COMPARISON OF CORONARY ARTERY CALCIUM SCORE AND PLAQUE CHARACTERISTICS USING CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN DIABETIC AND NON-DIABETIC PATIENTS

Phương Thảo Nghiêm, Thị Hồng Tuý Nguyễn, Đại Hùng Linh Nguyễn, Phạm Cao Minh Nguyễn

Main Article Content

Abstract

Objective: Our aim is to describe and compare the coronary artery calcium scores and plaque characteristics in two groups of patients with diabetes and non-diabetes using coronary computed tomography angiography (CCTA). Methods: This is a retrospective, cross-sectional study, conducted from January 2022 to July 2023. All patients ≥ 18 years old underwent coronary computed tomography angiography at Tam Anh General Hospital, Ho Chi Minh City. Results: 60 cases, consisting of 30 cases of diabetes and 30 cases of non-diabetes, were included in the study. Among them, there were 48 males, accounting for 80%; the average age was 63.4 years old (ranging from 45 to 80). As for the cardiovascular risk factors, dyslipidemia accounted for the highest rate (98.3%), followed by hypertension (93.3%), while smoking accounted for the lowest rate (11.7%). There were 50 patients with three cardiovascular risk factors or more, accounting for 83% of the total cases. The total coronary artery calcium score (CACS) in the diabetic group was 987 ± 949 (Agatston score), higher than that in the non-diabetic group (535 ± 661). This difference was statistically significant (p = 0.037). The CACS separately calculated in each coronary artery branch had a similar higher pattern in the diabetic group; however, these differences were not statistically significant. In terms of plaque characteristics, the proportions of calcified, non-calcified, mixed, and high-risk plaques in the diabetic group were higher. The diabetic group had more eccentric and diffuse coronary stenosis lesions, with the diffuse stenosis being 2.6 times higher than the non-diabetic group; this difference was statistically significant (p = 0.018). Conclusion: In addition to the coronary artery calcium score, coronary plaque characteristics, especially high-risk plaque, can be determined on coronary computed tomography angiography to better prevent plaque ruptures causing acute coronary syndrome, particularly in the group of diabetic patients

Article Details

References

1. Aronson D, Edelman ER. Coronary artery disease and diabetes mellitus. Cardiol Clin. 2014;32(3):439-455.
2. De Graaf FR, Schuijf JD, van Velzen JE, et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. J European heart journal. 2010;31(15):1908-1915.
3. Fuchs FD, Whelton PKJH. High blood pressure and cardiovascular disease. J Hypertension. 2020;75(2):285-292.
4. Hạnh NTM. Cập nhật vai trò của chụp CT mạch vành trong chẩn đoán bệnh động mạch vành ổn định. Thời sự tim mạch học. 2014.
5. Hoàng Thị Vân Hoa PMT. Đánh giá điểm vôi hóa và xơ vửa động mạch vành trên chụp cắt lớp vi tính 64 dãy Bệnh Viện Bạch Mai. 2017:22-28.
6. Kwon Y-S, Jang J-S, Lee C-W, et al. Comparison of plaque composition in diabetic and non-diabetic patients with coronary artery disease using multislice CT angiography. Korean circulation journal. 2010;40(11):581-586.
7. Nghĩa NT. Giá trị của một số phương pháp chẩn đoán bệnh mạch vành so sánh với chụp động mạch vành cản quang. Luận án Tiến Sĩ Y học. Đại học Y dược TP. Hồ Chí Minh; 2010.
8. Ohnesorge BM, Flohr TG, Becker CR, Knez A, Reiser MF. Multi-slice and dual-source CT in cardiac imaging: principles-protocols-indications-outlook. 2nd edition ed. Springer Science & Business Media; 2006.
9. Sỹ HV. Ứng dụng siêu âm nội mạch trong chẩn đoán và điều trị can thiệp bệnh động mạch vành. Đại học Y Dược TP. HCM; 2014.
10. Youssef MA, Dawoud MA, Elbarbary AA, Elbedewy MM, Elkhateeb HMJTEJoR, Medicine N. Role of 320-slice multislice computed tomography coronary angiography in the assessment of coronary artery stenosis. The Egyptian Journal of Radiology Nuclear Medicine. 2014;45(2):317-324.