Abstract:
Abstract
The aim of the study was to examine the predictive value of coronary computed tomographic angiography (CCTA) and
coronary artery calcium score (CACS) on 1-year all-cause mortality in type 2 diabetes (T2D) patients with peripheral
artery disease (PAD) undergoing partial foot amputations (PFA).
Methods: This is a single-center prospective cohort study including 199 consecutive patients with T2D, PAD (mean age
62.3 ± 7.2 years; 62.8% males), and preoperative CACS and CCTA undergoing PFA and followed-up over 1 year.
Results: Over a period of 1 year follow-up, a total of 35 (17.6%) participants died. The area under ROC curve to predict
mortality for the CACS was 0.835 (95% CI:0.769–0.900), for CCTA 0.858 (95% CI:0.788–0.927). After adjustment for
confounders, compared to no-stenosis on CCTA (reference), the risk of all-cause mortality in non-obstructive coronary
atery disease (CAD) increased (HR = 1.38, 95% CI [0.75–12.86], p = .284), 1-vessel obstructive CAD (HR = 8.13, 95% CI
[0.87–75.88], p = .066), 2-vessels (HR = 10.94, 95% CI [1.03–115.8], p = .047), and 3-vessels (HR = 45.73, 95% CI [4.6–
454.7], p = .001) respectively. Increasing levels of CACS tended to be associated with increased risk of all-cause mortality
(HR = 1.002, 95% CI [1.0–1.003], p = .061). 61/95 patients with obstructive CAD underwent coronary revascularization.
Conclusions: Coronary artery calcium score and CCTA have a high predictive value for 1-year all-cause mortality in T2D patients undergoing minor amputations and may be considered for preoperative risk assessment allowing timely preventive
interventions.
