Prognostic value of CT coronary angiography in diabetic and non-diabetic subjects with suspected CAD: importance of presenting symptoms

AIM: To assess the prognostic relevance of 64-slice computed tomography coronary angiography (CT-CA) and symptoms in diabetics and non-diabetics referred for cardiac evaluation. METHODS: We followed 210 patients with diabetes type 2 (DM) and 203 non-diabetic patients referred for CT-CA for ruling out coronary artery disease (CAD). Patients were without known history of CAD and were divided into four categories on the basis of symptoms at presentation (none, atypical angina, typical angina and dyspnoea). Clinical end points were major cardiac events (MACE): cardiac-related death, non-fatal myocardial infarction, unstable angina and cardiac revascularizations. Cox proportional hazard models, with and without adjustment for risk factors and multiplicative interaction term (obstructive CAD 7 DM), were developed to predict outcome. RESULTS: DM patients with dyspnoea or who were asymptomatic showed a higher prevalence of obstructive CAD than non-diabetics (p\u2009 64\u20090.01). At mean follow-up of 20.4 months, DM patients had worse cardiac event-free survival in comparison with non-DM patients (90% vs. 81%, p\u2009=\u20090.02). In multivariate analysis, CT-CA evidence of obstructive CAD (in DM patients: HR: 6.4; 95% CI: 2.3-17.5; p\u2009100 in non-DM patients (HR: 5.6; 95% CI: 1.4-21.5; p\u2009=\u20090.01). In Cox regression analysis of the overall population, interaction term obstructive CAD 7 DM resulted in non-significance. CONCLUSIONS: Among DM patients, dyspnoea carried a high event risk with a MACE rate four times higher. CT-CA findings were strongly predictive of outcome and proved valuable for further risk stratification

Dairy products and total calcium intake at 13 years of age and its association with obesity at 21 years of age

Background/objectives: Dairy products and specifically calcium have been suggested to play a role in obesity development but more longitudinal evidence is still needed. The objective of this study was to assess the association between dairy products and total calcium intake at age 13 and body mass index at age 21. Subjects/methods: This longitudinal study included 2159 individuals from the Epidemiological Health Investigation of Teenagers cohort (EPITeen), Porto, Portugal, evaluated at ages 13 and 21. Assessment consisted of anthropometrics measurements and structured questionnaires namely a semi-quantitative food frequency questionnaire to appraise food consumption in the past 12 months. Linear regression models were run in 941 individuals with complete information of confounders: gender, follow-up period, parents’ education, physical activity, energy, and total calcium intake. Results: Negative association was found on total calcium intake at age 13 with BMI at age 21 (model 0: β = −0.059 (95% CI: −0.113, −0.004) and model 1: −0.057 (95% CI: −0.113, −0.002)), however, no statistically significant association was found when adjusting for energy intake (model 2: β = −0.031 (95% CI: −0.110, 0.047). There were no associations between milk, yogurt, and cheese consumption at age 13 and BMI at age 21 when adjusting for confounders. Conclusions: This study did not support an independent effect of dairy products or total calcium intake in adolescence on later early adulthood adiposity.This study was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) (POCI-01-0145-FEDER-016829), under the project MetHyOS (Ref. FCT PTDC/DTP-EPI/6506/2014) and the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013). Also this study was developed with the support of the research teams of the Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine of Porto University; the EPIUnit—Public Health Institute of Porto University; and the EPITeen Cohort Study