(RxWiki News) For diabetes patients, heart disease can be a serious concern. Even diabetes patients with mild heart disease may benefit from proper treatment.
A new study of patients with diabetes found that those with even a mild blockage (obstruction) of the heart arteries faced a raised risk of heart attack.
Lead study author Philipp Blanke, MD, of the University of British Columbia in Vancouver, said in a press release that past studies "suggested that a diabetic patient with mild or non-obstructive coronary artery disease had a lower risk of major adverse cardiovascular events and death than patients with obstructive disease."
The current study, however, found that both "non-obstructive and obstructive coronary artery disease ... in diabetic patients are both associated with higher rates of mortality," Dr. Blanke said.
The team of researchers used information from a database of 1,823 men and women with diabetes who underwent cardiac computed tomography angiography (CCTA). The average age of the patients was about 62.
In a CCTA procedure, dye is injected into a patient's blood vessels. The dye makes the heart (coronary) arteries easy to see with X-rays. Doctors can use CCTA to see if the arteries contain plaque — a waxy material that can build up in arteries and block them.
People with diabetes either do not make insulin (type 1) or cannot use it effectively (type 2). Insulin is a hormone that regulates blood sugar.
Dr. Blanke and team grouped the patients in the study according to how much blockage the CCTA found in the patients' coronary arteries. The groups consisted of the following: patients with no blockage, those with half of a coronary artery blocked (mild) or those with more than half of an artery blocked (severe).
These researchers followed the health of the patients for five years. During that time, about 13 percent of the patients died. About 30 percent of patients with some degree of blockage had a heart event. Heart events included heart attack, death, a procedure to unblock heart arteries or angina. Angina is chest pain due to poor blood flow through the vessels of the heart.
The risk of death was about the same whether the patients had mild or severe coronary artery disease, Dr. Blanke and team found.
Heart events were 10 times more likely in patients with severe artery disease than in patients with no blockage of the heart arteries. Heart events were five times more likely in patients with mild artery disease than in patients with no blockage.
"[CCTA] is helpful for identifying diabetic patients who are at a higher risk for heart events," said study author Jonathon A. Leipsic, MD, of the University of British Columbia. These diabetes patients are the people who may see benefits from more aggressive treatment, Dr. Leipsic said.
This study was presented Dec. 3 at the annual meeting of the Radiological Society of North America in Chicago.
Several authors received grants or other fees from companies involved with heart imaging.
