Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by non invasive CT angiography |
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Authors: | Uzoma N Ibebuogu Khurram Nasir Ambarish Gopal Naser Ahmadi Song S Mao Emily Young Lily Honoris Vivek K Nuguri Robert S Lee Nudrat Usman Babak Rostami Raveen Pal Ferdinand Flores Matthew J Budoff |
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Institution: | (1) Section of Cardiology, Medical College of Georgia, 1120 15th Street (BBR 6518), Augusta, GA 30912, USA;(2) Beth Israel Medical Deaconess Center, Boston, MA, USA;(3) Los Angeles Biomedical Research Institute at Habor-UCLA, Torrance, CA, USA |
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Abstract: | Type 2 diabetes mellitus (DM) is associated with a higher risk of cardiovascular disease and atherosclerotic burden. However
little data exists in regards to plaque distribution and plaque composition in these patients. To assess for differences in
the coronary plaques burden and composition among symptomatic patients with and without type 2 DM using multidetector computed
tomography angiography (MDCTA). The 416 symptomatic patients (64% males, mean age: 61 ± 13 years) with 61 (15%) reporting
type 2 DM, who underwent contrast-enhanced MDCTA were studied. Enrolled patients had an intermediate to high pre-test probability
of obstructive coronary artery disease. Multivariate analysis was used to correct for differences in age and gender. Patients
with type 2 DM were more likely to have significant stenosis ≥70% in at least one coronary segments (33% in type 2 DM vs.
18% in non diabetic, P = 0.013), whereas 11% of both type 2 DM and non diabetics had stenosis of 50–70% (P = NS). Also type 2 DM patients had a higher number of coronary segments with mixed plaques compared to nondiabetic patients
(1.67 ± 2.01 vs. 1.23 ± 1.61, P = 0.05), whereas no such differences were observed for non-calcified or calcified plaques. Nearly half (43%) of type 2 DM
had coronary artery calcium scores (CACS) ≥400 vs. 29% in non diabetic patients (P = 0.03). Patients with type 2 DM tend to have atherosclerotic plaques which are more likely to be mixed in nature. Future
studies need to elucidate the prognostic value of differences in plaque characteristics observed according to type 2 diabetic
status. |
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Keywords: | Diabetes mellitus Atherosclerosis Coronary computed tomography |
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