CT Measures Soft Coronary Plaque in Patients with Diabetes

Coronary CT angiography helps clinicians assess soft coronary plaque in patients with diabetes, identifying those who are at risk of cardiac disease or event.

Computed tomography (CT) imaging helps detect and assess arterial plaque in patients with diabetes, according to a study published in the journal Radiology.

Researchers from Maryland and Utah performed a multi-center study to determine the relationship between coronary plaque detected by coronary CT angiography and clinical parameters and cardiovascular risk factors in patients with diabetes who had no symptoms of heart disease.

“Calcium scoring measures how much calcified plaque a person has, but it doesn’t measure the component that’s not calcified, and that’s the component that tends to be more dangerous,” co-author Joao A. C. Lima, MD, said in a release.

A total of 224 asymptomatic patients (121 men) with diabetes with a  mean age of 61.8 underwent coronary CT angiography with which the coronary artery wall volume in all three vessels was measured. The wall volume was divided by the coronary length to determine the coronary plaque volume index (PVI).

The researchers found that the mean PVI score was 11.2 mm2 and the mean coronary artery calcium (CAC) score was 382. Sixty-seven percent of total plaque was noncalcified. The PVI was related to age, male sex, body mass index and duration of diabetes. Younger subjects who had not had diabetes as long as the older subjects had a greater percentage of soft plaque.

“Coronary plaque volume index by CCTA is not only clinically feasible and reproducible in patients with diabetes, it provides a more complete picture of the coronary arteries that could be routinely applied in at-risk patients,” co-author David A. Bluemke, MD, PhD, said in the release.

The researchers concluded that in this patient group, body mass index was the primary modifiable risk factor associated with total and soft coronary plaque, as detected and assessed with coronary CT angiography.

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