SavedAdd your journal

Journals / Turkish Journal of Clinics and Laboratory / 2026 / Cilt: 15 Sayı: 3

Coronary computed tomographic angiography findings in diabetic patients: A tertiary clinic findings

Diyabetli hastalarda koroner bilgisayarlı tomografi anjiyografi bulguları: Üçüncü basamak klinik bulguları

Zeynep Atçeken(KOC UNIVERSITY)0000-0002-3137-6022
Nurullah Kaya(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0003-0074-159X
Fatma Zeynep Arslan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RADYOLOJİ ANABİLİM DALI)0000-0001-6506-2577
Pages
393–399
Publication Date
2024-09-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

CCTA results showed high sensitivity and specificity when compared to invasive angiography.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: The aim of this study is to identify different types of plaques in diabetic patients suspected of coronary atherosclerosis using coronary computed tomography angiography (CCTA) and assess the extent of coronary artery disease (CAD).
📊
Key Findings & Data:Material and Methods: Data from 252 diabetic patients who underwent CCTA were reviewed retrospectively.
💡
Conclusion & Impact:CCTA results showed high sensitivity and specificity when compared to invasive angiography.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Diyabet · plak · anjiografi

Abstract

Aim: The aim of this study is to identify different types of plaques in diabetic patients suspected of coronary atherosclerosis using coronary computed tomography angiography (CCTA) and assess the extent of coronary artery disease (CAD). Material and Methods: Data from 252 diabetic patients who underwent CCTA were reviewed retrospectively. The mean age of the patients was 60 ± 10 years, and all underwent MSCT angiography. Plaque types were categorized into three groups: calcified, soft, and mixed. Statistical analyses were performed using SPSS v. 15.0 software. Results: Of the 252 diabetic patients, 137 (54.4%) were male and 115 (45.6%) were female. CCTA detected stenosis ≥30% in 40 patients (15%). Calcified plaques (38%) and soft plaques (40%) were observed most frequently in the proximal LAD. CCTA results showed high sensitivity and specificity when compared to invasive angiography. Conclusion: While invasive coronary angiography is considered the gold standard, coronary CTA is a reliable and non-invasive method for evaluating atherosclerosis in diabetic patients. Its high negative predictive value may be effective in ruling out bypass graft stenosis and can reduce the need for invasive procedures, minimizing patient risk.

Özet

Amaç: Bu çalışmanın amacı, koroner ateroskleroz şüphesiyle değerlendirilen diyabetik hastalarda, koroner bilgisayarlı tomografi anjiyografi (CCTA) kullanarak farklı plak tiplerini tanımlamak ve koroner arter hastalığının (KAH) kapsamını değerlendirmektir. Gereç ve Yöntemler: CCTA uygulanan 252 diyabetik hastanın verileri retrospektif olarak incelendi. Hastalara CT anjiyografi uygulandı. Plak tipleri, kalsifiye, yumuşak ve miks olmak üzere üç gruba ayrıldı. İstatistiksel analizler SPSS v. 15.0 yazılımı ile yapıldı. Bulgular: Toplamda 252 diyabetik hastanın 137'si (%54,4) erkek, 115'i (%45,6) kadındır. CCTA, %30 ve üzeri darlık bulunan 40 hastada %15 oranında stenoz bulguları tespit etti. En çok kalsifiye (%38) ve yumuşak plaklar (%40) proximal LAD’de gözlemlendi. Koroner anjiyografi sonuçları ile CCTA'nın bulguları karşılaştırıldığında, CCTA'nın tespit ettiği progresyonlar arasında yüksek bir duyarlılık ve özgüllük olduğu görüldü. Sonuçlar: İnvaziv koroner anjiyografi altın standart olarak kabul edilse de , koroner CCTA, diyabetik hastalarda aterosklerozun değerlendirilmesi için güvenilir ve non-invaziv bir yöntemdir. CCTA'nın yüksek negatif prediktif değeri, bypass greft stenozunu dışlamakta etkili olabilir ve invazif prosedür gereksinimini azaltarak hasta riskini minimize edebilir.

🔖

Cite This Article

Atçeken, Z., Kaya, N., Arslan, F. Z. (2024). Coronary computed tomographic angiography findings in diabetic patients: A tertiary clinic findings. Turkish Journal of Clinics and Laboratory, Cilt: 15 Sayı: 3, 393–399. https://doi.org/10.18663/tjcl.1519880

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (29)

  1. Sundell J. Obesity and diabetes as risk factors for coronary artery disease: from the epidemiological aspect to the initial vascular mechanisms. Diabetes, Obesity & Metabolism 2007; 7: 9-20.
  2. Schramm TK, Gislason GH, Køber L, Rasmussen S, Rasmussen JN, Abildstrøm SZ, Hansen ML, Folke F, Buch P, Madsen M, Vaag A, Torp-Pedersen C. Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people. Circulation. 2008 Apr 15;117(15):1945-54. doi: 10.1161/CIRCULATIONAHA.107.720847. Epub 2008 Mar 31. PMID: 18378618.
  3. Libby P, Nathan DM, Abraham K, Brunzell JD, Haffner SM, Hsueh W, et al. National Heart, Lung, and Institute; National Institute of Diabetes and Digestive and Kidney Diseases working Group on Cardiovascular Complications of Type 1 Diabetes Mellitus. Circulation 2005; 111:3489-3493.
  4. Malmberg K, Yusuf S, Gerstein HC et al. Impact of diabetes on long-term prognosis inpatients with unstable angina and nory Q-wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation 2000; 102:1014-1019.
  5. Bauduceau B, Baigts F, Bordier L et al. Epidemiology of the metabolic syndrome in 2045 French military personnel (EPIMIL study). Diabetes and Metabolism 2005; 31:353-359.
  6. Waller BF, Palumbo PJ, Lie JT, Roberts WC. Status of the coronary arteries at necropsy in Diabetes mellitus with onset aner age 33 years. Analysis of 229 diabetic patients with and without clinical evidence of coronary heart diseae and comparison to 183 control subjects. Am J Med 1980; 69:498—506.
  7. Boyle PJ. Diabetes mellitus and macrovascular disease: mechanisms and mediators. Am J Med 2007; 120:S12—7. Kjaergaard SC, Hansen HH, Fog L, et al. In- hospital outcome for diabetic patients with acute myocardial infarction in the thrombolytic era. Scand Cardiovasc J 1999; 33:166-170
  8. Moreno PR, Murcia AM, Palacios IF, Leon MN, Bernardi VH, Fuster V, et al. Coronary composition and macrophage infiltration in atherectomy specimens from patients with Diabetes mellitus. Circulation 2000; 102:2180—4.
  9. Ge J, Erbel R, Gerber T, Görge G, Koch L, Haude M, et al. Intravascular ultrasound imaging of angiographically normal coronary arteries: a prospective study in vivo. Br Heart J 1994; 71:572—578.
  10. Xu S, Zhang J, Yang J, Mao J, Mao B, Chen Q, Fu F. Evaluating the association between vascular remodeling and plaque calcification patterns of the carotid artery and its effects on ischemic symptoms using CT angiography. Cardiovasc Diagn Ther. 2024 Apr 30;14(2):229-239. doi: 10.21037/cdt-23-428. Epub 2024 Apr 16. PMID: 38716319; PMCID: PMC11071001.
  11. Nafee T, Shah A, Forsberg M, Zheng J, Ou J. State-of-art review: intravascular imaging in percutaneous coronary interventions. Cardiol Plus. 2023 Oct-Dec;8(4):227-246. doi: 10.1097/CP9.0000000000000069. Epub 2024 Jan 4. PMID: 38304487; PMCID: PMC10829907.
  12. Warnes CA, Roberts WC. Sudden coronary death: relation of amount and distribution of coronary narrowing at necropsy to previous symptoms of myocardial ischemia, left ventricular scarring and heart weight. Am J Cardiol. 1984 Jul 1;54(1):65-73. doi: 10.1016/0002-9149(84)90305-9. PMID: 6234790.
  13. Schlosser T, Konorza T, Hunold P, et al. Noninvasive visualization of coronary artery by-pass grafts using 16-detector row computed tomography. J Am Coll Cardiol 2004; 44:124-9.
  14. Lepor LE, Madyoon H, Friede G. The emerging use of 16 and 64-slice computed tomography coronary angiography in clinical cardiovascular practice. Rev Cardiovasc Med 2005; 6:47-53.
  15. Weustink AC, Nieman K, Pugliese F, Mollet NR, Meijboom WB, van Mieghem C, ten Kate GJ, Cademartiri F, Krestin GP, de Feyter PJ. Diagnostic accuracy of computed tomography angiography in patients after bypass grafting: comparison with invasive coronary angiography. JACC Cardiovasc Imaging. 2009 Jul;2(7):816-24.
  16. Nieman K, Rensing BJ, van Geuns RJ, et al. Non-invasive coronary angiography with multislice spiral computed tomography: impact of heart rate. Heart 2002; 88:470-4.
  17. Ropers D, Ulzheimer S, Wenkel E, Baum U, Giesler T, Derlien H, Moshage W, Bautz WA, Daniel WG, Kalender WA, Achenbach S. Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction. Am J Cardiol 2001; 88:792—795.
  18. Mollet NR, Cademartiri F, van Mieghem CA, et al. High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation 2005; 1 12:2318—23.
  19. Raggi P, Shaw LJ, Berman DS, Callister TQ. Proglostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 2004; 4311663-9.
  20. Das KM, El-Menyar AA. Contrast-enhanced 64-Section Coronary Multidetector CT Angiography versus Conventional Coronary Angiogaphy for Stent Assessment. Radiology 2007; 245:111-121.
  21. Libague G, Rossi C, Favalli M, et al. Noninvasive evaluation of coronary artery stents patency after PTCA: role of Multislice Computed Tomography. Radiol Med 2004; 108:128-37.
  22. Abbara, S., Blanke, P., Maroules, C. D., Cheezum, M. K., Choi, A. D., Han, B. K.,. & White, R. D. (2016). SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the Society of Cardiovascular Computed Tomography Guidelines Committee. Journal of Cardiovascular Computed Tomography, 10(6), 435-449.
  23. Joshi, A. R., Cohen, M. C., & Lutz, J. R. (2020). Current clinical outcomes of patients with drug-eluting stents vs bare-metal stents: A systematic review. Cardiovascular Intervention and Therapeutics, 35(3), 263–274. doi:10.1007/s12928-020-00586-7.
  24. Stein PD, Beemath A, Skaf E, Kayali F, Janjua M, Alesh I, et al. Usefulness of 4-, 8-, and 16-slice computed tomography for detection of graft occlusion or patency after coronary artery bypass grafting. Am J Cardiol 2005; 96:1669—73.
  25. Burgstahler C, Kuettner A, Kopp AF, Herdeg C, Martensen J, Claussen CD, et al. Non- invasive evaluation of coronary artery bypass grafts using multi-slice computed tomography: initial clinical experience. Int J Cardiol 2003; 90:275—80.
  26. Yoo KJ, Choi D, Choi B W, Lim SH, Chang BC. The comparison of the graft patency aner coronary artery bypass grafting using coronary angiography and multi-slice computed tomography. Eur J Cardiothorac Surg 2003; 24:86—91.
  27. Treede H, Becker C, Reichenspurner H, Knez A, Detter C, Reiser M, et al. Multidetector computed tomography (MDCT) in coronary surgery: first experiences with anew tool for diagnosis of coronary artery disease. Ann Thorac surg 2002; 74.•S1398-402.
  28. Ropers D, Ulzheimer S, Wenkel E, Baum U, Giesler T, Derlien H, Moshage W, Bautz WA, Daniel WG, Kalender WA, Achenbach S. Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction. Am J Cardiol 2001; 88:792—795.
  29. Abbara, S., Blanke, P., Maroules, C. D., Cheezum, M. K., Choi, A. D., Han, B. K.,. & White, R. D. (2016). SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the Society of Cardiovascular Computed Tomography Guidelines Committee. Journal of Cardiovascular Computed Tomography, 10(6), 435-449.