Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

<div>Computed tomography coronary angiography (CTCA) and fractional flow reserve CT (<svg height="11.6836pt" id="M9" style="vertical-align:-3.29562pt" version="1.1" viewbox="-0.0498162 -8.38798 34.5206 11.6836" width="34.5206pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M493 503C489 551 484 614 483 650H43V622C120 616 128 611 128 525V126C128 40 120 34 40 28V0H312V28C221 34 213 40 213 126V307H316C407 307 412 296 424 227H453V420H424C412 355 407 346 316 346H213V584C213 613 216 616 246 616H322C398 616 419 607 436 579C449 559 455 539 464 499L493 503Z" id="g121-68"></path></g><g transform="matrix(.013,0,0,-0.013,6.877,0)"><path d="M493 503C489 551 484 614 483 650H43V622C120 616 128 611 128 525V126C128 40 120 34 40 28V0H312V28C221 34 213 40 213 126V307H316C407 307 412 296 424 227H453V420H424C412 355 407 346 316 346H213V584C213 613 216 616 246 616H322C398 616 419 607 436 579C449 559 455 539 464 499L493 503Z" id="g121-68"></path></g><g transform="matrix(.013,0,0,-0.013,13.754,0)"><path d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z" id="g121-80"></path></g><g transform="matrix(.0091,0,0,-0.0091,22.039,3.132)"><path d="M618 181C565 77 513 26 413 26C264 26 151 150 151 336C151 486 240 625 407 625C516 625 573 582 600 475L634 483C627 540 622 581 613 638C585 643 518 665 435 665C211 665 46 526 46 315C46 158 157 -15 406 -15C480 -15 564 4 594 12C612 43 638 121 651 168L618 181Z" id="g58-65"></path></g><g transform="matrix(.0091,0,0,-0.0091,28.164,3.132)"><path d="M601 496C596 555 591 627 591 675H567C551 656 544 650 516 650H120C91 650 79 651 64 675H41C38 619 34 555 29 492H63C75 537 83 566 96 582C110 604 128 612 207 612H272V126C272 46 264 38 170 33V0H464V33C368 38 359 48 359 126V612H430C502 612 520 605 535 582C547 566 556 541 567 492L601 496Z" id="g58-82"></path></g></svg>). (a) Left anterior descending (LAD) artery. White arrow indicates a mixed, severely obstructive plaque at middle LAD. (b) Right coronary artery (RCA) with a small calcific spot. (c) Left circumflex (LCx) artery does not show atherosclerotic plaques. (d), (e) Graphic representation of <svg height="11.6836pt" id="M10" style="vertical-align:-3.29562pt" version="1.1" viewbox="-0.0498162 -8.38798 34.5206 11.6836" width="34.5206pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M493 503C489 551 484 614 483 650H43V622C120 616 128 611 128 525V126C128 40 120 34 40 28V0H312V28C221 34 213 40 213 126V307H316C407 307 412 296 424 227H453V420H424C412 355 407 346 316 346H213V584C213 613 216 616 246 616H322C398 616 419 607 436 579C449 559 455 539 464 499L493 503Z" id="g121-68"></path></g><g transform="matrix(.013,0,0,-0.013,6.877,0)"><path d="M493 503C489 551 484 614 483 650H43V622C120 616 128 611 128 525V126C128 40 120 34 40 28V0H312V28C221 34 213 40 213 126V307H316C407 307 412 296 424 227H453V420H424C412 355 407 346 316 346H213V584C213 613 216 616 246 616H322C398 616 419 607 436 579C449 559 455 539 464 499L493 503Z" id="g121-68"></path></g><g transform="matrix(.013,0,0,-0.013,13.754,0)"><path d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z" id="g121-80"></path></g><g transform="matrix(.0091,0,0,-0.0091,22.039,3.132)"><path d="M618 181C565 77 513 26 413 26C264 26 151 150 151 336C151 486 240 625 407 625C516 625 573 582 600 475L634 483C627 540 622 581 613 638C585 643 518 665 435 665C211 665 46 526 46 315C46 158 157 -15 406 -15C480 -15 564 4 594 12C612 43 638 121 651 168L618 181Z" id="g58-65"></path></g><g transform="matrix(.0091,0,0,-0.0091,28.164,3.132)"><path d="M601 496C596 555 591 627 591 675H567C551 656 544 650 516 650H120C91 650 79 651 64 675H41C38 619 34 555 29 492H63C75 537 83 566 96 582C110 604 128 612 207 612H272V126C272 46 264 38 170 33V0H464V33C368 38 359 48 359 126V612H430C502 612 520 605 535 582C547 566 556 541 567 492L601 496Z" id="g58-82"></path></g></svg> calculation. (d) Following LAD stenosis (white arrow), the value is 0.71. (e) Following RCA stenosis (white arrow), the value is 0.84.</div>

BioMed Research International

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Figure 3

Figure 3: Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives 

Figure 3 | Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives 