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- Title
Carotid Artery Stenosis by Multidetector Computed Tomography Is a Good Predictor for Coronary Artery Disease in Korean Type 2 Diabetic Patients.
- Authors
Kim, Hyo-Jeong; Kim, Hyun-Jin; Park, Kang Seo; Han, Kyung Ah; Min, Kyung Wan; Kim, Eung Jin
- Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability in type 2 diabetic patients but the diagnosis can be delayed due to higher prevalence of silent myocardial ischemia. The aim of this study was to investigate the usefulness of carotid artery lesions for predicting CVD in Korean type 2 diabetic patients. We evaluated the prevalence of carotid artery stenosis (CS) and coronary artery disease (CAD) by multidetector coronary CT angiography in 57 diabetic patients who had one or more components of followings; increases of carotid intimal-media thickness (IMT) with/without plaque by high resolution B-mode ultrasound (hr-US) (n=27), atypical chest pain (n=12), ischemic changes on EKG (n=31), or previous CVD history (n=5) (patients who had 1 component ; n=40, 2 components ; n=16, and 3 components ; n=1). Peripheral artery disease (PAD) was also evaluated by using ankle-brachial index (ABI < 0.9) or pulse wave velocity (PWV ≥ 9 m/sec). The age of subjects was 61.5 ± 9.8 years, the duration of diabetes was 12.3 ± 9.2 years, HbA1c was 7.5 ± 1.4%, and the mean/maximal IMT were 0.79 ± 0.17 mm / 0.96 ± 0.22 mm. The prevalence of hypertension, hyperlipidemia, smoking, and previous CVD histoy were 80.0%, 85.5%, 21.8% and 14.6%. The prevalence of CS, CAD and PAD were 21.1%, 59.6%, and 56.0%, respectively. CS and CAD were strongly associated with each other (r = 0.43, P <0.01), but not with PAD. The prevalence of CAD in patients who had an increases of carotid IMT with/without plaque in hr-US was comparable to those in whom had other three components suspecting CAD (66.7% vs. 54.5% in case of atypical chest pain, 54.2% in case of ischemic changes on EKG, 100% in case of previous CVD history, respectively) (P = NS). CS was the most reliable predictor for CAD, analyzed by multiple regression analysis (r²=0.39, P <0.05) (Table). We concluded that carotid lesions detected by hr-US and CS measured by multidetector CT angiography could be used as useful screening tools for predicting CAD better than any other traditional atherosclerotic risk factors in Korean type 2 diabetic patients.
- Subjects
CAROTID artery stenosis; STENOSIS; TOMOGRAPHY; CORONARY disease; PEOPLE with diabetes; KOREANS; CARDIOVASCULAR diseases; DIABETES complications
- Publication
Diabetes, 2007, Vol 56, pA185
- ISSN
0012-1797
- Publication type
Article