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Coronary Artery Plaque Volume and Obesity in Patients with Diabetes: The Factor-64 Study.
MedLine Citation:
PMID:  24754493     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes. Materials and Methods All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.8 years; mean duration of diabetes, 10.4 years) underwent coronary CT angiography. Total coronary artery wall volume in all three vessels was measured by using semiautomated software. The coronary plaque volume index (PVI) was determined by dividing the wall volume by the coronary length. The relationship between the PVI and cardiovascular risk factors was determined with multivariable analysis. Results The mean PVI (±standard deviation) was 11.2 mm(2) ± 2.7. The mean coronary artery calcium (CAC) score (determined with the Agatston method) was 382; 67% of total plaque was noncalcified. The PVI was related to age (standardized β = 0.32, P < .001), male sex (standardized β = 0.36, P < .001), body mass index (BMI) (standardized β = 0.26, P < .001), and duration of diabetes (standardized β = 0.14, P = .03). A greater percentage of soft plaque was present in younger individuals with a shorter disease duration (P = .02). The soft plaque percentage was directly related to BMI (P = .002). Patients with discrepancies between CAC score and PVI rank quartiles had a higher percentage of soft and fibrous plaque (18.7% ± 3.3 vs 17.4% ± 3.5 [P = .008] and 52.2% ± 7.2 vs 47.2% ± 8.8 [P < .0001], respectively). Conclusion In asymptomatic diabetic patients, BMI was the primary modifiable risk factor that was associated with total and soft coronary plaque as assessed with coronary CT angiography. © RSNA, 2014 Clinical trial registration no. NCT00488033 Online supplemental material is available for this article.
Authors:
Alan C Kwan; Heidi T May; George Cater; Christopher T Sibley; Boaz D Rosen; João A C Lima; Karen Rodriguez; Donald L Lappe; Joseph B Muhlestein; Jeffrey L Anderson; David A Bluemke
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-17
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-4-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  140611     Citation Subset:  -    
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