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Atherosclerotic coronary plaque in subjects with diabetic neuropathy: the prognostic cardiovascular role of Charcot neuroarthropathy—a case–control study

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Abstract

The aim of this study was to investigate the severity of coronary artery disease (CAD) and the plaque composition in neuropathic type 2 diabetic subjects with and without Charcot neuroarthropathy (CN) undergoing multidetector computed tomography coronary angiography (MDCT-CA). The study was a single-center, observational, with unmatched case–control design. We selected 17 CN patients and 18 patients with diabetic neuropathy (DN) without CN. In all the patients, multidetector computed tomography was performed to assess the coronary artery calcium score (CACS) and degree of coronary artery stenosis. Patients were classified as positive in the presence of significant CAD if there was at least one stenosis >50 % on MDCT-CA. The invasive coronary angiography was performed in case of significant stenosis detected with MDCT-CA, both as reference to standard and eventually as treatment. Groups were matched for age, sex, and traditional CAD risk factors. As compared to DN individuals, CN exhibited higher rates of significant coronary stenoses (p = 0.027; OR 7.7 [1.3–43.5]). However, no significant differences were observed in the CACS, which reflects plaque burden, in the two groups (p = 0.759). No significant differences were observed comparing CACS distribution in all subjects for stenosis higher/equal or lower than 50 % (p = 0.320). Finally, no significant differences were observed comparing CACS distribution in CN and DN subjects for coronary stenoses higher/equal or lower than 50 %. Our results suggest that CN patients have a higher prevalence of severe coronary plaques compared to DN patients. Nevertheless, coronary plaques in CN patients did not exhibit an increased degree of calcification.

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Conflict of interest

D. Pitocco, R. Marano, E. Di Stasio, G. Scavone, G. Savino, F. Zaccardi, A. Rizzi, F. Martini, T. Musella, V. Silvestri, F. Costantini, M. Galli, S. Caputo, L. Bonomo and G. Ghirlanda declare they have no conflict of interest.

Human and Animal Rights

All the procedures have been followed in accordance with the guidelines of our institutional ethics committee and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent

All persons gave their informed consent prior to their inclusion in the study. No identifying details are shown in the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Catholic University School of Medicine, Rome, Italy

    D. Pitocco, G. Scavone, F. Zaccardi, A. Rizzi, F. Martini, T. Musella, F. Costantini, S. Caputo & G. Ghirlanda

  2. Department of Radiology, Catholic University School of Medicine, Rome, Italy

    R. Marano, G. Savino, V. Silvestri & L. Bonomo

  3. Department of Orthopedics and Traumatology, Catholic University School of Medicine, Rome, Italy

    M. Galli

  4. Department of Clinical Biochemistry, Catholic University School of Medicine, Rome, Italy

    E. Di Stasio

  5. Diabetologia, Policlinico A. Gemelli, L.go Agostino Gemelli, 00168, Rome, Italy

    D. Pitocco

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  1. D. Pitocco
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Correspondence to D. Pitocco.

Additional information

Communicated by Massimo Federici.

D. Pitocco, R. Marano, and E. Di Stasio have contributed equally to this work.

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Pitocco, D., Marano, R., Di Stasio, E. et al. Atherosclerotic coronary plaque in subjects with diabetic neuropathy: the prognostic cardiovascular role of Charcot neuroarthropathy—a case–control study. Acta Diabetol 51, 587–593 (2014). https://doi.org/10.1007/s00592-014-0559-1

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