Association of epicardial adipose tissue with coronary CT angiography plaque parameters on cardiovascular outcome in patients with and without diabetes mellitus.
Computed tomography
Coronary artery disease
Diabetes mellitus
Epicardial adipose tissue
Outcome
Plaque parameter
Journal
Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
14
09
2022
revised:
06
10
2022
accepted:
13
10
2022
pubmed:
25
10
2022
medline:
15
12
2022
entrez:
24
10
2022
Statut:
ppublish
Résumé
We aimed to evaluate the association of epicardial adipose tissue (EAT) with coronary CT angiography (CCTA) plaque parameters on cardiovascular outcome in patients with and without diabetes mellitus. Data of 353 patients (62.9 ± 10.4 years, 62% male), who underwent CCTA as part of their clinical workup for the evaluation of suspected or known CAD, were retrospectively analyzed. EAT volume and plaque parameters from CCTA were compared in patients with diabetes (n = 63) and without diabetes (n = 290). Follow-up was performed to record adverse cardiovascular events. The predictive value to detect adverse cardiovascular events was assessed using concordance indices (CIs) and multivariable Cox proportional hazards analysis. In total, 33 events occurred after a median follow-up of 5.1 years. In patients with diabetes, EAT volume and plaque parameters were significantly higher than in patients without diabetes (all p < 0.05). A multivariable model demonstrated an incrementally improved C-index of 0.84 (95%CI 0.80-0.88) over the Framingham risk score and single measures alone. In multivariable Cox regression analysis EAT volume (Hazard ratio[HR] 1.21, p = 0.022), obstructive CAD (HR 1.18, p = 0.042), and ≥2 high-risk plaque features (HR 2.13, p = 0.031) were associated with events in patients with diabetes and obstructive CAD (HR 1.88, p = 0.017), and Agatston calcium score (HR 1.009, p = 0.039) in patients without diabetes. EAT, as a biomarker of inflammation, and plaque parameters, as an extent of atherosclerotic CAD, are higher in patients with diabetes and are associated with increased adverse cardiovascular outcomes. These parameters may help identify patients at high risk with need for more aggressive therapeutic and preventive care.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
We aimed to evaluate the association of epicardial adipose tissue (EAT) with coronary CT angiography (CCTA) plaque parameters on cardiovascular outcome in patients with and without diabetes mellitus.
METHODS
METHODS
Data of 353 patients (62.9 ± 10.4 years, 62% male), who underwent CCTA as part of their clinical workup for the evaluation of suspected or known CAD, were retrospectively analyzed. EAT volume and plaque parameters from CCTA were compared in patients with diabetes (n = 63) and without diabetes (n = 290). Follow-up was performed to record adverse cardiovascular events. The predictive value to detect adverse cardiovascular events was assessed using concordance indices (CIs) and multivariable Cox proportional hazards analysis.
RESULTS
RESULTS
In total, 33 events occurred after a median follow-up of 5.1 years. In patients with diabetes, EAT volume and plaque parameters were significantly higher than in patients without diabetes (all p < 0.05). A multivariable model demonstrated an incrementally improved C-index of 0.84 (95%CI 0.80-0.88) over the Framingham risk score and single measures alone. In multivariable Cox regression analysis EAT volume (Hazard ratio[HR] 1.21, p = 0.022), obstructive CAD (HR 1.18, p = 0.042), and ≥2 high-risk plaque features (HR 2.13, p = 0.031) were associated with events in patients with diabetes and obstructive CAD (HR 1.88, p = 0.017), and Agatston calcium score (HR 1.009, p = 0.039) in patients without diabetes.
CONCLUSIONS
CONCLUSIONS
EAT, as a biomarker of inflammation, and plaque parameters, as an extent of atherosclerotic CAD, are higher in patients with diabetes and are associated with increased adverse cardiovascular outcomes. These parameters may help identify patients at high risk with need for more aggressive therapeutic and preventive care.
Identifiants
pubmed: 36280469
pii: S0021-9150(22)01477-0
doi: 10.1016/j.atherosclerosis.2022.10.006
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
78-84Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: No funding was received. Dr. Tesche has received speaker's fees from Siemens Healthineers, Heartflow Inc., and AstraZeneca. Dr. Schoepf receives institutional research support and/or honoraria for speaking and consulting from Bayer, ElucidBio, Guerbet, HeartFlow, Inc., Keya Medical, and Siemens Healthineers. Dr. Straube has received honoraria for lectures from Philips GmbH, Medtronic GmbH, and Bristol-Myers-Squibb. Dr. Hoffmann EH is head of the department; the department received compensation for participation in clinical research trials outside the submitted work from Abbott, Bayer, Biotronik, Boehringer Ingelheim, Edwards, Elixier, Medtronic, and Stentys. The other authors have no conflict of interest to disclose.