Difference of coronary artery disease severity, extent and plaque characteristics between patients with hypertension, diabetes mellitus or dyslipidemia

Abstract

The purpose of this study was to investigate the difference of coronary artery disease (CAD) severity and extent as well as plaque characteristics between patients with either one of hypertension (HT), diabetes mellitus (DM) or dyslipidemia (DL). We retrospectively reviewed the records of 1,161 patients (HT 442, DM 77, DL 248, no disease 394) who underwent coronary computed tomography angiography. Stenosis severity was classified as normal, non-obstructive (1-49 % stenosis), moderate (50-69 % stenosis) or severe (≥70 % stenosis). Segment involvement score (SIS) and segment severity score (SSS) was calculated. We defined patients at risk as patients with obstructive CAD or non-obstructive CAD with extensive disease (SIS ≥ 5). Plaque characteristics were evaluated including positive remodeling, low attenuation and spotty calcification. Obstructive CAD was most frequent in DM patients, followed by HT and DL patients (34, 19 and 15 %, respectively, p < 0.0001). DM patients had more extensive disease than HT and DL patients (SIS 3.1 vs 2.1 vs 1.4, SSS 4.0 vs 2.7 vs 2.0). DM patients were more at risk than HT and DL patients (p < 0.05). The prevalence of positive remodeling, low attenuation and spotty calcium were all highest in DM patients (p < 0.005, vs HT and DL), while low attenuation was more frequent in DL than HT patients (p < 0.005). The median calcium score of HT and DM patients were higher than DL patients (p < 0.01 and p < 0.005, respectively), while no significant difference was observed between HT and DM patients. In conclusion, DM patients possessed more high risk plaque and obstructive as well as extensive CAD compared with HT and DL patients. Coronary calcification was similarly high in HT and DM patients. Low attenuation plaque was more frequent in DL than HT patients.

The diagnosis of coronary plaque stability by multi-slice computed tomography coronary angiography

“…The difference was subtle between the two types of plaques, but it was able to discriminate with the naked eye for most patients. Previous studies revealed plaques with a thin fibrous cap was more frequently associated with ACS (23,24) and in vivo evaluation of plaque fibrous cap thickness by intravascular optical coherence tomography and/or IVUS (25)(26)(27). Furthermore, Sato et al (12) found that the presence of ring-like enhancement at CCTA had a higher accuracy of 88% for detection of plaques with a thin fibrous cap in patients with unstable angina pectoris.…”

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

“…An algorithm was formulated, which allowed correction of the CT density of the vessel wall closest to the lumen. Another clinical study investigated the difference of coronary artery disease (CAD) severity and extent as well as plaque characteristics in 1161 patients with hypertension (HT), diabetes mellitus (DM) or dyslipidemia (DL) [67]. Obstructive CAD was most frequent in DM patients, followed by HT and DL patients (34,19 and 15 %, respectively, p \ 0.0001).…”

Current Trends for ST-segment Elevation Myocardial Infarction during the Past 5 Years in Rural Areas of China's Liaoning Province

“…These concomitant risk factors were closely related to the severity of coronary artery disease. [373839] It has been reported that about half of the decline in MI mortality was due to the primary prevention of an MI (reduction in the proportions of cardiovascular risk factors). [26]…”