Objectives: To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Methods: Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. Results: CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. Conclusions: These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. Key Points: • Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. • MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. • Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.

Marano, R., Pitocco, D., Di Stasio, E., Savino, G., Merlino, B., Trani, C., Pirro, F., Rutigliano, C., Santangelo, C., Minoiu, A. C., Natale, L., Bonomo, L., MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy, <<EUROPEAN RADIOLOGY>>, 2016; 26 (3): 788-796. [doi:10.1007/s00330-015-3864-3] [http://hdl.handle.net/10807/92614]

MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

Marano
;
Riccardo; Pitocco
Secondo
;
Dario; Di Stasio;Enrico; Savino;Giancarlo; Merlino;Biagio; Trani;Carlo; Pirro;Federica; Rutigliano;Claudia; Santangelo;Aurelian Costin; Natale
Penultimo
;
Luigi; Bonomo
Ultimo
2016

Abstract

Objectives: To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Methods: Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. Results: CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. Conclusions: These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. Key Points: • Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. • MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. • Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.
Inglese
Marano, R., Pitocco, D., Di Stasio, E., Savino, G., Merlino, B., Trani, C., Pirro, F., Rutigliano, C., Santangelo, C., Minoiu, A. C., Natale, L., Bonomo, L., MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy, <<EUROPEAN RADIOLOGY>>, 2016; 26 (3): 788-796. [doi:10.1007/s00330-015-3864-3] [http://hdl.handle.net/10807/92614]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/92614
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