Clinical relevance of coronary risk classification and reclassification with coronary artery calcium score in asymptomatic people living with diabetes. An observational study
Authors' conclusion
Following national guidelines, 66% of our population of asymptomatic diabetic persons at high a priori coronary risk were reclassified into the moderate risk category, translating into less stringent goals for risk factor control. Eighteen percent were reclassified into the very high-risk category, leading to 100% detection sensitivity for patients with ischemia and coronary stenoses.
Study context
- Population
- Asymptomatic primary prevention diabetic patients at high or very high a priori coronary risk per national guidelines; all had coronary artery calcium (CAC) score and stress myocardial scintigraphy, coronary angiography if ischemia
- Participants
- 377 patients
- Exposure
- Coronary risk classification a priori vs after CAC-reclassification for selecting patients for ischemia screening
- High a priori riskn = 242
- Very high a priori riskn = 135
- Outcome
- CAC-reclassification of patients at high a priori risk
Main finding
As reported in the abstract
Reclassified to moderate risk
n = 159, 66%
Remained high risk
n = 38
Reclassified to very high risk
45 patients
Observational data: associations, not effects.
Further findings
Myocardial ischemia and coronary stenoses detected (whole cohort)
- Myocardial ischemia
- 35 patients
- Coronary stenoses among those with ischemia
- 14
Screening only patients at very high a priori risk (n=135)
- Ischemia detected
- 18 patients (sensitivity 51%)
- Coronary stenoses detected
- 9 (sensitivity 64%)
Additional screening of 45 patients at very high risk after CAC-reclassification
- Additional patients with ischemia
- 7
- Additional patients with coronary stenoses
- 5
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →