Coronary Atherosclerosis Across the Glycemic Spectrum Among Asymptomatic Adults: The Miami Heart Study at Baptist Health South Florida.
Coronary Atherosclerosis Across the Glycemic Spectrum Among Asymptomatic Adults: The Miami Heart Study at Baptist Health South Florida.
复制标题
无症状成人的血糖谱中的冠状动脉粥样硬化：南佛罗里达州浸信会健康中心的迈阿密心脏研究。
DOI：
10.1161/circimaging.123.015314
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Cainzos-Achirica,Migue
中科院分区：
文献类型：
--
作者：
Patel,KershawV;Budoff,MatthewJ;Valero-Elizondo,Javier;Lahan,Shubham;Ali,ShozabS;Taha,MohamadB;Blaha,MichaelJ;Blankstein,Ron;Shapiro,MichaelD;Pandey,Ambarish;Arias,Lara;Feldman,Theodore;Cury,RicardoC;Cainzos-Achirica,Migue
背景使用冠状动脉计算机断层扫描血管造影（CCTA）评估的当代冠状动脉粥样硬化的负担和特征在美国无症状的糖尿病和糖尿病前期患者中尚不清楚。汇总队列方程和冠状动脉钙 (CAC) 评分对动脉粥样硬化性心血管疾病风险进行了分层，但它们与跨血糖类别的 CCTA 结果之间的关联尚未明确。 方法 纳入了迈阿密心脏研究中没有动脉粥样硬化性心血管疾病的有症状成年人。参与者接受了 CAC 和 CCTA 测试，并被分为血糖类别。通过 CCTA 评估的冠状动脉粥样硬化（任何斑块、非钙化斑块、具有 ≥1 个高风险特征的斑块、最大狭窄≥50%）的患病率在各个血糖类别中进行描述，并通过汇总队列方程（估计的动脉粥样硬化性心血管疾病风险和 CAC 评分）进一步分层。调整后的逻辑回归用于评估血糖类别与冠状动脉结局之间的关联。 结果在 2352 名参与者（49.5% 女性）中，血糖正常、糖尿病前期和糖尿病的患病率分别为 63%、30% 和 7%。冠状动脉斑块更常见于血糖恶化类别（血糖正常，43%；糖尿病前期，58%；糖尿病，69%），并且在其他冠状动脉结局中也观察到类似的模式。在调整分析中，与血糖正常相比，糖尿病前期和糖尿病均与冠状动脉斑块（OR，分别为 1.30 [95% CI，1.05–1.60] 和 1.75 [1.17–2.61]）、非钙化斑块（OR，1.47 [1.19–1.81] 和 1.99）的发生率较高相关。 [1.38–2.87]，分别），以及具有 ≥1 个高风险特征的斑块（OR，分别为 1.65 [1.14–2.39] 和 2.53 [1.48–4.33]）。糖尿病与狭窄≥50%相关（OR，3.01 [1.79–5.08]；参考=血糖正常）。在患有糖尿病且估计动脉粥样硬化性心血管疾病风险<5%的参与者中，46%的人有冠状动脉斑块，10%的人狭窄≥50%。在患有糖尿病且 CAC=0 的参与者中，30% 患有冠状动脉斑块，3% 患有≥50% 的狭窄。结论在无症状成人中，较差的血糖状况与冠状动脉粥样硬化、高风险斑块和狭窄的患病率和程度较高相关。在糖尿病中，与汇总队列方程相比，CAC 与 CCTA 结果的相关性更密切，并且在更大的人群中提供了更多信息。
BACKGROUNDThe contemporary burden and characteristics of coronary atherosclerosis, assessed using coronary computed tomography angiography (CCTA), is unknown among asymptomatic adults with diabetes and prediabetes in the United States. The pooled cohort equations and coronary artery calcium (CAC) score stratify atherosclerotic cardiovascular disease risk, but their association with CCTA findings across glycemic categories is not well established.METHODSAsymptomatic adults without atherosclerotic cardiovascular disease enrolled in the Miami Heart Study were included. Participants underwent CAC and CCTA testing and were classified into glycemic categories. Prevalence of coronary atherosclerosis (any plaque, noncalcified plaque, plaque with ≥1 high-risk feature, maximal stenosis ≥50%) assessed by CCTA was described across glycemic categories and further stratified by pooled cohort equations–estimated atherosclerotic cardiovascular disease risk and CAC score. Adjusted logistic regression was used to evaluate the associations between glycemic categories and coronary outcomes.RESULTSAmong 2352 participants (49.5% women), the prevalence of euglycemia, prediabetes, and diabetes was 63%, 30%, and 7%, respectively. Coronary plaque was more commonly present across worsening glycemic categories (euglycemia, 43%; prediabetes, 58%; diabetes, 69%), and similar pattern was observed for other coronary outcomes. In adjusted analyses, compared with euglycemia, prediabetes and diabetes were each associated with higher odds of any coronary plaque (OR, 1.30 [95% CI, 1.05–1.60] and 1.75 [1.17–2.61], respectively), noncalcified plaque (OR, 1.47 [1.19–1.81] and 1.99 [1.38–2.87], respectively), and plaque with ≥1 high-risk feature (OR, 1.65 [1.14–2.39] and 2.53 [1.48–4.33], respectively). Diabetes was associated with stenosis ≥50% (OR, 3.01 [1.79–5.08]; reference=euglycemia). Among participants with diabetes and estimated atherosclerotic cardiovascular disease risk <5%, 46% had coronary plaque and 10% had stenosis ≥50%. Among participants with diabetes and CAC=0, 30% had coronary plaque and 3% had stenosis ≥50%.CONCLUSIONSAmong asymptomatic adults, worse glycemic status is associated with higher prevalence and extent of coronary atherosclerosis, high-risk plaque, and stenosis. In diabetes, CAC was more closely associated with CCTA findings and informative in a larger population than the pooled cohort equations.
登录
查看更多内容
前 B 细胞白血病中的表面免疫球蛋白轻链表达
影响因子：
5.2
作者：
B. Koziner;J. Stavnezer;A. Al;D. Gebhard;A. Mittelman;M. Andreeff;B. Clarkson
通讯作者：
B. Clarkson
通过 kappa/lambda 分析检测淋巴增殖性疾病中的克隆过量：与免疫球蛋白基因 DNA 重排的相关性。
影响因子：
20.3
作者：
Berliner,N;Ault,KA;Martin,P;Weinberg,DS
通讯作者：
Weinberg,DS
通过细胞 DNA 和 RNA 的流式细胞术分析区分人类白血病亚型。
影响因子：
20.3
作者：
M. Andreeff;Zbigniew Darzynkiewicz;T. Sharpless;Bayard Clarkson;Myron R. Melamed
通讯作者：
Myron R. Melamed
识别人 B 淋巴细胞上三种不同分化抗原（BL1、BL2、BL3）的单克隆抗体的制备和表征。
影响因子：
4.4
作者：
C. Y. Wang;W. Azzo;A. Al;N. Chiorazzi;D. Knowles
通讯作者：
D. Knowles
白血病骨髓母细胞上常见急性淋巴细胞白血病抗原 (gp100) 的数量变化。
DOI：
10.1172/jci111368
发表时间：
1984
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Look,AT;Melvin,SL;Brown,LK;Dockter,ME;Roberson,PK;Murphy,SB
通讯作者：
Murphy,SB