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Characteristics of Subclinical Coronary Artery Disease in Diabetic Patients without Known Coronary Artery Disease

並列摘要


Patients with diabetes have a high prevalence of subclinical coronary artery disease (CAD). Our purpose is to study the coronary artery characteristics in diabetic patients. We performed coronary computed tomographic angiography in 374 patients without known CAD. We divided these patients into those with diabetes (diabetes group, n=138) and those without diabetes (nondiabetes group, n=236). We compared coronary calcium score (CCS), prevalence of significant stenosis, coronary plaque, and high-risk plaque (positive remodeling and low attenuation plaque) between the two groups. Patient characteristics were not significantly different between the two groups. The CCS was significantly higher in diabetes group than in nondiabetes group (median with 95% confidence interval [CI] 202, 95% CI: 7.5-673 vs. 60, 95%CI: 0-291, p=0.0002). The prevalence of significant stenosis (17.4% vs. 6.8%, p=0.0014) and coronary plaques (4.3±4.3 vs. 3.1±4.4, p=0.0089) were significantly higher in diabetes group compared with nondiabetes group. The prevalence of high-risk plaque (9.4% vs. 9.7%, p=0.92) was not significantly different between the two groups. However, in a multiple logistic regression analysis adjusted for variables associated with a high-risk plaque, only diabetes were significantly associated with a high-risk plaque. Our results showed that diabetic patients had higher CCS, higher prevalence of significant stenosis, and coronary plaque compared with nondiabetic patients. Moreover, diabetes was significantly associated with the presence of high-risk plaque by multivariate analysis.

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