| 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. | |
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MedLine Citation:
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PMID: 19786264 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article Date: 2009-06-25 |
Journal Detail:
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Title: Archives of cardiovascular diseases Volume: 102 ISSN: 1875-2136 ISO Abbreviation: Arch Cardiovasc Dis Publication Date: 2009 Aug-Sep |
Date Detail:
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Created Date: 2009-09-29 Completed Date: 2009-12-02 Revised Date: 2011-04-25 |
Medline Journal Info:
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Nlm Unique ID: 101465655 Medline TA: Arch Cardiovasc Dis Country: Netherlands |
Other Details:
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Languages: eng Pagination: 607-15 Citation Subset: IM |
Affiliation:
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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:
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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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