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Can cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-up

2014Journal article Open access
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dc.contributor.authorFaustino, A
dc.contributor.authorProvidência, R
dc.contributor.authorMota, P
dc.contributor.authorBarra, S
dc.contributor.authorSilva, J
dc.contributor.authorFernandes, A
dc.contributor.authorCatarino, R
dc.contributor.authorBasso, S
dc.contributor.authorCosta, M
dc.contributor.authorLeitão-Marques, A
dc.date.accessioned2014-02-28T12:16:16Z
dc.date.available2014-02-28T12:16:16Z
dc.date.issued2014
dc.description.abstractBACKGROUND: Doubts remain about atherosclerotic disease and risk stratification of asymptomatic type-2 diabetic patients (T2DP). This study aims to evaluate the usefulness of calcium score (CS) and coronary computed tomography (CT) angiography (CTA) to predict fatal and non fatal cardiovascular events (CVEV) in T2DP. METHODS: Eighty-five consecutive T2DP undergoing CT (Phillips Brilliance, 16-slice) with CS and CTA were prospectively enrolled in a transversal case-control study. Patients were followed for 48 months (range 18 - 68) to assess CVEV: cardiovascular death, acute coronary syndrome, revascularisation and stroke. Potential predictors of CVEV were identified. Predictive models based on clinical features, CTA and CS were created and compared. RESULTS: Performing CT impacted T2DP treatment. Cardiovascular risk was lowered during follow-up but metabolic control remained suboptimal. CVEV occurred in 11.8% T2DP (3.1%/year). CS ≥86.6 was predictor of CVEV over time, with a high negative predictive value, an 80% sensitivity and 74.7% specificity. Although its prognostic value was not independent of the presence/absence of obstructive CAD, adding CS and CTA data to clinical parameters improved the prediction of CVEV: the combined model had the highest AUC (0.888, 95%CI 0.789-0.987, p < 0.001) for the prediction of the study endpoints. CONCLUSIONS: CS showed great value in T2DP risk stratification and its prognostic value was further enhanced by CTA data. Information provided by CT may help predict CVEV in T2DP and potentially improve their outcome.por
dc.identifier.citationBMC Cardiovasc Disord. 2014 Jan 8;14:2.por
dc.identifier.urihttp://hdl.handle.net/10400.4/1647
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherBMCpor
dc.subjectDoenças Cardiovascularespor
dc.subjectTomografia Computorizadapor
dc.subjectDiabetes Mellitus Tipo 2por
dc.titleCan cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-uppor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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