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.
Lingua originaleEnglish
pagine (da-a)788-796
Numero di pagine9
RivistaEuropean Radiology
Volume26
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Amyotrophic Lateral Sclerosis
  • Arthropathy, Neurogenic
  • CT coronary angiography
  • Charcot neuro-arthropathy
  • Coronary Angiography
  • Coronary Artery Disease
  • Coronary artery calcium score
  • Diabetes Mellitus, Type 2
  • Diabetes mellitus
  • Diabetic Neuropathies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Prevention
  • Prospective Studies
  • Radiology, Nuclear Medicine and Imaging
  • Risk Factors
  • Severity of Illness Index

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