Abstract

Abstract OBJECTIVE-- Cardiovascular events are high in patients with type 2 diabetes while their risk stratification is more difficult. The higher risk may be related to differences in coronary plaque burden and composition. The purpose of the study was to evaluate whether differences in the extent and composition of coronary plaques in patients with and without diabetes can be observed using MSCT.

Abstract RESEARCH DESIGN AND METHODS- MSCT was performed in 215 patients (86, 40% with type 2 diabetes). The 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. Plaque characteristics were compared in patients with and without diabetes. Regression analysis was performed to assess correlation between plaque characteristics and diabetes.

Abstract RESULTS- Patients with diabetes showed significantly more diseased coronary segments compared to non-diabetic patients (4.9±3.5 vs. 3.9±3.2, p=0.03) with more non-obstructive (3.7±3.0 vs. 2.7±2.4, p=0.008) plaques. Relatively more non-calcified (28% vs. 19%), calcified (49% vs. 43%) and less mixed (23% vs. 38%) plaques were observed in diabetes (p<0.0001). Diabetes correlated with the number of diseased segments, non-obstructive, non-calcified and calcified plaques.

Abstract CONCLUSIONS- Differences in coronary plaque characteristics on MSCT were observed between patients with and without diabetes. Diabetes was associated with higher coronary plaque burden. More non-calcified and calcified plaques while less mixed plaques were observed in diabetic patients. Thus, MSCT may be used to identify differences in coronary plaque burden, which may be useful for risk stratification.