Cargando…
Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry
OBJECTIVE: We examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individuals with and without diabetes (DM) who are similar in CAD risk factors. RESEARCH DESIGN AND METHODS: We identified 23,643 consecutive individuals without known CAD undergoing coronary c...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2012
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402246/ https://www.ncbi.nlm.nih.gov/pubmed/22699296 http://dx.doi.org/10.2337/dc11-2403 |
_version_ | 1782238718584684544 |
---|---|
author | Rana, Jamal S. Dunning, Allison Achenbach, Stephan Al-Mallah, Mouaz Budoff, Matthew J. Cademartiri, Filippo Callister, Tracy Q. Chang, Hyuk-Jae Cheng, Victor Y. Chinnaiyan, Kavitha Chow, Benjamin J.W. Cury, Ricardo Delago, Augustin Feuchtner, Gudrun Hadamitzky, Martin Hausleiter, Jörg Kaufmann, Philipp Karlsberg, Ronald P. Kim, Yong-Jin Leipsic, Jonathon Labounty, Troy M. Lin, Fay Y. Maffei, Erica Raff, Gilbert Villines, Todd C. Shaw, Leslee J. Berman, Daniel S. Min, James K. |
author_facet | Rana, Jamal S. Dunning, Allison Achenbach, Stephan Al-Mallah, Mouaz Budoff, Matthew J. Cademartiri, Filippo Callister, Tracy Q. Chang, Hyuk-Jae Cheng, Victor Y. Chinnaiyan, Kavitha Chow, Benjamin J.W. Cury, Ricardo Delago, Augustin Feuchtner, Gudrun Hadamitzky, Martin Hausleiter, Jörg Kaufmann, Philipp Karlsberg, Ronald P. Kim, Yong-Jin Leipsic, Jonathon Labounty, Troy M. Lin, Fay Y. Maffei, Erica Raff, Gilbert Villines, Todd C. Shaw, Leslee J. Berman, Daniel S. Min, James K. |
author_sort | Rana, Jamal S. |
collection | PubMed |
description | OBJECTIVE: We examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individuals with and without diabetes (DM) who are similar in CAD risk factors. RESEARCH DESIGN AND METHODS: We identified 23,643 consecutive individuals without known CAD undergoing coronary computed tomography angiography. A total of 3,370 DM individuals were propensity matched in a 1-to-2 fashion to 6,740 unique non-DM individuals. CAD was defined as none, nonobstructive (1–49% stenosis), or obstructive (≥50% stenosis). All-cause mortality was assessed by risk-adjusted Cox proportional hazards models. RESULTS: At a 2.2-year follow-up, 108 (3.2%) and 115 (1.7%) deaths occurred among DM and non-DM individuals, respectively. Compared with non-DM individuals, DM individuals possessed higher rates of obstructive CAD (37 vs. 27%) and lower rates of having normal arteries (28 vs. 36%) (P < 0.0001). CAD extent was higher for DM versus non-DM individuals for obstructive one-vessel disease (19 vs. 14%), two-vessel disease (9 vs. 7%), and three-vessel disease (9 vs. 5%) (P < 0.0001 for comparison), with higher per-segment stenosis in the proximal and mid-segments of every coronary artery (P < 0.001 for all). Compared with non-DM individuals with no CAD, risk of mortality for DM individuals was higher for those with no CAD (hazard ratio 3.63 [95% CI 1.67–7.91]; P = 0.001), nonobstructive CAD (5.25 [2.56–10.8]; P < 0.001), one-vessel disease (6.39 [2.98–13.7]; P < 0.0001), two-vessel disease (12.33 [5.622–27.1]; P < 0.0001), and three-vessel disease (13.25 [6.15–28.6]; P < 0.0001). CONCLUSIONS: Compared with matched non-DM individuals, DM individuals possess higher prevalence, extent, and severity of CAD. At comparable levels of CAD, DM individuals experience higher risk of mortality compared with non-DM individuals. |
format | Online Article Text |
id | pubmed-3402246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-34022462013-08-01 Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry Rana, Jamal S. Dunning, Allison Achenbach, Stephan Al-Mallah, Mouaz Budoff, Matthew J. Cademartiri, Filippo Callister, Tracy Q. Chang, Hyuk-Jae Cheng, Victor Y. Chinnaiyan, Kavitha Chow, Benjamin J.W. Cury, Ricardo Delago, Augustin Feuchtner, Gudrun Hadamitzky, Martin Hausleiter, Jörg Kaufmann, Philipp Karlsberg, Ronald P. Kim, Yong-Jin Leipsic, Jonathon Labounty, Troy M. Lin, Fay Y. Maffei, Erica Raff, Gilbert Villines, Todd C. Shaw, Leslee J. Berman, Daniel S. Min, James K. Diabetes Care Original Research OBJECTIVE: We examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individuals with and without diabetes (DM) who are similar in CAD risk factors. RESEARCH DESIGN AND METHODS: We identified 23,643 consecutive individuals without known CAD undergoing coronary computed tomography angiography. A total of 3,370 DM individuals were propensity matched in a 1-to-2 fashion to 6,740 unique non-DM individuals. CAD was defined as none, nonobstructive (1–49% stenosis), or obstructive (≥50% stenosis). All-cause mortality was assessed by risk-adjusted Cox proportional hazards models. RESULTS: At a 2.2-year follow-up, 108 (3.2%) and 115 (1.7%) deaths occurred among DM and non-DM individuals, respectively. Compared with non-DM individuals, DM individuals possessed higher rates of obstructive CAD (37 vs. 27%) and lower rates of having normal arteries (28 vs. 36%) (P < 0.0001). CAD extent was higher for DM versus non-DM individuals for obstructive one-vessel disease (19 vs. 14%), two-vessel disease (9 vs. 7%), and three-vessel disease (9 vs. 5%) (P < 0.0001 for comparison), with higher per-segment stenosis in the proximal and mid-segments of every coronary artery (P < 0.001 for all). Compared with non-DM individuals with no CAD, risk of mortality for DM individuals was higher for those with no CAD (hazard ratio 3.63 [95% CI 1.67–7.91]; P = 0.001), nonobstructive CAD (5.25 [2.56–10.8]; P < 0.001), one-vessel disease (6.39 [2.98–13.7]; P < 0.0001), two-vessel disease (12.33 [5.622–27.1]; P < 0.0001), and three-vessel disease (13.25 [6.15–28.6]; P < 0.0001). CONCLUSIONS: Compared with matched non-DM individuals, DM individuals possess higher prevalence, extent, and severity of CAD. At comparable levels of CAD, DM individuals experience higher risk of mortality compared with non-DM individuals. American Diabetes Association 2012-08 2012-07-14 /pmc/articles/PMC3402246/ /pubmed/22699296 http://dx.doi.org/10.2337/dc11-2403 Text en © 2012 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Original Research Rana, Jamal S. Dunning, Allison Achenbach, Stephan Al-Mallah, Mouaz Budoff, Matthew J. Cademartiri, Filippo Callister, Tracy Q. Chang, Hyuk-Jae Cheng, Victor Y. Chinnaiyan, Kavitha Chow, Benjamin J.W. Cury, Ricardo Delago, Augustin Feuchtner, Gudrun Hadamitzky, Martin Hausleiter, Jörg Kaufmann, Philipp Karlsberg, Ronald P. Kim, Yong-Jin Leipsic, Jonathon Labounty, Troy M. Lin, Fay Y. Maffei, Erica Raff, Gilbert Villines, Todd C. Shaw, Leslee J. Berman, Daniel S. Min, James K. Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title | Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title_full | Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title_fullStr | Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title_full_unstemmed | Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title_short | Differences in Prevalence, Extent, Severity, and Prognosis of Coronary Artery Disease Among Patients With and Without Diabetes Undergoing Coronary Computed Tomography Angiography: Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry |
title_sort | differences in prevalence, extent, severity, and prognosis of coronary artery disease among patients with and without diabetes undergoing coronary computed tomography angiography: results from 10,110 individuals from the confirm (coronary ct angiography evaluation for clinical outcomes): an international multicenter registry |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402246/ https://www.ncbi.nlm.nih.gov/pubmed/22699296 http://dx.doi.org/10.2337/dc11-2403 |
work_keys_str_mv | AT ranajamals differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT dunningallison differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT achenbachstephan differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT almallahmouaz differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT budoffmatthewj differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT cademartirifilippo differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT callistertracyq differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT changhyukjae differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT chengvictory differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT chinnaiyankavitha differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT chowbenjaminjw differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT curyricardo differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT delagoaugustin differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT feuchtnergudrun differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT hadamitzkymartin differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT hausleiterjorg differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT kaufmannphilipp differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT karlsbergronaldp differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT kimyongjin differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT leipsicjonathon differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT labountytroym differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT linfayy differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT maffeierica differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT raffgilbert differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT villinestoddc differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT shawlesleej differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT bermandaniels differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat AT minjamesk differencesinprevalenceextentseverityandprognosisofcoronaryarterydiseaseamongpatientswithandwithoutdiabetesundergoingcoronarycomputedtomographyangiographyresultsfrom10110individualsfromtheconfirmcoronaryctangiographyevaluationforclinicaloutcomesaninternat |