Differences in atherosclerotic plaque burden and morphology between type 1 and 2 diabetes as assessed by multislice computed tomography.

Abstract

OBJECTIVE It is unclear whether the coronary atherosclerotic plaque burden is similar in patients with type 1 and type 2 diabetes. By using multislice computed tomography (MSCT), the presence, degree, and morphology of coronary artery disease (CAD) in patients with type 1 and type 2 diabetes were compared. RESEARCH DESIGN AND METHODS Prospectively, coronary artery calcium (CAC) scoring and MSCT coronary angiography were performed in 135 asymptomatic patients (65 patients with type 1 diabetes and 70 patients with type 2 diabetes). The presence and extent of coronary atherosclerosis as well as plaque phenotype were assessed and compared between groups. RESULTS No difference was observed in average CAC score (217 +/- 530 vs. 174 +/- 361) or in the prevalence of coronary atherosclerosis (65% vs. 71%) in patients with type 1 and type 2 diabetes. However, the prevalence of obstructive atherosclerosis was higher in patients with type 2 diabetes (n = 24; 34%) compared with that in patients with type 1 diabetes (n = 11; 17%) (P = 0.02). In addition, a higher mean number of atherosclerotic and obstructive plaques was observed in patients with type 2 diabetes. In addition, the percentage of noncalcified plaques was higher in patients with type 2 (66%) versus type 1 diabetes (27%) (P < 0.001), resulting in a higher plaque burden for each CAC score compared with that in type 1 diabetic patients. CONCLUSIONS Although CAC scores and the prevalence of coronary atherosclerosis were similar between patients with type 1 and type 2 diabetes, CAD was more extensive in the latter. Also, a relatively higher proportion of noncalcified plaques was observed in patients with type 2 diabetes. These observations may be valuable in the development of targeted management strategies adapted to diabetes type.

• Authors: Roxana Djaberi, Joanne D Schuijf, Eric Boersma, Lucia J M Kroft, Alberto M Pereira, Johannes A Romijn, Arthur J Scholte, J Wouter Jukema, Jeroen J Bax
• Journal: Diabetes care (Diabetes Care) Vol. 32 Issue 8 Pg. 1507-12 (Aug 2009) ISSN: 1935-5548 [Electronic] United States
• PMID: 19487642 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Atherosclerosis (diagnostic imaging, pathology)
• Body Mass Index
• Coronary Angiography (methods)
• Coronary Artery Disease (diagnostic imaging, pathology)
• Diabetes Mellitus, Type 1 (complications, diagnostic imaging, pathology)
• Diabetes Mellitus, Type 2 (complications, diagnostic imaging, pathology)
• Diabetic Angiopathies (diagnostic imaging, pathology)
• Female
• Humans
• Male
• Middle Aged
• Radionuclide Imaging
• Tomography, X-Ray Computed