Type 2 diabetes is associated with more advanced coronary atherosclerosis on multislice computed tomography and virtual histology intravascular ultrasound.
BACKGROUND
Data on coronary plaque observations on multi-slice computed tomography (MSCT) in patients with type 2 diabetes are scarce.


RESULTS
In total, 60 patients (19 with diabetes) underwent 64-slice MSCT, followed by conventional coronary angiography with intravascular ultrasound (IVUS). Non-invasively, the extent of coronary atherosclerosis and 3 plaque types (non-calcified, calcified, mixed) were visually evaluated on MSCT. Invasively, plaque burden was assessed on gray-scale IVUS. Plaque composition was evaluated on virtual histology intravascular ultrasound (VH IVUS). Concerning geometrical plaque data, diabetic patients showed more plaques on MSCT (7.1 +/- 3.2 vs 4.9 +/- 3.2 in non-diabetic patients, P = .01). On gray-scale IVUS, diabetes was associated with a larger plaque burden (48.7 +/- 10.7% vs 40.0 +/- 12.1%, P = .003). Concerning plaque composition, diabetes was associated with more calcified plaques on MSCT (52% vs 24%). Relatively more fibrocalcific plaques in diabetic patients (29% versus 9%) were observed on VH IVUS. Moreover, these plaques contained more necrotic core (10.8 +/- 5.9% vs 8.6 +/- 5.2%, P = .01).


CONCLUSIONS
A higher plaque extent and more calcified lesions were observed in diabetic patients on MSCT. The findings were confirmed on gray-scale and VH IVUS. Thus, MSCT may potentially be used to explore patterns of coronary atherosclerosis in diabetic patients.
Pundziute
Gabija
G
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. g.pundziute@lumc.nl
Schuijf
Joanne D
JD
Jukema
J Wouter
JW
van Werkhoven
Jacob M
JM
Nucifora
Gaetano
G
Decramer
Isabel
I
Sarno
Giovanna
G
Vanhoenacker
Piet K
PK
Reiber
Johannes H C
JH
Wijns
William
W
Bax
Jeroen J
JJ
D050197:Atherosclerosis / Q000175:diagnosis* / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*