Prediction of microvascular complications in diabetic patients without obstructive coronary stenosis based on peri-coronary adipose tissue attenuation model

Yu, Yarong; Ding, Xiaoying; Yu, Li; Lan, Ziting; Wang, Yufan; Zhang, Jiayin

doi:10.1007/s00330-022-09176-6

Cited by 9 publications

(9 citation statements)

References 48 publications

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“…Further investigation focusing on individuals with T2DM has highlighted that the effectiveness of RCA-FAI in identifying coronary artery disease was more representative than the Left anterior descending (LAD) and Left circum ex (LCX) arteries, making it a better diagnostic tool for coronary artery disease in T2DM patients [20] . Additionally, RCA-FAI has been identi ed as an independent prognostic factor for the onset of microvascular complications in T2DM patients [21] . Despite these ndings showed that RCA-FAI seems to better re ect the overall in ammatory state of T2DM patients, our study did not corroborate a statistical discrepancy in RCA-FAI between T2DM patients who suffered from MACE and those without.…”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of Lesion-Specific Fat Attenuation Index for Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes

Liu,

Zhen,

Shang

et al. 2024

Preprint

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Background The purpose of this study was to explore the prognostic significance of the lesion-specific Fat Attenuation Index (FAI) in forecasting major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). Methods This study conducted a retrospective analysis of 304 patients diagnosed with T2DM who underwent coronary computed tomography angiography (CCTA) in our hospital from December 2011 to October 2021. All participants were followed for a period exceeding three years. Detailed clinical data and CCTA imaging features were carefully recorded, encompassing lesion-specific FAI, FAI of the right coronary artery, features of high-risk plaques, and the coronary artery calcium score (CACS). The spectrum of MACE included in the study comprised cardiac death, acute coronary syndrome (which encompasses unstable angina pectoris and myocardial infarction), late-phase coronary revascularization procedures, and hospital admissions prompted by heart failure. Results Within the three-year follow-up, 76 patients with T2DM suffered from MACE. The lesion-specific FAI in patients who experienced MACE was notably higher compared to those without MACE (-84.87 ± 11.36 Hounsfield Units (HU) vs. -88.65 ± 11.89 HU, P = 0.016). Multivariate Cox regression analysis revealed that CACS of 100 or greater (hazard ratio [HR] = 3.766, 95% confidence interval [CI]: 2.045–6.938, P < 0.001) and lesion-specific FAI higher than − 83.5 HU (HR = 2.172, 95% CI: 1.336–3.532, P = 0.002) were independently associated with heightened risk of MACE in T2DM patients over a three-year period. Subgroup analysis indicated that a lesion-specific FAI higher than − 83.5 HU (HR = 2.017, 95% CI: 1.143–3.559, P = 0.015) independently correlated with MACE in T2DM patients exhibiting severe coronary calcification. Moreover, the combination of CACS ≥ 100 and lesion-specific FAI>-83.5 HU significantly enhanced the predictive value of MACE in T2DM patients within 3 years. Conclusions The elevated lesion-specific FAI emerged as an independent prognostic factor for MACE in individuals with T2DM, inclusive of those with severe coronary artery calcification. Incorporating lesion-specific FAI with the CACS provided incremental predictive power for MACE in the T2DM patients.

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Section: Discussionmentioning

confidence: 99%

The Predictive Value of Lesion-Specific Fat Attenuation Index for Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes

Liu,

Zhen,

Shang

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Further investigation focusing on individuals with T2DM has highlighted that the effectiveness of RCA-FAI in identifying coronary artery disease was more representative than the LAD and LCX arteries, making it a better diagnostic tool for coronary artery disease in patients with T2DM [ 23 ]. Additionally, RCA-FAI has been identified as an independent prognostic factor for the onset of microvascular complications in patients with T2DM [ 24 ]. Despite these findings showed that RCA-FAI seems to better reflect the overall inflammatory state of patients with T2DM, our study did not corroborate a statistical discrepancy in RCA-FAI between patients with T2DM who suffered from MACE and those without.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of lesion-specific pericoronary fat attenuation index for major adverse cardiovascular events in patients with type 2 diabetes

Liu,

Zhen,

Shang

et al. 2024

Cardiovasc Diabetol

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Background The purpose of this study was to explore the prognostic significance of the lesion-specific pericoronary fat attenuation index (FAI) in forecasting major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). Methods This study conducted a retrospective analysis of 304 patients diagnosed with T2DM who underwent coronary computed tomography angiography (CCTA) in our hospital from December 2011 to October 2021. All participants were followed for a period exceeding three years. Detailed clinical data and CCTA imaging features were carefully recorded, encompassing lesion-specific pericoronary FAI, FAI of the three prime coronary arteries, features of high-risk plaques, and the coronary artery calcium score (CACS). The MACE included in the study comprised cardiac death, acute coronary syndrome (which encompasses unstable angina pectoris and myocardial infarction), late-phase coronary revascularization procedures, and hospital admissions prompted by heart failure. Results Within the three-year follow-up, 76 patients with T2DM suffered from MACE. The lesion-specific pericoronary FAI in patients who experienced MACE was notably higher compared to those without MACE (–84.87 ± 11.36 Hounsfield Units (HU) vs. –88.65 ± 11.89 HU, p = 0.016). Multivariate Cox regression analysis revealed that CACS ≥ 100 (hazard ratio [HR] = 4.071, 95% confidence interval [CI] 2.157–7.683, p < 0.001) and lesion-specific pericoronary FAI higher than − 83.5 HU (HR = 2.400, 95% CI 1.399–4.120, p = 0.001) were independently associated with heightened risk of MACE in patients with T2DM over a three-year period. Kaplan-Meier analysis showed that patients with higher lesion-specific pericoronary FAI were more likely to develop MACE (p = 0.0023). Additionally, lesions characterized by higher lesion-specific pericoronary FAI values were found to have a greater proportion of high-risk plaques (p = 0.015). Subgroup analysis indicated that lesion-specific pericoronary FAI higher than − 83.5 HU (HR = 2.017, 95% CI 1.143–3.559, p = 0.015) was independently correlated with MACE in patients with T2DM who have moderate to severe coronary calcification. Moreover, the combination of CACS ≥ 100 and lesion-specific pericoronary FAI>-83.5 HU significantly enhanced the predictive value of MACE in patients with T2DM within 3 years. Conclusions The elevated lesion-specific pericoronary FAI emerged as an independent prognostic factor for MACE in patients with T2DM, inclusive of those with moderate to severe coronary artery calcification. Incorporating lesion-specific pericoronary FAI with the CACS provided incremental predictive power for MACE in patients with T2DM.

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“…In a recent study evaluating the predictive value of EAT and coronary plaque characteristics on CCTA in patients with diabetes mellitus, EAT was higher in patients with diabetes mellitus and associated with increased adverse cardiovascular events. 37 In addition, EAT was found to be associated with higher microvascular complication burden in T2DM patients 38 and may affect myocardial performance irrespective of CAD. 39 Our overall study suggests that EAT attenuation and CAD severity are associated; EAT characteristics are similar in both groups, which nevertheless have different cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

Relationship between epicardial adipose tissue attenuation and coronary artery disease in type 2 diabetes mellitus patients

Liu

Neuber

Klose

et al. 2023

Journal of Cardiovascular Medicine

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Background and aimsHigh epicardial adipose tissue (EAT) attenuation is a key characteristic of adipose tissue dysfunction and associated with coronary artery disease (CAD). As little is known about the modulation of EAT attenuation by metabolic disorders, we investigated the association between EAT attenuation and CAD risk factors, CAD presence and CAD severity in type 2 diabetes mellitus (T2DM) patients.MethodsWe included 276 inpatients with T2DM and 305 control patients with normal glucose metabolism (NGM), who underwent cardiac computed tomography angiography (CCTA) and coronary artery calcium (CAC) scoring. EAT attenuation and volume were evaluated by contrast-enhanced CCTA image analysis. Furthermore, segment stenosis scores (SSSs) of the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCX), right coronary artery (RCA), diagonal/intermediate branch (D/I) and obtuse marginal branch (OM) were calculated to assess CAD severity.ResultsT2DM patients showed higher significant CAC scores, coronary plaque prevalence, total SSSs and LMCA-SSSs, LAD-SSSs, LCX-SSSs, RCA-SSSs and D/I-SSSs compared with NGM controls. In contrast to NGM controls, EAT volume was significantly increased in T2DM patients, whereas EAT attenuation was similar. In T2DM patients, EAT attenuation was associated with discrete CAD risk factors, the presence of coronary and triple-vessel plaques, as well as LAD-SSSs, LCX-SSSs, RCA-SSSs and total SSSs. In addition, EAT attenuation was only associated with the total SSS of calcified plaques, but not with noncalcified plaques.ConclusionIn T2DM patients, high EAT attenuation is associated with the presence and severity of CAD in general and with coronary stenosis caused by calcified plaques in particular.

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Prediction of microvascular complications in diabetic patients without obstructive coronary stenosis based on peri-coronary adipose tissue attenuation model

Cited by 9 publications

References 48 publications

The Predictive Value of Lesion-Specific Fat Attenuation Index for Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes

The Predictive Value of Lesion-Specific Fat Attenuation Index for Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes

The predictive value of lesion-specific pericoronary fat attenuation index for major adverse cardiovascular events in patients with type 2 diabetes

Relationship between epicardial adipose tissue attenuation and coronary artery disease in type 2 diabetes mellitus patients

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