Association between diabetes and different components of coronary atherosclerotic plaque burden as measured by coronary multidetector computed tomography.
OBJECTIVE
The aim of the study was to assess differences in the presence, extent, and composition of coronary atherosclerotic plaque burden as detected by coronary multidetector computed tomography (MDCT) between patients with and without diabetes mellitus.


METHODS
We compared coronary atherosclerotic plaques (any plaque, calcified [CAP], non-calcified [NCAP, and mixed plaque [MCAP]]) between 144 symptomatic diabetic and non-diabetic patients (36 diabetics, mean age: 54.4+/-12, 64% females) who underwent coronary 64-slice MDCT (Siemens Medical Solutions, Forchheim, Germany) for the evaluation of acute chest pain but proven absence of myocardial ischemia.


RESULTS
Patients with diabetes had a higher prevalence of any plaque, CAP, MCAP, and NCAP (p=0.08, 0.07, 0.05, and 0.05, respectively) and a significantly higher extent of any plaque, CAP, MCAP, and NCAP (3.8+/-4.2 vs. 2.0+/-3.2, p=0.01; 3.3+/-4.0 vs. 1.7+/-3.0, p=0.03; 1.4+/-2.6 vs. 0.6+/-1.5, p=0.03; and 1.9+/-3.0 vs. 1.0+/-1.9, p=0.03, respectively) as compared to controls. In addition, patients with diabetes had a significant higher prevalence of significant coronary artery stenosis (42% vs. 14%, p=0.0004) and an approximately 3.5-fold higher risk of significant coronary stenosis independent of the presence of hypertension and BMI (OR: 3.46, 95% CI: 1.37-8.74, p=0.009).


CONCLUSIONS
Patients with diabetes have an approximately 3.5-fold higher risk of coronary stenosis independent of other cardiovascular risk factors and an overall increased coronary atherosclerotic plaque burden.
Yun
Chun-Ho
CH
Massachusetts General Hospital, Harvard Medical School, Boston, United States.
Schlett
Christopher L
CL
Rogers
Ian S
IS
Truong
Quynh A
QA
Toepker
Michael
M
Donnelly
Patrick
P
Brady
Thomas J
TJ
Hoffmann
Udo
U
Bamberg
Fabian
F
D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D023921:Coronary Stenosis / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D048909:Diabetes Complications / Q000473:pathology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*