BMI identified as risk factor in asymptomatic diabetic patients with coronary plaque

Body mass index (BMI) has been identified as the primary modifiable risk factor associated with total and soft coronary plaque on coronary CT angiography in asymptomatic diabetic patients, according to a study published online April 22 by Radiology.

Noninvasive imaging methods could be useful in identifying the high prevalence of cardiovascular disease in patients with diabetes. A promising method for the quantification of both calcified and noncalcified plaque is coronary CT angiography. “To our knowledge, the use of coronary CT angiography to noninvasively evaluate total plaque volume in at-risk diabetic patients has not yet been demonstrated,” wrote lead author Alan C. Kwan, BA, of the National Institutes of Health Clinical Center in Bethesda, Md., and colleagues.

The researchers aimed to determine the relationship between coronary CT angiography and clinical parameters and cardiovascular risk factors in asymptomatic diabetic patients.

Two hundred twenty-four asymptomatic diabetic patients who underwent coronary CT angiography were included in the study. The mean plaque volume index was 1.22 mm2 and the mean coronary artery calcium (CAC) score was 382. Results revealed that the plaque volume index was related to age, male sex, BMI and duration of diabetes.

A greater percentage of soft plaque was present in younger individuals with a shorter disease duration and was directly related to BMI. Patients who had discrepancies between CAC score and plaque volume index rank quartiles had a higher percentage of soft and fibrous plaque.

“In this study, we demonstrate that measurement of both calcified and noncalcified plaque with coronary CT angiography is reproducible,” wrote Kwan and colleagues.

“We found that BMI was the only modifiable risk factor associated with overall plaque index for diabetic patients,” they continued. “Further follow-up of this diabetic cohort is warranted to determine if coronary plaque assessment contributes to predictive risk assessment in this challenging patient population.”