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.
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.


METHODS
In 70 patients, coronary calcium scoring and non-invasive coronary angiography were performed. Angiograms showing atherosclerosis were further classified as obstructive (> or =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.
Scholte
A J H A
AJ
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. a.j.h.a.scholte@lumc.nl
Schuijf
J D
JD
Kharagjitsingh
A V
AV
Jukema
J W
JW
Pundziute
G
G
van der Wall
E E
EE
Bax
J J
JJ
D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods