Abstract 19480: Non-Calcified Coronary Plaque (NCCP) Burden & its Correlation with Left Ventricular Mass (LVM) in Diabetic vs Non-Diabetic Patients

Abstract

Determine Non-Calcified Coronary Plaque (NCCP) burden & its correlation with Left Ventricular Mass (LVM) in Diabetic vs Non-diabetic patients.

Methods: IRB approved, retrospective review of 190 patients imaged with 320-row MDCTA [89 Diabetics (mean age 62.5 ± 8.73 Yrs & BMI 31.49 ± 5.13) & 101 Non-diabetic (mean age 61.15±14.6 Yrs & BMI 27.47 ± 5.47)]. Measurements were taken for plaque subtypes and total plaque burden (TPB) using Vitrea 5.2. RCA, LM, LAD and LCX were analyzed to quantify fatty, fibrous and calcified plaque in mm³. LVM was calculated from left ventricular inner diameter (LVID), posterior wall thickness (PWD) and Septal wall thickness (SWT) measured in diastolic phase from 4 and 2 chamber views using ASE formula. STATA was used for analyses.

Results: TPB & LVM for diabetic vs. non-diabetic were: RCA: 10.00±3.80 mm³ vs 8.69±4.2 mm³, p = 0.029; LM 16.66±5.24 mm³ vs 13.74±4.58 mm³,p = <0.001, LAD: 7.41±2.67 mm³ vs 6.55±2.72 mm³, p = 0.034; LCX: 9.69±2.93 mm³ vs 8.30±2.76 mm³,p = 0.002 & LVM: 175.29 ± 53.8 vs 173.92 ± 71.6 gm, p = 0.0881 respectively Diabetic had significantly ↑ TPB in all arteries compared to non-diabetics. Diabetics had significantly ↑ fibrous and fatty plaque in LM, LAD & LCX and fatty plaque only in RCA. Calcified plaque volume and LVM were same in both groups (Table 1). Adjusting for demographic and clinical variables, linear regression showed no difference in TPB in all vessels. In sub analyses LAD had significantly ↑ fibrous (p = 0.050), fatty (p =0.042) and calcified plaque (p = 0.031) whereas LM had ↑ fibrous (p =0.039) and LCX had ↑ calcified plaque (p =0.039) in diabetics. Linear regression showed significantly ↑ PWT (p =0.017), LVID (p =<0.001) and LVM (p =<0.001) in diabetics.

Conclusion: Diabetes is associated with higher non-calcified plaque burden with increase in LVM which may provide a reason for increased risk of adverse cardiac events in diabetics. Timely screening and appropriate medical therapy may reduce coronary events in this specific group.