Lee Chang Hoon, Lee Seung Whan, Park Seong Wook
Department of Cardiology, Veterans Health Service Medical Center, Seoul, Korea.
Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Diabetes Metab J. 2018 Oct;42(5):355-363. doi: 10.4093/dmj.2018.0041.
It is well known that diabetic patients have a high risk of cardiovascular events, and although there has been a tremendous effort to reduce these cardiovascular risks, the incidence of cardiovascular morbidity and mortality in diabetic patients remains high. Therefore, the early detection of coronary artery disease (CAD) is necessary in those diabetic patients who are at risk of cardiovascular events. Significant medical and radiological advancements, including coronary computed tomography angiography (CCTA), mean that it is now possible to investigate the characteristics of plaques, instead of solely evaluating the calcium level of the coronary artery. Recently, several studies reported that the prevalence of subclinical coronary atherosclerosis (SCA) is higher than expected, and this could impact on CAD progression in asymptomatic diabetic patients. In addition, several reports suggest the potential benefit of using CCTA for screening for SCA in asymptomatic diabetic patients, which might dramatically decrease the incidence of cardiovascular events. For these reasons, the medical interest in SCA in diabetic patients is increasing. In this article, we sought to review the results of studies on CAD in asymptomatic diabetic patients and discuss the clinical significance and possibility of using CCTA to screen for SCA.
众所周知，糖尿病患者发生心血管事件的风险很高，尽管人们已经付出巨大努力来降低这些心血管风险，但糖尿病患者心血管疾病的发病率和死亡率仍然很高。因此，对于有心血管事件风险的糖尿病患者，早期检测冠状动脉疾病（CAD）很有必要。包括冠状动脉计算机断层扫描血管造影（CCTA）在内的重大医学和放射学进展意味着，现在可以研究斑块的特征，而不仅仅是评估冠状动脉的钙化水平。最近，几项研究报告称，亚临床冠状动脉粥样硬化（SCA）的患病率高于预期，这可能会影响无症状糖尿病患者的CAD进展。此外，几份报告表明，使用CCTA对无症状糖尿病患者进行SCA筛查可能有益，这可能会显著降低心血管事件的发生率。出于这些原因，医学界对糖尿病患者SCA的关注度正在提高。在本文中，我们试图回顾无症状糖尿病患者CAD的研究结果，并讨论使用CCTA筛查SCA的临床意义和可能性。
