April - June 2014, Volume 10, Issue 2

Tinica G, Chistol R.O, Furnica C, Luca C, Anghel D, Grecu M

Asymptomatic Coronary Artery Disease in Type 2 Diabetes Mellitus Patients Compared to a Non-Diabetic Control Group

Acta Endo (Buc) 2014, 10 (2): 238-248
doi: 10.4183/aeb.2014.238

Background. Coronary artery disease (CAD), often asymptomatic, is the most common cause of morbidity, mortality and costs in diabetes. Early detection of CAD in patients with diabetes may be of paramount importance and substantially improve the outcome in diabetic patients. Objective. The aims of the current study were to determine if there are significant differences concerning the prevalence of occult CAD in asymptomatic type 2 diabetic patients compared to asymptomatic nondiabetic patients. Design, subjects and methods. The authors retrospectively reviewed a group of 120 non-diabetic (77 men, 43 women, mean age 61±10.2 years) and 120 diabetic (81 men, 39 women, mean age 58±11.4 years) asymptomatic patients that underwent coronary computed tomography angiography (CCTA) for various reasons between January 2013 and January 2014. Results. Coronary plaques were identified in 105 diabetic patients (87.5%) and in 75 non-diabetic patients (62.5%) the prevalence being significantly different (p=0.023). Regarding plaque composition and degree of stenosis, we found a higher prevalence of calcified (p=0.016) and significantly stenotic (≥50% luminal narrowing) plaques (p=0.008) in the diabetic group. Agatston calcium score, relevant for atherosclerotic plaque load, was higher (p=0.005) in type 2 diabetic patients (350.3) compared to non-diabetic patients (158.7). Conclusion. CCTA could represent a screening method able to detect silent atherosclerotic plaques thus contributing to the prevention of acute coronary syndrome (ACS) by an early and adequate treatment of CAD. Obstructive atherosclerotic plaques can be accurately identified using CCTA, limiting the use of invasive imaging methods and selecting patients that could benefit of coronary revascularization.

Keywords: coronary artery disease, type 2 diabetes mellitus, coronary computed tomography angiography, calcium score, coronary stenosis.

Correspondence: Raluca Ozana Chistol MD, “Prof.Dr. George I.M. Georgescu” Institute for Cardiovascular Diseases, Radiology, B-dul Carol I, no. 50, Iasi, 700503, Romania, E-mail: ralucachistol@gmail.com