title: Coronary Atherosclerotic Plaque Detected by Computed Tomographic Angiography in Subjects with Diabetes Compared to Those without Diabetes.
abstract: OBJECTIVE
  Little data are available regarding coronary plaque composition and semi-quantitative scores in individuals with diabetes; the extent to which diabetes may affect the presence and extent of Coronary Artery Calcium (CAC) needs more evaluation. Considering that this information may be of great value in formulating preventive interventions in this population, we compared these findings in individuals with diabetes to those without.
  
  
  METHODS
  Multi-Detector Computed Tomographic (MDCT) images of 861 consecutive patients with diabetes who were referred to Los Angeles Biomedical Research Institute from January 2000 to September 2012, were evaluated using a 15-coronary segment model. All 861 patients underwent calcium scoring and from these; 389 had coronary CT angiography (CTA). CAC score was compared to 861 age, sex and ethnicity matched controls without diabetes after adjustment for Body Mass Index (BMI), family history of coronary artery disease, hyperlipidemia, hypertension and smoking. Segment Involvement Score (SIS; the total number of segments with any plaque), Segment Stenosis Score (SSS; the sum of maximal stenosis score per segment), Total Plaque Score (TPS; the sum of the plaque amount per segment) and plaque compositionwere compared to 389 age, sex and ethnicity matched controls without diabetes after adjustment for BMI, family history of coronary artery disease, hyperlipidemia, hypertension and smoking.
  
  
  RESULTS
  Diabetes was positively correlated to the presence and extent of CAC (P<0.0001 for both). SIS, SSS and TPS were significantly higher in those with diabetes (P<0.0001). Number of mixed and calcified plaques were significantly higher in those with diabetes (P = 0.018 and P<0.001 respectively) but there was no significant difference in the number of non-calcified plaques between the two groups (P = 0.398).
  
  
  CONCLUSIONS
  Patients with diabetes have higher CAC and semi-quantitative coronary plaque scores compared to the age, gender and ethnicity matched controls without diabetes after adjustment for cardiovascular risk factors. Since mixed plaque is associated with worse long-term clinical outcomes, these findings support more aggressive preventive measures in this population.
authors.affiliation: Department of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
authors.forename: Bahram
authors.initials: B
authors.lastname: Khazai
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, UCLA School of Medicine, Torrance, California, United States of America.
authors.forename: Yanting
authors.initials: Y
authors.lastname: Luo
authors.affiliation: CardioDx, Inc., Palo Alto, California, United States of America.
authors.forename: Steven
authors.initials: S
authors.lastname: Rosenberg
authors.affiliation: CardioDx, Inc., Palo Alto, California, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Wingrove
authors.affiliation: Department of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, UCLA School of Medicine, Torrance, California, United States of America.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D002118:Calcium / Q000378:metabolism; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000000981:diagnostic imaging*; D012044:Regression Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D002118:Calcium