Purpose: The clinical significance of coronary computed tomography angiography (CCTA) in asymptomatic type 2 diabetes mellitus (T2DM) patients was not clear. We performed a retrospective study to evaluate a method of coronary heart disease (CHD) screening in asymptomatic T2DM patients by the combination of CCTA and CHD risk stratification prediction.
Methods: Data of 141 T2DM patients (58±8 years, 57% males) without known symptoms suggestive of CHD and underwent CCTA were retrospectively analyzed. Patients were classified into three groups based on UK Prospective Diabetes Study (UKPDS) CHD risk stratification prediction. Other 76 healthy screening persons underwent CCTA successively were chosen as control group. Difference of CCTA scores among groups were compared using Post Hoc Multiple comparisons.
Results: Segment involvement score in intermediate risk group（4.6±3.2）and high risk group (5.3±3.3) was significantly higher than control group (2.9±2.9). This indicates that stenosis was more widely distributed in intermediate and high risk groups. Segment stenosis score in intermediate risk group (7.2±7.0) and high risk group (9.2±8.0) was significantly higher than control group (3.5±4.4). Stenosis modulus in intermediate risk group (1.2±0.6) and high risk group (1.5±0.6) was also significantly higher than control group (0.8±0.5). This means stenosis was more severe in intermediate and high risk groups. Percentage of severe proximal plaque in intermediate risk group (14.5%) and high risk group (28.6%) was significantly higher than control group (3.9%), which had been known to be associated with a poor prognosis.
Conclusion: In the intermediate-high CHD risk groups, the distribution of coronary artery stenosis was more extensive and more severe. Combined with risk stratification prediction, CCTA may be used for screening CHD in intermediate-high risk asymptomatic T2DM patients.
Funding Support, Disclosures, and Conflict of Interest: This work was supported by Shandong medical and health science and technology development plan project(202009040454),Tai'an science and technology development plan (guidance plan) project(2019NS156), Innovative training program for College Students(S202010439080),Jianfeng Q. was supported by the Taishan Scholars Program of Shandong Province (TS201712065).
Type 2 Diabetes Mellitus，Coronary Computed Tomography Angiography，Risk Stratification Prediction
IM- CT: Perfusion imaging, CTA, coronary artery calcium scoring