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Intrinsic calcification angle: a novel feature of the vulnerable coronary plaque in patients with type 2 diabetes: an optical coherence tomography study

Reith, Sebastian; Milzi, Andrea; Lemma, Enrico Domenico; Dettori, Rosalia; Burgmaier, Kathrin; Marx, Nikolaus; Burgmaier, Mathias

Abstract:
Background: Coronary calcification is associated with high risk for cardiovascular events. However, its impact on plaque vulnerability is incompletely understood. In the present study we defined the intrinsic calcification angle (ICA) as the angle externally projected by a vascular calcification and analyzed its role as novel feature of coronary plaque vulnerability in patients with type 2 diabetes.
Methods: Optical coherence tomography was used to determine ICA in 219 calcifications from 56 patients with stable coronary artery disease (CAD) and 143 calcifications from 36 patients with acute coronary syndrome (ACS). We then used finite elements analysis to gain mechanistic insight into the effects of ICA.
Results: Minimal (139.8 ± 32.8° vs. 165.6 ± 21.6°, p < 0.001) and mean ICA (164.1 ± 14.3° vs. 176.0 ± 8.4°, p < 0.001) were lower in ACS vs. stable CAD patients. Mean ICA predicted ACS with very good diagnostic efficiency (AUC = 0.840, 95% CI 0.797–0.882, p < 0.001, optimal cut-off 175.9°); younger age (OR 0.95 per year, 95% CI 0.92–0.98, p = 0.002), male sex (OR 2.18, 95% CI 1.41–3.38, p < 0.001), lower HDL-cholesterol (OR 0.82 per 10 mg/dl, 95% CI 0.68–0.98, p = 0.029) and ACS (OR 14.71, 95% CI 8.47–25.64, p < 0.001) were determinants of ICA < 175.9°. ... mehr

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Verlagsausgabe §
DOI: 10.5445/IR/1000098613
Veröffentlicht am 01.10.2019
Originalveröffentlichung
DOI: 10.1186/s12933-019-0926-x
Coverbild
Zugehörige Institution(en) am KIT Zoologisches Institut (ZOO)
Publikationstyp Zeitschriftenaufsatz
Jahr 2019
Sprache Englisch
Identifikator ISSN: 1475-2840
KITopen-ID: 1000098613
Erschienen in Cardiovascular diabetology
Band 18
Heft 1
Seiten Art. Nr.: 122
Vorab online veröffentlicht am 24.09.2019
Schlagworte Coronary calcification, Plaque vulnerability, Optical coherence tomography, Coronary artery disease, Atherosclerosis, Diabetes mellitus
Nachgewiesen in Scopus
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