Even mild stenosis linked to death in diabetes (St. Paul's Hospital)

An observational study showed that even modest coronary plaque causing no symptoms has a long-term impact on mortality and heart disease in diabetes.

Philipp Blanke, MD, of the University of British Columbia and St. Paul's Hospital in Vancouver, and colleagues found in the CONFIRM registry that, the adjusted mortality risk was similarly elevated by twofold whether coronary CT angiography showed mild stenosis of less than 50% or obstructive stenosis of 50 per cent or more (hazard ratios 2.0 and 2.1, P=0.003 and P<0.001, respectively).

The mortality risk with nonobstructive coronary artery disease was similar to that of having single-vessel obstructive disease (P=0.42). Overall major adverse cardiovascular events (death, myocardial infarction, unstable angina or late coronary revascularization) showed about double the risk with obstructive disease as with the milder stenosis, but both were significant, with HRs of 10.4 and 4.9, respectively (both P<0.001).

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