Coronary artery calcium, coronary artery disease, and diabetes

Mielke, C. Harold; Shields, J. Paul; Broemeling, Lyle D.

doi:10.1016/s0168-8227(01)00239-x

Cited by 60 publications

(39 citation statements)

References 15 publications

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“…On the other hand, patients with diabetes have increased prevalence of CAC. In a study of 3,389 patients, Mielke et al showed that the mean and median CAC values were much larger for those with diabetes compared to those without for all age groups and in both sexes [23]. Qu et al studied 1,312 subjects (including 269 type 2 diabetic patients) and showed increased prevalence of CAC in diabetic patients compared with control subjects [24].…”

Section: Prevalence Of Coronary Artery Calcium In Diabetic Patientsmentioning

confidence: 99%

Imaging Atherosclerosis in Diabetes: Current State

2016

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(310) 222-4107 mbudoff@labiomed.org Fax (310) 782-9652This work was supported and funded by American Diabetes Association (ADA) with grant reference of 7-12-CT-08. 1 AbstractPrevalence of diabetes mellitus is rapidly increasing worldwide. Disease is an independent and important risk factor for cardiovascular disease in both men and women. Cardiovascular events including myocardial infarction and stroke are the primary causes of mortality in both type 1 and type 2 diabetes. Affected patients frequently have asymptomatic coronary artery disease.Studies have shown heterogeneity in cardiovascular risk among patients with diabetes. Imaging can help categorize patients based on their risk of future cardiovascular events by identifying those patients with atherosclerosis, rather than just relying on risk prediction based on population based studies. In this article we will review the evidence regarding use of atherosclerosis imaging in patients with diabetes.2

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Section: Prevalence Of Coronary Artery Calcium In Diabetic Patientsmentioning

confidence: 99%

Imaging Atherosclerosis in Diabetes: Current State

2016

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“…Part of the reason for increased plaque burden may be because of the observed high rate of healed plaque ruptures, indicating subclinical ruptures that may participate in plaque progression (9). The effect of diabetes on plaque burden has been demonstrated by calcium imaging studies (10). The implications of these findings are unclear, but suggest a direct atherogenic effect of type II diabetes, probably related to the development of lipid-rich cores.…”

Section: Morphological Findings From the Registry Of Sudden Coronary mentioning

confidence: 99%

Morphological characteristics of coronary atherosclerosis in diabetes mellitus

Virmani

Burke

Kolodgie

2006

Canadian Journal of Cardiology

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“…Indeed, using invasive techniques, a considerably higher extent of CAD and plaque burden have been demonstrated in the presence of diabetes (8,9). To date, atherosclerosis has been noninvasively assessed in patients with type 2 diabetes using coronary calcium scoring, which reveals extensive atherosclerosis (10,11). Still, coronary calcium scoring may seriously underestimate coronary plaque burden as noncalcified lesions are not recognized (12).…”

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Noninvasive Assessment of Plaque Characteristics With Multislice Computed Tomography Coronary Angiography in Symptomatic Diabetic Patients

et al. 2007

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OBJECTIVE -Cardiovascular events are high in patients with type 2 diabetes, whereas their risk stratification is more difficult. The higher risk may be related to differences in coronary plaque burden and composition. The purpose of this study was to evaluate whether differences in the extent and composition of coronary plaques in patients with and without diabetes can be observed using multislice computed tomography (MSCT). RESEARCH DESIGN AND METHODS -MSCT was performed in 215 patients (86[40%] with type 2 diabetes). The number of diseased coronary segments was determined per patient; each diseased segment was classified as showing obstructive (Ն50% luminal narrowing) disease or not. In addition, plaque type (noncalcified, mixed, and calcified) was determined. Plaque characteristics were compared in patients with and without diabetes. Regression analysis was performed to assess the correlation between plaque characteristics and diabetes.RESULTS -Patients with diabetes showed significantly more diseased coronary segments than nondiabetic patients (4.9 Ϯ 3.5 vs. 3.9 Ϯ 3.2, P ϭ 0.03) with more nonobstructive (3.7 Ϯ 3.0 vs. 2.7 Ϯ 2.4, P ϭ 0.008) plaques. Relatively more noncalcified (28 vs. 19%) and calcified (49 vs. 43%) and less mixed (23 vs. 38%) plaques were observed in patients with diabetes (P Ͻ 0.0001). Diabetes correlated with the number of diseased segments and nonobstructive, noncalcified, and calcified plaques.CONCLUSIONS -Differences in coronary plaque characteristics on MSCT were observed between patients with and without diabetes. Diabetes was associated with higher coronary plaque burden. More noncalcified and calcified plaques and less mixed plaques were observed in diabetic patients. Thus, MSCT may be used to identify differences in coronary plaque burden, which may be useful for risk stratification. Diabetes Care 30:1113-1119, 2007A t present, 200 million people worldwide have diabetes, whereas its prevalence is expected to continue increasing exponentially (1). A close relationship between type 2 diabetes and the development of coronary artery disease (CAD) exists (2), and cardiovascular disease is the main cause of death in this patient population (3).Noninvasive testing, including myocardial perfusion scintigraphy and dobutamine stress echocardiography, has been used to detect CAD in diabetic patients (4,5), and a clear association between abnormal test results and worse outcome has been demonstrated, similar to that in the general population (6). Nonetheless, after normal findings, elevated event rates are still observed in diabetic patients compared with nondiabetic individuals (6,7), indicating a need for further refinement of prognostication in this population. The higher event rates in patients with diabetes compared with those in patients without diabetes could be related to differences in coronary plaque burden and composition. Therefore, direct visualization of coronary plaque burden could be a useful tool for risk stratification. Indeed, using invasive techniques, a considerably highe...

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Coronary artery calcium, coronary artery disease, and diabetes

Cited by 60 publications

References 15 publications

Imaging Atherosclerosis in Diabetes: Current State

Imaging Atherosclerosis in Diabetes: Current State

Morphological characteristics of coronary atherosclerosis in diabetes mellitus

Noninvasive Assessment of Plaque Characteristics With Multislice Computed Tomography Coronary Angiography in Symptomatic Diabetic Patients

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