Abstract TP129: Aging is Associated with Vulnerability of Carotid Plaques in Patients With Type 2 Diabetes Mellitus

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is a well-known risk factor for atherosclerosis. A previous carotid ultrasound study found diabetic patients had more echolucent plaques compared with nondiabetic patients. Another MRI-based carotid plaque imaging study revealed diabetes was associated with development of vulnerable plaques. Therefore diabetes is considered as a predictor for the presence of unstable plaques. The aim of this study is to investigate the association between vulnerability of carotid plaques and clinical characteristics in patients with T2DM. Methods: This study included type 2 diabetic patients with moderate to severe carotid artery stenosis (n=38, mean age 67.8, range 40-83). Using black-blood MRI of carotid arteries, the signal intensity of carotid plaques were measured in all patients. Univariable and multivariable analysis was conducted to examine the association between signal intensity of carotid plaques and clinical characteristics. Results: Vulnerable plaques (VP) , defined as plaques presenting more than one and a half times higher signal intensity than that of ipsilateral sternocleidomastoid muscle, were found in 8 patients. The rates of symptomatic lesions were significantly higher in patients with VP compared to patients without VP [odds ratio (OR) 17.4, 95% confidence interval (CI) 1.495-202.470, p=0.024]. In univariable analysis, VP was associated with age (p=0.0016) and ischemic heart disease (OD 10.5, 95% CI 1.142-96.576, p=0.0422). The association between other factors (sex, hypertension, hyperlipidemia, smoking habit, HbA1c, diabetic retinopathy, diabetic nephropathy) and VP was not significant. Multivariate logistic regression analysis proved that age was an independent factor associated with VP (OD 1.319, 95% CI 1.072-1.939, p=0.0455). Conclusion: This study suggests that there is a significant correlation between presence of VP detected by carotid MRI and ischemic symptoms, and that aging contributes to vulnerability of carotid plaques in patients with T2DM.