Keywords:
Arteriosclerosis, Diagnostic procedure, CT, Cardiac
Authors:
C. Grippo1, C. Rutigliano1, D. Curione2, D. V. Di Molfetta2, G. Savino2, R. Marano1, L. Bonomo1; 1Rome/IT, 2Roma/IT
Purpose
Type-2 diabetes mellitus (DM) is a well-recognized risk factor (RF) and negative prognostic/predictive factor for coronary artery disease (CAD) and cardiovascular (CV) events. Autonomic diabetic neuropathy (DN) increases the CV risk in type-2 DM [1-2]; Charcot neuroarthropathy (CN) is a severe disease of the foot,
with unknown pathogenesis (neurotraumatic/neurovascular), that often occurs in DN and further increases morbidity/mortality risk [3-4].
Screening for the early detection of CAD could be useful in these patients,
but the diagnostic approach of choice and its clinical/prognostic impact are still controversial [5-7].
Moreover,
the CV implications of CN have not yet been fully investigated,
and the accurate assessment/prevention of ischemic heart disease (IHD) is more difficult in such patients,
due to their frequent inability to perform stress tests [8-10].
Therefore,
alternative non-invasive diagnostic tests could be useful to stratify the CV risk in CN patients,
even in asymptomatic individuals.
Multi-detector computed tomography (MDCT) is the only non-invasive method able to directly detect coronary atherosclerosis.
The aim of this study was to analyze the role of MDCT in the CV risk assessment of asymptomatic type-2 DM patients with CN,
evaluating:
- the calcium score of the coronary arteries (CACS),
and of the carotid bifurcations and lower limb arteries (CS) at unenhanced MDCT;
- the presence of significant coronary stenosis at MDCT-coronary angiography (MDCT-CA).