Fabian Bamberg MD, MPH, Presenter: Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG Research Grant, Bayer AG Research Grant, Siemens AG

Elena Lochner BS, Abstract Co-Author: Nothing to Disclose

Roy Marcus BS, Abstract Co-Author: Nothing to Disclose

Daniel Theisen MD, Abstract Co-Author: Nothing to Disclose

Hannes Findeisen MD, Abstract Co-Author: Nothing to Disclose

Klaus Georg Parhofer, Abstract Co-Author: Research Consultant, Merck & Co, Inc Speakers Bureau, Merck & Co, Inc Speakers Bureau, Takeda Pharmaceutical Company Limited Speakers Bureau, Bayer AG Speakers Bureau, sanofi-aventis Group Research Grant, Bayer AG Research Grant, Merck & Co, Inc

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Sabine Weckbach MD, Abstract Co-Author: Nothing to Disclose

Diabetic patients are a heterogeneous population with increased but varying prevalence of atherosclerosis and risk. Whole body magnetic resonance imaging (WB-MRI) may provide a systemic assessment of prevalence of atherosclerosis and improve risk stratification. Thus, we determined the predictive value of WB-MRI for the occurrence of cardiovascular events in a cohort of subjects with diabetes mellitus.

We prospectively followed 65 patients with diabetes mellitus (type 1 and 2), who underwent a comprehensive, contrast-enhanced WB-MRI protocol (1.5/3 T), including dedicated brain, cardiac, arterial (carotid, abdominal, pelvic, and peripheral arteries) sequences at baseline for 5 years. Follow-up was performed by phone interview by an independent investigator and endpoints were verified. The primary endpoint was occurrence of a MACE, defined as fatal cardiovascular event, non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, or congestive heard failure (NYHA ≥III). MRI was assessed for the presence of carotid and peripheral atherosclerotic vessel changes, chronic ischemic cortical and myocardial changes. Kaplan-Meier-Survival and Cox regression analysis was performed to determine independent associations.

Follow-up was completed in 60 subjects (92%, 62.8±13 years, 48% female) with a median follow-up period of 66.1 months. At the end of the follow-up, 20 (33%) patients experienced MACE (CV death: n=8, nonfatal MI: n=3, stroke: n=4, and PCI: n=3, CHF: n=2). Any detectable ischemic/atherosclerotic change on WB-MRI was associated with an 18-fold higher risk for MACE (HR: 17.6, 95%-CI: 2.3-133.7, median survival in subjects with changes: 52.5 months, p<0.01), independent of diabetes type, duration and age. Similarly, each territory with ischemic/atherosclerotic changes conferred a 3-fold higher adjusted risk for MACE (HR: 2.8, for each territory, 95%-CI: 1.6-4.8, Figure 1). Among subjects with normal WB-MRI exams, the annualized event rate was <1%.

Whole body MRI provides a systemic assessment of the subclinical disease burden conferring strong prognostic information, which may enhance individual risk stratification in patients with diabetes mellitus.

Assessment of atherosclerotic / ischemic changes on whole body MRI may enhance current risk stratification schemes in patients with diabetes mellitus.

Bamberg, F, Lochner, E, Marcus, R, Theisen, D, Findeisen, H, Parhofer, K, Schoenberg, S, Reiser, M, Weckbach, S, Long-term Prognostic Value of Whole Body Magnetic Resonance Imaging in Patients with Diabetes Mellitus for the Occurrence of Cardiovascular Events.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12032334.html