Coronary inflammation based on pericoronary adipose tissue attenuation in type 2 diabetic mellitus: effect of diabetes management
Authors' conclusion
Inadequate diabetes management, including poor GC and lack of GLDIS, may be associated with increased coronary artery inflammation in T2DM patients, as indicated by PCAT attenuation on CCTA, leading to increased cardiovascular risk. This finding could help healthcare providers identify T2DM patients with increased cardiovascular risk, develop improved cardiovascular management programs, and reduce subsequent cardiovascular related mortality.
Study context
- Population
- Patients with coronary computed tomography angiography (CCTA) in two tertiary hospitals: 547 T2DM and 795 non-T2DM547 T2DM
- Participants
- 1,342 patients
- Exposure
- T2DM subgroups by glycemic control (GC) status and by glucose-lowering drug interventions (GLDIS) vs non-T2DM, and GLDIS vs non-GLDIS
- Non-T2DMn = 795reference
- Outcome
- Pericoronary adipose tissue (PCAT) attenuation (LAD, LCX, RCA)
Methodological detailspropensity-score matched, two tertiary hospitals
- Propensity-score matched
- Two tertiary hospitals
Main finding
As reported in the abstract
| Group | Value | LCX-PCAT | RCA-PCAT |
|---|---|---|---|
| Poor GC | - 68.75 ± 7.59 HU | - 68.75 ± 7.59 HU | - 74.37 ± 8.44 HU |
| Non-T2DM | - 71.93 ± 7.25 HU | - 71.93 ± 7.25 HU | - 77.2 ± 7.42 HU |
Value
Poor GC- 68.75 ± 7.59 HU
Non-T2DM- 71.93 ± 7.25 HU
LCX-PCAT
Poor GC- 68.75 ± 7.59 HU
Non-T2DM- 71.93 ± 7.25 HU
RCA-PCAT
Poor GC- 74.37 ± 8.44 HU
Non-T2DM- 77.2 ± 7.42 HU
- Poor GC vs Non-T2DM: P = 0.008 — LCX-PCAT
- Poor GC vs Non-T2DM: P = 0.026 — RCA-PCAT
- Non-GLDIS vs GLDIS: P = 0.022 — LAD-PCAT; higher with non-GLDIS
- Non-GLDIS vs GLDIS: P = 0.037 — LCX-PCAT; higher with non-GLDIS
- Non-GLDIS vs GLDIS: P = 0.001 — RCA-PCAT; higher with non-GLDIS
Observational data: associations, not effects.
Further findings
LAD-PCAT, linear regression in T2DM
- Metformin associated with lower LAD-PCAT, β coefficient
- - 2.476, p=0.021
- Acarbose associated with lower LAD-PCAT, β coefficient
- - 1.841, p = 0.031
- Sex and duration of diabetes also associated
Original publication
Coronary inflammation based on pericoronary adipose tissue attenuation in type 2 diabetic mellitus: effect of diabetes management. Cardiovasc Diabetol. Published 29 March 2024. doi:10.
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