{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:53Z","timestamp":1787018093654,"version":"build-2736575974"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,6,13]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Type 2 diabetics are at increased risk for vascular events, but the value of further risk stratification for coronary heart disease (\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      ) in asymptomatic subjects is unclear. We examined the added value of coronary computed tomography angiography over clinical risk scores (United Kingdom Prospective Diabetes Study), and coronary artery calcium in a population\u2010based cohort of asymptomatic type 2 diabetics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Subjects (n=630) underwent baseline clinical assessment and computed tomography angiography (64\u2010slice scanner). Plaque site, volume, calcific content, and arterial remodeling were recorded using dedicated software. Coronary, macrovascular, and microvascular\u2010related events were assessed over 6.6\u00b10.6 (mean\u00b1\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ) (range 5.4\u20137.5) years and all\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      events were adjudicated. Discrimination of\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      events (cardiovascular death, myocardial infarction, unstable angina, or new\u2010onset angina requiring intervention) (n=41) was improved by addition of total plaque burden to the clinical risk and coronary artery calcium scores combined (C=0.789 versus 0.763,\n                      <jats:italic>P<\/jats:italic>\n                      =0.034) and further improved by addition of an angiographic score (C=0.824,\n                      <jats:italic>P<\/jats:italic>\n                      =0.021). Independent predictors of a\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      event were United Kingdom Prospective Diabetes Study risk score (hazard ratio 1.3 per 10% 10\u2010year risk,\n                      <jats:italic>P<\/jats:italic>\n                      =0.003) and the angiographic score (hazard ratio 3.2 per quartile,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Classification was improved over that by United Kingdom Prospective Diabetes Study and coronary artery calcium scores alone (overall net reclassification improvement 0.24). In subjects with coronary plaque (N=500), mild plaque calcification independently predicted a\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      event (hazard ratio 3.0,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02). Computed tomography angiography predicted combined macrovascular but not microvascular\u2010related events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Computed tomography angiography provides additional prognostic information in asymptomatic type 2 diabetics not obtainable from clinical risk assessment and coronary artery calcium alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.116.003226","type":"journal-article","created":{"date-parts":[[2016,6,13]],"date-time":"2016-06-13T23:00:59Z","timestamp":1465858859000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Coronary Computed Tomography (CT) Angiography as a Predictor of Cardiac and Noncardiac Vascular Events in Asymptomatic Type 2 Diabetics: A 7\u2010Year Population\u2010Based Cohort Study"],"prefix":"10.1161","volume":"5","author":[{"given":"David A.","family":"Halon","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Technion, Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mali","family":"Azencot","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Rubinshtein","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel"},{"name":"Technion, Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak","family":"Zafrir","sequence":"additional","affiliation":[{"name":"Department of 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