Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
Cardiovasc Diabetol. 2010 Nov 10;9:74. doi: 10.1186/1475-2840-9-74.
Coronary artery disease (CAD) is a common and severe complication of type 2 diabetes mellitus (DM). The aim of this study is to identify the features of CAD in diabetic patients using coronary CT angiography (CTA).
From 1 July 2009 to 20 March 2010, 113 consecutive patients (70 men, 43 women; mean age, 68 ± 10 years) with type 2 DM were found to have coronary plaques on coronary CTA. Their CTA data were reviewed, and extent, distribution and types of plaques and luminal narrowing were evaluated and compared between different sexes.
In total, 287 coronary vessels (2.5 ± 1.1 per patient) and 470 segments (4.2 ± 2.8 per patient) were found to have plaques, respectively. Multi-vessel disease was more common than single vessel disease (p < 0.001), and the left anterior descending (LAD) artery (35.8%) and its proximal segment (19.1%) were most frequently involved (all p < 0.001). Calcified plaques (48.8%) were the most common type (p < 0.001) followed by mixed plaques (38.1%). Regarding the different degrees of stenosis, mild narrowing (36.9%) was most common (p < 0.001); however, a significant difference was not observed between non-obstructive and obstructive stenosis (50.4% vs. 49.6%, p = 0.855). Extent of CAD, types of plaques and luminal narrowing were not significantly different between male and female diabetic patients.
Coronary CTA depicted a high plaque burden in patients with type 2 DM. Plaques, which were mainly calcified, were more frequently detected in the proximal segment of the LAD artery, and increased attention should be paid to the significant prevalence of obstructive stenosis. In addition, DM reduced the sex differential in CT findings of CAD.
冠状动脉疾病（CAD）是 2 型糖尿病（DM）的常见且严重的并发症。本研究旨在使用冠状动脉 CT 血管造影（CTA）来确定糖尿病患者 CAD 的特征。
2009 年 7 月 1 日至 2010 年 3 月 20 日，113 例连续确诊的 2 型糖尿病患者（70 名男性，43 名女性；平均年龄 68±10 岁）经冠状动脉 CTA 检查发现存在冠状动脉斑块。对其 CTA 数据进行了回顾性分析，并比较了不同性别之间斑块的程度、分布和类型以及管腔狭窄程度。
总共发现 287 支冠状动脉（每位患者 2.5±1.1 支）和 470 个节段（每位患者 4.2±2.8 个）存在斑块。多支血管病变比单支血管病变更常见（p<0.001），左前降支（LAD）动脉及其近端节段（19.1%）最常受累（均 p<0.001）。钙化斑块（48.8%）是最常见的类型（p<0.001），其次是混合斑块（38.1%）。根据不同程度的狭窄，轻度狭窄（36.9%）最常见（p<0.001）；然而，非阻塞性和阻塞性狭窄之间没有显著差异（50.4% vs. 49.6%，p=0.855）。2 型糖尿病男性和女性患者的 CAD 严重程度、斑块类型和管腔狭窄程度无显著差异。
冠状动脉 CTA 显示 2 型糖尿病患者存在高斑块负担。斑块主要为钙化斑块，更常发生在 LAD 动脉的近端节段，应高度重视阻塞性狭窄的显著流行。此外，糖尿病降低了 CT 对 CAD 发现的性别差异。
