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CTA provided accurate assessment of arterial plaque in patients with diabetes
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Quantitative plaque analysis with coronary CTA was an accurate assessment of calcified and noncalcified arterial plaque in patients with diabetes, according to new results from the Factor-64 study.
This findings could help clinicians better manage patients with diabetes at risk for CV events, according to the researchers.
Previous research demonstrated that noncalcified arterial plaque is more likely to rupture than calcified arterial plaque. However, coronary artery calcium (CAC) scoring with CT does not measure noncalcified arterial plaque, and IVUS, which measures both, is invasive and unsuitable as a screening tool. Thus, coronary CTA may be the best approach for screening, according to the study background.
João A.C. Lima
“Calcium scoring measures how much calcified plaque a person has, but it doesn’t measure the component that’s not calcified, and that’s the component that tends to be dangerous,” researcher João A.C. Lima, MD, from the cardiology division at Johns Hopkins University, said in a press release. “These findings represent a very important step in the ability to quantify plaque, particularly noncalcified plaque.”
Lima, a Cardiology Today Editorial Board member, and colleagues investigated the relationship between coronary plaque detected with coronary CTA and clinical parameters and CV risk factors in 224 asymptomatic patients with diabetes (54% men; mean age, 61.8 years; mean diabetes duration, 10.4 years). They calculated coronary plaque volume index by dividing the wall volume by the coronary length and performed multivariable analysis to assess the relationship between plaque volume index and CV risk factors.
Sixty-seven percent of total plaque was noncalcified in the study population. Plaque volume index was related to age (P<.001), male gender (P<.001), BMI (P<.001) and duration of diabetes (P=.03).
A greater percentage of soft plaque was present in younger patients with a shorter duration of diabetes (P=.02), and the percentage of soft plaque was directly related to BMI (P=.002), the researchers found.
Patients with a discrepancy between CAC score quartile and plaque volume index rank quartile had a higher percentage of soft and fibrous plaque compared with those who did not have a discrepancy (soft plaque, 18.7% vs. 17.4%; P=.008; fibrous plaque, 52.2% vs. 47.2%, P<.0001), Lima and colleagues found.
“People with soft plaque respond better to interventions, particularly medical therapy like statins,” Lima said in the press release.
Disclosure: The study was funded in part by the NIH intramural research program. Lima and another researcher report financial ties with Toshiba.
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