P75: Signs of Accelerated Carotid Atherosclerosis in Early Type 2 Diabetes assessed by Magnetic Resonance Imaging

Abstract

Background

Ischemic stroke from carotid plaque embolism remains a major cause of morbidity and mortality in patients with type 2 diabetes (T2DM). However, the effect of T2DM on early carotid plaque burden and composition is sparsely elucidated. We assessed carotid plaque composition by carotid magnetic resonance imaging (MRI) in short duration T2DM patients compared to a sex- and age-matched control group.

Methods

100 patients with T2DM (duration <5 years) and 100 sex- and age-matched control subjects underwent MRI of the carotid arteries bilaterally in a 1.5 T MRI scanner. Plaque burden was measured as normalized wall index, maximum wall thickness, maximum wall area, and minimum lumen size. Plaque characteristics were quantified by calcified plaque volume, necrotic core volume, and loose matrix volume.

Results

MRI data were available for 149 and 177 carotid arteries from T2DM patients and control subjects, respectively. T2DM was associated with a higher normalized wall index (ratio 1.03 (1.002; 1.06), p = 0.03), a lower minimum lumen area (ratio 0.81(0.74; 0.89), p < 0.001), and lower maximum wall area (ratio 0.94 (0.88; 1.00), p = 0.048) compared to controls. Body mass index (BMI) was associated with maximum wall area and all plaque characteristics independently of diabetes status. BMI > 30 kg/m² was associated with an 80% increase in total volume of calcified plaque, and a 44% increase in necrotic core volume compared to BMI < 25 kg/m².

Conclusions

T2DM patients had increased carotid plaque burden and negative remodeling. Obesity was associated with increased carotid artery necrotic core volume and calcification independently of diabetes status.