E. Belaid , S. Fawaz , R. Boulestreau , Y. Pucheu , C. Ducos , J.-S. Liegey , M. Darne , V. Maury , C. Labilloy , R. Lembeye , L. Hein , D. Sadki , R. Roland , C. Bazin , S. Sridi-Cheniti , P. Coste , K. Mohammedi , H. Cochet , M. Montaudon , T. Couffinhal
{"title":"通过综合影像学评价提高对冠状动脉对糖尿病反应的认识","authors":"E. Belaid , S. Fawaz , R. Boulestreau , Y. Pucheu , C. Ducos , J.-S. Liegey , M. Darne , V. Maury , C. Labilloy , R. Lembeye , L. Hein , D. Sadki , R. Roland , C. Bazin , S. Sridi-Cheniti , P. Coste , K. Mohammedi , H. Cochet , M. Montaudon , T. Couffinhal","doi":"10.1016/j.acvd.2024.10.088","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes is one of the main risk factors for cardiovascular disease and is associated with a significant coronary atherosclerosis burden. However, recent studies have shown that among patients with diabetes a significant part do not develop coronary artery disease (CAD), even in long-standing diabetes.</div></div><div><h3>Objective</h3><div>We aimed to identify the determinants of the coronary and carotid atherosclerosis burden in a population of patients with diabetes and no history of CAD.</div></div><div><h3>Method</h3><div>All patients underwent a coronary computed tomography angiography (CCTA) with the measure of the coronary calcium score (CAC) and the quantification of the percent atheroma volume (PAV, dividing the coronary atheroma volume by the total coronary volume), alongside with a 3D carotid ultrasonography to quantify the carotid atheroma volume.</div></div><div><h3>Results</h3><div>Between March 2021 and March 2024, we included 138 patients (58.6 years in mean, 59% of men), 32% of whom had a CAC of zero. Mean CAC was 351.6 AU and 10% had a stenosis<!--> <!-->><!--> <!-->50%. The mean PAV was 8.3%. Twenty-five percent of the patients had carotid plaques, with a mean volume of 41.5 mm3. In the hole cohort, male gender (<em>p</em> <!-->=<!--> <!-->0.014) and duration of diabetes (<em>p</em> <!-->=<!--> <!-->0.017) were independently associated with PAV. In patients with a diabetes<!--> <!--><<!--> <!-->5 years, the presence of carotid plaques was the only independent determinant of CAC (<em>p</em> <!-->=<!--> <!-->0.016). In patients with long-standing diabetes (><!--> <!-->10 years), only male gender was independently associated with CAC (<em>p</em> <!-->=<!--> <!-->0.031). We found no correlation between the carotid atheroma volume and CAC or PAV.</div></div><div><h3>Conclusion</h3><div>Our study suggests that the male gender and the duration of diabetes are the two clinical determinants of CAD in patients with diabetes, and that the carotid ultrasound could be used to identify the patients with short-standing diabetes who are the most at risk to develop CAD through the detection of carotid plaques. More studies are needed to precise the role of the carotid atheroma volume in patients with diabetes and no CAD.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S21"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhancing the understanding of coronary response to diabetes through comprehensive imaging evaluation\",\"authors\":\"E. Belaid , S. Fawaz , R. Boulestreau , Y. Pucheu , C. Ducos , J.-S. Liegey , M. Darne , V. Maury , C. Labilloy , R. Lembeye , L. Hein , D. Sadki , R. Roland , C. Bazin , S. Sridi-Cheniti , P. Coste , K. Mohammedi , H. Cochet , M. Montaudon , T. Couffinhal\",\"doi\":\"10.1016/j.acvd.2024.10.088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Diabetes is one of the main risk factors for cardiovascular disease and is associated with a significant coronary atherosclerosis burden. However, recent studies have shown that among patients with diabetes a significant part do not develop coronary artery disease (CAD), even in long-standing diabetes.</div></div><div><h3>Objective</h3><div>We aimed to identify the determinants of the coronary and carotid atherosclerosis burden in a population of patients with diabetes and no history of CAD.</div></div><div><h3>Method</h3><div>All patients underwent a coronary computed tomography angiography (CCTA) with the measure of the coronary calcium score (CAC) and the quantification of the percent atheroma volume (PAV, dividing the coronary atheroma volume by the total coronary volume), alongside with a 3D carotid ultrasonography to quantify the carotid atheroma volume.</div></div><div><h3>Results</h3><div>Between March 2021 and March 2024, we included 138 patients (58.6 years in mean, 59% of men), 32% of whom had a CAC of zero. Mean CAC was 351.6 AU and 10% had a stenosis<!--> <!-->><!--> <!-->50%. The mean PAV was 8.3%. Twenty-five percent of the patients had carotid plaques, with a mean volume of 41.5 mm3. In the hole cohort, male gender (<em>p</em> <!-->=<!--> <!-->0.014) and duration of diabetes (<em>p</em> <!-->=<!--> <!-->0.017) were independently associated with PAV. In patients with a diabetes<!--> <!--><<!--> <!-->5 years, the presence of carotid plaques was the only independent determinant of CAC (<em>p</em> <!-->=<!--> <!-->0.016). In patients with long-standing diabetes (><!--> <!-->10 years), only male gender was independently associated with CAC (<em>p</em> <!-->=<!--> <!-->0.031). We found no correlation between the carotid atheroma volume and CAC or PAV.</div></div><div><h3>Conclusion</h3><div>Our study suggests that the male gender and the duration of diabetes are the two clinical determinants of CAD in patients with diabetes, and that the carotid ultrasound could be used to identify the patients with short-standing diabetes who are the most at risk to develop CAD through the detection of carotid plaques. 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Enhancing the understanding of coronary response to diabetes through comprehensive imaging evaluation
Introduction
Diabetes is one of the main risk factors for cardiovascular disease and is associated with a significant coronary atherosclerosis burden. However, recent studies have shown that among patients with diabetes a significant part do not develop coronary artery disease (CAD), even in long-standing diabetes.
Objective
We aimed to identify the determinants of the coronary and carotid atherosclerosis burden in a population of patients with diabetes and no history of CAD.
Method
All patients underwent a coronary computed tomography angiography (CCTA) with the measure of the coronary calcium score (CAC) and the quantification of the percent atheroma volume (PAV, dividing the coronary atheroma volume by the total coronary volume), alongside with a 3D carotid ultrasonography to quantify the carotid atheroma volume.
Results
Between March 2021 and March 2024, we included 138 patients (58.6 years in mean, 59% of men), 32% of whom had a CAC of zero. Mean CAC was 351.6 AU and 10% had a stenosis > 50%. The mean PAV was 8.3%. Twenty-five percent of the patients had carotid plaques, with a mean volume of 41.5 mm3. In the hole cohort, male gender (p = 0.014) and duration of diabetes (p = 0.017) were independently associated with PAV. In patients with a diabetes < 5 years, the presence of carotid plaques was the only independent determinant of CAC (p = 0.016). In patients with long-standing diabetes (> 10 years), only male gender was independently associated with CAC (p = 0.031). We found no correlation between the carotid atheroma volume and CAC or PAV.
Conclusion
Our study suggests that the male gender and the duration of diabetes are the two clinical determinants of CAD in patients with diabetes, and that the carotid ultrasound could be used to identify the patients with short-standing diabetes who are the most at risk to develop CAD through the detection of carotid plaques. More studies are needed to precise the role of the carotid atheroma volume in patients with diabetes and no CAD.
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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