Evolocumab attenuate pericoronary adipose tissue density via reduction of lipoprotein(a) in type 2 diabetes mellitus: a serial follow-up CCTA study

医学 Evolocumab公司 血管病学 内科学 2型糖尿病 脂肪组织 糖尿病 心脏病学 2型糖尿病 还原(数学) 脂蛋白 胆固醇 内分泌学 载脂蛋白A1 几何学 数学
作者
Meng-Meng Yu,Xin Zhao,Yinyin Chen,Xinwei Tao,Junbo Ge,Hang Jin,Meng-Su Zeng
出处
期刊:Cardiovascular Diabetology [BioMed Central]
卷期号:22 (1) 被引量:1
标识
DOI:10.1186/s12933-023-01857-w
摘要

Abstract Background Pericoronary adipose tissue (PCAT) density is a biomarker of vessel inflammation, which is supposed to be increased in patients with type 2 diabetes mellitus (T2DM). However, whether the coronary inflammation revealed by this novel index could be alleviated after evolocumab treatment in T2DM remains unknown. Methods From January 2020 to December 2022, consecutive T2DM patients with low-density lipoprotein cholesterol ≥ 70 mg/dL on maximally tolerated statin and taking evolocumab were prospectively included. In addition, patients with T2DM who were taking statin alone were recruited as control group. The eligible patients underwent baseline and follow-up coronary CT angiography with an interval of 48-week. To render patients with evolocumab as comparable to those controls, a propensity-score matching design was used to select the matched pairs with a 1:1 ratio. Obstructive lesion was defined as the extent of coronary artery stenosis ≥ 50%; the numbers inside the brackets were interquartile ranges. Results A total of 170 T2DM patients with stable chest pain were included [(mean age 64 ± 10.6 [range 40–85] years; 131 men). Among those patients, 85 were in evolocumab group and 85 were in control group. During follow-up, low-density lipoprotein cholesterol (LDL-C) level (2.02 [1.26, 2.78] vs. 3.34 [2.53, 4.14], p < 0.001), and lipoprotein(a) (12.1 [5.6, 21.8] vs. 18.9 [13.2, 27.2], p = 0.002) were reduced after evolocumab treatment. The prevalence of obstructive lesions and high-risk plaque features were significantly decreased ( p < 0.05 for all). Furthermore, the calcified plaque volume were significantly increased (188.3 [115.7, 361.0] vs. 129.3 [59.5, 238.3], p = 0.015), while the noncalcified plaque volume and necrotic volume were diminished (107.5 [40.6, 180.6] vs. 125.0 [65.3, 269.7], p = 0.038; 0 [0, 4.7] vs. 0 [0, 13.4], p < 0.001, respectively). In addition, PCAT density of right coronary artery was significantly attenuated in evolocumab group (− 85.0 [− 89.0, − 82.0] vs. − 79.0 [− 83.5, − 74.0], p < 0.001). The change in the calcified plaque volume inversely correlated with achieved LDL-C level (r = − 0.31, p < 0.001) and lipoprotein(a) level (r = − 0.33, p < 0.001). Both the changes of noncalcified plaque volume and necrotic volume were positively correlated with achieved LDL-C level and Lp(a) ( p < 0.001 for all). However, the change of PCAT RCA density only positively correlated with achieved lipoprotein(a) level (r = 0.51, p < 0.001). Causal mediation analysis revealed Lp(a) level mediated 69.8% ( p < 0.001) for the relationship between evolocumab and changes of PCAT RCA . Conclusions In patients with T2DM, evolocumab is an effective therapy to decrease noncalcified plaque volume necrotic volume, and increase calcified plaque volume. Furthermore, evolocumab could attenuate PCAT density, at least in part, via the reduction of lipoprotein(a).
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
1秒前
汉堡包应助NOTHING采纳,获得10
1秒前
SYLH应助科研通管家采纳,获得50
1秒前
quhayley应助科研通管家采纳,获得10
1秒前
爆米花应助科研通管家采纳,获得10
1秒前
坦率的匪应助科研通管家采纳,获得10
2秒前
田様应助科研通管家采纳,获得10
2秒前
SYLH应助科研通管家采纳,获得50
2秒前
orixero应助科研通管家采纳,获得10
2秒前
SYLH应助科研通管家采纳,获得50
2秒前
思源应助科研通管家采纳,获得10
2秒前
2秒前
隐形曼青应助科研通管家采纳,获得10
2秒前
czh应助科研通管家采纳,获得10
2秒前
赘婿应助科研通管家采纳,获得10
2秒前
华仔应助科研通管家采纳,获得10
2秒前
科研通AI2S应助科研通管家采纳,获得10
2秒前
3秒前
SYLH应助科研通管家采纳,获得50
3秒前
大模型应助科研通管家采纳,获得10
3秒前
3秒前
斯文败类应助Keyl采纳,获得10
3秒前
褪黑素应助科研通管家采纳,获得10
3秒前
完美世界应助科研通管家采纳,获得10
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
3秒前
努力科研霸王龙完成签到 ,获得积分10
4秒前
nns关闭了nns文献求助
4秒前
田様应助jiabaoyu采纳,获得10
5秒前
脑洞疼应助林林林林采纳,获得10
5秒前
xiaoxiao完成签到,获得积分10
5秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988732
求助须知:如何正确求助?哪些是违规求助? 3531027
关于积分的说明 11252281
捐赠科研通 3269732
什么是DOI,文献DOI怎么找? 1804764
邀请新用户注册赠送积分活动 881869
科研通“疑难数据库(出版商)”最低求助积分说明 809021