Coronary atherosclerotic burden vs. coronary vascular function in diabetic and nondiabetic patients with normal myocardial perfusion: a propensity score analysis | springermedizin.de

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European Journal of Nuclear Medicine and Molecular Imaging

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14.03.2017 | Original Article

Coronary atherosclerotic burden vs. coronary vascular function in diabetic and nondiabetic patients with normal myocardial perfusion: a propensity score analysis

verfasst von: Roberta Assante, Wanda Acampa, Emilia Zampella, Parthiban Arumugam, Carmela Nappi, Valeria Gaudieri, Mariarosaria Panico, Mario Magliulo, Christine M. Tonge, Mario Petretta, Alberto Cuocolo

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2017

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Abstract

Purpose

To assess the relationship between coronary atherosclerotic burden and vascular function in diabetic and nondiabetic patients after balancing for coronary risk factors.

Methods

We studied 672 patients without overt coronary artery disease and normal myocardial perfusion on stress ⁸²Rb PET/CT imaging. To account for differences in baseline characteristics between diabetic patients and nondiabetic patients, we created a propensity score-matched cohort considering clinical variables and coronary risk factors.

Results

Before matching, diabetic patients had higher coronary artery calcium (CAC) scores (p < 0.001) and lower coronary flow reserve (CFR; p < 0.001) than nondiabetic patients. After matching, CAC scores were comparable between diabetic and nondiabetic patients, but diabetic patients still had lower hyperaemic myocardial blood flow (p < 0.001) and CFR (p < 0.05). Patients were categorized by ln(CAC score) quartiles. There was a decrease in CFR with increasing CAC score quartile in both diabetic patients (p for trend < 0.01) and nondiabetic patients (p for trend < 0.005). Diabetes was associated with lower CFR across quartile categories (p < 0.002). In a multivariable linear regression analysis, CAC score was inversely related to CFR in both diabetic patients (p < 0.05) and nondiabetic patients (p < 0.001).

Conclusion

Diabetic patients had higher CAC scores than nondiabetic patients, but the difference disappeared when clinical characteristics were taken into account. Of note, diabetic patients also had lower CFR regardless of CAC score than nondiabetic patients after matching. Thus, coronary atherosclerotic burden and vascular function have to be seen as two different entities.

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Titel: Coronary atherosclerotic burden vs. coronary vascular function in diabetic and nondiabetic patients with normal myocardial perfusion: a propensity score analysis
verfasst von: Roberta Assante
Wanda Acampa
Emilia Zampella
Parthiban Arumugam
Carmela Nappi
Valeria Gaudieri
Mariarosaria Panico
Mario Magliulo
Christine M. Tonge
Mario Petretta
Alberto Cuocolo
Publikationsdatum: 14.03.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2017
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3671-y