Relationship between glycemic control and coronary artery disease severity, prevalence and plaque characteristics by computed tomography coronary angiography in asymptomatic type 2 diabetic patients

Autor(es)

Tavares, C. A. F. ; Rassi, C. H. R. E. ; Fahel, M. G. ; Wajchenberg, B. L. ; Rochitte, C. E. ; Lerario, A. C.

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING; v. 32, n. 10, p. 1577-1585, OCT 2016.
• Citações Web of Science: 7

Resumo

Evaluate whether glycemic control in type 2 diabetes (DM2) asymptomatic for coronary artery disease (CAD) affects not only the presence and magnitude of CAD but also the characteristics of plaque vulnerability using multidetector row computed coronary tomography (MDCT). Acute coronary syndrome (ACS) is frequently observed in asymptomatic DM2 patients. Positive vessel remodeling (PR) and low-attenuation plaques (LAP) identified by MDCT have been demonstrated to be characteristics of subsequent culprit lesions of ACS. However, little is known regarding plaque characteristics in asymptomatic diabetic patients and their relationship with glycemic control. Ninety asymptomatic DM2 patients, aged 40-65 years old, underwent MDCT. The presence of atherosclerotic obstruction, defined as coronary stenosis aeyen50 %, and plaque characteristics were compared between two groups of patients with A1c < 7 and A1c aeyenaEuroe7 %. Of the 90 patients, 38 (42.2 %) presented with coronary atherosclerotic plaques, 11 had A1c < 7 % and 27 had A1c aeyenaEuroe7 % (p = 0.0006). Fourteen patients had significant lumen obstruction higher than 50 %: 3 in the A1c < 7 % group and 11 in the A1c aeyenaEuroe7 % group (p = 0.02). Non-calcified plaque was more prevalent in the A1c aeyenaEuroe7 % group (p = 0.005). In eleven patients, the simultaneous presence of two vulnerability plaque characteristics (PR and LAP) were observed more frequently in the A1c aeyenaEuroe7 group (n = 8) than in the A1c < 7 group (n = 3) (p = 0.04). Asymptomatic DM2 patients with A1c aeyenaEuroe7 % have a higher frequency of CAD and a higher proportion of vulnerable atherosclerotic coronary plaque by MDCT compared to patients with DM2 with A1c < 7 in our study. (AU)

• Processo FAPESP: 10/51705-6 - Diagnóstico de doença cardiovascular assintomática em portadores de Diabetes tipo 2
• Beneficiário: Antonio Carlos Lerario
• Modalidade de apoio: Auxílio à Pesquisa - Regular