Morphology Of Coronary Artery Disease Research Articles

The Morphology of Coronary Artery Disease in South Asians vs White Caucasians and Its Implications.

South Asians (SAs) experience a higher prevalence and earlier onset of coronary artery disease and have worse outcomes compared with White Caucasians (WCs) following invasive revascularisation procedures, a mainstay of coronary artery disease (CAD) management. We sought to review the differences in the CAD pattern and risk factors between SA and WC patients and to discuss their potential impact on the development of coronary disease, acute coronary syndrome, and revascularisation outcomes. SAs have a more diffuse pattern with multivessel involvement compared with WCs. However, less is known about other morphologic characteristics, such as calcification of atherosclerotic plaque and coronary diameter in SA populations. Despite a similar coronary calcification burden, higher noncalcified plaque composition, elevated thrombosis, and inflammatory markers likely contribute to the disease pattern. Although the current evidence on the role of coronary vessel size remains inconsistent, smaller diameters in SAs could play a potential role in the higher disease prevalence. This is especially important given the impact of coronary artery diameter on revascularisation outcomes. In conclusion, SAs have a unique CAD risk profile composed of traditional and novel risk factors. Our findings highlight the need for additional awareness of health professionals of this specific risk profile and potential therapeutic targets, as well as the need for further research in this vulnerable population.

Morphology of Coronary Artery Disease in a Patient with, Psoriasis Presenting with an Acute Coronary Syndrome

Background: This study was designed to evaluate the patterns of coronary artery disease in patients with Psoriasis presenting with acute coronary syndrome (ACS). Methods: This was a prospective, observational study, conducted on 28 patients with Psoriasis, presenting with acute coronary syndrome undergoing coronary angiogram from September 2017 to March 2021. All patients had undergone coronary angiogram; severity and morphology of coronary lesion were analyzed. Echocardiography was used to analyze LV wall motion and LV function. Results: The study showed that of 28 patients with Psoriasis who presented with ACS, 45.8% of patients were presented with NSTEMI, 39.2% % STEMI, and Unstable angina 15%. The average time of presentation after the onset of the symptom was 14.8 hours. 66 % of patients were a smoker. Coronary involvement 50% had TVD, 40% DVD, and 10% had SVD. In 77.6% culprit vessel was LAD, 10.4% LCX, and 12% RCA. In 75% of patient's coronary lesion was located in the proximal LAD. Chronic total occlusion was found in almost 26% of patients. Extensive LV wall motion abnormality with severe LV systolic dysfunction was noted in Psoriasis patients at the time of presentation (mean LVEF=28%). Conclusions: Psoriasis patients presenting with ACS, associated with increased severity of coronary lesions, multivessel involvement, and depressed LV systolic function.

Gender and coronary artery bypass grafting in cardiogenic shock.

Bypass surgery in patients undergoing cardiogenic shock caused by acute coronary syndrome is one of the most urgent and often performed cardiac operations. It remains unclear if patients gender independently influences the outcome. Literature reveals that females and males primarily differ from each other with regard to many important preoperative characteristics. Our objective was to compare the outcome and postoperative courses of both genders, using matched samples, eliminating these preoperative differences. Between 2007 and 2015, 491 patients in cardiogenic shock underwent urgent bypass surgery in our institution. To assess the impact of gender on outcomes, we performed a propensity score matching to create two groups [males and females] which were matched for age, severity of shock, coronary artery disease morphology, and other comorbidities. Two groups were created: (1) 103 female and (2) 103 male patients. We analyzed the outcomes, complications and potential mortality predictors. Most of the patients had three-vessel disease (70.1%, n = 344) with proximal left anterior descending lesion (88%, n = 432). Our study showed no differences between female and male patients regarding choice of conduits, number of anastomosed vessels, and outcome. Acute kidney injury (AKI) occurred significantly more often in female patients and pericardial tamponade in their male counterparts. There were no differences regarding other major complications. Gender does not appear to influence long-term outcomes in the study sample. Female gender is an independent risk factor for postoperative AKI. Other complications occurred with comparable rates in both genders. Exertion tolerance in the follow-up period was similar between genders.

Low Levels of Plasma Osteoglycin in Patients with Complex Coronary Lesions.

Aim: Osteoglycin is one of proteoglycans that are biologically active components of vascular extracellular matrix. However, the role of osteoglycin in atherosclerosis remains unclear.Methods: We investigated plasma osteoglycin levels and the presence, severity, and lesion morphology of coronary artery disease (CAD) in 462 patients undergoing elective coronary angiography.Results: Of 462 patients, 245 had CAD. Osteoglycin levels were higher in patients with CAD than without CAD (median 29.7 vs. 25.0 ng/mL, P < 0.05). However, osteoglycin levels did not differ among patients with one-vessel, two-vessel, or three-vessel disease (30.8, 30.6, and 29.4 ng/mL, respectively) and did not correlate with the number of stenotic segments. Among 245 CAD patients, 41 had complex coronary lesions, and 70 had total occlusion, of whom 67 had good collateralization. Between 70 patients with occlusion and 175 without occlusion, osteoglycin levels did not differ (30.4 vs. 29.5 ng/mL). Notably, osteoglycin levels were lower in 41 patients with complex lesions than in 204 without such lesions (24.2 vs. 31.6 ng/mL, P < 0.02). In multivariate analysis, osteoglycin levels were an independent factor for complex lesion but not for CAD. Odds ratio for complex lesion was 0.80 (95%CI = 0.67–0.96) for each 10 ng/mL increase in osteoglycin levels (P < 0.02).Conclusion: Although plasma osteoglycin levels were high in patients with CAD, they did not correlate with the severity of CAD and were not an independent factor for CAD. Notably, osteoglycin levels were low in patients with complex lesions and were a factor for complex lesions, suggesting that osteoglycin plays a role in coronary plaque stabilization.

PROMISE of Coronary CT Angiography: Precise and Accurate Diagnosis and Prognosis in Coronary Artery Disease.

Coronary computed tomography angiography (CCTA) is a rapidly growing and powerful diagnostic test that offers a great deal of precision with respect to diagnosing coronary artery disease (CAD). Guideline statements for patients with stable ischemic heart disease have recommended CCTA for only a limited portion of intermediate-risk patients who have relative or absolute contraindications for exercise or vasodilator stress testing. The publication of two large, prospective randomized clinical trials, the Prospective Multicenter Imaging Study for Evaluation of Chest Pain and the Scottish Computed Tomography of the Heart Trial are likely to expand these indications. These new data from large trials, in addition to other studies, show that CCTA is highly sensitive for the detection of CAD, identifies high-risk patients for cardiac events based on extent or plaque morphology of CAD that would not be identified by other noninvasive means, and provides significantly greater diagnostic certainty for proper treatment, including referral for invasive coronary angiography with revascularization more appropriately. Superior diagnostic accuracy and prognostic data with CCTA, when compared with other functional stress tests, may result in a reduction in unnecessary downstream testing and cost savings. In addition, newer CCTA applications hold the promise of providing a complete evaluation of a patient's coronary anatomy as well as a per-vessel ischemic evaluation. This review focuses on the interval knowledge obtained from newer data on CCTA in patients with stable ischemic heart disease, primarily focusing on the contributions of the Prospective Multicenter Imaging Study for Evaluation of Chest Pain and the Scottish Computed Tomography of the Heart Trial.

157 CD14++CD16+CCR2+ monocytes are increased in diffuse coronary artery disease

Background Monocytes play an integral role in the development of atherosclerosis. Specific monocyte subsets have been associated with excess cardiovascular events in different patient populations and highlighted as a potential therapeutic target. Objective To compare blood monocyte subsets in patients with focal coronary artery disease (CAD) and diffuse CAD. Methods Three monocyte subsets (CD14 + +CD16-CCR2+ [classical, Mon 1], CD14 + +CD16 + CCR2+ [intermediate, Mon 2] and CD14 + CD16 + +CCR2- [non-classical, Mon 3]) and their aggregates with platelets (monocyte-platelet aggregates, MPAs) were quantified by flow cytometry in 71 CAD patients (subdivided into a group with diffuse CAD [n = 50] and a group with focal CAD [n = 21] based on angiographic coronary artery morphology) and 39 age, sex and risk factor matched controls with normal coronary arteries assessed either invasively or non-invasively using computed tomography coronary angiography (CTCA). Results The clinical characteristics of each group are shown in Table 1. Patients with diffuse CAD had a significantly higher proportion of Mon 2 than patients with focal disease (p = 0.02) or normal coronary arteries (p = 0.03) (Table 2). MPA associated with Mon 2 was also significantly higher in the diffuse CAD group (p Conclusion Patients with diffuse CAD have higher peripheral blood levels of Mon 2 and MPA associated with Mon 2 than patients with focal CAD. Our data support the notion that Mon 2 is related to worse CAD morphology.

Association of blood level of inflammatory mediators and morphology of coronary artery stenosis in patients with stable angina

Aim. To study the association of morphology of coronary artery disease and pentraxin-3, tumor necrosis factor α blood levels in patients with stable angina who undergo coronary artery bypass surgery. Methods. The study included 92 patients aged 44-73 years with stable angina of II-III functional class. The coronary artery disease type was classified by AHA/ACC criteria: type A - concentric stenosis with flat plague and plague length less than 10 mm, type B - eccentric stenosis or blunt-edged stenosis with moderate calcinosis or signs of mural trombosis, with length not exceeding 200 mm, type C - stenosis with plague length over 20 mm, plague ulceration, marked calcinosis, diffuse lesions, chronic coronary artery occlusion. Pentraxin-3, tumor necrosis factor α blood levels were measured by ELISA in all patients before the surgery, 8 and 24 hours after the surgery. Results. There was a relation found between the type of stenosis and pentraxin-3 and tumor necrosis factor α blood levels. In patients with С type stenosis, pentraxin-3 blood level was 4 times higher (p 0.001) 24 hours after the coronary artery bypass surgery compared to patients with A type stenosis, and by 1.8 and 1.3 times higher compared to patients with В1 and В2 stenosis type, accordingly. Conclusion. There was a close relation revealed between the morphology of coronary artery stenosis and pentraxin-3 and tumor necrosis factor α blood levels in patients with stable angina.

TCT-410 Comparison of Coronary Artery Bypass Surgery, Percutaneous Drug-eluting Stent Implantation, and Medical Therapy for Unprotected Left Main Coronary Artery Disease

Background: Unprotected left main coronary artery (ULMCA) disease is considered an indication for revascularization. However, in “real-world” clinical practice some patients receive medical therapy only. The arm of this study was to evaluate long-term results in patients with ULMCA disease in a “real-world” practice. Methods: Between January 2006 and June 2011, 218 stable patients were diagnosed with de novo ULMCA stenosis. 52 (23.9%) patients received medical therapy only, coronary artery bypass grafting (CABG) was performed in 106 (48.6%) patients, percutaneous coronary intervention (PCI) in 60 (27.5%) patients. The composite of death, myocardial infarction, and stroke defined as major adverse cardiac and cerebrovascular events (MACCE) and target vessel revascularization (TVR) were defined as primary endpoints. The median follow-up period was 4 years. Results: Baseline clinical and descriptive morphology of coronary artery disease revealed more comorbidities and more complex anatomies in the medical therapy group compare with CABG and PCI groups. Revascularization might not have been used due to physician's decision (operative risk considered excessive) in 24 (46.2%) cases or when patients refused revascularization in 28 (53.8%) cases. At 4-year follow-up MACCE rate was higher in nonsurgical group (34.6%) compare with CABG (13.2%; p1⁄40.002) and PCI (14.5%; p1⁄40.016) groups, but there was no difference between CABG and PCI groups. Survival in CABG (4.7%; p<0.001) and PCI (5.5%; p1⁄40.009) groups was higher in compare with nonsurgical group (23.1%). On the multivariable Cox regression analysis, coronary revascularization (CABG and PCI) was independent predictor of long-term survival (HR 3.49; 95% CI 1.39-8.75; P<0.001). Conclusions: PCI, like CABG improves survival for patients with unprotected left main coronary artery disease compared with medical therapy only in “real-world” clinical practice.

Outcome of percutaneous coronary intervention with drug-eluting stents in unprotected left main versus non-left main native coronary artery disease: results from the prospective multicenter German DES.DE registry

Unprotected left main coronary artery (ULMCA) disease is considered an indication for surgical revascularization. However, refined percutaneous coronary intervention (PCI) technology and modern drug-eluting stents (DES) render the ULMCA a target for interventional treatment. Between October 2005 and September 2009, 374 patients receiving DES in ULMCA and 18,678 patients receiving DES in non-left main coronary arteries (nLMCA) with no previous coronary artery bypass graft surgery, were registered at 130 DES.DE sites. The composite of death, myocardial infarction (MI), and stroke defined as major adverse cardiac and cerebrovascular events (MACCE) and target vessel revascularization (TVR) were defined as primary endpoints. Baseline clinical and descriptive morphology of coronary artery disease revealed more comorbidities and more complex anatomies in the ULMCA group. At 1-year follow-up, the ULMCA group suffered from higher rates of overall death (5.6 versus 2.3 %; p < 0.0001), stroke (2.0 versus 0.8 %; p < 0.05), MACCE (8.6 versus 4.9 %; p < 0.01); whereas rates for definite/probable stent thrombosis (2.4 versus 1.6 %; p = 0.29), TVR (14.2 versus 10.8 %; p = 0.06) and MI (1.3 versus 1.9 %; p = 0.44) were not statistically different. These results persisted even after adjustment for different baseline characteristics, except MACCE that was no longer statistically significant. Data collected in DES.DE revealed that ULMCA PCI with DES result in similar TVR rates as compared to PCI in nLMCA. Moreover, modern DES have not offset the higher comorbidity index and higher procedure-related complication rate with PCI of ULMCA lesions.

Protective effect of Tranilast on radiation-induced heart fibrosis in C57BL/6 mouse

ABSTRACT The heart is a major dose ‐ limiting organ for radiotherapy of cancer in the thoracic region. The purpose of this study was to examine the protective effect of tranilast on the radiation ‐ induced heart fibrosis model using the C57BL/6 murine strain. A significant reduction in the expression of TGF ‐β 1, collagen type Ⅰ and collagen type Ⅲ was observed in the radiation plus tranilast group. The authors also suggest the use of tranilast in a clinical trial for the prevention of radiation-induced heart fibrosis. Keywords : Heart Fibrosis, Radiation, Tranilast 1. INTRODUCTION interplay of cellular and mole 1.1 General Appearance The cardiac structures (heart and pericardium) are recognized as being sufficiently radiosensitive to be dose‐limiting structures during radiotherapy for cancers in the thoracic region. The term heart (RIHD) was coined in the 1960s [1],[2] and describes the conglomerate of structural alterations produced by radiation of the cardiac tissues and the clinical manifestations of these alterations RIHD may vary depending on the total dose of radiation administered, the fractionation schedule, the volume of the heart radiated, the existence of prior heart disease, and the use of chemotherapeutic medications in the management of the disease. Clinically evident RIHD has a characteristic morphology. The most common morphologic alterations occur in the pericardium [3]. The parietal pericardium develops variable degrees of fibrosis that replace the outer adipose tissue. The visceral pericardium also develops fibrosis, although not to the same degree as the parietal pericardium. The myocardium is involved less frequently than the pericardium, but it develops a more serious lesion [3],[4]. The valvular lesions induced by radiation are nonspecific and could be the result of conditions other than RIHD. The morphology of coronary artery disease after radiation is not different from that of spontaneous atherosclerosis. Therefore, these lesions cannot be diagnosed as specifically associated with radiation therapy. The underlying mechanisms of radiation‐induced fibrosis remain unresolved. Based on our present knowledge of

Real-world experience of drug-eluting stents in saphenous vein grafts compared to native coronary arteries: results from the prospective multicenter German DES.DE registry

Bypass-graft intervention was associated with worse outcomes in the bare-metal stent era. Without sufficiently powered data from subgroup analyses, and in absence of randomized controlled trials targeting clinical endpoints, controversy is ongoing over safety and efficacy of drug-eluting stents (DES) in saphenous vein graft (SVG) lesions. Between October 2005 and October 2006, 5,183 patients receiving DES in SVG (n=251) or native coronary arteries (NCA) (n=4,932) were enrolled at 98 DES.DE sites. The composite of death, myocardial infarction (MI), and stroke defined as major adverse cardiac and cerebrovascular events (MACCE) and target-vessel revascularization (TVR) were defined as primary endpoints. Baseline clinical and descriptive morphology of coronary artery disease revealed more severe lesions and comorbidities in the SVG group. At 1-year follow-up, the SVG group suffered from higher rates of overall death (6.6 vs. 2.5%; p<0.0001), myocardial infarction (5.9 vs. 2.2%; p<0.0001), MACCE (13.6 vs. 5.4%; p<0.0001), TVR (17.7 vs. 10.4%; p<0.001) and overall stent thrombosis (10.0 vs. 3.7%; p<0.0001). Data collected in DES.DE revealed that first generation DES used in SVG lesions did not offset the worse clinical outcomes of bypass-graft intervention. Such sobering results in SVG may suggest to opt for native vessel PCI preferentially or occasionally for surgical reintervention as decided by the Heart Team.

Myocardial perfusion imaging by computed tomography: today and tomorrow

Cardiac perfusion along with imaging of coronary artery stenosis is an important tool in assessing the degree of coronary artery disease (CAD) and decision-making regarding further treatment. SPECT, PET, echocardiography and cardiac magnetic resonance imaging are clinically established techniques to evaluate myocardial perfusion and viability with a high diagnostic accuracy and relatively few unwanted side effects. However, none of these modalities Glose can reliably assess the extent and morphology of CAD, features which also have implications as well as for patient management. In contrast, cardiac CT has emerged over the last years as a reliable tool to visualise coronary atherosclerotic plaque and stenosis, nearly unaffected by heart rate and carrying a relatively low radiation exposure; however, without allowing an adequate assessment of myocardial perfusion. Given the great promise of a combined cardiac CT examination to assess morphology and function, much research has recently been focused on the development of CT-based myocardial perfusion imaging techniques. In this article, we review recent developments in cardiac CT with respect to myocardial perfusion imaging, especially the two main techniques, first-pass and dynamic CT acquisitions.

Outcomes after differential use of drug‐eluting stents in diabetic patients: 1‐Year results from the DES.DE (Drug‐Eluting Stent.DEutschland) registry

The prospective multicenter German DES.DE registry provides real world data to evaluate the therapeutic principle of two different drug-eluting stents (DES) [Sirolimus- (SES) and Paclitaxel-eluting stent (PES)] in the context of the German Health System. Differential DES have been effective in randomized trials, but their difference in safety and efficacy in diabetic patients has not been well studied. Baseline, predefined procedural as well as clinical in-hospital and follow-up events were recorded for all 1,526 diabetic patients. The composite of death, myocardial infarction (MI), and stroke defined as major adverse cardiac and cerebrovascular events (MACCE) and target vessel revascularization (TVR) were defined as primary endpoints. Between October 2005 and October 2006, 1,526 diabetic patients, 34.2% of them being insulin-dependent, were enrolled (SES: n = 612; PES: n = 914) at 98 DES.DE sites. Overall, one third of patients were admitted with acute coronary syndrome (ACS) and 70% had multivessel-disease reflecting a real world scenario. With similar baseline clinical and descriptive morphology of coronary artery disease (CAD) in both DES groups, there were no statistical differences in 1-year follow-up with respect to rates of overall mortality (5.8% vs. 5.4%), TVR (12.0% vs. 11.3%), overall stent thrombosis (5.6% vs. 4.6%) and MACCE (11.4% vs. 10.3%) between both DES. The data collected in DES.DE revealed no differences in clinical outcomes within 1 year between SES and PES in diabetic patients in a "real-world" setting.

Clinical outcomes in diabetic and non-diabetic patients with drug-eluting stents: results from the first phase of the prospective multicenter German DES.DE registry

Patients with diabetes mellitus (DM) undergoing coronary revascularization are at increased risk for adverse outcomes. Without sufficiently powered data from diabetic subgroup analyses and in absence of randomized controlled trials in diabetic patients with primary clinical outcomes controversy is ongoing over safety and efficacy of drug-eluting stents (DES) in diabetic patients. Between October 2005 and October 2006, 1,659 diabetic and 3,559 non-diabetic patients treated with DES (Paclitaxel or Sirolimus-eluting stents) were enrolled at 98 Drug-Eluting-Stent.DEutschland (DES.DE) sites. Major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of death, myocardial infarction, and stroke, as well as target vessel revascularization (TVR) were defined as primary endpoints. The baseline clinical and descriptive morphology of coronary artery disease revealed more severe findings in diabetic patients. At 1-year follow-up, diabetic patients treated with DES had significantly higher rates for overall death (5.6 vs. 3.4%; p < 0.01), myocardial infarction (4.8 vs. 3.4%; p = 0.05), stroke (1.7 vs. 0.9%; p < 0.05), MACCE (10.9 vs. 7.1%; p < 0.001), and overall stent thrombosis (4.9 vs. 3.3%; p < 0.01) with slightly elevated rates for TVR (12.0 vs. 10.4%; p = 0.17); data which remained after risk-adjustment. Data collected in DES.DE revealed that despite the use of DES the risk of myocardial infarction, death, and thrombotic events remains higher in diabetic patients.

Clinical Outcomes After Sirolimus-Eluting, Paclitaxel-Eluting, and Bare Metal Stents (from the First Phase of the Prospective Multicenter German DES.DE Registry)

The prospective multicenter German Drug-Eluting Stent (DES.DE) registry is an observational study to analyze and evaluate the therapeutic principle of the differential drug-eluting stents (sirolimus- and paclitaxel-eluting stents) and bare metal stents under real world conditions in the context of the German healthcare system. The baseline clinical and angiographic characteristics and follow-up events for 1 year were recorded for all enrolled patients. In addition, a health economics assessment was performed at 3, 6, 9, and 12 months after initial stent placement. The composite of death, myocardial infarction, and stroke, defined as major adverse cardiac and cerebrovascular events, and target vessel revascularization were used as the primary objectives. From October 2005 to October 2006, 6,384 patients were enrolled (sirolimus-eluting stents, n = 2,137; paclitaxel-eluting stents, n = 2,740; bare metal stents, n = 485) at 98 Deutsches Drug-Eluting Stent Register sites. With similar baseline clinical and descriptive morphology of coronary artery disease between both drug-eluting stent groups, no differences were present at 1 year of follow-up in the rates of overall mortality (3.8% vs 4.1%), target vessel revascularization (10.4% vs 10.4%), overall stent thrombosis (3.6% vs 3.8%), and major adverse cardiac and cerebrovascular events (8.1% vs 8.0%). Compared with the bare metal stent group, patients treated with drug-eluting stents had significantly lower rates of myocardial infarction (3.2% vs 6.0%; p <0.01), stroke (1.2% vs 2.7%; p <0.05), and target vessel revascularization (10.4% vs 14.9%; p <0.01) without any difference in the stent thrombosis rate (3.7% vs 4.3%; p = 0.57) or mortality rate (4.0% vs 5.2%; p = 0.21). In conclusion, the data generated from the German Drug-Eluting Stent registry revealed no differences between patients receiving a paclitaxel-eluting stent and sirolimus-eluting stent in a "real-world" setting with regard to the clinical outcomes at 1 year.

Differences in Atherosclerotic Plaque Burden and Morphology Between Type 1 and 2 Diabetes as Assessed by Multislice Computed Tomography

OBJECTIVEIt is unclear whether the coronary atherosclerotic plaque burden is similar in patients with type 1 and type 2 diabetes. By using multislice computed tomography (MSCT), the presence, degree, and morphology of coronary artery disease (CAD) in patients with type 1 and type 2 diabetes were compared.RESEARCH DESIGN AND METHODSProspectively, coronary artery calcium (CAC) scoring and MSCT coronary angiography were performed in 135 asymptomatic patients (65 patients with type 1 diabetes and 70 patients with type 2 diabetes). The presence and extent of coronary atherosclerosis as well as plaque phenotype were assessed and compared between groups.RESULTSNo difference was observed in average CAC score (217 ± 530 vs. 174 ± 361) or in the prevalence of coronary atherosclerosis (65% vs. 71%) in patients with type 1 and type 2 diabetes. However, the prevalence of obstructive atherosclerosis was higher in patients with type 2 diabetes (n = 24; 34%) compared with that in patients with type 1 diabetes (n = 11; 17%) (P = 0.02). In addition, a higher mean number of atherosclerotic and obstructive plaques was observed in patients with type 2 diabetes. In addition, the percentage of noncalcified plaques was higher in patients with type 2 (66%) versus type 1 diabetes (27%) (P < 0.001), resulting in a higher plaque burden for each CAC score compared with that in type 1 diabetic patients.CONCLUSIONSAlthough CAC scores and the prevalence of coronary atherosclerosis were similar between patients with type 1 and type 2 diabetes, CAD was more extensive in the latter. Also, a relatively higher proportion of noncalcified plaques was observed in patients with type 2 diabetes. These observations may be valuable in the development of targeted management strategies adapted to diabetes type.