Key Points
• Conclusion/Relevance: “A high prevalence of HRP [High-risk coronary artery plaque] was detected in this population of asymptomatic T2D. The presence of HRP was associated with a particular patient profile, but was not ruled out by the absence of coronary artery calcium. CCTA [coronary computed tomography angiography] provides important information on plaque morphology, which may be used to risk stratify this high-risk population.”
• In the current study, researchers analyzed the prevalence of HRP in asymptomatic patients with type 2 diabetes, and its link cardiovascular risk factors, diabetes profile, and coronary artery calcium score (CACS).
• There were four main findings in this study. First, HRP was observed in 86 asymptomatic T2D patients. Second, men were more likely to exhibit HRP. Third, the only diabetes-specific risk factor that significantly related to HRP was HbA1C. Fourth, HRP was most commonly observed in those with mild coronary artery disease. Nevertheless, HRP was also observed in those with no CAD.
• The authors noted certain limitations. “This was a small observational study and is therefore prone to confounding and bias by design. We did not include a control group to compare asymptomatic patients with diabetes to individuals without diabetes. Furthermore, we did not report any prognostic information to back up the claim, that HRP is in fact associated with cardiovascular events, although this point has been supported by several trials in recent years …. [T]he proportion of patients with evidence of CAD and HRP was high in our study compared to other studies of asymptomatic diabetes [23, 54] which could indicate that this was in fact a selected high-risk population.”
• The authors stressed that an issue with regard to plaque-morphology studies is a paucity of agreement on definition. This issue makes it challenging to compare results of different studies.