Seventy-four patients were finally included in the control group after propensity score matching due to the difference in age, triglycerides, and high-density lipoprotein (HDL) cholesterol between the control group and the DM group. One hundred and forty-eight other continuous non-T2DM non-CHD patients at the Affiliated Hospital of Jining Medical University, who were found to have slight electrocardiogram abnormalities and underwent CCTA to exclude any coronary artery disease, from December 2019 to January 2020 were chosen as the control group.Ī structured interview was performed to record the demographic and clinical data. The exclusion criteria were as follows: type 1 diabetes known or suspected CHD abnormal resting electrocardiographic results history of prior myocardial infarction, history of coronary artery bypass grafting or stenting and incomplete clinical data. The cardiovascular risk factors included the following: hypertension (defined as blood pressure ≥140/90 mmHg or the use of antihypertensive medication) ( 18), dyslipidemia (defined as a total cholesterol level ≥5.2 mmol/l or treatment with lipid-lowering drugs) ( 19), smoking, obesity (body mass index ≥28 kg/m 2) ( 20) or lack of exercise (defined as not exercise regularly at least three times a week), and family history of myocardial infarction in first-degree relatives. Patients without CHD were defined as asymptomatic. The symptom asymptomatic status of the patients was evaluated using the Rose questionnaire for angina. Type 2 diabetes mellitus was confirmed according to the criteria of the American Diabetes Association ( 17): Glycated hemoglobin (HbA1c) levels ≥6.5%, fasting blood glucose levels ≥7.0 mmol/l and/or a post-challenge blood glucose level ≥11.1 mmol/l (2 h after a 75 g oral glucose load) or the current use of hypoglycemic treatment. All T2DM patients had at least one other cardiovascular risk factor. We compared the CCTA scores among different risk groups and the control group to clarify the role of CCTA in asymptomatic T2DM patient screening.Ī total of 149 continuously T2DM patients at the Affiliated Hospital of Jining Medical University without known symptoms suggestive of CHD who underwent CCTA from July 2019 to December 2019 were enrolled in the study. This study was performed to investigate a method of CHD screening in asymptomatic T2DM patients using CCTA and CHD fatal risk stratification prediction. There are few data on the clinical significance of CCTA in asymptomatic T2DM patients ( 15, 16).

Compared with ICA, CCTA has good sensitivity, specificity and negative predictive value in the detection of CHD, but the positive predictive value of CCTA is lower than that of ICA ( 14). As a more advanced technology, CCTA now has enough temporal and spatial resolution to evaluate the coronary artery tree and even the distal lumen and has allowed for the accurate assessment of the stenosis severity and atherosclerotic plaque composition ( 13). In addition to providing a faster and possibly more cost-effective way to assess the patients at a moderate CHD fatal risk, CCTA also avoids the risks associated with invasive surgery. Although invasive coronary angiography (ICA) is still the gold standard for the diagnosis of coronary artery disease, CCTA is increasingly becoming a viable non-invasive alternative. Additionally, T2DM patients are at a higher risk for developing CHD, about four times that of their peers without diabetes, even if they lack any pertinent symptoms ( 7, 8).Ĭurrently, coronary computed tomography angiography (CCTA) is widely used to evaluate the degree of coronary artery stenosis and the characteristics of atherosclerotic plaque ( 9– 12). Comparing with non-diabetics patients, patients with T2DM suffer from CHD at a much younger age ( 6). Many studies in the literature have shown a clear correlation between type 2 diabetes mellitus (T2DM) and the risk of coronary heart disease (CHD) ( 2– 5).

Diabetes will be a significant problem in the future, from 537 million patients affected worldwide in 2021 to 783 million people projected by 2045, representing an approximately 46% growth ( 1).

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