The aim – to study the value of the multidetector computed tomography (MDCT) to assess atherosclerotic lesions in coronary arteries (CA) of patients with ischemic heart disease (IHD) with co-morbid type 2 diabetes mellitus (DM) and chronic kidney disease (CKD)
Material and methods. 64-slice MDCT was performed in 86 IHD patients (49 males and 37 females, age 37–80 yrs), including 15 with comorbid DM and 21 with CKD. For diagnostic purposes, the calcium level in CA was quantified with a non-contrast CT scan using Agatston calcium scoring method to define calcium index (CI).
Results. Data from MDCT showed the following degrees calcification in CA: 7 (8.14 %) patients – 1st degree (CI 1–10), in 23 (26.74 %) – 2nd degree (CI 11–100), 25 (29.01 %) – 3rd degree (CI 101–400), in 31 (36.04 %) – 4th degree (CI > 400). The level of CI ranged from 5 to 3780 units and averaged – 520.28±136.78 units. Higher levels of calcification were revealed in CKD patients (Р<0.05) and DM (Р<0.05). IHD patients with diabetes had mainly calcified and mixed atherosclerotic plaques, soft plaques were found in 40.0 % cases. Diffuse lesions of СА were prevalent in patients with comorbid DM and CKD. CKD-patients developed predominantly calcified atherosclerotic plaques (85.7 %). Conclusions. MDCT is a highly informative non-invasive method (sensitivity 87.5 %, specificity – 95.4 %, accuracy – 93.7 %) for diagnosis of coronary atherosclerosis. It is comparable to selective coronary ventriculography in patients with confirmed hemodynamically significant stenosis of СА. Arteriosclerotic changes with multiple focal lesions in СА were found in IHD patients with type 2 DM. IHD patients with co-morbid CKD mostly had calcified atherosclerotic plaques and hemodynamically significant stenosis in lumen of LAD-CA.