Skip to main content
SpringerLink
Log in

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

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Epilogue Braunwald E (2006) What do clinicians expect from imagers? J Am Coll Cardiol 47:C101–C103

    Article  Google Scholar 

  2. Kamimura M, Moroi M, Isobe M et al (2012) Role of coronary CT angiography in asymptomatic patients with type 2 diabetes mellitus. Int Heart J 53:23–28

    Article  PubMed  Google Scholar 

  3. Ibebuogu UN, Nasir K, Gopal A et al (2009) Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by non invasive CT angiography. Int J Cardiovasc Imaging 25:717–723

    Article  PubMed  Google Scholar 

  4. Loffroy R, Bernard S, Sérusclat A et al (2009) Noninvasive assessment of the prevalence and characteristics of coronary atherosclerotic plaques by multidetector computed tomography in asymptomatic type 2 diabetic patients at high risk of significant coronary artery disease: a preliminary study. Arch Cardiovasc Dis 102:607–615

    Article  PubMed  Google Scholar 

  5. Motoyama S, Sarai M, Harigaya H et al (2009) Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol 54:49–57

    Article  PubMed  Google Scholar 

  6. de Araújo Gonçalves P, Garcia-Garcia HM, Carvalho MS et al (2012) Diabetes as an independent predictor of high atherosclerotic burden assessed by coronary computed tomography angiography: the coronary artery disease equivalent revisited. Int J Cardiovasc Imaging 29:1105–1114

    Google Scholar 

  7. Rana JS, Dunning A, Achenbach S et al (2012) Differences in prevalence, extent, severity, and prognosis of coronary artery disease among patients with and without diabetes undergoing coronary computed tomography angiography: results from 10,110 individuals from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes): an InteRnational Multicenter Registry. Diabetes Care 35:1787–1794

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kuzuya T, Nakagawa S, Satoh J et al (1999) Report of the Committee of Japan Diabetes Society on the classification and diagnostic criteria of diabetes mellitus. J Jpn Diabet Soc 42:385–404

    Google Scholar 

  9. Teramoto T, Sasaki J, Ueshima H et al (2007) Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases. Japan Atherosclerosis Society, Tokyo, Japan, 6 (article in Japanese)

  10. Morise AP, Haddad WJ, Beckner D (1997) Development and validation of a clinical score to estimate the probability of coronary artery disease in men and women presenting with suspected coronary disease. Am J Med 102:350–356

    Article  CAS  PubMed  Google Scholar 

  11. Agatston AS, Janowitz WR, Hildner FJ et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832

    Article  CAS  PubMed  Google Scholar 

  12. Raff GL, Abidov A, Achenbach S et al (2009) SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr 3:122–126

    Article  PubMed  Google Scholar 

  13. Nakazato R, Arsanjani R, Achenbach S et al (2014) Age-related risk of major adverse cardiac event risk and coronary artery disease extent and severity by coronary CT angiography: results from 15187 patients from the International Multisite CONFIRM Study. Eur Heart J Cardiovasc Imaging 15:586–594

    Article  PubMed  Google Scholar 

  14. Bittencourt MS, Hulten E, Ghoshhajra B et al (2014) Prognostic value of nonobstructive and obstructive coronary artery disease detected by coronary computed tomography angiography to identify cardiovascular events. Circ Cardiovasc Imaging 7:282–291

    Article  PubMed  Google Scholar 

  15. Kodama T, Kondo T, Oida A et al (2012) Computed tomographic angiography-verified plaque characteristics and slow-flow phenomenon during percutaneous coronary intervention. J Am Coll Cardiol Interv 5:636–643

    Article  Google Scholar 

  16. Hadamitzky M, Achenbach S, Al-Mallah M et al (2013) Optimized prognostic score for coronary computed tomographic angiography: results from the CONFIRM registry (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry). J Am Coll Cardiol 62:468–476

    Article  PubMed  Google Scholar 

  17. Ferencik M, Schlett CL, Ghoshhajra BB et al (2012) A computed tomography-based coronary lesion score to predict acute coronary syndrome among patients with acute chest pain and significant coronary stenosis on coronary computed tomographic angiogram. Am J Cardiol 110:183–189

    Article  PubMed Central  PubMed  Google Scholar 

  18. Zeb I, Li D, Nasir K et al (2013) Effect of statin treatment on coronary plaque progression—a serial coronary CT angiography study. Atherosclerosis 231:198–204

    Article  CAS  PubMed  Google Scholar 

  19. Amano T, Matsubara T, Uetani T et al (2007) Impact of metabolic syndrome on tissue characteristics of angiographically mild to moderate coronary lesions integrated backscatter intravascular ultrasound study. J Am Coll Cardiol 49:1149–1156

    Article  CAS  PubMed  Google Scholar 

  20. Madhavan MV, Tarigopula M, Mintz GS et al (2014) Coronary artery calcification: pathogenesis and prognostic implications. J Am Coll Cardiol 63:1703–1714

    Article  CAS  PubMed  Google Scholar 

  21. Prado CM, Rossi MA (2006) Circumferential wall tension due to hypertension plays a pivotal role in aorta remodeling. Int J Exp Path 87:425–436

    Article  CAS  Google Scholar 

  22. Achenbach S, Boehmer K, Pflederer T et al (2010) Influence of slice thickness and reconstruction kernel on the computed tomographic attenuation of coronary atherosclerotic plaque. J Cardiovasc Comput Tomogr 4:110–115

    Article  PubMed  Google Scholar 

  23. Cademartiri F, Mollet NR, Runza G et al (2005) Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol 15:1428–1431

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, 270-2232, Japan

    Nobuo Tomizawa, Takeshi Nojo, Shinichi Inoh & Sunao Nakamura

  2. Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, 270-2232, Japan

    Nobuo Tomizawa, Takeshi Nojo, Shinichi Inoh & Sunao Nakamura

Authors
  1. Nobuo Tomizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takeshi Nojo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shinichi Inoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sunao Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nobuo Tomizawa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tomizawa, N., Nojo, T., Inoh, S. et al. Difference of coronary artery disease severity, extent and plaque characteristics between patients with hypertension, diabetes mellitus or dyslipidemia. Int J Cardiovasc Imaging 31, 205–212 (2015). https://doi.org/10.1007/s10554-014-0542-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-014-0542-5

Keywords

Search

Navigation