ORIGINAL PAPER Comparison of atherosclerotic plaque burden and composition between diabetic and non diabetic patients by non invasive CT angiography Uzoma N. Ibebuogu Æ Khurram Nasir Æ Ambarish Gopal Æ Naser Ahmadi Æ Song S. Mao Æ Emily Young Æ Lily Honoris Æ Vivek K. Nuguri Æ Robert S. Lee Æ Nudrat Usman Æ Babak Rostami Æ Raveen Pal Æ Ferdinand Flores Æ Matthew J. Budoff Received: 15 October 2008 / Accepted: 13 July 2009 / Published online: 26 July 2009 Ó Springer Science+Business Media, B.V. 2009 Abstract Type 2 diabetes mellitus (DM) is associ- ated with a higher risk of cardiovascular disease and atherosclerotic burden. However little data exists in regards to plaque distribution and plaque composition in these patients. To assess for differences in the coronary plaques burden and composition among symptomatic patients with and without type 2 DM using multidetector computed tomography angiogra- phy (MDCTA). The 416 symptomatic patients (64% males, mean age: 61 ± 13 years) with 61 (15%) reporting type 2 DM, who underwent contrast- enhanced MDCTA were studied. Enrolled patients had an intermediate to high pre-test probability of obstructive coronary artery disease. Multivariate anal- ysis was used to correct for differences in age and gender. Patients with type 2 DM were more likely to have significant stenosis C70% in at least one coronary segments (33% in type 2 DM vs. 18% in non diabetic, P = 0.013), whereas 11% of both type 2 DM and non diabetics had stenosis of 50–70% (P = NS). Also type 2 DM patients had a higher number of coronary segments with mixed plaques compared to nondiabetic patients (1.67 ± 2.01 vs. 1.23 ± 1.61, P = 0.05), whereas no such differences were observed for non- calcified or calcified plaques. Nearly half (43%) of type 2 DM had coronary artery calcium scores (CACS) C400 vs. 29% in non diabetic patients (P = 0.03). Patients with type 2 DM tend to have atherosclerotic plaques which are more likely to be mixed in nature. Future studies need to elucidate the prognostic value of differences in plaque characteristics observed accord- ing to type 2 diabetic status. Keywords Diabetes mellitus Á Atherosclerosis Á Coronary computed tomography Abbreviations DM Diabetes mellitus MDCTA Multidetector computed tomography angiography CAD Coronary artery disease VH IVUS Virtual histology intravascular ultrasound TCFA Thin-cap fibroatheromas Introduction Patients with type 2 diabetes mellitus (DM) have a fourfold increased risk of cardiovascular event U. N. Ibebuogu (&) Section of Cardiology, Medical College of Georgia, 1120 15th Street (BBR 6518), Augusta, GA 30912, USA e-mail: ibebuogu@yahoo.com K. Nasir Beth Israel Medical Deaconess Center, Boston, MA, USA A. Gopal Á N. Ahmadi Á S. S. Mao Á E. Young Á L. Honoris Á V. K. Nuguri Á R. S. Lee Á N. Usman Á B. Rostami Á R. Pal Á F. Flores Á M. J. Budoff Los Angeles Biomedical Research Institute at Habor-UCLA, Torrance, CA, USA 123 Int J Cardiovasc Imaging (2009) 25:717–723 DOI 10.1007/s10554-009-9483-9