Abstract 3686: Prevalence Of Coronary Artery Disease And Plaque Morphology By Multi Slice Computed Tomography In Asymptomatic Patients With Type 2 Diabetes
OBJECTIVE Cardiovascular complications, including coronary artery disease (CAD), are the leading causes of morbidity and mortality in individuals with type 2 diabetes. The prevalence of CAD in asymptomatic patients with type 2 diabetes is unknown. The purpose of the study was to evaluate the prevalence of CAD as well as plaque morphology in this patient population using Multi Slice Computed Tomography (MSCT).
METHODS In 70 patients, 64-slice MSCT for coronary calcium scoring and coronary angiography was performed. Calcium score and number of diseased coronary segments was determined per patient; each diseased segment was classified as showing obstructive (≥ 50% luminal narrowing) disease or not. In addition, plaque type (non-calcified, mixed and calcified) was determined.
RESULTS No or minimal calcium (calcium score < 10) was observed in 31 (44%) patients. A calcium score of 10 –100 was observed in 14 (20%) patients while a score of 101– 400 or > 400 was identified in respectively 12 (17%) and 13 (19%) patients. On coronary angiography, a total of 56 (80%) patients showed CAD, of which 38 (54%) non-obstructive CAD and 18 (26%) obstructive CAD. In total, 322 coronary segments with plaque were identified, of which 132 (41%) contained non-calcified plaques, 65 (20%) mixed plaques and 125 (39%) calcified plaques. While the percentage of patients with obstructive CAD paralleled increasing calcium score, the presence of CAD was also noted in 17 (55%) of patients with no or minimal calcium (< 10).
CONCLUSIONS MSCT angiography detected a high prevalence of CAD in asymptomatic patients with type 2 diabetes. The majority of detected plaques were either non-calcified or calcified. Importantly, a calcium score < 10 did not exclude CAD in these patients. MSCT might be a useful technique to identify CAD in asymptomatic patients with type 2 diabetes.