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.
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. g.pundziute@lumc.nl
Gabija
G
Pundziute
Joanne D
JD
Schuijf
J Wouter
JW
Jukema
Jacob M
JM
van Werkhoven
Gaetano
G
Nucifora
Isabel
I
Decramer
Giovanna
G
Sarno
Piet K
PK
Vanhoenacker
Johannes H C
JH
Reiber
William
W
Wijns
Jeroen J
JJ
Bax
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*