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BioMed Research International
Volume 2018, Article ID 8927281, 13 pages
https://doi.org/10.1155/2018/8927281
Review Article

Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

1Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy
2Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
3Section of Diagnostic Imaging, Interdisciplinary Department of Medicine, University Hospital Policlinico of Bari, Bari, Italy
4Centro Cardiologico Monzino, IRCCS, Milano, Italy
5CMO Torre Annunziata, Napoli, Italy

Correspondence should be addressed to Gianluca Pontone; ti.mfcc@enotnop.aculnaig

Received 30 June 2017; Accepted 2 December 2017; Published 15 January 2018

Academic Editor: Charbel Abi Khalil

Copyright © 2018 Andrea Igoren Guaricci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box. Detecting CAD in asymptomatic high risk individuals is controversial and, what is more, in patients with diabetes is challenging, and that is why the reliability of traditional cardiac stress tests for detecting myocardial ischemia is limited. Cardiac computed tomography angiography (CCTA) represents an emerging noninvasive technique able to explore the atherosclerotic involvement of the coronary arteries and, thus, to distinguish different risk categories tailoring this evaluation on each patient. The aim of the review is to provide a wide overview on the clinical meaning of CCTA in this field and to integrate the anatomical information with a reliable therapeutic approach.