Research on the Dual-source CT Coronary Angiography of Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus_West China Medical Journal

Authors：

 LIUYing ¹ , GUOJia-chuan ² ,  LUOKe-jin ³ , JIANGJin ²

1. Department of Radiology, Sichuan Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;
2. Department of Radiology, Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;
3. Department of Radiology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563099, P. R. China;

Corresponding author：

LUOKe-jin, Email: gjc601@163.com

Keywords：

Dual-source CT; Coronary computed tomography; Coronary heart disease; Type 2 diabetes mellitus; Plaque characteristics

DOI：

10.7507/1002-0179.20140680

Video：

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Objective To discuss the characteristics of coronary artery disease in patients with type 2 diabetes using coronary angiography of Dual Source CT. Methods We collected the clinical data of patients who underwent coronary angiography of Dual Source CT between December 2010 and November 2012 in Sichuan Provincial People's Hospital and Sichuan Orthopedic Hospital. A total of 302 patients (74 with type 2 diabetes, and 228 with no diabetes) were examined with CT coronary angiography. All images were comprehensively assessed. Types of plaques and luminal narrowing were evaluated. Results Patients with type 2 diabetes had more plaques (P<0.05), especially mixed plaques and non-calcified plaques, than non-diabetic patients (P<0.05). The proportions of calcified plaque, mixed plaques, non-calcified plaque in patients with type 2 diabetes were 29.1%, 41.1%, 29.8%, respectively. The proportions of calcified plaque, mixed plaques, non-calcified plaque in patients with nondiabetic patients were 39.7%, 36.0%, 24.3%, respectively. The difference of the composition between diabetes and nondiabetic was significant (P<0.05). There were more mild, moderate and severe narrowing in type 2 diabetic patients than those in non-diabetic patients (P<0.05). Conclusion Coronary angiography of CT depicts a high plaque burden in patients with type 2 diabetes mellitus (mixed plaque is the most common type), which may cause stenosis easily.

Citation： LIUYing, GUOJia-chuan, LUOKe-jin, JIANGJin. Research on the Dual-source CT Coronary Angiography of Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus. West China Medical Journal, 2014, 29(12): 2250-2253. doi: 10.7507/1002-0179.20140680 Copy

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10.	黄旭东, 赖海辉, 程传虎. 应用64排螺旋CT检测合并糖尿病的心绞痛患者冠状动脉粥样硬化斑块特点[J]. 临床放射学杂志, 2012, 31(1):37-40.
11.	Ibebuogu UN, Nasir K, Gopal A, et al. Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by non invasive CT angiography[J]. Int J Cardiovasc Imaging, 2009, 25(7):717-723.
12.	Loffroy R, Bernard S, Sérusclat A, et al. Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease:a preliminary study[J]. Arch Cardiovasc Dis, 2009, 102(8/9):607-615.
13.	Alexander CM, Landsman PB, Teutsch SM. Diabetes mellitus, impaired fasting glucose, atherosclerotic risk factors, and prevalence of coronary heart disease[J]. Am J Cardiol, 2000, 86(9):897-902.
14.	Wackers FJ, Young LH, Inzucchi SE, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects:the DIAD study[J]. Diabetes Care, 2004, 27(8):1954-1961.
15.	Zeina AR, Odeh M, Rosenschein U, et al. Coronary artery disease among asymptomatic diabetic and nondiabetic patients undergoing coronary computed tomography angiography[J]. Coron Artery Dis, 2008, 19(1):37-41.
16.	欧昌元. 2型糖尿病合并心绞痛的病变特点-冠脉造影和血管内超声的研究[D]. 云南:昆明医学院, 2011:16-22.
17.	Pundziute G, Schuijf JD, Jukema JW, et al. Evaluation of plaque characteristics in acute coronary syndromes:non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis[J]. Eur Heart J, 2008, 29(19):2373-2381.
18.	Haffner SM, Miettinen H. Insulin resistance implications for type Ⅱ diabetes mellitus and coronary heart disease[J]. Am J Med, 1997, 103(2):152-162.

1. Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy[J]. Circulation, 2007, 115(3):387-397.
2. Glucose tolerance and mortality:comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology:collaborative analysis of diagnostic criteria in Europe[J].Lancet, 1999, 354(9179):617-621.
3. 左稳, 陈竹碧, 王建秋, 等. 128层螺旋CT对冠状动脉斑块成分与狭窄程度的诊断价值[J]. 华西医学, 2013, 28(10):1564-1567.
4. Van Velzen JE, Schuijf JD, De Graaf FR, et al. Plaque type and composition as evaluated non-invasively by MSCT angiography and invasively by VH IVUS in relation to the degree of stenosis[J]. Heart, 2009, 95(24):1990-1996.
5. 刘英. 2型糖尿病患者与非糖尿病患者冠状动脉病变的双源CT血管成像对比研究[D]. 贵州:遵义医学院, 2012:8-15.
6. Hausleiter J, Meyer T, Hadamitzky M, et al. Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients with an intermediate risk for significant coronary artery disease[J]. J Am Coll Cardiol, 2006, 48(2):312-318.
7. Kang JW, Do KH, Chung JY, et al. Concept of minimal heart rate for each pitch value to avoid interpolation artifact when using dual-source CT:a phantom study[J]. Int J Cardiovasc Imaging, 2010, 26(Suppl 1):103-109.
8. Chu ZG, Yang ZG, Dong ZH, et al. Comparative analysis of coronary artery disease assessed by coronary CT angiography between patients with type 2 diabetes mellitus and non-diabetic patients[J]. Int J Cardiol, 2011, 147(1):178-181.
9. 刘新, 赵锡海, 程流泉, 等. 冠状动脉CT和MR血管成像诊断粥样硬化斑块和狭窄的对比研究[J]. 中华放射学杂志, 2006, 40(11):1156-1160.
10. 黄旭东, 赖海辉, 程传虎. 应用64排螺旋CT检测合并糖尿病的心绞痛患者冠状动脉粥样硬化斑块特点[J]. 临床放射学杂志, 2012, 31(1):37-40.
11. Ibebuogu UN, Nasir K, Gopal A, et al. Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by non invasive CT angiography[J]. Int J Cardiovasc Imaging, 2009, 25(7):717-723.
12. Loffroy R, Bernard S, Sérusclat A, et al. Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease:a preliminary study[J]. Arch Cardiovasc Dis, 2009, 102(8/9):607-615.
13. Alexander CM, Landsman PB, Teutsch SM. Diabetes mellitus, impaired fasting glucose, atherosclerotic risk factors, and prevalence of coronary heart disease[J]. Am J Cardiol, 2000, 86(9):897-902.
14. Wackers FJ, Young LH, Inzucchi SE, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects:the DIAD study[J]. Diabetes Care, 2004, 27(8):1954-1961.
15. Zeina AR, Odeh M, Rosenschein U, et al. Coronary artery disease among asymptomatic diabetic and nondiabetic patients undergoing coronary computed tomography angiography[J]. Coron Artery Dis, 2008, 19(1):37-41.
16. 欧昌元. 2型糖尿病合并心绞痛的病变特点-冠脉造影和血管内超声的研究[D]. 云南:昆明医学院, 2011:16-22.
17. Pundziute G, Schuijf JD, Jukema JW, et al. Evaluation of plaque characteristics in acute coronary syndromes:non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis[J]. Eur Heart J, 2008, 29(19):2373-2381.
18. Haffner SM, Miettinen H. Insulin resistance implications for type Ⅱ diabetes mellitus and coronary heart disease[J]. Am J Med, 1997, 103(2):152-162.

West China Medical Journal

Research on the Dual-source CT Coronary Angiography of Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

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