ACCESSMENT OF HIGH-RISK CORONARY PLAQUE USING 128-SLIDE CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN PATIENT WITH TYPE 2 DIABETES MELLITUS
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Abstract
Background: Coronary computed tomography angiography allows not only assessment of luminal stenosis but also identification of high-risk plaque features. In Vietnam, data on high-risk coronary plaques, particularly in patients with type 2 diabetes mellitus, remain limited.
Objectives: To evaluate high-risk coronary plaque features using 128-slice coronary computed tomography angiography, compare these characteristics between patients with and without type 2 diabetes mellitus, and identify independent predictors of high-risk plaques.
Methods: This cross-sectional analytical study was conducted from March 2023 to August 2024 in 110 patients with suspected ischemic heart disease, including 55 patients with type 2 diabetes mellitus and 55 patients without diabetes. High-risk plaque was defined as the presence of at least two of four high-risk features at the same coronary lesion: positive remodeling, low-attenuation plaque, spotty calcification, and napkin-ring sign.
Results: Coronary computed tomography angiography detected 79 high-risk features in 44 patients, accounting for 40% of the study population. Positive remodeling, low-attenuation plaque, napkin-ring sign, and spotty calcification accounted for 60.8%, 12.7%, 7.6%, and 19% of all high-risk features, respectively. High-risk plaques were identified in 22 patients, corresponding to 20% of the study population. The prevalence of high-risk features and high-risk plaques did not differ significantly between patients with and without type 2 diabetes mellitus. Independent predictors of high-risk plaques included acute coronary syndrome, left main coronary artery calcification, and left anterior descending artery calcification.
Conclusions: High-risk coronary plaques were detected with a considerable frequency on 128-slice coronary computed tomography angiography. Their presence was associated with acute coronary syndrome and specific patterns of coronary artery calcification, but did not significantly differ by type 2 diabetes status.
Recommendations: High-risk plaque features and characteristics of high-risk plaques should be routinely described in coronary computed tomography angiography reports.
Keywords
High-risk plaque, coronary computed tomography angiography, type 2 diabetes mellitus, coronary artery disease, acute coronary syndrome
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References
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