Mild Coronary Artery Disease Puts Diabetics at Cardiovascular Risk

New study results dispute the belief that diabetic patients with mild or non-obstructive coronary artery disease have a lower risk of major adverse cardiovascular events and death than their counterparts with obstructive disease.

New study results dispute the belief that diabetic patients with mild or non-obstructive coronary artery disease (CAD) have a lower risk of major adverse cardiovascular events (MACE) and death than their counterparts with obstructive disease.

The study of more than 8000 patients with diabetes determined that those with mild CAD face the same relative risk for MACE or death as individuals with a serious single-vessel obstructive disease, according to researchers at the University of British Columbia and St. Paul's Hospital in Vancouver who presented the findings at the annual meeting of the Radiological Society of North America.

The patients involved in the study underwent cardiac computed tomography angiography (CCTA) to determine the extent of their CAD. According to a press release, the researchers relied on data from the Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry, which was developed to establish the prognostic value of CCTA for predicting adverse cardiac events related to CAD.

The study subjects were categorized as having no CAD, mild CAD defined as defined as <50% artery obstruction, or obstructive disease defined as >50% artery obstruction. Roughly 5 years later, 246 deaths were reported, and of the 973 patients with available MACE data, 295 had experienced some type of MACE, the study authors found.

The researchers discovered that both obstructive and mild or non-obstructive CAD were related to the patients’ risk for death and MACE.

"Until now, 2-year follow-up studies suggested that a diabetic patient with mild or non-obstructive CAD had a lower risk of MACE and death than patients with obstructive disease," said study co-author Philipp Blanke, MD, a radiologist at the University of British Columbia and St. Paul's Hospital, in the press release. "Our 5-year follow-up data suggests that non-obstructive and obstructive CAD as detected by cardiac CTA in diabetic patients are both associated with higher rates of mortality."