{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:34:21Z","timestamp":1784288061009,"version":"3.55.0"},"reference-count":35,"publisher":"American Diabetes Association","issue":"7","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The usefulness of coronary computed tomography angiography (CTA) for the evaluation of coronary artery disease (CAD) in patients with diabetes is ambiguous. We therefore performed a meta-analysis of studies reporting event rates and hazard ratios (HR) to determine the prognostic value of CTA in this patient population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We searched PubMed and Embase up to November 2015. Study subjects\u2019 characteristics, events (all-cause mortality or cardiac death, nonfatal myocardial infarction, unstable angina pectoris, stroke, revascularization), and events excluding revascularization were collected. We calculated the prevalence of obstructive and nonobstructive CAD on CTA, annualized event rates, and pooled unadjusted and adjusted HR using a generic inverse random model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Eight studies were eligible for inclusion into this meta-analysis, with 6,225 participants (56% male; weighted age, 61 years) with a follow-up period ranging from 20 to 66 months. The prevalence of obstructive CAD, nonobstructive CAD, and no CAD was 38%, 36%, and 25%, respectively. The annualized event rate was 17.1% for obstructive CAD, 4.5% for nonobstructive CAD, and 0.1% for no CAD. Obstructive and nonobstructive CAD were associated with an increased HR of 5.4 and 4.2, respectively. A higher HR for obstructive CAD was observed in studies including revascularization compared with those that did not (7.3 vs. 3.7, P = 0.124).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>CTA in patients with diabetes allows for safely ruling out future events, and the detection of CAD could allow for the identification of high-risk patients in whom aggressive risk factor modification, medical surveillance, or elective revascularization could potentially improve survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0281","type":"journal-article","created":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T16:32:59Z","timestamp":1466699579000},"page":"1274-1280","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":32,"title":["Prognostic Value of Coronary Computed Tomography Angiography in Patients With Diabetes: A Meta-analysis"],"prefix":"10.2337","volume":"39","author":[{"given":"Csilla","family":"Celeng","sequence":"first","affiliation":[{"name":"MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e1l","family":"Maurovich-Horvat","sequence":"additional","affiliation":[{"name":"MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian B.","family":"Ghoshhajra","sequence":"additional","affiliation":[{"name":"Cardiac MR PET CT Program, Division of Cardiovascular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Leiner","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.P.","family":"Takx","sequence":"additional","affiliation":[{"name":"Cardiac MR PET CT Program, Division of Cardiovascular Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA"},{"name":"Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,6,9]]},"reference":[{"key":"2022031301115060100_B1","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1001\/jama.1979.03290450033020","article-title":"Diabetes and cardiovascular disease. The Framingham study","volume":"241","author":"Kannel","year":"1979","journal-title":"JAMA"},{"key":"2022031301115060100_B2","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1016\/S0140-6736(10)60484-9","article-title":"Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies","volume":"375","author":"Sarwar","year":"2010","journal-title":"Lancet"},{"key":"2022031301115060100_B3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1056\/NEJM199807233390404","article-title":"Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction","volume":"339","author":"Haffner","year":"1998","journal-title":"N Engl J Med"},{"key":"2022031301115060100_B4","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.jacc.2013.11.009","article-title":"ACCF\/AHA\/ASE\/ASNC\/HFSA\/HRS\/SCAI\/SCCT\/SCMR\/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons","volume":"63","author":"Wolk","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B5","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.amjcard.2006.10.071","article-title":"Assessing prognosis in patients with diabetes mellitus--the Achilles\u2019 heel of cardiac stress imaging tests","volume":"99","author":"Kamalesh","year":"2007","journal-title":"Am J Cardiol"},{"key":"2022031301115060100_B6","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1001\/jama.2009.476","article-title":"Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: the DIAD study: a randomized controlled trial","volume":"301","author":"Young","year":"2009","journal-title":"JAMA"},{"key":"2022031301115060100_B7","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.jacc.2005.05.056","article-title":"Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography","volume":"46","author":"Raff","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B8","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1161\/CIRCULATIONAHA.105.533471","article-title":"High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography","volume":"112","author":"Mollet","year":"2005","journal-title":"Circulation"},{"key":"2022031301115060100_B9","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.2337\/dc12-2123","article-title":"Prognostic value of multidetector computed tomography coronary angiography in diabetes: excellent long-term prognosis in patients with normal coronary arteries","volume":"36","author":"Andreini","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B10","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1148\/radiol.1090600","article-title":"Diabetes: prognostic value of CT coronary angiography--comparison with a nondiabetic population","volume":"256","author":"van Werkhoven","year":"2010","journal-title":"Radiology"},{"key":"2022031301115060100_B11","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1001\/jama.2014.15825","article-title":"Effect of screening for coronary artery disease using CT angiography on mortality and cardiac events in high-risk patients with diabetes: the FACTOR-64 randomized clinical trial","volume":"312","author":"Muhlestein","year":"2014","journal-title":"JAMA"},{"key":"2022031301115060100_B12","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"2022031301115060100_B13","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann Intern Med"},{"key":"2022031301115060100_B14","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"2022031301115060100_B15","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s10554-015-0785-9","article-title":"Prognostic value of coronary CT angiography in diabetic patients: a 5-year follow up study","volume":"32","author":"Nadjiri","year":"2016","journal-title":"Int J Cardiovasc Imaging"},{"key":"2022031301115060100_B16","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.2337\/dc11-2403","article-title":"Differences in prevalence, extent, severity, and prognosis of coronary artery disease among patients with and without diabetes undergoing coronary computed tomography angiography: results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry","volume":"35","author":"Rana","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B17","doi-asserted-by":"crossref","first-page":"SI4","DOI":"10.1016\/S0140-6736(97)90021-0","article-title":"The epidemiology of cardiovascular disease in type 2 diabetes mellitus: how sweet it is ... or is it","volume":"350","author":"Nathan","year":"1997","journal-title":"Lancet"},{"key":"2022031301115060100_B18","doi-asserted-by":"crossref","first-page":"2901","DOI":"10.2337\/diacare.28.12.2901","article-title":"Type 2 diabetes as a \u201ccoronary heart disease equivalent\u201d: an 18-year prospective population-based study in Finnish subjects","volume":"28","author":"Juutilainen","year":"2005","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B19","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.2337\/diacare.28.7.1588","article-title":"Should diabetes be considered a coronary heart disease risk equivalent?: results from 25 years of follow-up in the Renfrew and Paisley survey","volume":"28","author":"Whiteley","year":"2005","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B20","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.2337\/dc06-2094","article-title":"Cardiac imaging for risk stratification in diabetes","volume":"30","author":"Bax","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B21","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1093\/eurheartj\/eht108","article-title":"ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD)","volume":"34","author":"Ryd\u00e9n","year":"2013","journal-title":"Eur Heart J"},{"key":"2022031301115060100_B22","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/0735-1097(90)90178-R","article-title":"Exertional myocardial ischemia in diabetes: a quantitative analysis of anginal perceptual threshold and the influence of autonomic function","volume":"15","author":"Ambepityia","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B23","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.2337\/dci15-0012","article-title":"Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association","volume":"38","author":"Fox","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B24","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1016\/j.jacc.2008.07.031","article-title":"Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial","volume":"52","author":"Budoff","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B25","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1016\/j.jacc.2010.12.043","article-title":"Meta-analysis and systematic review of the long-term predictive value of assessment of coronary atherosclerosis by contrast-enhanced coronary computed tomography angiography","volume":"57","author":"Bamberg","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B26","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1001\/jama.293.12.1501","article-title":"Diabetes and coronary revascularization","volume":"293","author":"Flaherty","year":"2005","journal-title":"JAMA"},{"key":"2022031301115060100_B27","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1067\/mhj.2003.56","article-title":"Diabetes mellitus is associated with a shift in the temporal risk profile of inhospital death after percutaneous coronary intervention: an analysis of 25,223 patients over 20 years","volume":"145","author":"Marso","year":"2003","journal-title":"Am Heart J"},{"key":"2022031301115060100_B28","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/j.jacc.2013.01.044","article-title":"Risk factor control for coronary artery disease secondary prevention in large randomized trials","volume":"61","author":"Farkouh","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2022031301115060100_B29","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1056\/NEJMoa0805796","article-title":"A randomized trial of therapies for type 2 diabetes and coronary artery disease","volume":"360","author":"Frye","year":"2009","journal-title":"N Engl J Med"},{"key":"2022031301115060100_B30","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.2337\/dc07-9927","article-title":"Screening for coronary artery disease in patients with diabetes","volume":"30","author":"Bax","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031301115060100_B31","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s13244-010-0053-4","article-title":"Prognostic value of CT coronary angiography in diabetic and non-diabetic subjects with suspected CAD: importance of presenting symptoms","volume":"2","author":"Maffei","year":"2011","journal-title":"Insights Imaging"},{"key":"2022031301115060100_B32","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s12350-015-0213-5","article-title":"Prognostic value of coronary computed tomography angiography in diabetic patients without chest pain syndrome","volume":"23","author":"van den Hoogen","year":"2016","journal-title":"J Nucl Cardiol"},{"key":"2022031301115060100_B33","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.amjcard.2013.11.028","article-title":"Coronary computed tomographic angiographic findings in asymptomatic patients with type 2 diabetes mellitus","volume":"113","author":"Park","year":"2014","journal-title":"Am J Cardiol"},{"key":"2022031301115060100_B34","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.atherosclerosis.2013.09.025","article-title":"Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals","volume":"232","author":"Min","year":"2014","journal-title":"Atherosclerosis"},{"key":"2022031301115060100_B35","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1093\/ehjci\/jev106","article-title":"Impact of diabetes duration on the extent and severity of coronary atheroma burden and long-term clinical outcome in asymptomatic type 2 diabetic patients: evaluation by coronary CT angiography","volume":"16","author":"Kim","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/7\/1274\/626678\/dc160281.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/7\/1274\/626678\/dc160281.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T04:52:21Z","timestamp":1647147141000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/39\/7\/1274\/37328\/Prognostic-Value-of-Coronary-Computed-Tomography"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,9]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2016,6,9]]},"published-print":{"date-parts":[[2016,7,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc16-0281","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,9]]}}}