Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes. Issue 3 (23rd July 2007)

• Record Type: Journal Article
• Authors: Scholte, A J H A; Schuijf, J D; Kharagjitsingh, A V; Jukema, J W; Pundziute, G; van der Wall, E E; Bax, J J
• Is Part Of: Heart. Volume 94:Issue 3(2008)
• Page Start: 290
• Page End: 295
• Publication Date: 2007-07-23
• Subjects: coronary artery disease -- type 2 diabetes mellitus; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2007.121921
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: The purpose of the study was to evaluate the prevalence of CAD as well as plaque morphology in asymptomatic patients with type 2 diabetes using multi-slice computed tomography (MSCT). In addition, the relation between calcium score and MSCT findings was explored. Design: In 70 patients, coronary calcium scoring and non-invasive coronary angiography were performed. Angiograms showing atherosclerosis were further classified as obstructive (⩾50% luminal narrowing) CAD or not. Plaque type (non-calcified, mixed and calcified) was determined. Finally, the relation between calcium score and MSCT findings was explored. Results: A 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 12 (17%) and 13 (19%) patients respectively. Non-invasive coronary angiography showed CAD in 56 (80%) patients. 322 coronary segments with plaque were identified, of which 132 (41%) contained non-calcified plaques, 65 (20%) mixed plaques and 125 (39%) calcified plaques. The percentage of patients with obstructive CAD paralleled increasing calcium score. The presence of CAD was noted in 17 (55%) patients with no or minimal calcium (score <10). Conclusions: MSCT angiography detected a high prevalence of CAD in asymptomatic patients with type 2 diabetes. A relatively high proportion of plaques were non-calcified (41%). 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 with incremental value over calcium scoring.