Taha Okan^1,2, Caner Topaloglu²

¹ Kardiya Medical Center, Izmir

²Izmir University of Economics, Medical Point Hospital, Cardiology, Izmir

Background: Computed tomography angiography (CTA) is frequently used to evaluate the risk of coronary artery disease in patients with Diabetes Mellitus (DM). Characteristic plaque features of coronary arteries can be evaluated with CTA. The aim of this study is to evaluate the coronary artery plaque structure on CTA between patients diagnosed with DM and patients without a diagnosis of DM.

Methods: A total of 192 patients, 96 patients diagnosed with DM and 96 patients without a diagnosis of DM, who underwent coronary CTA, were included in the study between January 2024 and July 2024. The groups were evaluated according to the plaque structure, number of plaques, and degree of stenosis on coronary CTA. High sensitive C-reactive protein (hsCRP) levels of the patients were measured from blood samples. The number of plaques, degree of stenosis, structure of plaques and hsCrp levels were evaluated between both groups.

Results: In coronary CTA, coronary artery lumen stenosis, plaque count and multipl vascular disease are higher in the DM patient group (p<0.001). While there was no significant difference between the groups in terms of non-calcific plaques, calcific and mixed plaques were more common in the DM patient group (p<0.001). Similarly, while no statistically significant difference was found between mild stenosis between the groups, moderate/severe stenosis and total occlusion were more common in the DM patient group (p<0.001). Additionally, hsCRP levels were increased in patients with calcific plaque and/or severe vascular stenosis on coronary CTA (p<0.001).

Conclusions: Patients with DM are at high risk for the development of coronary artery disease and their prognosis is worse. The number of plaques, severe lumen stenosis, calcific and/or mixed plaque structure are more common in patients with DM, and the combination of CTA and hsCRP is the most effective method in detecting the risk of early coronary artery disease.