The Effect of Clinical Risk factors on Coronary Artery Remodeling in Diabetic Patients a Multi-Detector Computed Tomography Study

Abstract

Background: Type two diabetes mellitus (T2DM) is a strong risk factor for coronary artery disease (CAD). It is associated with diffuse coronary atherosclerosis with different pattern of coronary artery remodeling. Numerous imaging studies have been done to understand the pattern of coronary remodeling in diabetic patients, comparing it with non diabetics.
Aim of study: To assess coronary artery remodeling in patients with T2DM by computed tomography coronary angiography (CTCA).
Patients and Methods: This observational cross-sectional study was held in Cairo University hospitals. It enrolled 530 Egyptian patients, whom underwent CTCA, during the period between January 2019 to January 2021. We studied 263 patients with T2DM and 267 served as non diabetic patients control group. Baseline anthropometric, clinical and CTCA features of diabetics were compared with those without diabetes.
Results: Diabetic patients were older than non diabetics (p value= 0.001). Hypertension, dyslipidemia, use of statin were more in diabetic group (p value= 0.047) (p value= 0.000) (p value= 0.000) respectively, and smoking was more in non diabetic group (p value= 0.037). Coronary remodeling index (RI) was less in diabetic patients (p value= 0.018), while no statistical significant difference between the two groups regarding the type of RI (p value= 0.082).
Coronary artery remodeling index was less in male patients, and in patients who presented with chest pain/SOB. Negative remodeling index pattern was more evident in diabetic patients on insulin and statin (p value= 0.041), (p value= 0.043), respectively.
Conclusion: Negative coronary artery remodeling in diabetics is associated with more insulin use, statin use.