DIFFERENCES OF CORONARY PLAQUE COMPOSITION BETWEEN DIABETIC AND NON-DIABETIC DIALYSIS PATIENTS BY MUTISLICE COMPUTED TOMOGRAPHY ANGIOGRAPHY

초록

INTRODUCTION AND AIMS: Dialysis patients have a significant risk for cardiovascular disease(CVD), and role of coronary imaging in dialysis patients is not only to prove the presence of coronary artery narrowing but to detect those patients with higher risk. Plaque composition rather than degree of degree of luminal narrowing may be predictive of future coronary events in high risk diaysis patients. The purpose of this study is to compare degree of paque burden and composition with mutislice computed tomography(MSCT) angiography between diabetic and non-diabetic dialysis patients. METHODS: A total of 132 consecutive MSCT angiography examination were performed in Hemodialysis Center from September 2009 to August 2010. Of these, the patients who underwent invasive coronary angiography were evaluated for the presence and type of atherosclerotic plaque severity of luminal narrowing. RESULTS: Ninty-two (46 in the diabetic group and 46 in the non-diabetic group) dialysis patients underwent both MSCT angiography and conventional coronary angiography. Among them, 30 patients(65.2%)in the diabetic group and 26 patients(56.5%) in the non-diabetic group had significant narrowing on MSCT angiography. Forty-two patients(93.3%) in the diabetics and 39 patients(88.6%) in the non-diabetic dialysis patients had multiple types of coronary plaque(p=0.485). MSCT Angiography was similar to conventional angiography in its ability to predict significant coronary artery disease in that the area under the curve was 0.88(95% confidence interval, 0.81 to 0.95). Diabetic dialysis patients had more mixed plaque compared with non-diabetic patients on hemodialysis. CONCLUSIONS: Differences in coronary plaque composition between diabetic and non-diabetic dialysis patients can be determined noninvasively by MSCT angiography. In diabetic dialysis patients, mixed plaque types contributes to the total plaque burden to a higher degree than in non-diabetic dialysis patients.