Introduction:
We investigated the association between carotid plaque and the presence, extent and severity coronary atherosclerosis using coronary computed tomography angiography (CCTA) and long-term clinical outcome in asymptomatic type 2 diabetic patients.
Methods:
We consecutively enrolled 788 asymptomatic type 2 diabetic patients without known coronary artery disease (CAD) who underwent CCTA and carotid ultrasound. The presence of carotid plaque was defined as a focal increase in thickness of 1.5 mm or 50% of the surrounding IMT value. We compared the prevalence, extent and severity of coronary atherosclerosis, including coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS), and segment stenosis score (SSS) between groups. All-cause mortality during 5 years follow-up was also compared.
Results:
Higher rates of obstructive CAD (p<0.001) and multi-vessel disease (p<0.005) were noted for patients with carotid plaque. Patients with carotid plaque showed greater degree of CACS, ABOS, SIS, and SSS (p<0.001 for all) on CCTA scans, and had a higher risk of all-cause mortality (p=0.025). The presence of carotid plaque was associated with an increased risk of significant coronary stenosis, independent of conventional cardiovascular risk factors (odds ratio 2.102, confidence interval 1.454-3.039, p<0.001).
Conclusions:
The presence of carotid plaque is associated with the increased prevalence, extent and severity of coronary atherosclerosis on CCTA and the risk of all-cause mortality. Moreover, carotid plaque was an independent predictor for significant coronary stenosis in asymptomatic type 2 diabetic patients.
Excess of all-cause mortality after a fracture in type 2 diabetic patients: a population-based cohort study
