Table 3

Coronary CTA Findings in Asymptomatic Patients With Diabetes

First Author (Ref. #)Primary OutcomePatientsMain ResultsAdditional Notes
Kamimura et al. (91)Prevalence of obstructive CAD and high-risk plaques in patients with a CAC score ≤400Asymptomatic diabetic patients (mean age 65 years, 75% men)A luminal stenosis >50% was present in 30.5% of patients; high-risk plaques in 17% of the patients.CAC was present in 83% of the patients. Obstructive CAD was seen in 5% of patients with a CAC score = 0
Roos et al. (93)Prevalence of obstructive CAD and CACCross-sectional analysis of 120 South-Asian and 120 Caucasian diabetic patients (mean age 53 years, 77% men)South-Asian patients had a higher prevalence of obstructive CAD (41% vs. 28%; p = 0.008)The prevalence of CAC and the Agatston scores were significantly higher in South-Asian patients
Halon et al. (96)Prevalence of obstructive CAD in asymptomatic type 2 diabetic patients and correlation with increased pulse pressure477 patients, age 55–74 years, 58% womenAny coronary atheroma was present in 76.6% of patients, and multivessel coronary atheroma in 55%. Obstructive CAD was present in 22.9% of patientsPulse pressure correlated with extent of atheroma (p = 0.005). The correlation was independent of Framingham and United Kingdom Prospective Diabetic Study risk scores
Park et al. (146)Composite outcome of cardiac death, nonfatal myocardial infarction, acute coronary syndrome requiring hospitalization, or late revascularization577 patients (mean age 62 years, 59% men) submitted to CTA and followed for an average of 34 ± 8 months19 cardiac events during follow-up. Patients with significant CAD had more cardiac events (7.1% vs. 0.5%) and lower 3-year event-free survival than those without (99.2% vs. 90.9%; p < 0.001)Obstructive CAD was detected in 30.5% of patients; 26.7% had obstructive disease of the left main (2%) or proximal left anterior descending coronary artery (24.7%)
Muhlestein et al. (102) (FACTOR 64 Study)Composite outcome of all-cause mortality, nonfatal MI, or unstable angina requiring hospitalization900 patients with type 1 or 2 diabetes mellitus for 3 to 5 years randomized to CTA screening or optimal medical management alone; follow-up 4 ± 1.7 yearsThe primary outcome was not significantly different between the CTA and the control groups (6.2% [28 events] vs 7.6% [34 events]; HR: 0.80 [95% CI: 0.49–1.32]; p = 0.38)The secondary outcome (composite of CAD death, nonfatal MI, or unstable angina) was also not statistically different (4.4% [20 events] vs. 3.8% [17 events]; HR: 1.15 [95% CI: 0.60–2.19]; p = 0.68)
Scholte et al. (147)Prevalence of CAC, ischemia on MPI, and obstructive CAD on CTA100 asymptomatic patients (age 30 to 72 years) with type 2 diabetes mellitusObstructive CAD by CTA was found in 24% of patients; however, the correlation between CAC, CTA, and MPI findings was poorAn abnormal MPI was found in 23% of patients, CAC in 60%, and plaque on CTA in 70% of the patients