Abstract 14319: A Novel Scoring System for Predicting the Risk of Obstructive Coronary Artery Disease in Asymptomatic Patients With Type 2 Diabetes

IntroductionPatients with type 2 diabetes have a higher prevalence and extent of coronary atherosclerosis and higher rates of silent atherosclerotic lesion without ischemic symptoms. Therefore, the risk prediction and early screening for coronary artery disease (CAD) is important in this population. However, there is a controversy in performing routine screening for CAD due to low sensitivity and specificity.PurposeThe aim of study was to develop a clinical risk scoring system for risk stratification to predict the likelihood of obstructive CAD among asymptomatic type 2 diabetic patients.MethodsFrom January 2006 to December 2010, we prospectively enrolled 933 asymptomatic patients with type 2 diabetes and no prior CAD who underwent CCTA. Obstructive CAD was defined as ≥50% stenosis in any coronary artery segment on CCTA. We developed the clinical scoring system using traditional risk factors representing the presence of obstructive CAD by multivariate logistic analysis.ResultsObstructive CAD was detected in 374/933 (40.1%) patients. Among all baseline demographic, clinical, and laboratory variables, we found 7 factors (age ≥65 years, male gender, prior stroke, hypertension, diabetes duration ≥10 years, and HbA1c >7.0, abnormal ECG) that were independently associated with an elevated risk of obstructive CAD. According to the regression coefficients of each variable, the clinical scoring system was created, with scores ranging from 0 to 9 points. The C-statistic of the scoring system was 0.677. The prevalence of obstructive CAD according to the scoring system was 07.7%, 124.0%, 224.3%, 332.8%, 442.8%, 554.6%, 658.3%, 770.8%, 878.6%, 9100%. (Figure 1.)ConclusionThe clinical scoring system accurately predicted the presence of obstructive CAD in asymptomatic diabetic patients. It may help to identify and counsel high-risk patients requiring CAD screening, also support physicians to make appropriate therapeutic decision.