New Strategy for Detection of Subclinical Coronary Atherosclerosis in Asymptomatic Patients With Type 2 Diabetes Based on Cardiac Multi-Detector Computed Tomography and Treadmill Test
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概要
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Background: The current screening strategy for subclinical coronary atherosclerosis in asymptomatic diabetic patients is not sufficient in real clinical practice. A new strategy was investigated that uses cardiac multi-detector computed tomography (MDCT) and a treadmill test (TMT). Methods and Results: A total of 445 self-referred asymptomatic diabetic patients underwent cardiac MDCT. The treatment plan was determined according to the new strategy that uses MDCT and TMT. All patients underwent clinical follow-up and cardiac events were investigated. The incidence of subclinical atherosclerosis was 49.4%. The group without plaque underwent clinical follow-up without treatment and did not experience any cardiac events in 675.1 person-years of follow-up. Among patients with subclinical atherosclerosis without significant stenosis (n=136) who received medical treatment only, 11 patients experienced cardiac events over 326.4 person-years. The patients with significant stenosis (n=84) underwent TMT. Patients with positive TMT (n=14) underwent coronary angiograms and revascularization therapy was performed in all of them over 39.2 person-years. Patients with negative TMT (n=70) underwent medical treatment, and 27 of them experienced cardiac events. The incidence of cardiac death was 0% during 3 years of follow-up. Conclusions: The new strategy for detecting subclinical atherosclerosis on MDCT combined with TMT may be a useful method for minimizing the mortality rate from cardiovascular disease in asymptomatic diabetic patients.
- 一般社団法人 日本循環器学会の論文
著者
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PARK Keun
Department of Internal Medicine, Chonnam National University Hospital
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SIM Doo
Department of Internal Medicine, Chonnam National University Hospital
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CHO Jeong
Department of Internal Medicine, Chonnam National University Hospital
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Ahn Youngkeun
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University
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Kim Yun
Department Of Chemistry Korea Advanced Institute Of Science & Technology
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Jeong Hae
Department Of Mechanical Engineering School Of Mechanical Aerospace & Systems Engineering Korea
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Park Jong
Department Mathematics Pusan National University
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Jeong Myung
Department Of Cardiovascular Medicine Chonnam National University Medical School
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Kim Ju
Department Of Chemical And Biological Engineering Korea University
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Seon Hyun
Department Of Radiology Chonnam National University Hospital Chonnam National University Medical School
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HONG Young
Department of Chemical Engineering, Konkuk University
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Kim Yun
Department of Radiology, Chonnam National University Hospital
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Kim Inna
Department of Cardiology, Chonnam National University Hospital
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Moon Jae
Health Promotion Center, Chonnam National University Hwasun Hospital
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Jeong Myung
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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Jeong Hae
Department of Cardiology, Chonnam National University Hospital
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Hong Young
Department of Cardiology, Chonnam National University Hospital
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Kim Ju
Department of Cardiology, Chonnam National University Hospital
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Cho Jeong
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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Park Jong
Department of Cardiology, Chonnam National University Hospital
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Park Keun
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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Sim Doo
Department of Cardiology, Chonnam National University Hospital
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Sim Doo
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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Hong Young
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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Kim Ju
Department of Cardiology, Cardiovascular Center, Clinical Trial Center, Chonnam National University Hospital
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