The Role of Coronary Computed Tomography Angiography in the Diagnosis, Risk Stratification, and Management of Patients with Diabetes and Chest Pain DOI Creative Commons

Willem R. van de Vijver,

John Hennecken,

Ioannis Lagogiannis

и другие.

Reviews in Cardiovascular Medicine, Год журнала: 2024, Номер 25(12)

Опубликована: Дек. 17, 2024

Coronary artery disease (CAD) affects over 200 million individuals globally, accounting for approximately 9 deaths annually. Patients living with diabetes mellitus exhibit an up to fourfold increased risk of developing CAD compared without diabetes. Furthermore, is responsible 40 80 percent the observed mortality rates among patients type 2 typically present non-specific clinical complaints in setting myocardial ischemia, and as such, it critical select appropriate diagnostic tests identify those at major adverse cardiac events (MACEs) determining optimal management strategies. Studies indicate that often more advanced atherosclerosis, a higher calcified plaque burden, smaller epicardial vessels. The performance coronary computed tomographic angiography (CCTA) identifying significant stenosis well-established, CCTA has been incorporated into current guidelines. However, predictive accuracy obstructive less extensively characterized. provides detailed insights anatomy, vessel stenosis, high-risk features, other features associated incidence MACEs. Recent evidence supports efficacy diagnosing improving patient outcomes, leading its recommendation primary tool stable angina stratification. specific benefits require further elucidation. This review examines several key aspects utility diabetes: (i) detecting CAD, (ii) effect first-line test individualized stratification cardiovascular (iii) role guiding therapeutic management, (iv) future perspectives artificial intelligence.

Язык: Английский

Phenotyping atherosclerotic plaque and perivascular adipose tissue: signalling pathways and clinical biomarkers in atherosclerosis DOI
Kajetan Grodecki, Jolien Geers, Jacek Kwieciński

и другие.

Nature Reviews Cardiology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 2, 2025

Язык: Английский

Процитировано

2

Computed Tomography Angiography Identified High-Risk Coronary Plaques: From Diagnosis to Prognosis and Future Management DOI Creative Commons
Kyriakos Dimitriadis, Nikolaos Pyrpyris, Panagiotis Theofilis

и другие.

Diagnostics, Год журнала: 2024, Номер 14(15), С. 1671 - 1671

Опубликована: Авг. 1, 2024

CT angiography has become, in recent years, a main evaluating modality for patients with coronary artery disease (CAD). Recent advancements the field have allowed us to identity not only presence of obstructive but also characteristics identified lesions. High-risk atherosclerotic plaques are angiographies via number specific and may provide prognostic therapeutic implications, aiming prevent future ischemic events optimizing medical treatment or providing interventions. In light new evidence safety efficacy intervening high-risk plaques, even non-flow-limiting disease, we aim comprehensive review diagnostic algorithms implications plaque vulnerability angiography, identify any differences invasive imaging, analyze factors potential options such patients, as well discuss frontiers, including stenoses role patient stratification.

Язык: Английский

Процитировано

4

Association of sodium–glucose cotransporter-2 inhibitors with mortality across the spectrum of myocardial infarction: a systematic review and meta-analysis DOI Creative Commons

Michele Maremmani,

Ramin Ebrahimi, Marco Centola

и другие.

Cardiovascular Diabetology, Год журнала: 2025, Номер 24(1)

Опубликована: Янв. 22, 2025

Abstract Background The impact of sodium–glucose cotransporter-2 (SGLT2) inhibitors on mortality following myocardial infarction (MI) remains uncertain. Additionally, the role type 2 diabetes mellitus (T2DM) and heart failure (HF) in modulating effectiveness these drugs post-MI are not fully understood. This meta-analysis aimed to assess association SGLT2 with all-cause patients explore key moderators influencing this benefit. Methods PubMed, Embase, Scopus were searched for randomized controlled trials (RTCs) propensity score-matched (PSM) observational studies assessing inhibitors' mortality. primary outcome was We pooled hazard ratios (HRs) estimate intervention's effect overall population stratified into early (SGLT2 administered within eight weeks post-MI) delayed treatment trials. Meta-regression assessed moderating effects T2DM HF. Results A total five RCTs four PSM involving 26,753 (mean [SD] age, 62.9 [10.5] years; 6,406 female [24.0%]; 16,369 [61.2%]; 13,933 HF [52.1%]) included. Early comprised 16,165 (60.4%) 10,588 (39.6%) patients, respectively. reduced MI (HR 0.79, 95% CI [0.68, 0.91]; p = 0.001; I 59%). Stratified analysis demonstrated consistent both 0.76, [0.59, 0.98]; 0.03; 65%) 0.81, [0.67, 60%) treatment. identified as a significant moderator benefit (β − 0.0049; 0.0006). Conclusion In meta-analysis, associated reduction . Furthermore, presence greater reduction, while significantly outcome. Graphical Association Inhibitors Mortality Across Spectrum Myocardial Infarction. Data from summarized, including baseline characteristics. plots represent confidence intervals (CIs), comparing control (placebo/no treatment), HRs below 1 favoring inhibitors. diagram shows trial subgroups, presenting number participants, percentage receiving inhibitors, respective meta-regression panel highlights moderators, reporting β-coefficients (β), p-values, residual heterogeneity (I ). Negative β (−) indicates that increases, HR decreases. Abbreviations: HF, failure; MI, infarction; SGLT2i, inhibitors; T2DM, mellitus.

Язык: Английский

Процитировано

0

Association of pericoronary inflammation with atherosclerotic plaque progression in diabetic patients with improved modifiable cardiovascular risk factors: a longitudinal CCTA cohort study DOI Creative Commons
Tianhao Zhang, Hongkai Zhang,

Xuelian Gao

и другие.

Diabetology & Metabolic Syndrome, Год журнала: 2025, Номер 17(1)

Опубликована: Фев. 25, 2025

Pericoronary adipose tissue (PCAT) attenuation, as assessed by coronary computed tomography angiography (CCTA), has been identified a marker of pericoronary inflammation and predictor future adverse atherosclerotic events. However, the impact changes in PCAT evaluated consecutive CCTAs, on plaque progression high-risk patients with improved modifiable cardiovascular risk factors (mCRFs) remains unclear. Consecutive type 2 diabetes mellitus (T2DM) who had mCRFs underwent serial, clinically indicated CCTA examinations (time interval ≥ 12 months) at our center between July 2019 2022 were screened. Eligible participants least one study plaque, defined without significant anatomic stenosis, located major arteries, which not intervened upon or caused events serial scans. Percent atheroma volume (PAV) attenuation measured for each baseline follow-up using analysis software. Changes PAV (δPAV = – PAV) compared based [δPCAT attenuation] (> 0 ≤ 0). Multivariate linear regression models used to evaluate relationship δPCAT δPAV. A total 98 T2DM (mean age: 59.9 years; 75.3% men; 152 plaques) that reached therapeutic targets CCTA. overall progressed from all [(41.68 ± 12.47)% vs. (43.71 12.24)%, p 0.035], accompanied an increase (i.e., attenuation) during median 13.5 months (interquartile range [IQR]: 12.2, 17.5 months).Compared 0, those > significantly greater [(4.09 12.09)% (-0.82 10.74)%, 0.011], calcified [1.57% (IQR: 0.13%, 3.84%) 0.38% -0.26%, 2.58%), 0.008], numerical but non-significant non-calcified [(1.29 11.75)% (-1.87 10.47)%, 0.089]. demonstrated increased was associated (β 0.339, 95% CI: 0.129–0.549), 0.237, 0.019–0.455), 0.109, 0.019-0.200), independent age, sex, factors, medications, (all < 0.05). The effect elevated consistent across subgroups interaction In this longitudinal cohort mCRFs, particularly plaque.

Язык: Английский

Процитировано

0

Coronary atherosclerotic plaque modification: the present and the future DOI
Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis

и другие.

Expert Review of Cardiovascular Therapy, Год журнала: 2025, Номер 23(3), С. 65 - 71

Опубликована: Март 4, 2025

Introduction Coronary atherosclerosis, marked by lipid deposition and inflammation, drives cardiovascular morbidity. Traditional treatments focus on reduction, yet newer therapies target plaque composition, aiming to enhance stability prevent coronary events.

Язык: Английский

Процитировано

0

The Role of Coronary Computed Tomography Angiography in the Diagnosis, Risk Stratification, and Management of Patients with Diabetes and Chest Pain DOI Creative Commons

Willem R. van de Vijver,

John Hennecken,

Ioannis Lagogiannis

и другие.

Reviews in Cardiovascular Medicine, Год журнала: 2024, Номер 25(12)

Опубликована: Дек. 17, 2024

Coronary artery disease (CAD) affects over 200 million individuals globally, accounting for approximately 9 deaths annually. Patients living with diabetes mellitus exhibit an up to fourfold increased risk of developing CAD compared without diabetes. Furthermore, is responsible 40 80 percent the observed mortality rates among patients type 2 typically present non-specific clinical complaints in setting myocardial ischemia, and as such, it critical select appropriate diagnostic tests identify those at major adverse cardiac events (MACEs) determining optimal management strategies. Studies indicate that often more advanced atherosclerosis, a higher calcified plaque burden, smaller epicardial vessels. The performance coronary computed tomographic angiography (CCTA) identifying significant stenosis well-established, CCTA has been incorporated into current guidelines. However, predictive accuracy obstructive less extensively characterized. provides detailed insights anatomy, vessel stenosis, high-risk features, other features associated incidence MACEs. Recent evidence supports efficacy diagnosing improving patient outcomes, leading its recommendation primary tool stable angina stratification. specific benefits require further elucidation. This review examines several key aspects utility diabetes: (i) detecting CAD, (ii) effect first-line test individualized stratification cardiovascular (iii) role guiding therapeutic management, (iv) future perspectives artificial intelligence.

Язык: Английский

Процитировано

0