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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. Arthur Scholte (a.j.h.a.scholte{at}lumc.nl)
  1. Department of Cardiology, Leiden University Medical Center, Netherlands
    1. Joanne Schuijf
    1. Department of Cardiology, Leiden University Medical Center, Netherlands
      1. Antje Kharagjitsingh
      1. Department of Internal Medicine, Medisch Centrum Haaglanden, The Hague, Netherlands
        1. Wouter Jukema
        1. Department of Cardiology, Leiden University Medical Center, Netherlands
          1. Gabia Pundziute
          1. Department of Cardiology, Leiden University Medical Center, Netherlands
            1. Ernst van der Wall
            1. Department of Cardiology, Leiden University Medical Center, Netherlands
              1. Jeroen Bax
              1. Department of Cardiology, Leiden University Medical Center, Netherlands

                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 was performed. Angiograms showing atherosclerosis were further classified as obstructive (¡Ý50% 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 respectively 12 (17%) and 13 (19%) patients. <BR> Non-invasive coronary angiography showed CAD in 56 (80%) patients.<BR> 322 coronary segments with plaque were identified, of which 132 (41%) contained non-calcified plaques, 65 (20%) mixed plaques and 125 (39%) calcified plaques.<BR> 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.

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