BACKGROUND: Early detection of atherosclerosis in individuals with diabetes is important because of high cardiovascular mortality in this population. We performed multidetector-row computed tomography (MDCT) in asymptomatic individuals to investigate the status of coronary artery stenosis and plaque characteristics depending on the glucose level. METHODS AND RESULTS: The plaque burden (number of diseased coronary segments), severity of stenosis, plaques characteristics, and coronary artery calcium score (CACS) were assessed by MDCT in 1043 asymptomatic individuals. Anthropometric parameters and metabolic profiles were also acquired. Twenty-one percents of subjects had plaques and 5% had significant stenosis. Mean (+/-S.D.) CACS of study population was 17+/-81. Subjects with impaired fasting glucose (IFG, n=215, 21%) or diabetes (n=112, 11%) had a greater plaque burden, more coronary stenosis (>50% of diameter stenosis) and higher CACS than normal subjects (all, p<0.01). Noncalcified and mixed plaques were observed more in subjects with diabetes (19%) and IFG (11%) than normal (7%). After adjustment for confounding factors, higher fasting glucose was strongly associated with significant coronary stenosis and a greater plaque burden. CONCLUSIONS: More significant coronary stenosis and multivessel involvement, higher CACS, and greater plaque burden were observed in subjects with IFG or diabetes by MDCT, even they are asymptomatic. Proactive screening, irrespective of the imaging modalities used, in asymptomatic subjects with prediabetes and diabetes is helpful to identify those who have a higher cardiovascular morbidity and mortality. Further studies will guide us with respect to which imaging modality is more appropriate.
BACKGROUND: Early detection of atherosclerosis in individuals with diabetes is important because of high cardiovascular mortality in this population. We performed multidetector-row computed tomography (MDCT) in asymptomatic individuals to investigate the status of coronary artery stenosis and plaque characteristics depending on the glucose level. METHODS AND RESULTS: The plaque burden (number of diseased coronary segments), severity of stenosis, plaques characteristics, and coronary artery calcium score (CACS) were assessed by MDCT in 1043 asymptomatic individuals. Anthropometric parameters and metabolic profiles were also acquired. Twenty-one percents of subjects had plaques and 5% had significant stenosis. Mean (+/-S.D.) CACS of study population was 17+/-81. Subjects with impaired fasting glucose (IFG, n=215, 21%) or diabetes (n=112, 11%) had a greater plaque burden, more coronary stenosis (>50% of diameter stenosis) and higher CACS than normal subjects (all, p<0.01). Noncalcified and mixed plaques were observed more in subjects with diabetes (19%) and IFG (11%) than normal (7%). After adjustment for confounding factors, higher fasting glucose was strongly associated with significant coronary stenosis and a greater plaque burden. CONCLUSIONS: More significant coronary stenosis and multivessel involvement, higher CACS, and greater plaque burden were observed in subjects with IFG or diabetes by MDCT, even they are asymptomatic. Proactive screening, irrespective of the imaging modalities used, in asymptomatic subjects with prediabetes and diabetes is helpful to identify those who have a higher cardiovascular morbidity and mortality. Further studies will guide us with respect to which imaging modality is more appropriate.
Authors: E Maffei; A Palumbo; C Martini; C Tedeschi; T Arcadi; L La Grutta; R Malagò; A C Weustink; N R Mollet; R De Rosa; O Catalano; I Salamone; A Blandino; M Midiri; F Cademartiri Journal: Radiol Med Date: 2011-09-02 Impact factor: 3.469
Authors: Frank Y F Xing; Ian J Neeland; M Odette Gore; Colby R Ayers; Andre R M Paixao; Aslan T Turer; Jarett D Berry; Amit Khera; James A de Lemos; Darren K McGuire Journal: Diab Vasc Dis Res Date: 2014-01 Impact factor: 3.291
Authors: Martin K Rutter; Joseph M Massaro; Udo Hoffmann; Christopher J O'Donnell; Caroline S Fox Journal: Diabetes Care Date: 2012-07-06 Impact factor: 19.112
Authors: Seon Mee Kang; Ji Won Yoon; Hwa Young Ahn; So Yeon Kim; Kyoung Ho Lee; Hayley Shin; Sung Hee Choi; Kyong Soo Park; Hak Chul Jang; Soo Lim Journal: PLoS One Date: 2011-11-11 Impact factor: 3.240
Authors: Katarzyna Janda; Marcin Krzanowski; Mariusz Gajda; Paulina Dumnicka; Danuta Fedak; Grzegorz J Lis; Piotr Jaśkowski; Jan A Litwin; Władysław Sułowicz Journal: Int J Endocrinol Date: 2013-12-18 Impact factor: 3.257