Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

Andrea Igoren Guaricci, Delia De Santis, Mariangela Carbone, Giuseppe Muscogiuri, Marco Guglielmo, Andrea Baggiano, Gaetano Serviddio, Gianluca Pontone

Research output: Contribution to journalReview article

Abstract

The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.

Original languageEnglish
Pages (from-to)8927281
JournalBioMed Research International
Volume2018
DOIs
Publication statusPublished - 2018

Fingerprint

Angiography
Coronary Angiography
Coronary Artery Disease
Medical problems
Population
Tomography
Diabetes Mellitus
Exercise Test
Myocardial Ischemia
Coronary Vessels
Computed Tomography Angiography
Incidence
Therapeutics

Keywords

  • Asymptomatic Diseases/epidemiology
  • Computed Tomography Angiography
  • Coronary Angiography
  • Coronary Artery Disease/diagnosis
  • Coronary Vessels/diagnostic imaging
  • Diabetes Mellitus, Type 2/complications
  • Humans
  • Risk Factors
  • Tomography, X-Ray Computed

Cite this

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title = "Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives",
abstract = "The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.",
keywords = "Asymptomatic Diseases/epidemiology, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease/diagnosis, Coronary Vessels/diagnostic imaging, Diabetes Mellitus, Type 2/complications, Humans, Risk Factors, Tomography, X-Ray Computed",
author = "Guaricci, {Andrea Igoren} and {De Santis}, Delia and Mariangela Carbone and Giuseppe Muscogiuri and Marco Guglielmo and Andrea Baggiano and Gaetano Serviddio and Gianluca Pontone",
year = "2018",
doi = "10.1155/2018/8927281",
language = "English",
volume = "2018",
pages = "8927281",
journal = "BioMed Research International",
issn = "2314-6133",
publisher = "Hindawi Publishing Corporation",

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TY - JOUR

T1 - Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population

T2 - A Critical Systematic Review of the Literature and Future Perspectives

AU - Guaricci, Andrea Igoren

AU - De Santis, Delia

AU - Carbone, Mariangela

AU - Muscogiuri, Giuseppe

AU - Guglielmo, Marco

AU - Baggiano, Andrea

AU - Serviddio, Gaetano

AU - Pontone, Gianluca

PY - 2018

Y1 - 2018

N2 - The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.

AB - The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.

KW - Asymptomatic Diseases/epidemiology

KW - Computed Tomography Angiography

KW - Coronary Angiography

KW - Coronary Artery Disease/diagnosis

KW - Coronary Vessels/diagnostic imaging

KW - Diabetes Mellitus, Type 2/complications

KW - Humans

KW - Risk Factors

KW - Tomography, X-Ray Computed

U2 - 10.1155/2018/8927281

DO - 10.1155/2018/8927281

M3 - Review article

C2 - 29511691

VL - 2018

SP - 8927281

JO - BioMed Research International

JF - BioMed Research International

SN - 2314-6133

ER -