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Impact of diabetes on coronary artery plaque volume by coronary CT angiography and subsequent adverse cardiac events.
J Cardiovasc Comput Tomogr. 2019 Jan - Feb; 13(1):31-37.JC

Abstract

BACKGROUND

To investigate the impact of diabetes on coronary artery total plaque volume (TPV) and adverse events in long-term follow-up.

METHODS

One-hundred-and-eight diabetic patients were matched to 324 non-diabetic patients, with respect to age, sex, body-mass index, hypertension, smoking habits, LDL and HDL cholesterol, family history for CAD as well as aspirin and statin medication. In all patients, TPV was quantified from coronary CT angiographies (CTA) using dedicated software. All-cause mortality, acute coronary syndrome and late revascularisation (>90 days) served as combined endpoint.

RESULTS

Patients were followed for 5.6 years. The endpoint occurred in 18 (16.7%) diabetic and 26 (8.0%) non-diabetic patients (odds ratio 2.3, p = 0.03). Diabetic patients had significantly higher TPV than non-diabetic patients (55.1 mm³ [IQR: 6.2 and 220.4 mm³] vs. 24.9 mm³ [IQR: 0 and 166.7 mm³], p = 0.02). A TPV threshold of 110.5 mm³ provided good separation of diabetic and non-diabetic patients at higher and lower risk for adverse events. Noteworthy, diabetic and non-diabetic patients with a TPV<110.5 mm³ had comparable outcome (hazard ratio: 1.3, p = 0.59), while diabetic patients with TPV>110.5 mm³ had significantly higher incidence of adverse events (hazard ratio 2.3, p = 0.03) compared to non-diabetic patients with TPV>110.5 mm³. There was incremental prognostic value in diabetic and non-diabetic patients over the Framingham Risk Score (Integrated Discrimination Improvement: 0.052 and 0.012, p for both <0.05).

CONCLUSION

Diabetes is associated with significantly higher TPV, which is independent of other CAD risk factors. Quantification of TPV improves the identification of diabetic patients at higher risk for future adverse events.

Authors+Show Affiliations

Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany. Electronic address: simon.deseive@med.uni-muenchen.de.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging Systems bv, Leiden, the Netherlands.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany.Division of Radiology, Deutsches Herzzentrum München, Munich, Germany.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30293793

Citation

Deseive, Simon, et al. "Impact of Diabetes On Coronary Artery Plaque Volume By Coronary CT Angiography and Subsequent Adverse Cardiac Events." Journal of Cardiovascular Computed Tomography, vol. 13, no. 1, 2019, pp. 31-37.
Deseive S, Straub R, Kupke M, et al. Impact of diabetes on coronary artery plaque volume by coronary CT angiography and subsequent adverse cardiac events. J Cardiovasc Comput Tomogr. 2019;13(1):31-37.
Deseive, S., Straub, R., Kupke, M., Broersen, A., Kitslaar, P. H., Stocker, T. J., Massberg, S., Hadamitzky, M., & Hausleiter, J. (2019). Impact of diabetes on coronary artery plaque volume by coronary CT angiography and subsequent adverse cardiac events. Journal of Cardiovascular Computed Tomography, 13(1), 31-37. https://doi.org/10.1016/j.jcct.2018.09.008
Deseive S, et al. Impact of Diabetes On Coronary Artery Plaque Volume By Coronary CT Angiography and Subsequent Adverse Cardiac Events. J Cardiovasc Comput Tomogr. 2019 Jan - Feb;13(1):31-37. PubMed PMID: 30293793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of diabetes on coronary artery plaque volume by coronary CT angiography and subsequent adverse cardiac events. AU - Deseive,Simon, AU - Straub,Ramona, AU - Kupke,Maximilian, AU - Broersen,Alexander, AU - Kitslaar,Pieter H, AU - Stocker,Thomas J, AU - Massberg,Steffen, AU - Hadamitzky,Martin, AU - Hausleiter,Jörg, Y1 - 2018/10/01/ PY - 2018/07/09/received PY - 2018/08/27/revised PY - 2018/09/29/accepted PY - 2018/10/9/pubmed PY - 2019/3/15/medline PY - 2018/10/9/entrez KW - Coronary CT angiography KW - Coronary artery disease KW - Coronary artery plaque volume KW - Diabetes KW - Plaque volume quantification SP - 31 EP - 37 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 13 IS - 1 N2 - BACKGROUND: To investigate the impact of diabetes on coronary artery total plaque volume (TPV) and adverse events in long-term follow-up. METHODS: One-hundred-and-eight diabetic patients were matched to 324 non-diabetic patients, with respect to age, sex, body-mass index, hypertension, smoking habits, LDL and HDL cholesterol, family history for CAD as well as aspirin and statin medication. In all patients, TPV was quantified from coronary CT angiographies (CTA) using dedicated software. All-cause mortality, acute coronary syndrome and late revascularisation (>90 days) served as combined endpoint. RESULTS: Patients were followed for 5.6 years. The endpoint occurred in 18 (16.7%) diabetic and 26 (8.0%) non-diabetic patients (odds ratio 2.3, p = 0.03). Diabetic patients had significantly higher TPV than non-diabetic patients (55.1 mm³ [IQR: 6.2 and 220.4 mm³] vs. 24.9 mm³ [IQR: 0 and 166.7 mm³], p = 0.02). A TPV threshold of 110.5 mm³ provided good separation of diabetic and non-diabetic patients at higher and lower risk for adverse events. Noteworthy, diabetic and non-diabetic patients with a TPV<110.5 mm³ had comparable outcome (hazard ratio: 1.3, p = 0.59), while diabetic patients with TPV>110.5 mm³ had significantly higher incidence of adverse events (hazard ratio 2.3, p = 0.03) compared to non-diabetic patients with TPV>110.5 mm³. There was incremental prognostic value in diabetic and non-diabetic patients over the Framingham Risk Score (Integrated Discrimination Improvement: 0.052 and 0.012, p for both <0.05). CONCLUSION: Diabetes is associated with significantly higher TPV, which is independent of other CAD risk factors. Quantification of TPV improves the identification of diabetic patients at higher risk for future adverse events. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/30293793/Impact_of_diabetes_on_coronary_artery_plaque_volume_by_coronary_CT_angiography_and_subsequent_adverse_cardiac_events_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(18)30256-9 DB - PRIME DP - Unbound Medicine ER -