Coronary artery plaque characterization using MDCT in symptomatic and asymptomatic subgroups of diabetic and...

The study was designed with the aims to evaluate the use of multidetector CT (MDCT) in coronary plaque detection and characterization in diabetic and non-diabetic subjects. Further, to compare the plaque morphology and composition in diabetic and non-diabetic patients in both symptomatic and asymptomatic subgroups.

We performed CT coronary angiography (CTCA) of 100 patients, out of which 50 had type II diabetes and further subdivided into symptomatic and asymptomatic groups. For every patient, we mapped the disease with different grades of coronary artery disease (CAD), the number of plaques, and histological types of plaques, as well as different atherosclerotic scores were derived to assess the severity and extent of CAD.

The total number of assessable segments was 1410 (96%). The symptomatic diabetic patient had a higher prevalence of significant CAD. Coronary, atherosclerotic, and extent scores showed significant difference in diabetic patients as compared to non-diabetic (p < 0.0181, < 0.0125, < 0.0043) whereas severity score was insignificant (p < 0.0627). There was a significant difference in all the scores in symptomatic diabetic and symptomatic non-diabetic subgroups. Further, no difference was observed in the asymptomatic subgroup. Diabetic patients harbor twice the plaque volume as compared to non-diabetic. Vulnerable plaques were more prevalent in asymptomatic patients with intermediate grade stenosis.

CTCA plays a pivotal role in the risk stratification. Diabetic patients were found have intermediate grade stenosis and higher load of both stable and vulnerable plaques than non-diabetics. Furthermore, the percentage of vulnerable plaque was higher in asymptomatic group as compared to symptomatic patients.