Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study.

Aims: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity. Methods and results: This cohort study included 16,949 patients (median age 57 years; 57% women) with new-onset symptoms suggestive of CAD, who underwent CCTA between January 2008 and December 2012. The endpoint was a composite of late coronary revascularization procedure >90 days after CCTA, myocardial infarction, and all-cause death. The Kaplan-Meier estimator was used to compute 91 day to 3.5 year risk according to the CAD severity. Comparisons between patients with and without CAD were based on Cox-regression adjusted for age, sex, comorbidity, cardiovascular risk factors, concomitant cardiac medications, and post-CCTA treatment within 90 days. The composite endpoint occurred in 486 patients. Risk of the composite endpoint was 1.5% for patients without CAD, 6.8% for obstructive CAD, and 15% for three-vessel/left main disease. Compared with patients without CAD, higher relative risk of the composite endpoint was observed for non-obstructive CAD [hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.01-1.63], obstructive one-vessel CAD (HR: 1.83; 95% CI: 1.37-2.44), two-vessel CAD (HR: 2.97; 95% CI: 2.09-4.22), and three-vessel/left main CAD (HR: 4.41; 95% CI :2.90-6.69). The results were consistent in strata of age, sex, and comorbidity. Conclusion: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden.

Diabetes, glycemic control and risk of medical glaucoma treatment: A population-based case-control study.

PURPOSE: To examine the association between diabetes and risk of medical glaucoma treatment and to assess the role of long-term glycemic control in the putative association. DESIGN: Population-based case-control study. METHODS: Cases of treated glaucoma were all persons filling at least three prescriptions for glaucoma medication for the first time within one year between 2001 and 2006 in Northern Jutland, Denmark. We used risk set sampling to select 10 gender- and age-matched general population controls per case using the Danish Civil Registration System. Data on diabetes, comorbidities, and laboratory tests, including glycosylated hemoglobin (as a measure of glycemic control) were obtained from population-based medical registries. We calculated odds ratio (OR) as an estimate of relative risk for treated glaucoma comparing patients with and without diabetes, adjusted for comorbid conditions and medication use. RESULTS: We included 5,991 persons with incident medical glaucoma treatment and 59,910 population controls. The adjusted OR for treated glaucoma for patients with diabetes was 1.81 (95% confidence interval: 1.65-1.98). The strength of the association between diabetes and glaucoma risk did not vary by diabetes duration or by the level of glycemic control. CONCLUSIONS: Regardless of glycemic control, diabetes is associated with a substantially increased risk for medical glaucoma treatment.

Stereoscopic fluorescein angiography in diabetic maculopathy.

PURPOSE: To explore the possible differences in the depth location of microaneurysms in focal as well as diffuse diabetic macular edema. METHODS: The density of superficial and deep retinal microaneurysms was assessed using a stereoscopic fluorescein angiographic method. RESULTS: The density of deep retinal microaneurysms was nearly identical in the group with diffuse macular edema (89.9 +/- 28.5 microaneurysms/test grid) and the group with focal macular edema (90 +/- 65.4 microaneurysms/test grid). The density of superficial retinal microaneurysms was significantly lower in the group with diffuse macular edema (22.8 +/- 12.5) than in the group with focal macular edema (47.9 +/- 30.6). The density fraction of superficial retinal microaneurysms was lower in the group with diffuse macular edema (0.19 +/- 0.07) than in the group with focal macular edema (0.36 +/- 0.14). In the group with focal macular edema, areas without edema had a significantly lower density of superficial (6.1 +/- 2.8) and deep (15.6 +/- 7.8) retinal microaneurysms than did areas with edema (superficial: 47.9 +/- 30.6; deep: 90.0 +/- 65.4). In the group with focal macular edema, the density fraction of superficial retinal microaneurysms was nearly identical in areas with (0.36 +/- 0.14) and areas without (0.30 +/- 0.10) edema. CONCLUSION: The development of focal macular edema might be linked to the density of microaneurysms. Diffuse macular edema might be a result of some unknown effect on the deeper retina and/or the choroid.