Cerebrovascular disease highly prevalent in Type 2 diabetics
MedWire News: Atherosclerotic plaques are present in the vast majority of patients with Type 2 diabetes mellitus, a state-of-the-art imaging study has found.
The study, which used dual-source computed tomography angiography (DSCTA), also reveals that plaque in these patients is typically noncalcified, nonobstructive, and distributed extensively throughout the carotid and cerebrovascular vasculature.
Zhi-gang Yang (West China Hospital of Sichuan University, China) and co-authors studied the prevalence, distribution, and morphology of atherosclerotic plaque in patients with symptomatic Type 2 diabetes mellitus.
In all, 125 patients were imaged using DSCTA, a recently developed imaging method that is able not only to identify plaque and assess the degree of stenosis but also to predict plaque composition. A total of 4723 carotid and cerebrovascular arterial segments >1.5 mm in diameter were analyzed.
The overall prevalence of atherosclerotic plaque was 91.2%, and the most common location for any plaque was the cavernous segment, report Yang et al in the journal Cardiovascular Diabetology.
The most common type of plaque was noncalcified, which accounted for 45% of all plaque and was found predominantly in the intracranial arteries (81.8%).
Calcified plaque was the second most common type, accounting for 39% of all plaque and being present mainly in the intracranial internal carotid artery (ICA) (65.9%) and extracranial arteries (28.2%).
Finally, mixed plaques accounted for 16% of all plaque and were most commonly found in the intracranial arteries (25.2%) and intracranial ICA (56.1%).
Plaques were typically nonobstructive, with just 9% being classified as obstructive (>70% luminal narrowing).
Discussing their study, Yang and co-authors note that DSCTA has many advantages over conventional CTE, including the ability to discriminate plaque subtypes, lower radiation dose, faster scan acquisition time, and higher resolution.
"DSCTA detected a high prevalence of cerebrovascular disease in patients with symptomatic Type 2 diabetes mellitus," they conclude.
"A relatively high proportion of plaques was noncalcified and calcified, primarily leading to nonobstructive stenoses. The distributions of plaques were different and extensive, with the most common site being the cavernous segment of ICA."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Joanna Lyford