Abstract 18510: Glycemic Status and Coronary Atherosclerosis in Asymptomatics: Evaluation by Coronary CT Angiography
Background: We investigated the prevalence, extent, and severity of coronary atheroma burden in normal glucose regulation (NGR), prediabetes and diabetes of varying duration using coronary computed tomography angiography (CCTA) in indivisuals without chest pain.
Methods: We consecutively enrolled 2758 patients without known or suspected coronary artery disease (CAD) undergoing CCTA, and divided into NGR, prediabetes, and diabetes groups. We then reclassified the 1446 diabetic patients into three groups according to the duration of diabetes: <5 years, 5-10 years, and ≥10 years. We compared the prevalence, extent and severity of CAD, including coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS) and segment stenosis score (SSS) among groups.
Results: Diabetic patients showed significantly greater degrees of CACS, ABOS,
SIS, and SSS, compared with NGR or prediabetes individuals (p<0.001 for all). Longer duration of diabetes was associated with higher rate of significant CAD (p<0.001) and multi-vessel disease (p<0.001), and proportionately greater degree of CACS, ABOS, SIS, and SSS (p<0.001 for all). Diabetes, even newly diagnosed or with the duration of less than 5 years was associated with an increased risk of CAD as compared with NGR individuals [diabetes duration <5 years (odds ratio (OR) 2.15, 95% confidence interval (CI) 1.294-3.574, p<0.001); diabetes duration 5~10 years (OR 3.461, 95% CI 1.850-6.472, p<0.001); diabetes duration ≥10 years (OR 9.152, 95% CI 5.557-15.072, p<0.001)], although no differences were found between NGR and prediabetes individuals.
Conclusions: In asymptomatic diabetic patients, the prevalence, extent and severity of coronary atherosclerosis are significantly higher in patients with long-standing diabetes. However, prediabetes was not associated with an increased risk of coronary atherosclerosis.
Author Disclosures: S. Na: None. P. Kim: None. S. Ihm: None. J. Kim: None. K. Seung: None. K. Chang: None.
- © 2014 by American Heart Association, Inc.