Author + information
- Kevin Kris Warnakula Olesen1,
- Anders Hammerich Riis2,
- Lene Hüche Nielsen3,
- Flemming Hald Steffensen3,
- Bjarne Norgaard4,
- Troels Thim5,
- T. Henrik Sørensen2 and
- Michael Maeng5
The risk of myocardial infarction (MI) in patients with diabetes mellitus (DM) is greater than in patients without DM. However, it remains controversial whether this also accounts for long-term outcome in DM patients without coronary artery disease at one point. We aimed to estimate the risk of adverse cardiac events in DM and non-DM patients with and without coronary artery disease (CAD) after coronary computed tomography angiography (CCTA).
A population-based cohort study of patients from the Western Denmark Cardiac Computed Tomography Registry who underwent CCTA between January 1, 2008 and December 31, 2015. Patients were stratified according to CAD severity: no (0%), non-obstructive (1-49%), and obstructive (≥50%) CAD and DM. Endpoints included all-cause death and MI. Unadjusted and adjusted rate ratios (RRs) were computed. Non-DM patients with no CAD was reference group.
A total of 42,445 patients, of whom 7.8% had DM, were included. Median follow-up was 3.2 years. DM and non-DM patients with no CAD had a very low risk of MI; 1.48 and 2.32 events pr. 1000 person years, respectively. The cumulative incidence curves for MI are shown in the figure. DM patients with no (adjusted RR 1.01, 95% confidence interval (CI) 0.43-2.37, p=0.98) and with non-obstructive CAD (adjusted RR 1.40, 95% CI 0.74-2.65, p=0.30) had a similar risk of MI compared to non-DM patients with no CAD.
In a real-world setting, DM patients with no CAD by CCTA had a similar MI-risk as non-DM patients with no CAD. DM patients with insignificant CAD also showed a low risk of MI as patients with no sign of CAD.