Coronary flow impairment in asymptomatic patients with early stage type-2 diabetes: Detection by FFRCT

Monija Mrgan*, Bjarne Linde Nørgaard, Damini Dey, Jørgen Gram, Michael Hecht Olsen, Jeppe Gram, Niels Peter Rønnow Sand

*Corresponding author for this work

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Abstract

PURPOSE: To determine the occurrence of physiological significant coronary artery disease (CAD) by coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) in asymptomatic patients with a new diagnosis (<1 year) of type-2 diabetes mellitus (T2DM).

METHODS: FFRCT-analysis was performed from standard acquired coronary CTA data sets. The per-patient minimum distal FFRCT-value (d-FFRCT) in coronary vessels (diameter ⩾1.8 mm) was registered. The threshold for categorizing FFRCT-analysis as abnormal was a d-FFRCT ⩽0.75. Total plaque volume and volumes of calcified plaque, non-calcified plaque, and low-density non-calcified plaque (LD-NCP) were assessed by quantitative plaque analysis.

RESULTS: Overall, 76 patients; age, mean (SD): 56 (11) years; males, n (%): 49(65), were studied. A total of 57% of patients had plaques. The d-FFRCT was ⩽0.75 in 12 (16%) patients. The d-FFRCT, median (IQR), was 0.84 (0.79-0.87). Median (range) d-FFRCT in patients with d-FFRCT ⩽0.75 was 0.70 (0.6-0.74). Patients with d-FFRCT⩽0.75 versus d-FFRCT >0.75 had numerically higher plaque volumes for all plaques components, although only significant for the LD-NCP component.

CONCLUSION: Every sixth asymptomatic patient with a new diagnosis of T2DM has hemodynamic significant CAD as evaluated by FFRCT. Flow impairment by FFRCT was associated with coronary plaque characteristics.

Original languageEnglish
JournalDiabetes & vascular disease research
Volume17
Issue number5
Pages (from-to)1-7
ISSN1479-1641
DOIs
Publication statusPublished - Sep 2020

Keywords

  • AutoPlaque
  • FFR
  • Type-2 diabetes mellitus
  • coronary computed tomography angiography
  • coronary computed tomography angiography derived fractional flow reserve
  • coronary plaque analysis

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