Publicação

Diabetes as an independent predictor of high atherosclerotic burden assessed by coronary computed tomography angiography

Detalhes bibliográficos
Resumo:	(1) To study the prevalence and severity of coronary artery disease (CAD) in diabetic patients. (2) To provide a detailed characterization of the coronary atherosclerotic burden, including the localization, degree of stenosis and plaque composition by coronary computed tomography angiography (CCTA). Single center prospective registry including a total of 581 consecutive stable patients (April 2011-March 2012) undergoing CCTA (Dual-source CT) for the evaluation of suspected CAD without previous myocardial infarction or revascularization procedures. Different coronary plaque burden indexes and plaque type and distribution patterns were compared between patients with (n = 85) and without diabetes (n = 496). The prevalence of CAD (any plaque; 74.1 vs. 56 %; p = 0.002) and obstructive CAD (≥50 % stenosis; 31.8 vs. 10.3 %; p<0.001) were significantly higher in diabetic patients. The remaining coronary atherosclerotic burden indexes evaluated (plaque in LM-3v-2v with prox. LAD; SIS; SSS; CT-LeSc) were also significantly higher in diabetic patients. In the per segment analysis, diabetics had a higher percentage of segments with plaque in every vessel (2.6/13.1/7.5/10.5 % for diabetics vs. 1.4/7.1/3.3/4.4 % for nondiabetics for LM, LAD, LCx, RCA respectively; p<0.001 for all) and of both calcified (19.3 vs. 9.2 %, p<0.001) and noncalcified or mixed types (14.4 vs. 7.0 %; p<0.001); the ratio of proximal-to-distal relative plaque distribution (calculated as LM/proximal vs. mid/distal/branches) was lower for diabetics (0.75 vs. 1.04; p = 0.009). Diabetes was an independent predictor of CAD and was also associated with more advanced CAD, evaluated by indexes of coronary atherosclerotic burden. Diabetics had a significantly higher prevalence of plaques in every anatomical subset and for the different plaque composition. In this report, the relative geographic distribution of the plaques within each subgroup, favored a more mid-to-distal localization in the diabetic patients.
Autores principais:	De Araújo Gonçalves, Pedro
Outros Autores:	Garcia-Garcia, Hector M.; Carvalho, Maria Salomé; Dores, Helder; Dores, Helder; Sousa, Pedro Jeronimo; Marques, Hugo; Pinto Marques, Hugo; Ferreira, Antonio; Cardim, Nuno; Cardim, Nuno; Teles, Rui Campante; Raposo, Luís; Gabriel, Henrique Mesquita; Almeida, Manuel; Aleixo, Ana; Aleixo, Ana; Carmo, Miguel Mota; Mota Carmo, M; Machado, Francisco Pereira; Mendes, Miguel
Assunto:	Atherosclerotic burden Coronary artery disease Coronary CT angiography Diabetes Radiology Nuclear Medicine and imaging Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being
Ano:	2013
País:	Portugal
Tipo de documento:	artigo
Tipo de acesso:	acesso aberto
Instituição associada:	Universidade Nova de Lisboa
Idioma:	inglês
Origem:	Repositório Institucional da UNL

Descrição
Resumo:	(1) To study the prevalence and severity of coronary artery disease (CAD) in diabetic patients. (2) To provide a detailed characterization of the coronary atherosclerotic burden, including the localization, degree of stenosis and plaque composition by coronary computed tomography angiography (CCTA). Single center prospective registry including a total of 581 consecutive stable patients (April 2011-March 2012) undergoing CCTA (Dual-source CT) for the evaluation of suspected CAD without previous myocardial infarction or revascularization procedures. Different coronary plaque burden indexes and plaque type and distribution patterns were compared between patients with (n = 85) and without diabetes (n = 496). The prevalence of CAD (any plaque; 74.1 vs. 56 %; p = 0.002) and obstructive CAD (≥50 % stenosis; 31.8 vs. 10.3 %; p<0.001) were significantly higher in diabetic patients. The remaining coronary atherosclerotic burden indexes evaluated (plaque in LM-3v-2v with prox. LAD; SIS; SSS; CT-LeSc) were also significantly higher in diabetic patients. In the per segment analysis, diabetics had a higher percentage of segments with plaque in every vessel (2.6/13.1/7.5/10.5 % for diabetics vs. 1.4/7.1/3.3/4.4 % for nondiabetics for LM, LAD, LCx, RCA respectively; p<0.001 for all) and of both calcified (19.3 vs. 9.2 %, p<0.001) and noncalcified or mixed types (14.4 vs. 7.0 %; p<0.001); the ratio of proximal-to-distal relative plaque distribution (calculated as LM/proximal vs. mid/distal/branches) was lower for diabetics (0.75 vs. 1.04; p = 0.009). Diabetes was an independent predictor of CAD and was also associated with more advanced CAD, evaluated by indexes of coronary atherosclerotic burden. Diabetics had a significantly higher prevalence of plaques in every anatomical subset and for the different plaque composition. In this report, the relative geographic distribution of the plaques within each subgroup, favored a more mid-to-distal localization in the diabetic patients.