The following plaque measures were predictors of MACE using multivariable Cox regression analysis (hazard ratio [HR]) in patients with diabetes: segment stenosis score (HR 1.20, p<0.001), low-attenuation plaque (HR 3.47, p=0.05), and in non-diabetic patients: segment stenosis score (HR 1.92, p<0.001), Agatston score (HR 1.0009, p=0.04), and low-attenuation plaque (HR 4.15, p=0.04). A multivariable model showed significantly improved C-index of 0.96 (95% CI 0.94-0.0.97) for MACE prediction, when compared to single measures alone.ConclusionDiabetes is associated with a significantly higher extent of CAD and plaque features, which have independent predictive values for MACE. cCTA-derived plaque information portends improved risk stratification of patients with diabetes beyond assessment of obstructive stenosis on cCTA alone.

scholarly journals Long-Term Prognostic Utility of Coronary CT Angiography in Stable Patients With Diabetes Mellitus

2016 ◽  
Vol 9 (11) ◽  
pp. 1280-1288 ◽  
Author(s):  
Philipp Blanke ◽  
Christopher Naoum ◽  
Amir Ahmadi ◽  
Chaitu Cheruvu ◽  
Jeanette Soon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Coronary Ct ◽  
Patients With Diabetes ◽  
Prognostic Utility

Outcomes and complications after percutaneous release for trigger digits in diabetic and non-diabetic patients

2015 ◽  
Vol 40 (7) ◽  
pp. 735-739 ◽  
Author(s):  
H.-K. Huang ◽  
J.-P. Wang ◽  
S.-T. Wang ◽  
Y.-A. Liu ◽  
Y.-C. Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Patients ◽  
Short Term ◽  
Level Of Evidence ◽  
Evidence Level ◽  
Percutaneous Release ◽  
Patients With Diabetes

We compared the short-term (3 months) and long-term (2 years) outcomes and complications of percutaneous release of 187 trigger digits of 154 patients treated between 2009 and 2012, all treated by a single surgeon. The 154 patients included 48 patients with diabetes mellitus and 106 non-diabetic patients. The only short-term complication was pain, occurring in three digits (5%) in the diabetic patients and six digits (5%) in the non-diabetic patients. The long-term complications were pain in 15 digits (25%) in the diabetic patients and 18 digits (14%) in the non-diabetic patients. This was not significant ( p = 0.058). Recurrent triggering occurred in nine digits (15%) in the diabetic patients, which was significantly greater than the six digits (5%) in the non-diabetic patients ( p = 0.013). The non-diabetic patients were significantly more satisfied. Level of Evidence: level III

scholarly journals Predictive Value of N-Terminal Prohormone of Brain Natriuretic Peptide in Long-Term Remodeling of the Left Ventricle in Diabetic Patients of Young and Middle Age With Acute Coronary Syndrome After Percutaneous Coronary Intervention

2021 ◽  
Vol 9 (4) ◽  
pp. 511-520
Author(s):  
Z. Wang ◽  
E. A. Asaphyeva ◽  
T. I. Makeeva
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Middle Age ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
Long Term Prognosis

Abstract. Recently, quantitative analysis of the level of the N-terminal prohormone of the brain naturetic peptide (NT-proBNP) has been widely used to diagnose heart failure (HF). A statistically significant correlation was found between the serum NT-proBNP concentration and HF stage. It was found that in patients with high cardiovascular risk, NT-proBNP has the highest predictive value in relation to mortality. In young and middle-aged patients with diabetes mellitus (DM) with myocardial infarction (MI) and stents of an infarct-associated artery, the frequency of unfavorable remodeling (UR) of the left ventricle (LV) in the long-term prognosis was studied. The frequency of atherosclerotic lesions of the coronary arteries (CA) in patients with diabetes in acute coronary syndrome (ACS) was determined, the results of echocardiographic parameters were presented in the follow-up dynamics, the value of serum NT-proBNP in predicting LV UR 12 months after myocardial infarction (MI) was determined.Aim of study. To assess the diagnostic capabilities of NT-proBNP in the long-term prediction of the development of LV infarction in patients with MI with diabetes in young and middle age after percutaneous coronary intervention (PCI).Design. Prospective controlled non-randomized trial. The patients were examined twice: on the first day of ACS after PCI with stenting of infarct-associated coronary artery and 12 months after AMI. The study included 191 patients with ACS with / without ST-segment elevation, who were divided into two groups. The main group included 76 patients with ACS with diabetes mellitus, the comparison group included 115 patients with ACS without diabetes mellitus. Patients in both groups were comparable in age, gender, comorbidity, and complications of AMI. The duration of diabetes was, on average, 6 years (from one to 12 years).Material and methods. All patients underwent electrocardiography, echocardiography, tests for the content of troponin I, NT-proBNP, glycosylated hemoglobin, lipids, determined the level of creatinine in the blood and the glomerular filtration rate according to the Modification of diet in renal disease (MDRD). All patients were examined twice: on the first day of ACS after PCI with stenting of infarct-associated coronary artery and 12 months later.Results. In 69% of diabetic patients with anterior myocardial infarction and in 63% of patients with posterolateral MI 12 months after PCI, signs of LV inferiority were revealed in the form of an increase in the indices of end-diastolic and systolic volumes of the LV and low ejection fraction (≤45%). In patients without diabetes, these figures were 18% and 31%, respectively. High concentrations of NT-proBNP on the first day of myocardial infarction after PCI were of the greatest value in the diagnosis and prognosis of LV UR after 12 months.Conclusion. The NT-proBNP level of more than 776 pg/ml on the first day after PCI is an indicator of an unfavorable long-term prognosis in patients with young and middle-aged diabetes in terms of the development of LV systolic dysfunction.

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