Carotid and cerebrovascular disease in symptomatic patients with type 2 diabetes: assessment of prevalence and plaque morphology by dual-source computed tomography angiography

He, Chao; Yang, Zhi‐gang; Chu, Zhi‐gang; Dong, Zhihui; Shao, Huanjie; Deng, Weiming; Chen, Jing; Peng, Liqing; Tang, Sishi; Xiao, Jin-Long

doi:10.1186/1475-2840-9-91

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…In the Atherosclerosis Risk in Communities (ARIC) study (4), where ;10% of .12,000 subjects had T2D, and in the Northern Manhattan Study (NOMAS) (14), where ;20% of 1,118 subjects had T2D, arterial calcific lesions predicted cardiac and cerebrovascular events. In T2D, atherosclerotic plaque composition has been evaluated in several arterial districts: In the coronary bed, mixed or noncalcified plaques detected by computed tomography seem predominant with respect to calcified lesions (32,33) and significantly associated with acute cardiac events. At the carotid level, predominance of both echolucent plaques (9) and calcified plaques (15) has been reported.…”

Section: Discussionmentioning

confidence: 99%

Carotid Plaque Calcification Predicts Future Cardiovascular Events in Type 2 Diabetes

et al. 2015

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OBJECTIVEThe presence of carotid plaques is associated with future cardiovascular events, with local plaque composition being an independent outcome predictor. We examined the association between ultrasonographically determined carotid plaque calcification and incident major adverse cardiovascular events (MACE) and death in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODSWe enrolled 581 patients with T2D who underwent routine carotid ultrasonography. Plaques were classified as echolucent (lipid rich), heterogenous, and echogenic (calcific). We collected demographic, anthropometric, and clinical data at baseline and followed the patients for up to 9 years. RESULTSPlaques were detected in 81.8% of the patients (echolucent in 16.4%, heterogenous in 43.2%, and echogenic in 22.2%). During follow-up (4.3 6 0.1 years), 58 deaths (27 cardiovascular) and 236 fatal and nonfatal MACE occurred. In univariate analyses, presence versus absence of any carotid plaque was associated with incident MACE, and the hazard ratio (95% CI) progressively increased from echolucent (1.97 [0.93-3.44]), to heterogeneous (3.10 [2.09-4.23]), to echogenic (3.71 [2.09-5.59]) plaques. Compared with echolucent plaques, echogenic plaques were associated with incident MACE independently from confounders. This association was attenuated after adjusting for the degree of stenosis, but in patients with stenosis £30%, echogenic plaque type still predicted total and atherosclerotic MACE, even after further adjusting for mean intima-media thickness. CONCLUSIONSIn T2D, carotid plaque calcification predicts MACE, especially in patients with a low degree of stenosis. The biology of atherosclerotic calcification in diabetes needs to be further elucidated to understand the basis of this association.Atherosclerosis is a common complication of diabetes, driving severe morbidity and mortality. Atherosclerotic plaques are complex structures with multiple tissues and cell types that differentially contribute to lesion vulnerability (1). In populationbased longitudinal studies, atherosclerotic plaque characteristics have been shown to predict atherosclerosis progression at a systemic level, being associated with incident cardio-and cerebrovascular events (2-7). Based on ultrasonographic plaque characterization, echolucent (lipid-rich) plaques seem to be a better predictor of stroke and cardiovascular events than echogenic or echorich plaques containing

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Section: Discussionmentioning

confidence: 99%

Carotid Plaque Calcification Predicts Future Cardiovascular Events in Type 2 Diabetes

et al. 2015

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“…[1][2][3] For the treatment of patients with carotid artery stenosis, plaque imaging to analyze plaque characteristics is important to detect vulnerable plaque and avoid ischemic complications. Magnetic resonance imaging, 4-7 computed tomography, 8,9 positron emission tomography, 10,11 carotid ultrasonography, 5 and intravascular ultrasound (IVUS) 12,13 have been reported as carotid plaque imaging devices. Conventional IVUS has been used for over a decade in carotid stenting, not only to assess the plaque before treatment, but also to measure arterial diameters and subsequently to assess the completeness of stent deployment.…”

Section: Introductionmentioning

confidence: 99%

Virtual Histology Analysis of Carotid Atherosclerotic Plaque: Plaque Composition at the Minimum Lumen Site and of the Entire Carotid Plaque

Tsurumi

Hososhima

et al. 2012

Journal of Neuroimaging

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“…Some noninvasive modalities, such as MR imaging (MRI), computed tomography (CT), and digital subtraction angiography (DSA) can provide more accurate information about plaque, stenosis, or stroke [41]. In addition, the circulating level of microparticles, oxidized low-density lipoproteins, and intima-media thickness are associated with the arterial elasticity of diabetes patient [42-44].…”

Section: Discussionmentioning

confidence: 99%

Using the spring constant method to analyze arterial elasticity in type 2 diabetic patients

Wei

Shi

Bau

2012

Cardiovasc Diabetol

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BackgroundThis study tests the validity of a newly-proposed spring constant method to analyze arterial elasticity in type 2 diabetic patients.MethodsThe experimental group comprised 66 participants (36 men and 30 women) ranging between 46 and 86 years of age, all with diabetes mellitus. In the experimental group, 21 participants suffered from atherosclerosis. All were subjected to the measurements of both the carotid-femoral pulse wave velocity (cfPWV) and the spring constant method. The comparison (control) group comprised 66 normal participants (37 men and 29 women) with an age range of 40 to 80 years who did not have diabetes mellitus. All control group members were subjected to measurement by the spring constant method.ResultsStatistical analysis of the experimental and control groups indicated a significant negative correlation between the spring constant and the cfPWV (P < .001; r = - 0.824 and – 0.71). Multivariate analysis similarly indicated a close relationship. The Student’s t test was used to examine the difference in the spring constant parameter between the experimental and control groups. A P-value less than .05 confirmed that the difference between the 2 groups was statistically significant. In receiver operating characteristic curve (ROC), the Area Under Curve (AUC, = 0.85) indicates good discrimination. These findings imply that the spring constant method can effectively identify normal versus abnormal characteristics of elasticity in normal and diabetic participants.ConclusionsThis study verifies the use of the spring constant method to assess arterial elasticity, and found it to be efficient and simple to use. The spring constant method should prove useful not only for improving clinical diagnoses, but also for screening diabetic patients who display early evidence of vascular disease.

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Carotid and cerebrovascular disease in symptomatic patients with type 2 diabetes: assessment of prevalence and plaque morphology by dual-source computed tomography angiography

Cited by 9 publications

References 26 publications

Carotid Plaque Calcification Predicts Future Cardiovascular Events in Type 2 Diabetes

Carotid Plaque Calcification Predicts Future Cardiovascular Events in Type 2 Diabetes

Virtual Histology Analysis of Carotid Atherosclerotic Plaque: Plaque Composition at the Minimum Lumen Site and of the Entire Carotid Plaque

Using the spring constant method to analyze arterial elasticity in type 2 diabetic patients

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