苏格兰-心脏试验中糖尿病对冠状动脉斑块特征和结果的影响

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography Pub Date : 2025-03-01 DOI:10.1016/j.jcct.2024.12.083

Zuzanna M. Gebert , Jacek Kwiecinski , Jonathan R. Weir-McCall , Philip D. Adamson , Nicholas L. Mills , Giles Roditi , Edwin J.R. van Beek , Edward D. Nicol , Daniel S. Berman , Piotr J. Slomka , Marc R. Dweck , Damini Dey , David E. Newby , Michelle C. Williams

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引用次数: 0

摘要

背景：糖尿病是一种确定的心血管危险因素。我们在苏格兰心脏计算机断层扫描（SCOT-HEART）试验中评估了糖尿病对糖尿病患者和非糖尿病患者定量斑块和长期预后的影响。方法：采用非对比计算机断层扫描（CT）评价冠状动脉钙（CAC）。冠状动脉CT血管造影评估冠状动脉狭窄、目测不良斑块特征和定量斑块负担（钙化、非钙化、低衰减和总数、Autoplaque 2.5）。进行多变量分析和生存分析。结果：1769例患者的图像被评估（56%男性，58±9岁）。196例（11%）患者有糖尿病。糖尿病患者的10年心血管风险评分更高(29[四分位数范围21,40]比15 [9,21]%，p结论：糖尿病是定量评估斑块负担的独立预测因子，特别是钙化斑块，并与心肌梗死风险增加相关。

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Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial

Background

Diabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Methods

Coronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT). Coronary stenoses, visually assessed adverse plaque characteristics and quantitative plaque burdens (calcified, non-calcified, low attenuation and total, Autoplaque 2.5) were assessed on coronary CT angiography. Multivariable and survival analyses were performed.

Results

Images of 1769 patients were assessed (56 % male, 58 ± 9 years). Diabetes mellitus was present in 196 (11 %) patients. Patients with diabetes mellitus had higher 10-year cardiovascular risk score (29 [interquartile range 21, 40] versus 15 [9, 21] %, p < 0.001) and CAC score (71 [1, 447] versus 17 [0, 209] Agatston units, p < 0.001), but were not more likely to have obstructive disease or visually assessed adverse plaque characteristics. Patients with diabetes mellitus had higher quantitatively assessed calcified, non-calcified, low attenuation and total plaque burdens. After adjustment for age and sex, diabetes mellitus was an independent predictor of calcified plaque burden (p = 0.009), but not the other plaque types. During 8.7 [IQR 8, 9.6] years follow-up, diabetes mellitus was associated with an increased risk of fatal or non-fatal myocardial infarction, adjusted for age and sex (hazard ratio 1.85, 95 % confidence interval 1.09 to 3.17, p = 0.024).

Conclusion

Diabetes mellitus was an independent predictor of quantitatively assessed plaque burden, particularly calcified plaque, and was associated with an increased risk of myocardial infarction.

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来源期刊

Journal of Cardiovascular Computed Tomography CARDIAC & CARDIOVASCULAR SYSTEMS-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.50

自引率

14.80%

发文量

212

审稿时长

40 days

期刊介绍： The Journal of Cardiovascular Computed Tomography is a unique peer-review journal that integrates the entire international cardiovascular CT community including cardiologist and radiologists, from basic to clinical academic researchers, to private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our cardiovascular imaging community across the world. The goal of the journal is to advance the field of cardiovascular CT as the leading cardiovascular CT journal, attracting seminal work in the field with rapid and timely dissemination in electronic and print media.