Document Detail


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.
MedLine Citation:
PMID:  19786264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Romaric Loffroy; Sophie Bernard; André Sérusclat; Loïc Boussel; Eric Bonnefoy; Philippe D'Athis; Philippe Moulin; Didier Revel; Philippe Douek
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-06-25
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  102     ISSN:  1875-2136     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:    2009 Aug-Sep
Date Detail:
Created Date:  2009-09-29     Completed Date:  2009-12-02     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  607-15     Citation Subset:  IM    
Affiliation:
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.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Calcinosis / etiology,  radiography
Carotid Artery Diseases / etiology,  radiography
Coronary Angiography / methods*
Coronary Artery Disease / epidemiology,  etiology,  radiography*
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / complications,  epidemiology,  radiography*
Diabetic Angiopathies / epidemiology,  etiology,  radiography*
Humans
Middle Aged
Pilot Projects
Predictive Value of Tests
Prevalence
Prospective Studies
Radiographic Image Interpretation, Computer-Assisted
Risk Assessment
Severity of Illness Index
Tomography, Spiral Computed*

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