Menu

rss
Heart 94:290-295 doi:10.1136/hrt.2007.121921
  • Original research
  • Diabetes, lipids and metabolism

Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes

  1. A J H A Scholte1,
  2. J D Schuijf1,
  3. A V Kharagjitsingh2,
  4. J W Jukema1,3,
  5. G Pundziute1,
  6. E E van der Wall1,
  7. J J Bax1
  1. 1
    Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2
    Department of Internal Medicine, Medisch Centrum Haaglanden, The Hague, The Netherlands
  3. 3
    The Interuniversity Cardiology Institute of The Netherlands, Utrecht, The Netherlands
  1. Arthur J H A Scholte, MD, Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands; a.j.h.a.scholte{at}lumc.nl
  • Accepted 10 July 2007
  • Published Online First 23 July 2007

Abstract

Objective: The purpose of the study was to evaluate the prevalence of CAD as well as plaque morphology in asymptomatic patients with type 2 diabetes using multi-slice computed tomography (MSCT). In addition, the relation between calcium score and MSCT findings was explored.

Design: In 70 patients, coronary calcium scoring and non-invasive coronary angiography were performed. Angiograms showing atherosclerosis were further classified as obstructive (⩾50% luminal narrowing) CAD or not. Plaque type (non-calcified, mixed and calcified) was determined. Finally, the relation between calcium score and MSCT findings was explored.

Results: A calcium score <10 was observed in 31 (44%) patients. A calcium score of 10–100 was observed in 14 (20%) patients while a score of 101–400 or >400 was identified in 12 (17%) and 13 (19%) patients respectively. Non-invasive coronary angiography showed CAD in 56 (80%) patients. 322 coronary segments with plaque were identified, of which 132 (41%) contained non-calcified plaques, 65 (20%) mixed plaques and 125 (39%) calcified plaques. The percentage of patients with obstructive CAD paralleled increasing calcium score. The presence of CAD was noted in 17 (55%) patients with no or minimal calcium (score <10).

Conclusions: MSCT angiography detected a high prevalence of CAD in asymptomatic patients with type 2 diabetes. A relatively high proportion of plaques were non-calcified (41%). Importantly, a calcium score <10 did not exclude CAD in these patients. MSCT might be a useful technique to identify CAD in asymptomatic patients with type 2 diabetes with incremental value over calcium scoring.

Footnotes

  • Competing interests: None declared.

Articles citing this article

  • Enhanced Risk Stratification With Noninvasive Measurement of Coronary Flow Reserve Using Positron Emission Tomography Circulation 2012;126:15 1808-1811
  • Coronary computed tomography: current role and future perspectives for cardiovascular risk stratification Eur Heart J Cardiovasc Imaging 2012;13:6 453-458
  • Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk Diabetes and Vascular Disease Research 2012;9:1 10-17
  • Effects of pioglitazone and metformin on vascular endothelial function in patients with type 2 diabetes treated with sulfonylureas Diabetes and Vascular Disease Research 2012;9:1 52-58
  • CT coronary plaque burden in asymptomatic patients with familial hypercholesterolaemia Heart 2011;97:14 1151-1157
  • Coronary Artery Calcium Scoring Does Not Add Prognostic Value to Standard 64-Section CT Angiography Protocol in Low-Risk Patients Suspected of Having Coronary Artery Disease Radiology 2011;259:1 92-99
  • 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation 2010;122:25 e584-e636
  • 2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation 2010;122:25 2748-2764
  • Multislice computed tomography coronary angiography for risk stratification in patients with an intermediate pretest likelihood Heart 2009;95:19 1607-1611
  • Relation between coronary atherosclerotic plaques and traditional risk factors in people with no history of cardiovascular disease undergoing multi-detector computed coronary angiography Heart 2009;95:15 1265-1272
  • Differences in Atherosclerotic Plaque Burden and Morphology Between Type 1 and 2 Diabetes as Assessed by Multislice Computed Tomography Diabetes Care 2009;32:8 1507-1512
  • Lesions without calcium: lessons from CT angiography Heart 2009;95:13 1038-1040

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All Versions of this Article:
    1. hrt.2007.121921v1
    2. hrt.2007.121921v2
    3. 94/3/290 most recent

Responses

  1. Submit a response
  2. No responses published

Social bookmarking

Register for free content


Free sample
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of Heart.
View free sample issue >>

Free archive
The full back archive is now available for Heart. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006, back to volume 1 issue 1.
Register to access the free archive >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.