Plaque morphology in diabetic vs. non diabetic patients assessed by Multi-Slice Computed Tomography coronary angiography
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Abstract
Background and Objectives: Multi-slice computed tomography (MSCT) provides high accuracy for noninvasive assessment of coronary artery disease (CAD). The introduction of the latest computed tomography technology allows comprehensive evaluation of various aspects of CAD, including the coronary calcium score, coronary artery stenosis, bypass patency, and myocardial function. This study aimed to assess the effect of DM on coronary arteries evaluated by MSCT-CA Comparing Plaque Morphology in Diabetic patients with Non-Diabetic Whoever Controlled or not assessed by HbA1c.
Methods: In this study we randomly assigned 150 adult patients were diagnosed with suspected coronary artery disease underwent MSCT-CA for evaluation their coronaries regarding luminal stenosis, Plaque analysis, Remodeling index, SSS, SIS and Ca score.
Results: There was statistically significant difference between diabetics & non-diabetic groups in LM lesions with (P = 0.029). also, the results of multivariate logistic regression analysis after adjustment for age and sex, diabetics were shown a trend toward more mixed plaque with statistically significant {(OR): 3.422, 95% CI 1.66-7.023, P = 0.001}; whereas, after adjustment for age, sex, history of hypertension, smoking, and hypercholesterolemia, patients with diabetes also shown a trend toward more mixed plaque with statistically significant (OR: 3.456, 95% CI 1.668-7.160, P = 0.001). It means significant differences in coronary atherosclerotic plaque burden and composition between diabetic and non-diabetic patients, with a higher proportion of mixed plaques, a more vulnerable form of atherosclerotic plaque in diabetics (P < 0.001) otherwise No significant difference.
Conclusion: MSCT angiography may be useful for the identification of CAD in diabetic and non-diabetic patients. There were statistically significant differences in coronary atherosclerotic plaque burden and composition, with a higher proportion of mixed plaques, between diabetic and nondiabetic patients. Furthermore, MSCT may give accurate information about plaque characteristics according to different coronary risk factors, thereby identifying high risk features warranting a more intensive anti-atherosclerotic treatment.
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Tomizawa N, Nojo T, Inoh S, Nakamura S. Difference of coronary artery disease severity, extent and plaque Characteristics between patients with hypertension d; mellitus dys-lipidemia. Int J Cardiovasc Imaging. 2015; 31: 205-212. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25262436
Tomizawa N, Inoh S, Nojo T, Nakamura S. The association of hemoglobin A1c and high risk plaque and plaque extent assesed by MDCT. Int J Cardiovasc Imaging. 2016; 32: 493-500. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26463885
Burgstahler C, Beck T, Reimann A, Kuettner A, Kopp AF, et al. Diagnostic accuracy of multislice computed tomography for the detection of coronary artery disease in diabetic patients. J Diabetes Complicat. 2007; 21: 69-746. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17331854
Nakazato R, Arsanjani R, Achenbach S, et al. Age-related risk of major adverse cardiac event risk and coronary artery disease extent and severity by coronary CTangiography: results from 15,187 patients from the International Multisite CONFIRM Study. Eur Heart J Cardiovasc Imaging. 2014; 15: 586-594. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24714312
Motoyama S. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009; 54: 49-57. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19555840
Kim JJ, Hwang BH, Choi IJ, Choo EH, Lim S, et al. Impact of diabetes duration on the extent and severity of coronary atheroma burden and long-term clinical outcome in asymptomatic type 2 diabetic patients: evaluation by Coronary CT angiography. Eur Heart J Cardiovasc Imaging. 2015; 16: 606: 608. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26069244
Kodama T, Kondo T, Oida A, Fujimoto S, Narula J. Computed tomographic angiography-verified plaque characteristics and slow-flow phenomenon during percutaneous coronary intervention. JACC Cardiovasc Interv. 2012; 5: 636-643. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22721658
Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827-832. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2407762
Deguchi JO, Aikawa M, Tung CH, et al. Inflammation in atherosclerosis: visualizing matrix metalloproteinase action in macrophages in vivo. Circulation. 2006; 114: 55-62. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16801460
Ceriello A, Esposito K, Piconi L, Ihnat M, Thorpe J, et al. Glucose "peak" and glucose "spike": Impact on endothelial function and oxidative stress. Diabetes Res Clin Pract. 2008; 82: 262-267. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18950890
Sima A, Stancu C, Simionescu M. Vascular endothelium in atherosclerosis. Cell Tissue Res. 2009; 335: 191-203. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18797930
Komatsu S, Hirayama A, Omori Y, Ueda Y, Mizote I, et al. Detections of coronary plaque by computed tomography with a novel plaque analysis system, plaque map. And comparison with intravascular u/s and angioscopy. Circ J. 2005; 69: 72-77. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15635207
Greenland P, Alpert JS, Beller GA et al. ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults. J Am Coll Cardiol. 2010; 56: 50-63.
Wheeler G, Shi R, Beck S, Langefeld CD, Lenchik L, et al. Pericardial and visceral adipose tissues measured volumetrically with computed tomography are highly associated in type 2 diabetic families. Invest Radiol. 2005; 40: 97-101. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15654254
Wayhs R, Zelinger A, Raggi P. High coronary artery calcium scores pose an extremely elevated risk for hard events. J Am Coll Cardiol 2002; 39: 225-230. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11788211
Kim D, Choi SY, Choi EK, et al. Distribution of coronary artery calcification in an asymptomatic Korean population: association with risk factors of cardiovascular disease and metabolic syndrome. Korean Circ J. 2008; 38: 29-35.
Hartmann A, Schlottog B, Jungmann E, et al. Somatic pain threshold and reactive hyperemia in autonomic diabetic neuropathy and silent myocardial ischemia. Int J Cardiol. 1993; 42: 121-127. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8112916
Ibebuogu UN, Nasir K, Gopal A, Ahmadi N, Mao SS, et al. Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by noninvasive CT angiography. Int J Cardiovasc Imaging. 2009; 25: 717-723. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19633998
Nicholls SJ, Tuzcu EM, Crowe T, Sipahi I, Schoenhagen P, et al. Relationship between cardiovascular risk factors and atherosclerotic disease burden measured by intravascular ultrasound. J Am Coll Cardiol 2006; 47: 1967-1975. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16697312
Kwon YS, Jang JS, Lee CW, Kim DK, Kim U et al. Comparison of Plaque Composition in Diabetic and Non-Diabetic Patients With Coronary Artery Disease Using Multislice CT Angiography. Korean Circ J. 2010; 40: 581-586. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21217935
Zeina AR, Odeh M, Rosenschein U, Zaid G, Barmeir E. Coronary artery disease among asymptomatic diabetic and nondiabetic patients undergoing coronary computed tomography angiography. Coron Artery Dis. 2008; 19: 37-41. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18281814