Differences in atherosclerotic plaque burden and morphology between type 1 and 2 diabetes mellitus as assessed by multi-slice computed tomography
- Roxana Djaberi, MD1,
- Joanne D. Schuijf, PHD1,
- Eric Boersma, PHD2,
- Lucia J.M. Kroft, MD, PHD3,
- Alberto M. Pereira, MD, PHD4,
- Johannes A. Romijn, MD, PHD4,
- Arthur J. Scholte, MD1,
- J. Wouter Jukema, MD, PHD1,5,6 and
- Jeroen J. Bax, MD, PHD (J.J.Bax{at}LUMC.nl)1,6
- 1Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
- 2Department of Epidemiology and Statistics, Erasmus Medical Center, Rotterdam, the Netherlands
- 3Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- 4Department of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- 5Eindhoven Laboratory of Experimental Vascular Medicine, the Netherlands
- 6Interuniversity Cardiology Institute of the Netherlands (ICIN)
Abstract
Objective: It is unclear whether coronary atherosclerotic plaque burden is similar in patients with type 1 and type 2 diabetes. Using multi-slice CT (MSCT) the presence, degree and morphology of coronary artery disease (CAD) in type 1 and type 2 diabetes were compared.
Research design and methods: Prospectively, coronary artery calcium (CAC) scoring and MSCT coronary angiography were performed in 135 asymptomatic patients (65 patients with type 1 and 70 patients with type 2 diabetes). The presence and extent of coronary atherosclerosis as well as plaque phenotype were assessed and compared between groups.
Results: No difference was observed in average CAC score (217±530 vs. 174±361) nor the prevalence of coronary atherosclerosis (65% vs. 71%) in type 1 and type 2 diabetes. However, the prevalence of obstructive atherosclerosis was higher in patients with type 2 diabetes (n=24; 34%) as compared to type 1 diabetes (n=11; 17%) (P=0.02). Also, higher mean number of atherosclerotic and obstructive plaques was observed in type 2 diabetes. In addition, the percentage of non-calcified plaques was higher in type 2 diabetes (66%) versus type 1 diabetes (27%)(P<0.001), resulting in a higher plaque burden for each CAC score as compared to type 1 diabetic patients.
Conclusions: Although CAC scores and prevalence of coronary atherosclerosis were similar between type 1 and type 2 diabetes, CAD was more extensive in the latter. Also, a relatively higher proportion of non-calcified plaques was observed in type 2 diabetes. These observations may be valuable in the development of targeted management strategies adapted to diabetes type.
Footnotes
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- Received February 18, 2009.
- Accepted May 13, 2009.
- Copyright © American Diabetes Association
