Korean Circ J.  2010 Nov;40(11):581-586. 10.4070/kcj.2010.40.11.581.

Comparison of Plaque Composition in Diabetic and Non-Diabetic Patients With Coronary Artery Disease Using Multislice CT Angiography

• Kwon YS
• Jang JS
• Lee CW
• Kim DK
• Kim U
• Seol SH
• Kim DI
• Jo YW
• Jin HY
• Seo JS
• Yang TH
• Kim DK
• Kim DS

• KMID: 1826177
• DOI: http://doi.org/10.4070/kcj.2010.40.11.581

Abstract

BACKGROUND AND OBJECTIVES
Plaque composition rather than degree of luminal narrowing may be predictive of future coronary events in high risk patients. The purpose of this study was to compare degree of plaque burden and composition with multislice computed tomography (MSCT) angiography between diabetic and non-diabetic patients.
SUBJECTS AND METHODS
A total of 452 consecutive MSCT angiography examinations were performed between July 2007 and June 2009. Of these, the patients who underwent invasive coronary angiography were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing.
RESULTS
Ninety two (46 in the diabetic group and 46 in the non-diabetic group) patients underwent both MSCT angiography and invasive coronary angiography. Among them, 30 patients (65.2%) in the diabetic group and 26 patients (56.5%) in the non-diabetic group had significant coronary narrowing on MSCT angiography. Sixteen patients (34.8%) in the diabetic group and 15 patients (32.6%) in non-diabetic group underwent coronary angioplasty and stenting. Forty-two patients (93.3%) in the diabetic group and 39 patients (88.6%) in the non-diabetic group had multiple types of coronary plaque (p=0.485). MSCT angiography was similar to conventional coronary angiography in its ability to predict significant coronary artery disease in that the area under the curve was 0.88 (95% confidence interval, 0.81 to 0.95). Diabetic patients had more mixed plaque compared with non-diabetic patients.
CONCLUSION
Differences in coronary plaque composition between diabetic and non-diabetic patients can be determined noninvasively by MSCT angiography. In patients with diabetes, mixed plaque types contribute to the total plaque burden to a higher degree than in non-diabetic patients.

Keyword

Coronary artery diseases; Diabetes

MeSH Terms

Angiography
Angioplasty
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Humans
Multidetector Computed Tomography
Phenobarbital
Plaque, Atherosclerotic
Stents
Phenobarbital

Figure

• 

  Fig. 1 Example of different plaque types as visually assigned on the multislice computed tomography angiography. A: non-calcified plaque. B: mixed plaque. C: calcified plaque.

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  Fig. 2 Diagnostic performance of MSCT angiography. Receiver-operating-characteristic curve describing the diagnostic performance of MSCT angiography to identify coronary stenosis of 60% or more in culprit vessel. The area under the curve was 0.88 (95% confidence interval, 0.81 to 0.95). MSCT: multislice computed tomography.

• 

  Fig. 3 Bar graph demonstrating the relative distribution of the different lesion types in diabetic and non-diabetic patients (p=0.035).

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