Progression of carotid artery disease could stratify a risk of coronary artery disease patients with type 2 diabetes.

Abstract

Introduction Diabetic population has been defined as high-risk one. Those patients (pts) with diabetes and present coronary artery disease, due to actual risk scores have been defined as high-risk pts. Current guidelines propose imaging techniques for improvement of prognosis of high-risk pts. However, class of recommendation is not IA. We assessed an incremental value of carotid ultrasound in prognosis of pts with coronary artery disease and type 2 diabetes. Patients and methods In this cohort study, pts with coronary artery disease and present type 2 diabetes 264 pts were included. They were prospectively followed up for 31.5 + 10.4 months. Carotid ultrasound was used for detection of progression of carotid artery disease. Coronary artery disease in pts was confirmed with angiography. Results Cohort follow-up revealed: progression of IMT in 86.8% of pts, progression of carotid stenosis in 17.8% and occurrence of plaque in 41.8% of these pts. New cardiovascular (CV) events were registered in 145 pts with incidence of 0.55 events per pt. Multivariate analysis found as independent factors: change of IMT for total CV events (OR 2.30), change of IMT per year for new angina (OR 4.84) and occurrence of carotid plaque for onset of stroke (OR 2.14).