Abstract 21620: Evaluation of Plaque Morphology and Epicardial Fat by 64-Slice Multi-Detector Computed Tomography (MDCT) Associated With Glucose Levels
Background: Early detection of subclinical atherosclerosis in individuals with impaired glucose metabolism may allow better risk stratification therapeutic strategies in patients. To elucidate the role of epicardial fat (EPT) on the characteristics of coronary atherosclerosis, we evaluated the association between coronary artery plaque morphology and EPT according to the impairment of glucose metabolism
Methods: 450 consecutive individuals without coronary artery disease were enrolled in this study. Based on the fasting glucose level, normal fasting glucose (NFG), impaired fasting glucose (IFG) and Diabetes were defined. EPT volumes were obtained as the sum of volume from the bifurcation level of the main pulmonary artery to the diaphragm. Coronary atherosclerotic plaques were classified as calcified, mixed, or noncalcified. The clinical characteristics and detailed information from cardiac CT are compared according to the fasting glucose level.
Results: Among 450subjects, 194had NFG and 103 had IFG and 153 had DM. Coronary plaques were detected in 144(32%) of patients. Overall 462 coronary segments with plaque, 51non-calcified plaques, 168mixed plaques, 243 calcified plaques. No significant differences in the risk factor profile was observed between three groups. Subjects with DM had higher prevalence of significant stenosis and Ca scores were tended to be higher in patients with DM compared to NFG and IFG patients. In patients with DM, prevalence of all types of plaque was higher compared to those in NFG and IFG patients. There was a positive correlation between EPT and FPG and HbA1C. EPT was abundant in subjects impaired glucose metabolism (P<0.01). Subjects with abundant EPT had higher prevalence of coronary plaque. More plaque burden was observed in subjects with abundant EPT and DM. In patients with DM, number of coronary plaques was higher in patients with larger EPT volumes, this was not observed in patients with IFG and NFG.
Conclusion: Even in patients at prediabetic stage, the fasting glucose level and epicardial fat volume are associated with the extent of coronary plaques. 64-slice MDCT might be a useful tool to identify the plaque constitution and detect subclinical atherosclerosis
- © 2010 by American Heart Association, Inc.