Introduction & Objective: Data on cardiovascular (CV) risk in patients with type 1 diabetes (T1D) is lacking. Our study aimed to assess coronary arteries in high-risk T1D patients using optical coherent tomography (OCT) to estimate their CV risk.
Methods: Sixty-two patients with T1D > 10 years, age 30-67 years, with no history of CVD were examined by carotid ultrasound and coronary artery calcium (CAC) score. Twelve patients were recognized as high-risk defined as CAC score >400 and/or presence of ≥2 carotid plaques. Patients were subsequently examined by coronary angiography and OCT.
Results: Mean age was 64.5±1.8 years, T1D duration 36±11.5 years, HbA1c 7.5±0.8 % and baseline LDL 88.9±21.3 mg/dl. Thin-cap fibroatheroma (TCFA [Figure-A]) was identified in 7/12 (58.3%) patients and very high-risk plaque (TCFA with lumen area < 3.5 mm2 [B], lipid arch > 180° and macrophages [C]) was present in 4/12 (33.3%) patients. We saw intraluminal thrombus [D] and cholesterol crystal [E] in 3/12 (25%) patients. A strong correlation between OCT stenosis and CAC score at the left anterior descending artery (Pearson’s r=0.75, p=0.005) was identified.
Conclusion: Our study showed that asymptomatic T1D patients with high CAC score and carotid plaques had very severe OCT findings. We observed a significant proportion of high-risk lesions potentially associated with plaque rupture and risk of CV death.
M. Dubsky: None. R. Roland: None. N. Marhefková: None. P. Wohlfahrt: None. P. Novodvorsky: Speaker's Bureau; Sanofi, Boehringer-Ingelheim. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Novo Nordisk A/S. Research Support; Sanofi. Speaker's Bureau; Abbott, Medtronic, Berlin-Chemie AG, Viatris Inc., Novartis AG. V. Karmazin: None. M. Haluzik: Advisory Panel; Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Johnson & Johnson Medical Devices Companies. Consultant; Merck & Co., Inc., Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Johnson & Johnson Medical Devices Companies, Novatin. Research Support; Sanofi. Speaker's Bureau; Sanofi, Novo Nordisk. M. Pazdernik: None.
Supported by the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, Project No. LX22NPO5104) - Funded by the European Union - Next Generation EU.
