64层计算机断层扫描评估无症状糖尿病患者亚临床动脉粥样硬化的患病率

Prevalence of subclinical atherosclerosis in asymptomatic diabetic patients by 64-slice computed tomography.

作者信息

Iwasaki Kohichiro, Matsumoto Takeshi, Aono Hitoshi, Furukawa Hiroshi, Samukawa Masanobu

机构信息

Department of Cardiology, Okayama Central Hospital, Okayama, Japan.

出版信息

Coron Artery Dis. 2008 May;19(3):195-201. doi: 10.1097/MCA.0b013e3282f3fbef.

DOI:10.1097/MCA.0b013e3282f3fbef

PMID:18418237

Abstract

OBJECTIVES

Patients with diabetes have a 2-fold to 4-fold higher risk of a cardiovascular event than nondiabetic patients. Thus there is a need to identify patients with diabetes who are at risk of cardiovascular events before the onset of symptoms. We studied the prevalence of coronary artery disease in asymptomatic diabetic patients compared with asymptomatic nondiabetic patients by 64-slice computed tomography (CT).

METHODS

From 425 asymptomatic patients with coronary risk factors but without known coronary artery disease who underwent 64-slice CT, we identified 93 asymptomatic diabetic patients (diabetic group) and 93 age-matched and sex-matched asymptomatic nondiabetic patients.

RESULTS

Clinical characteristics were not significantly different between the two groups. Total coronary calcium score was significantly higher in diabetic group than that in nondiabetic group (median 117 vs. 53.5, P<0.0001). No coronary calcium was detected in 30.0% of nondiabetic group compared with 15.1% of diabetic group (P=0.0022). Coronary calcium score more than 400 was detected in 9.7% of nondiabetic group compared with 36.6% of diabetic group (P<0.0001). Coronary plaques were found in 67.7% of nondiabetic group compared with 91.4% of diabetic group (P<0.0001). Multiple plaques were detected in 57.0 and 77.4% of patients in nondiabetic and diabetic group, respectively (P=0.0030). Significant coronary stenosis was found in 16.1% of nondiabetic group compared with 33.3% of diabetic group (P=0.0065).

CONCLUSION

Our results show that the prevalence of coronary plaques detectable by 64-slice CT in asymptomatic diabetic patients is very high.

摘要

目的

糖尿病患者发生心血管事件的风险比非糖尿病患者高2至4倍。因此，有必要在症状出现之前识别出有心血管事件风险的糖尿病患者。我们通过64层计算机断层扫描（CT）研究了无症状糖尿病患者与无症状非糖尿病患者中冠状动脉疾病的患病率。

方法

从425例有冠状动脉危险因素但无已知冠状动脉疾病且接受64层CT检查的无症状患者中，我们识别出93例无症状糖尿病患者（糖尿病组）和93例年龄及性别匹配的无症状非糖尿病患者。

结果

两组的临床特征无显著差异。糖尿病组的总冠状动脉钙化积分显著高于非糖尿病组（中位数117对53.5，P<0.0001）。非糖尿病组30.0%未检测到冠状动脉钙化，而糖尿病组为15.1%（P=0.0022）。非糖尿病组9.7%的患者冠状动脉钙化积分超过400，而糖尿病组为36.6%（P<0.0001）。非糖尿病组67.7%发现有冠状动脉斑块，而糖尿病组为91.4%（P<0.0001）。非糖尿病组和糖尿病组分别有57.0%和77.4%的患者检测到多个斑块（P=0.0030）。非糖尿病组16.1%发现有显著冠状动脉狭窄，而糖尿病组为33.3%（P=0.0065）。