High pericoronary adipose tissue attenuation on computed tomography angiography predicts cardiovascular events in patients with type 2 diabetes mellitus: post-hoc analysis from a prospective cohort study.
High pericoronary adipose tissue attenuation on computed tomography angiography predicts cardiovascular events in patients with type 2 diabetes mellitus: post-hoc analysis from a prospective cohort study.
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计算机断层扫描血管造影显示的冠状动脉周围脂肪组织高衰减可预测2型糖尿病患者的心血管事件：一项前瞻性队列研究的事后分析
DOI：
10.1186/s12933-022-01478-9
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发表时间：
2022-03-18
影响因子：
9.3
通讯作者：
Ito H
中科院分区：
文献类型：
--
作者：
Ichikawa K;Miyoshi T;Osawa K;Nakashima M;Miki T;Nishihara T;Toda H;Yoshida M;Ito H
冠状动脉计算机断层扫描血管造影（CTA）上的冠状动脉周围脂肪组织（PCAT）衰减是冠状动脉周围炎症的非侵入性生物标志物。我们的目的是探讨PCAT衰减在2型糖尿病（T2 DM）患者中的预后价值。我们纳入了333例T2 DM患者平均年龄66岁，男性211例，平均体重指数，25 kg/m2），接受临床指征的冠状动脉CTA，并检查其CT结果、冠状动脉钙化评分、心包脂肪体积、狭窄（> 50%管腔狭窄）、低衰减斑块和/或阳性重塑和/或点状钙化的高危斑块特征以及PCAT衰减。我们评估了左前降支（LAD）和右冠状动脉（RCA）近端40 mm节段的Hounsfield单位（HU）PCAT衰减。心血管事件定义为心源性死亡、因急性冠状动脉综合征住院、晚期冠状动脉血运重建和因心力衰竭住院。在中位随访4.0年期间，我们观察到31例心血管事件。发生心血管事件的患者的LAD-PCAT衰减显著高于未发生心血管事件的患者（− 68.5 ± 6.5 HU vs − 70.8 ± 6.1 HU，p = 0.045），而RCA-PCAT衰减则没有（p = 0.089）。在一个包含CTA不良结果（如严重狭窄和/或高危斑块）的模型中，高LAD-PCAT衰减（> − 70.7 HU;中位数）与心血管事件显著相关（风险比; 2.69，95%置信区间; 1.17-0.20，p = 0.020）。在将LAD-PCAT衰减添加到不利CTA结果后，C统计量和总体卡方值分别从0.65显著增加到0.70（p = 0.037）和10.9-15.0（p = 0.043）。在接受临床指征冠状动脉CTA的T2 DM患者中，高LAD-PCAT衰减可显著预测心血管事件。这表明评估LAD-PCAT衰减可以帮助医生识别高风险T2 DM患者。在线版本包含补充材料，可通过10.1186/s12933-022-01478-9获得。
Pericoronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CTA) is a non-invasive biomarker for pericoronary inflammation. We aimed to investigate the prognostic value of PCAT attenuation in patients with type 2 diabetes mellitus (T2DM). We included 333 T2DM patients (mean age, 66 years; male patients, 211; mean body mass index, 25 kg/m2) who underwent clinically indicated coronary CTA and examined their CT findings, coronary artery calcium score, pericardial fat volume, stenosis (> 50% luminal narrowing), high-risk plaque features of low-attenuation plaque and/or positive remodelling and/or spotty calcification, and PCAT attenuation. We assessed PCAT attenuation in Hounsfield units (HU) of proximal 40-mm segments of the left anterior descending artery (LAD) and right coronary artery (RCA). Cardiovascular events were defined as cardiac death, hospitalisation for acute coronary syndrome, late coronary revascularisation, and hospitalisation for heart failure. During a median follow-up of 4.0 years, we observed 31 cardiovascular events. LAD-PCAT attenuation was significantly higher in patients with cardiovascular events than in those without (− 68.5 ± 6.5 HU vs − 70.8 ± 6.1 HU, p = 0.045), whereas RCA-PCAT attenuation was not (p = 0.089). High LAD-PCAT attenuation (> − 70.7 HU; median value) was significantly associated with cardiovascular events in a model that included adverse CTA findings, such as significant stenosis and/or high-risk plaque (hazard ratio; 2.69, 95% confidence interval; 1.17–0.20, p = 0.020). After adding LAD-PCAT attenuation to the adverse CTA findings, the C-statistic and global chi-square values increased significantly from 0.65 to 0.70 (p = 0.037) and 10.9–15.0 (p = 0.043), respectively. In T2DM patients undergoing clinically indicated coronary CTA, high LAD-PCAT attenuation could significantly predict cardiovascular events. This suggests that assessing LAD-PCAT attenuation can help physicians identify high-risk T2DM patients. The online version contains supplementary material available at 10.1186/s12933-022-01478-9.
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影响因子：
9.3
作者：
Ichikawa K;Miyoshi T;Osawa K;Miki T;Toda H;Ejiri K;Yoshida M;Nanba Y;Yoshida M;Nakamura K;Morita H;Ito H
通讯作者：
Ito H
DOI：
10.1056/nejmoa1603827
发表时间：
2016-07-28
期刊：
The New England journal of medicine
影响因子：
--
作者：
Marso SP;Daniels GH;Brown-Frandsen K;Kristensen P;Mann JF;Nauck MA;Nissen SE;Pocock S;Poulter NR;Ravn LS;Steinberg WM;Stockner M;Zinman B;Bergenstal RM;Buse JB;LEADER Steering Committee;LEADER Trial Investigators
通讯作者：
LEADER Trial Investigators
影响因子：
14
作者：
Halon, David A.;Lavi, Idit;Lewis, Basil S.
通讯作者：
Lewis, Basil S.
影响因子：
39.3
作者：
Oikonomou, Evangelos K.;Williams, Michelle C.;Antoniades, Charalambos
通讯作者：
Antoniades, Charalambos
影响因子：
24
作者：
Motoyama, Sadako;Ito, Hajime;Narula, Jagat
通讯作者：
Narula, Jagat