Increased prevalence of significant coronary artery calcification in patients with diabetes
Increased prevalence of significant coronary artery calcification in patients with diabetes
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DOI：
10.2337/diacare.24.2.335
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发表时间：
2001-02-01
期刊：
影响因子：
16.2
通讯作者：
Mazzone, T
中科院分区：
文献类型：
--
作者：
Schurgin, S;Rich, S;Mazzone, T
目的-冠状动脉疾病是糖尿病患者发病和死亡的主要原因。在第一次心肌梗死和心绞痛症状之前检测冠状动脉疾病将允许设计策略以降低该组患者的心血管事件发生率。电子束计算机断层扫描（EBCT）是一种非侵入性的技术，用于评估冠状动脉粥样硬化的程度，依赖于冠状动脉钙（CAC）的检测。我们使用电子束CT检测显着的冠状动脉粥样硬化的糖尿病患者没有心脏病的症状。研究设计和方法-我们使用电子束CT评估钙在冠状动脉的139个连续的糖尿病患者扫描超过20个月的时间。将该组患者的CAC评分与随机选择的非糖尿病对照组和选择与一些已建立的心血管危险因素相匹配的对照组进行比较。（25.9%）与随机选择的（7.2%）和匹配的（14.4%）非糖尿病对照组相比。据报道，该范围内的评分对异常负荷心肌灌注断层扫描和随后的冠状动脉事件具有高度预测性。结论-因此，我们的结果表明，与非糖尿病对照受试者相比，无症状糖尿病患者人群中严重冠状动脉疾病的患病率很高。他们还建议EBCT可能是一种有用的方法，用于选择一组糖尿病受试者，这些受试者将从亚临床冠状动脉疾病的额外评估中获益最多。
OBJECTIVE- Coronary artery disease is the major cause of morbidity and mortality in patients with diabetes. Detection of coronary artery disease before the first myocardial infarction and before anginal symptoms will allow for strategies designed to reduce the cardiovascular event rate in this group of patients. Electron beam-computed tomography (EBCT) is a noninvasive technology for evaluating the extent of coronary artery atherosclerosis that relies on the detection of coronary artery calcium (CAC). We used EBCT to detect significant coronary artery atherosclerosis in diabetic patients without symptoms of heart disease.RESEARCH DESIGN AND METHODS- We used EBCT to evaluate calcium in the coronary arteries of 139 consecutive diabetic patients scanned over a 20-month period. The CAC scores in this group were compared with a randomly selected nondiabetic control group and a control group that was selected to match a number of established cardiovascular risk factors.RESULTS- Patients with diabetes had a significant increase in the prevalence of CAC scores greater than or equal to 400 (25.9%) compared with the randomly selected (7.2%) and matched (14.4%) nondiabetic control groups. Scores in this range have been reported to be highly predictive for abnormal stress myocardial perfusion tomography and subsequent coronary events.CONCLUSIONS- Our results, therefore, indicate a substantial prevalence of significant coronary artery disease in an asymptomatic diabetic patient population compared with nondiabetic control subjects. They also suggest that EBCT may be a useful approach for selecting a group of diabetic subjects who would benefit most from additional evaluation for subclinical coronary artery disease.