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

Figure 4

Diabetic patient with carotid disease, active inflammatory pattern, and multivessel coronary artery disease (CAD). The sole coronary artery calcium scoring (CACS) and coronary invasive angiography do not entirely represent the effective risk of the patients (CACS Agatston score 130 and stenosis of 30% of left main artery [LM]). The red arrow represents a very large, remodelled plaque with a little calcific component at the level of LM and thus a “high risk plaque.” The blue arrow represents a large, remodelled plaque with a bigger calcific component at the level of left artery descending (LAD). In this case the plaque does not generate any significant stenosis. Overall, these CAD features confer an incremental event risk.