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Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study.

Abstract：

BACKGROUND:There is increasing evidence that a considerable proportion of patients with diabetes remain undiagnosed and untreated, however, it is unclear whether this is associated with more severe coronary artery disease (CAD) and microvasculature changes compared with diagnosed patients. We assessed CAD extent and severity, along with changes to the retinal microvascular structure in participants with undiagnosed versus diagnosed type 2 diabetes. METHODS:Participants of the Australian Heart Eye Study were stratified into participants with previously diagnosed diabetes (n=489), undiagnosed diabetes (n=76) and no diabetes (n=1,112). Retinal vessel caliber was measured from digital retinal images. Extent and severity of CAD was assessed using Extent and Gensini scores from angiography findings, respectively. RESULTS:Participants with undiagnosed and diagnosed diabetes versus those with no diabetes (reference group) had increased odds of being in the highest quartile of Gensini scores, multivariate adjusted odds ratios (OR) =7.02 [95% confidence interval (CI), 2.04-24.1] and OR =2.76 (95% CI, 1.67-4.55), respectively. Participants with undiagnosed and diagnosed diabetes versus those with no diabetes also had increased odds of being in the highest quartile of Extent scores, multivariate adjusted OR =7.63 (95% CI, 2.15-27.10) and OR =3.72 (95% CI, 2.22-6.27), respectively. No significant differences were observed in retinal vessel caliber between participants with undiagnosed versus diagnosed diabetes. CONCLUSIONS:The present study demonstrated that participants with undiagnosed diabetes compared to those with previously diagnosed diabetes, had a stronger likelihood of having more severe and extensive CAD. However, retinal microvascular signs did not differ by diabetes status.

journal_name

J Thorac Dis

journal_title

Journal of thoracic disease

authors

Phan K,Mitchell P,Liew G,Plant AJ,Wang SB,Xu J,Chiha J,Thiagalingam A,Burlutsky G,Gopinath B

doi

10.21037/jtd.2016.05.61

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

1532-9

issue

eissn

2072-1439

issn

2077-6624

pii

jtd-08-07-1532

journal_volume

pub_type

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Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study.