High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score
Abstract Background High-risk coronary artery plaque (HRP) is associated with increased risk of acute coronary syndrome. We aimed to investigate the prevalence of HRP in asymptomatic patients with type 2 diabetes (T2D), and its relation to patient characteristics including cardiovascular risk factor...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-021-01350-2 |
| _version_ | 1818778997358592000 |
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| author | Laurits Juhl Heinsen Gokulan Pararajasingam Thomas Rueskov Andersen Søren Auscher Hussam Mahmoud Sheta Helle Precht Jess Lambrechtsen Kenneth Egstrup |
| author_facet | Laurits Juhl Heinsen Gokulan Pararajasingam Thomas Rueskov Andersen Søren Auscher Hussam Mahmoud Sheta Helle Precht Jess Lambrechtsen Kenneth Egstrup |
| author_sort | Laurits Juhl Heinsen |
| collection | DOAJ |
| description | Abstract Background High-risk coronary artery plaque (HRP) is associated with increased risk of acute coronary syndrome. We aimed to investigate the prevalence of HRP in asymptomatic patients with type 2 diabetes (T2D), and its relation to patient characteristics including cardiovascular risk factors, diabetes profile, and coronary artery calcium score (CACS). Methods Asymptomatic patients with T2D and no previous coronary artery disease (CAD) were studied using coronary computed tomography angiography (CCTA) in this descriptive study. Plaques with two or more high-risk features (HRP) defined by low attenuation, positive remodeling, spotty calcification, and napkin-ring sign were considered HRP. In addition, total atheroma volume (TAV), proportions of dense calcium, fibrous, fibrous-fatty and necrotic core volumes were assessed. The CACS was obtained from non-enhanced images by the Agatston method. Cardiovascular and diabetic profiles were assessed in all patients. Results In 230 patients CCTA was diagnostic and 161 HRP were detected in 86 patients (37%). Male gender (OR 4.19, 95% CI 1.99–8.87; p < 0.01), tobacco exposure in pack years (OR 1.02, 95% CI 1.00–1.03; p = 0.03), and glycated hemoglobin (HbA1c) (OR 1.04, 95% CI 1.02–1.07; p < 0.01) were independent predictors of HRP. No relationship was found to other risk factors. HRP was not associated with increased CACS, and 13 (23%) patients with zero CACS had at least one HRP. Conclusion A high prevalence of HRP was detected in this population of asymptomatic T2D. The presence of HRP was associated with a particular patient profile, but was not ruled out by the absence of coronary artery calcium. CCTA provides important information on plaque morphology, which may be used to risk stratify this high-risk population. Trial registration This trial was retrospectively registered at clinical trials.gov January 11, 2017 trial identifier NCT03016910. |
| first_indexed | 2024-12-18T11:53:36Z |
| format | Article |
| id | doaj.art-81646d1b146349fda230ab963f8cfa89 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-18T11:53:36Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-81646d1b146349fda230ab963f8cfa892022-12-21T21:09:08ZengBMCCardiovascular Diabetology1475-28402021-08-0120111110.1186/s12933-021-01350-2High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium scoreLaurits Juhl Heinsen0Gokulan Pararajasingam1Thomas Rueskov Andersen2Søren Auscher3Hussam Mahmoud Sheta4Helle Precht5Jess Lambrechtsen6Kenneth Egstrup7Cardiovascular Research Unit, Odense University Hospital, Svendborg HospitalCardiovascular Research Unit, Odense University Hospital, Svendborg HospitalCardiovascular Research Unit, Odense University Hospital, Svendborg HospitalDepartment of Cardiology, Odense University Hospital, Svendborg HospitalDepartment of Cardiology, Odense University Hospital, Svendborg HospitalCardiovascular Research Unit, Odense University Hospital, Svendborg HospitalDepartment of Cardiology, Odense University Hospital, Svendborg HospitalCardiovascular Research Unit, Odense University Hospital, Svendborg HospitalAbstract Background High-risk coronary artery plaque (HRP) is associated with increased risk of acute coronary syndrome. We aimed to investigate the prevalence of HRP in asymptomatic patients with type 2 diabetes (T2D), and its relation to patient characteristics including cardiovascular risk factors, diabetes profile, and coronary artery calcium score (CACS). Methods Asymptomatic patients with T2D and no previous coronary artery disease (CAD) were studied using coronary computed tomography angiography (CCTA) in this descriptive study. Plaques with two or more high-risk features (HRP) defined by low attenuation, positive remodeling, spotty calcification, and napkin-ring sign were considered HRP. In addition, total atheroma volume (TAV), proportions of dense calcium, fibrous, fibrous-fatty and necrotic core volumes were assessed. The CACS was obtained from non-enhanced images by the Agatston method. Cardiovascular and diabetic profiles were assessed in all patients. Results In 230 patients CCTA was diagnostic and 161 HRP were detected in 86 patients (37%). Male gender (OR 4.19, 95% CI 1.99–8.87; p < 0.01), tobacco exposure in pack years (OR 1.02, 95% CI 1.00–1.03; p = 0.03), and glycated hemoglobin (HbA1c) (OR 1.04, 95% CI 1.02–1.07; p < 0.01) were independent predictors of HRP. No relationship was found to other risk factors. HRP was not associated with increased CACS, and 13 (23%) patients with zero CACS had at least one HRP. Conclusion A high prevalence of HRP was detected in this population of asymptomatic T2D. The presence of HRP was associated with a particular patient profile, but was not ruled out by the absence of coronary artery calcium. CCTA provides important information on plaque morphology, which may be used to risk stratify this high-risk population. Trial registration This trial was retrospectively registered at clinical trials.gov January 11, 2017 trial identifier NCT03016910.https://doi.org/10.1186/s12933-021-01350-2Coronary computed tomography angiographyAtherosclerosisAsymptomatic coronary artery diseaseHigh-risk plaqueCoronary artery calcium scoreType 2 diabetes |
| spellingShingle | Laurits Juhl Heinsen Gokulan Pararajasingam Thomas Rueskov Andersen Søren Auscher Hussam Mahmoud Sheta Helle Precht Jess Lambrechtsen Kenneth Egstrup High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score Cardiovascular Diabetology Coronary computed tomography angiography Atherosclerosis Asymptomatic coronary artery disease High-risk plaque Coronary artery calcium score Type 2 diabetes |
| title | High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score |
| title_full | High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score |
| title_fullStr | High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score |
| title_full_unstemmed | High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score |
| title_short | High-risk coronary artery plaque in asymptomatic patients with type 2 diabetes: clinical risk factors and coronary artery calcium score |
| title_sort | high risk coronary artery plaque in asymptomatic patients with type 2 diabetes clinical risk factors and coronary artery calcium score |
| topic | Coronary computed tomography angiography Atherosclerosis Asymptomatic coronary artery disease High-risk plaque Coronary artery calcium score Type 2 diabetes |
| url | https://doi.org/10.1186/s12933-021-01350-2 |
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