High Prevalence of Asymptomatic Coronary Artery Disease (CAD) Evaluated by Intravascular Ultrasound (IVUS) in a Norwegian Cohort with Type 2 Diabetes (T2D) as Compared with Asymptomatic Controls without T2D—A Cross-Sectional Study

Abstract

The prevalence of asymptomatic CAD in T2D is unclear. We investigated the CAD burden using the gold standard IVUS in an asymptomatic T2D-cohort compared to a reference population without T2D. Patients with T2D and ≥ 1 cardiovascular (CV) risk factor (n=56, 21% women, mean age/diabetes duration 65.2±7.8/13.1±5.8 years, HbA1c 7.2±1.1%, systolic BP 136±17 mmHg, LDL-cholesterol 2.3±0.8 mmol/L) underwent invasive coronary angiography with IVUS. Reference population comprised heart transplant donors free from T2D and CAD who had IVUS performed 7-11 weeks post-transplant (n=76). IVUS was described by maximal intimal thickness (MIT), percent atheroma volume (PAV) and normalized total atheroma volume (TAV). All indices of atherosclerosis were significantly increased in T2D (T2D cohort: MIT 0.75±0.27 mm, PAV 33.7±9.8%, TAV 277.0±137.2 mm3 vs. reference population: MIT 0.44±0.18 mm, PAV 20.1±7.4%, TAV 139.0±110.0 mm3, [p-values<0.001]) and the proportion with CAD defined by MIT was significantly higher in the T2D population (Figure). Our data suggest that asymptomatic T2D patients have extensively diseased coronary arteries suggesting a need for more aggressive residual CV risk management. Disclosure A.P. Ofstad: Employee; Self; Boehringer Ingelheim GmbH. S. Arora: None. G.R. Ulimoen: None. K.I. Birkeland: Research Support; Self; AstraZeneca, Novo Nordisk A/S, Eli Lilly and Company, Sanofi, Boehringer Ingelheim GmbH, Merck Sharp & Dohme Corp.. K. Endresen: None. L.L. Gullestad: None. O. Johansen: Employee; Self; Boehringer Ingelheim GmbH.