Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes
Background: Diabetes mellitus (DM) plays a key role in the pathophysiology of metabolic syndrome (MetS). This study aimed to investigate the association among DM, low-attenuation plaque (LAP) volume, and cardiovascular outcomes across metabolic phenotypes in patients with suspected coronary artery d...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-12-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412361 |
| _version_ | 1797365273619070976 |
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| author | Kenichiro Otsuka Hirotoshi Ishikawa Kenei Shimada Kana Hojo Hiroki Yamaura Yasushi Kono Noriaki Kasayuki Daiju Fukuda |
| author_facet | Kenichiro Otsuka Hirotoshi Ishikawa Kenei Shimada Kana Hojo Hiroki Yamaura Yasushi Kono Noriaki Kasayuki Daiju Fukuda |
| author_sort | Kenichiro Otsuka |
| collection | DOAJ |
| description | Background: Diabetes mellitus (DM) plays a key role in the pathophysiology of metabolic syndrome (MetS). This study aimed to investigate the association among DM, low-attenuation plaque (LAP) volume, and cardiovascular outcomes across metabolic phenotypes in patients with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA). Methods: We included 530 patients who underwent CCTA. MetS was defined as the presence of a visceral adipose tissue area ≥100 cm2 in patients with DM (n = 58) or two or more MetS components excluding DM (n = 114). The remaining patients were categorised as non-MetS patients with DM (n = 52) or without DM (n = 306). A CCTA-based high-risk plaque was defined as a LAP volume of >4%. The primary endpoint was the presence of a major cardiovascular event (MACE), which was defined as a composite of cardiovascular death, acute coronary syndrome, and coronary revascularization. Results: The incidence of MACE was the highest in the non-MetS with DM group, followed hierarchically by the MetS with DM, MetS without DM, and non-MetS without DM groups. In the multivariable Cox hazard model analysis, DM as a predictor was associated with MACE independent of LAP volume >4% (hazard ratio, 2.68; 95% confidence interval, 1.16–6.18; p = 0.02), although MetS did not function as an independent predictor. A LAP volume >4% functioned as a predictor of MACE, independent of each metabolic phenotype or DM. Conclusions: This study demonstrated that DM, rather than MetS, is a predictor of coronary events independent of high-risk plaque volume in patients who underwent CCTA. |
| first_indexed | 2024-03-08T16:46:47Z |
| format | Article |
| id | doaj.art-1f716b0ab49f4a68812ea065467970c0 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-08T16:46:47Z |
| publishDate | 2023-12-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-1f716b0ab49f4a68812ea065467970c02024-01-05T09:04:31ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-12-01241236110.31083/j.rcm2412361S1530-6550(23)01150-XLow-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without DiabetesKenichiro Otsuka0Hirotoshi Ishikawa1Kenei Shimada2Kana Hojo3Hiroki Yamaura4Yasushi Kono5Noriaki Kasayuki6Daiju Fukuda7Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, 545-8585 Osaka, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Fujiikai Kashibaseiki Hospital, 639-0252 Kashiba, JapanDepartment of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, 545-8585 Osaka, JapanBackground: Diabetes mellitus (DM) plays a key role in the pathophysiology of metabolic syndrome (MetS). This study aimed to investigate the association among DM, low-attenuation plaque (LAP) volume, and cardiovascular outcomes across metabolic phenotypes in patients with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA). Methods: We included 530 patients who underwent CCTA. MetS was defined as the presence of a visceral adipose tissue area ≥100 cm2 in patients with DM (n = 58) or two or more MetS components excluding DM (n = 114). The remaining patients were categorised as non-MetS patients with DM (n = 52) or without DM (n = 306). A CCTA-based high-risk plaque was defined as a LAP volume of >4%. The primary endpoint was the presence of a major cardiovascular event (MACE), which was defined as a composite of cardiovascular death, acute coronary syndrome, and coronary revascularization. Results: The incidence of MACE was the highest in the non-MetS with DM group, followed hierarchically by the MetS with DM, MetS without DM, and non-MetS without DM groups. In the multivariable Cox hazard model analysis, DM as a predictor was associated with MACE independent of LAP volume >4% (hazard ratio, 2.68; 95% confidence interval, 1.16–6.18; p = 0.02), although MetS did not function as an independent predictor. A LAP volume >4% functioned as a predictor of MACE, independent of each metabolic phenotype or DM. Conclusions: This study demonstrated that DM, rather than MetS, is a predictor of coronary events independent of high-risk plaque volume in patients who underwent CCTA.https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412361acute coronary syndromeadipose tissuecomputed tomography angiographycoronary artery diseasediabetes mellitus |
| spellingShingle | Kenichiro Otsuka Hirotoshi Ishikawa Kenei Shimada Kana Hojo Hiroki Yamaura Yasushi Kono Noriaki Kasayuki Daiju Fukuda Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes Reviews in Cardiovascular Medicine acute coronary syndrome adipose tissue computed tomography angiography coronary artery disease diabetes mellitus |
| title | Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes |
| title_full | Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes |
| title_fullStr | Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes |
| title_full_unstemmed | Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes |
| title_short | Low-Attenuation Coronary Plaque Volume and Cardiovascular Events in Patients with Distinct Metabolic Phenotypes with or without Diabetes |
| title_sort | low attenuation coronary plaque volume and cardiovascular events in patients with distinct metabolic phenotypes with or without diabetes |
| topic | acute coronary syndrome adipose tissue computed tomography angiography coronary artery disease diabetes mellitus |
| url | https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412361 |
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