Assessing the prevalence, quantification and morphological composition of coronary atherosclerosis in patients with type 2 diabetes and the metabolic syndrome via 64-Slice CT angiography

Background: We determined the prevalence, morphology, and severity of coronary artery plaque in high-risk patients via 64- slice cardiovascular computed tomography (CVCT). Methods: Based on chart review, 101 subjects having a 64-slice CVCT were assigned to one of three groups: type 2 diabetes, metabolic syndrome, or comparison. Disease severity was classified as: no disease, subclinical disease (lesions <70%), or clinically significant disease (lesions >70%). Plaque morphology was stratified as either vulnerable or stable plaque by Houndsfield units and established American Heart Association criteria. Results: Diabetic subjects had the highest prevalence of CAD (78%), compared to 65% in the metabolic syndrome subjects and 55% in the comparison group (p<.05). Diabetic subjects were also most likely to have both significant CAD (41%), and stable plaque (52%) followed by metabolic syndrome subjects (33% and 25%) and the comparison group (15% and 20%) (p < 0.05). The metabolic syndrome group was most likely to have vulnerable lesions (36%) potentially placing them at increased risk of acute events. 22% of subjects in the diabetes group, 35% in the metabolic syndrome group, and 45% in the comparison cohort were disease-free. Conclusions: 64-slice CVCT allows non-invasive diagnosis and stratification of subjects with diabetes and the metabolic syndrome, providing relevant information regarding coronary disease prevalence, severity, and plaque composition, that are statistically different among these high risk patient cohorts. (Int J Diabetes Metab 14: 120-125, 2006)