Coronary Atherosclerosis Burden by Coronary Computed Tomography in Type II Diabetes With Preclinical Non-obstructive Carotid Atherosclerosis and without Inducible Myocardial Ischemia

Highlights • Palmieri V. et al. “Coronary Atherosclerosis Burden by Coronary Computed Tomography in Type II Diabetes With Preclinical Non-obstructive Carotid Atherosclerosis and without Inducible Myocardial Ischemia” • Persons with type II diabetes are considered a population at risk of cardiovascular events, therefore requiring stringent cardiovascular risk factors control. However, methods for identification of a specific phenotype candidate to aggressive cardiovascular risk factors control among asymptomatic persons with type II diabetes is controversial. Carotid atherosclerosis is an independent predictor of cardiovascular events, but those without inducible myocardial ischemia are thought to be at low cardiovascular risk even in the presence of type II diabetes. Coronary artery calcium is an independent predictor of cardiovascular events, but computed tomography for assessment of coronary artery disease burden in asymptomatic persons with type II diabetes remains controversial. • In our study in clinically healthy persons with non-obstructive carotid atherosclerosis with negative stress echocardiography, coronary artery calcium was higher and coronary flow velocity reserve was lower in persons with compared to those without type II diabetes. Coronary artery calcium-based 10-year hazard of cardiovascular events was found to be as high as 10-20%, or above 20%, i.e. coronary heart disease-like, in 78% and 11% of the persons with type II diabetes, respectively, as compared to 28% and 0%, respectively, in persons without type II diabetes.