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Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease: a preliminary study.
Arch Cardiovasc Dis. 2009 Aug-Sep; 102(8-9):607-15.AC

Abstract

BACKGROUND

There is a need to identify diabetic patients at risk of cardiovascular events before symptom onset.

AIMS

To evaluate the prevalence and characteristics of coronary atherosclerotic plaques in asymptomatic type 2 diabetic patients with coronary risk factors but without known coronary artery disease, using multidetector computed tomography.

METHODS

High-resolution 40-slice coronary computed tomography was performed prospectively in 42 consecutive type 2 diabetic patients (mean age 62 years; range 50-77 years; 28 men) with over one or more carotid atherosclerotic plaque and no coronary artery disease symptoms. Computed tomography data were evaluated for calcium score and the presence of coronary plaques. Plaque type, distribution, extensive character and obstructive nature were determined per patient for each segment.

RESULTS

No plaques were detected in 11 (26.2%) patients. Atherosclerotic plaques were detected in 31 (73.8%) patients. A total of 147 coronary segments with plaque were identified, of which 11 (7.5%) contained hypodense plaques, 28 (19%) mixed plaques and 108 (73.5%) calcified plaques. Hypodense plaques were noted in 4/15 (26.7%) patients without coronary calcifications. Most calcified and hypodense plaques resulted in lumen narrowing of less than 50%; most mixed plaques resulted in lumen narrowing greater than 50%. Obstructive disease was detected in 9/11 patients with a high calcium score (>400).

CONCLUSION

This preliminary study demonstrates that a high proportion of asymptomatic type 2 diabetic patients present without coronary plaques detectable by multidetector computed tomography, despite concomitant carotid atherosclerotic lesions. Computed tomography seems to detect a high proportion of plaques compared with conventional angiography in these specific patients.

Authors+Show Affiliations

Department of Cardiovascular Imaging, Louis-Pradel Hospital, LRMN Creatis, UMR CNRS 5515, Inserm U630, Claude-Bernard University, Lyon 1, 28 Avenue du Doyen-Jean-Lépine, 69500 Lyon, France. romaric.loffroy@chu-dijon.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19786264

Citation

Loffroy, Romaric, et al. "Noninvasive Assessment of the Prevalence and Characteristics of Coronary Atherosclerotic Plaques By Multidetector Computed Tomography in Asymptomatic Type 2 Diabetic Patients at High Risk of Significant Coronary Artery Disease: a Preliminary Study." Archives of Cardiovascular Diseases, vol. 102, no. 8-9, 2009, pp. 607-15.
Loffroy R, Bernard S, Sérusclat A, et al. Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease: a preliminary study. Arch Cardiovasc Dis. 2009;102(8-9):607-15.
Loffroy, R., Bernard, S., Sérusclat, A., Boussel, L., Bonnefoy, E., D'Athis, P., Moulin, P., Revel, D., & Douek, P. (2009). Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease: a preliminary study. Archives of Cardiovascular Diseases, 102(8-9), 607-15. https://doi.org/10.1016/j.acvd.2009.04.007
Loffroy R, et al. Noninvasive Assessment of the Prevalence and Characteristics of Coronary Atherosclerotic Plaques By Multidetector Computed Tomography in Asymptomatic Type 2 Diabetic Patients at High Risk of Significant Coronary Artery Disease: a Preliminary Study. Arch Cardiovasc Dis. 2009 Aug-Sep;102(8-9):607-15. PubMed PMID: 19786264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease: a preliminary study. AU - Loffroy,Romaric, AU - Bernard,Sophie, AU - Sérusclat,André, AU - Boussel,Loïc, AU - Bonnefoy,Eric, AU - D'Athis,Philippe, AU - Moulin,Philippe, AU - Revel,Didier, AU - Douek,Philippe, Y1 - 2009/06/25/ PY - 2009/01/20/received PY - 2009/04/14/revised PY - 2009/04/15/accepted PY - 2009/9/30/entrez PY - 2009/9/30/pubmed PY - 2009/12/16/medline SP - 607 EP - 15 JF - Archives of cardiovascular diseases JO - Arch Cardiovasc Dis VL - 102 IS - 8-9 N2 - BACKGROUND: There is a need to identify diabetic patients at risk of cardiovascular events before symptom onset. AIMS: To evaluate the prevalence and characteristics of coronary atherosclerotic plaques in asymptomatic type 2 diabetic patients with coronary risk factors but without known coronary artery disease, using multidetector computed tomography. METHODS: High-resolution 40-slice coronary computed tomography was performed prospectively in 42 consecutive type 2 diabetic patients (mean age 62 years; range 50-77 years; 28 men) with over one or more carotid atherosclerotic plaque and no coronary artery disease symptoms. Computed tomography data were evaluated for calcium score and the presence of coronary plaques. Plaque type, distribution, extensive character and obstructive nature were determined per patient for each segment. RESULTS: No plaques were detected in 11 (26.2%) patients. Atherosclerotic plaques were detected in 31 (73.8%) patients. A total of 147 coronary segments with plaque were identified, of which 11 (7.5%) contained hypodense plaques, 28 (19%) mixed plaques and 108 (73.5%) calcified plaques. Hypodense plaques were noted in 4/15 (26.7%) patients without coronary calcifications. Most calcified and hypodense plaques resulted in lumen narrowing of less than 50%; most mixed plaques resulted in lumen narrowing greater than 50%. Obstructive disease was detected in 9/11 patients with a high calcium score (>400). CONCLUSION: This preliminary study demonstrates that a high proportion of asymptomatic type 2 diabetic patients present without coronary plaques detectable by multidetector computed tomography, despite concomitant carotid atherosclerotic lesions. Computed tomography seems to detect a high proportion of plaques compared with conventional angiography in these specific patients. SN - 1875-2136 UR - https://www.unboundmedicine.com/medline/citation/19786264/Noninvasive_assessment_of_the_prevalence_and_characteristics_of_coronary_atherosclerotic_plaques_by_multidetector_computed_tomography_in_asymptomatic_type_2_diabetic_patients_at_high_risk_of_significant_coronary_artery_disease:_a_preliminary_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1875-2136(09)00149-1 DB - PRIME DP - Unbound Medicine ER -