Association Between Coronary CT Findings And Clinico-Biochemical Risk Factors Of Coronary Artery Disease In Asymptomatic Diabetic Patients

Abstract

Background: Multiple clinical and biochemical risk factors for CAD have been known. Computed tomography (CT) angiography [also abbreviated as CTA] has been proven to be useful in identifying patients with diabetes who are having underlying coronary artery disease (CAD), but there is a risk of radiation exposure associated with it. Hardly any studies are available in India in which the association of coronary CT findings with clinical and biochemical risk factors of CAD has been identified or explained. The objectives of the study were to determine risk factors associated with coronary artery stenosis, association between coronary calcium scoring (CACS) and Framingham Cardiovascular Disease Risk Score (FRS), and determine the association between Coronary Artery Disease- Reporting and Data System (CAD-RADS) scoring and Framingham Cardiovascular Disease Risk Score (FRS). Methods: A total of 56 patients were selected for the study.and coronary CT angiography along with calcium scoring performed on them. CAD-RADS scoring, presence of atherosclerotic plaque and plaque characterisation was done for each patient. Results: Higher age, longer duration of diabetes and higher Framingham cardiovascular risk score were found to be associated with increasing severity of coronary artery stenosis. Higher age, longer duration of diabetes, history of smoking, higher blood triglyceride levels, higher Framingham cardiovascular risk score and higher coronary artery calcium score were found to have association with presence of coronary artery plaques. It was also observed that higher coronary artery calcium score was associated with presence of significant coronary artery stenosis (≥70%). Increasing severity of coronary artery calcium burden was observed in male gender, smokers, decreased HDL and higher Framingham cardiovascular risk scores. Weak positive correlation was found between CACS and FRS (p-value < 0.001). Positive correlation was also observed between CAD-RADS and FRS (p-value < 0.001). Conclusion: Severity of coronary artery stenosis in asymptomatic diabetics may be predicted using FRS. Subjecting patients with higher FRS to screening for coronary artery disease by non-invasive CT coronary angiography may be appropriate.