Atherosclerotic Burden of Coronary Arteries in Diabetic Patients Using Multi-Slice Computed Tomography Angiography
Background: Multiple studies have confirmed the extensive burden of coronary artery disease in cases with diabetes. Yet, no optimal assessment technique has been proposed for risk stratification of this population. We performed this study to elucidate the impact of diabetes on the coronary atherosclerotic burden using Coronary Computed Tomography Angiography (CCTA).
Materials and Methods: This is cross-sectional comparative study was conducted at computed tomography unit in Cardiology Department in Police Hospital, Cairo, Egypt, during the period between March 2019 to March 2020 included 100 cases with coronary atherosclerosis who were divided into two groups; the non-diabetic group (63 cases), and the diabetic group (37 cases). All subjects were subjected to complete history taking, thorough physical examination, and routine laboratory investigations. Additionally, echocardiography and CCTA were done for all cases. Also, calcium score was calculated.
Results: The diabetic group displayed significant younger age 50.54 ± 8.80 and 56.57 ± 7.96 for non-diabetic group p=0.001. However, gender and body mass index did not significantly differ between the two groups. Although smoking prevalence was comparable in the study groups, hypertension showed significantly higher prevalence in the diabetic group 46% and 70.3% for non-diabetic and diabetic group respectively and p=0.019. dyslipidemia had significantly higher prevalence in the diabetic group 91.9% for diabetic group and 50.8% for nondiabetic group p<0.001. Most of the studied echocardiographic variables were comparable between the two groups. The diabetic cases showed a significant increase in plaque number where is the range of plaque number in non-diabetic was (0-9) vs. (0-13) for diabetic group p<0.001. The diabetic cases showed a significant increase diseased vessel number with average of 2 in non-diabetic group and 3 for diabetic group p<0.001. Obstructive lesions were more common in diabetic cases showing 70.3% of cases while non-diabetic showed 55.6% andp<0.001. Calcium score was significantly higher in the diabetic group compared to non-diabetics showing average of 210 and 165 for diabetic and non-diabetic respectively and p<0.001.
Conclusion: It is evident that diabetes is associated with a heavier atherosclerotic burden in the coronary arteries. Additionally, Calcium score appears to be a reliable option for assessment of the severity of coronary atherosclerosis.