TY - JOUR
T1 - Differences in prevalence, extent, severity, and prognosis of coronary artery disease among patients with and without diabetes undergoing coronary computed tomography angiography
T2 - Results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN for Clinical Outcomes): An InteRnational Multicenter Registry
AU - Rana, Jamal S.
AU - Dunning, Allison
AU - Achenbach, Stephan
AU - Al-Mallah, Mouaz
AU - Budoff, Matthew J.
AU - Cademartiri, Filippo
AU - Callister, Tracy Q.
AU - Chang, Hyuk Jae
AU - Cheng, Victor Y.
AU - Chinnaiyan, Kavitha
AU - Chow, Benjamin J.W.
AU - Cury, Ricardo
AU - Delago, Augustin
AU - Feuchtner, Gudrun
AU - Hadamitzky, Martin
AU - Hausleiter, Jörg
AU - Kaufmann, Philipp
AU - Karlsberg, Ronald P.
AU - Kim, Yong Jin
AU - Leipsic, Jonathon
AU - Labounty, Troy M.
AU - Lin, Fay Y.
AU - Maffei, Erica
AU - Raff, Gilbert
AU - Villines, Todd C.
AU - Shaw, Leslee J.
AU - Berman, Daniel S.
AU - Min, James K.
PY - 2012/8
Y1 - 2012/8
N2 - OBJECTIVE - We examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individualswith and without diabetes (DM) who are similar in CAD risk factors. RESEARCH DESIGN ANDMETHODS - 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.
AB - OBJECTIVE - We examined the prevalence, extent, severity, and prognosis of coronary artery disease (CAD) in individualswith and without diabetes (DM) who are similar in CAD risk factors. RESEARCH DESIGN ANDMETHODS - 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.
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U2 - 10.2337/dc11-2403
DO - 10.2337/dc11-2403
M3 - Article
C2 - 22699296
AN - SCOPUS:84864383665
SN - 0149-5992
VL - 35
SP - 1787
EP - 1794
JO - Diabetes care
JF - Diabetes care
IS - 8
ER -