Key result
Asymptomatic patients with type 2 diabetes had a higher prevalence of obstructive atherosclerosis (34% vs 17%, P=0.02) and noncalcified plaques (66% vs 27%, P<0.001) compared to type 1 diabetes.
Why the study?
Does the coronary atherosclerotic plaque burden and morphology differ between asymptomatic patients with type 1 and type 2 diabetes?
Observational (n=135)
Does the coronary atherosclerotic plaque burden and morphology differ between asymptomatic patients with type 1 and type 2 diabetes?
Asymptomatic patients with type 2 diabetes have more extensive and noncalcified coronary artery disease compared to those with type 1 diabetes, suggesting a higher risk plaque phenotype.
May support differential risk stratification by diabetes type; leaves open whether plaque phenotypes warrant tailored screening or therapy.
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.
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Djaberi et al. (2009) conducted an observational in Type 1 and Type 2 Diabetes (n=135). Type 2 diabetes vs. Type 1 diabetes was evaluated on Prevalence of obstructive atherosclerosis (p=0.02). Asymptomatic patients with type 2 diabetes had a higher prevalence of obstructive atherosclerosis (34% vs 17%, P=0.02) and noncalcified plaques (66% vs 27%, P<0.001) compared to type 1 diabetes.
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