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

Abstract

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

Methods: FFR_CT-analysis was performed from standard acquired coronary CTA data sets. The per-patient minimum distal FFR_CT-value (d-FFR_CT) in coronary vessels (diameter ⩾1.8 mm) was registered. The threshold for categorizing FFR_CT-analysis as abnormal was a d-FFR_CT ⩽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-FFR_CT was ⩽0.75 in 12 (16%) patients. The d-FFR_CT, median (IQR), was 0.84 (0.79-0.87). Median (range) d-FFR_CT in patients with d-FFR_CT ⩽0.75 was 0.70 (0.6-0.74). Patients with d-FFR_CT⩽0.75 versus d-FFR_CT >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 FFR_CT. Flow impairment by FFR_CT was associated with coronary plaque characteristics.