Coronary Atherosclerotic Plaque Detected by Computed Tomographic Angiography in Subjects with Diabetes Compared to Those without Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 758-779-Cardiometabolic Risk & Vascular Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-763
Bahram Khazai*1, Yanting Luo2, Steven Rosenberg3, James Wingrove3 and Matthew Budoff2
1Harbor-UCLA Medical Center, Torrance, CA, 2Los Angeles Biomedical Research Institute, Torrance, CA, 3CardioDx, Inc., Palo Alto, CA
Background: Little data are available regarding coronary plaque composition and semi-quantitative scores in individuals with diabetes; the extent to which diabetes may affect the presence and extent of Coronary Artery Calcium (CAC) needs more evaluation. Considering that this information may be of great value in formulating preventive interventions in this population, we compared these findings in individuals with diabetes to those without.

 

Methods: Multi-Detector Computed Tomographic (MDCT) images of 861 consecutive patients with diabetes who were referred to Los Angeles Biomedical Research Institute for different clinical reasons from January 2000 to September 2012 , were evaluated using a 15–coronary segment model. All the subjects provided informed consent. Segment Involvement Score (SIS; the total number of segments with any plaque), Segment Stenosis Score (SSS; the sum of maximal stenosis score per segment), Total Plaque Score (TPS; the sum of the plaque amount per segment), plaque composition and CAC score were compared to 861 age, sex and ethnicity matched controls without diabetes after adjustment for Body Mass Index (BMI), family history of coronary artery disease, hyperlipidemia, hypertension and smoking.

 

Results: Diabetes was positively correlated to the presence and extent of CAC (P<0.0001). Among 389 subjects with available data, SIS, SSS and TPS were significantly higher in those with diabetes (P<.0001). Number of mixed and calcified plaques were significantly higher in those with diabetes (P=0.018 and P<0.001 respectively) but there was no significant difference in the number of non-calcified plaques between the two groups (P=0.398).

Conclusions: Patients with diabetes have higher CAC and semi-quantitative coronary plaque scores compared to the age, gender and ethnicity matched controls without diabetes after adjustment for Body Mass Index (BMI), family history of coronary artery disease, hyperlipidemia, hypertension and smoking. Since mixed plaque is associated with worse long-term clinical outcomes, these findings support more aggressive preventive measures in this population.

Disclosure: SR: Chief Scientific Officer, CardioDx. JW: Researcher, CardioDx, Inc.. Nothing to Disclose: BK, YL, MB

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm