Introduction
Methods
Study population
Measurement of EAT thickness
Statistical analysis
Results
Baseline characteristics and EAT thickness
Total population | NODM (+) (n = 40) | NODM (−) (n = 281) | P value | |
---|---|---|---|---|
Demographic findings | ||||
Age (years) | 60 (51, 69) | 60 (51, 72) | 59 (51, 69) | 0.950 |
Sex (male, %) | 238 (74.1%) | 30 (75.0%) | 208 (74.0%) | 0.895 |
BMI (kg/m2) | 24.9 (23.2, 27.1) | 25.8 (23.7, 28.0) | 24.8 (23.2, 27.0) | 0.184 |
BMI > 25 kg/m2 | 157 (48.9%) | 23 (57.5%) | 134 (47.7%) | 0.245 |
Clinical diagnosis (%) | 0.984 | |||
Stable angina | 115 (35.8%) | 14 (35.0%) | 101 (35.9%) | |
Unstable angina | 48 (15.0%) | 7 (17.5%) | 41 (14.6%) | |
NSTEMI | 64 (19.9%) | 7 (17.5%) | 57 (20.3%) | |
STEMI | 94 (29.3%) | 12 (30.0%) | 82 (29.2%) | |
Hypertension (%) | 127 (39.6%) | 19 (47.5%) | 108 (38.4%) | 0.273 |
Current smoking (%) | 84 (26.2%) | 10 (25.0%) | 74 (26.3%) | 0.857 |
Previous CVA (%) | 11 (3.4%) | 0 (0.0%) | 11 (3.9%) | 0.203 |
Bronchial asthma (%) | 5 (1.6%) | 1 (2.5%) | 4 (1.4%) | 0.607 |
COPD (%) | 9 (2.8%) | 2 (5.0%) | 7 (2.5%) | 0.368 |
Dyslipidemia (%) | 80 (24.8%) | 9 (22.5%) | 71 (25.3%) | 0.705 |
Prediabetes (%) | 130 (40.5%) | 31 (77.5%) | 99 (35.2%) | < 0.001 |
Laboratory findings | ||||
WBC (/μL) | 7900 (5970, 10,950) | 7640 (5500, 10,450) | 7900 (6000, 11,040) | 0.589 |
Hemoglobin (g/dL) | 14.6 (13.5, 15.6) | 15.0 (13.6, 15.8) | 14.5 (13.4, 15.6) | 0.246 |
Fasting blood glucose (mg/dL) | 92 (84, 103) | 98 (90, 107) | 92 (84, 102) | 0.010 |
HbA1c (%/mmol/mol) | 5.7 (5.5, 5.9)/38.8 (36.6, 41.0) | 6.0 (5.7, 6.3)/42.1 (39.1, 45.4) | 5.7 (5.4, 5.8)/38.8 (35.5, 39.9) | < 0.001 |
Total cholesterol (mg/dL) | 207 (177, 240) | 210 (171, 246) | 207 (179, 240) | 0.774 |
Triglyceride (mg/dL) | 133 (90, 209) | 145 (99, 214) | 131 (89, 209) | 0.414 |
HDL-cholesterol (mg/dL) | 42 (37, 50) | 40 (35, 47) | 43 (37, 51) | 0.100 |
LDL-cholesterol (mg/dL) | 133 (110, 157) | 126 (112, 157) | 133 (108, 157) | 0.979 |
Serum creatinine (mg/dL) | 0.88 (0.73, 1.01) | 0.84 (0.76-1.00) | 0.98 (0.73, 1.02) | 0.524 |
hsCRP (mg/dL) | 0.15 (0.10, 0.31) | 0.15 (0.10, 0.25) | 0.15 (0.10, 0.32) | 0.264 |
Echocardiography | ||||
LVEDD (mm) | 48.0 (44.3, 51.9) | 49.0 (45.0, 52.1) | 48.0 (44.0, 51.9) | 0.408 |
LVESD (mm) | 31.0 (27.0, 35.0) | 32.0 (29.0, 34.6) | 30.3 (26.9, 35.1) | 0.319 |
LV ejection fraction (%) | 60.0 (53.5, 64.7) | 60.3 (54.9, 66.1) | 59.5 (53.1, 64.5) | 0.246 |
Left atrium dimension (mm) | 37.1 (33.7, 41.0) | 36.8 (34.1, 40.0) | 37.4 (33.7, 41.0) | 0.624 |
EAT diastole (mm) | 1.4 (1.0, 2.2) | 2.2 (1.4, 3.5) | 1.2 (1.0, 2.1) | < 0.001 |
EAT systole (mm) | 4.0 (3.0, 4.9) | 5.4 (4.2, 7.4) | 3.9 (2.9 4.8) | < 0.001 |
Baseline medication | ||||
Aspirin | 321 (100%) | 40 (100%) | 281 (100%) | NA |
Clopidogrel | 320 (99.7%) | 40 (100%) | 280 (99.6%) | 0.706 |
ACE inhibitor or ARB | 275 (85.7%) | 34 (85.0%) | 241 (85.8%) | 0.897 |
Beta blockers | 246 (76.6%) | 30 (75.0%) | 216 (76.9%) | 0.794 |
Thiazides | 36 (11.2%) | 4 (10.0%) | 32 (11.4%) | 0.795 |
Systemic steroid | 30 (9.3%) | 3 (7.5%) | 27 (9.6%) | 0.668 |
Statin | 0.128 | |||
Atorvastatin 40 mg | 204 (63.6%) | 20 (50.0%) | 184 (65.5%) | |
Atorvastatin 80 mg | 57 (17.8%) | 11 (27.5%) | 46 (16.4%) | |
Rosuvastatin 20 mg | 60 (18.7%) | 9 (22.5%) | 51 (18.1%) | |
Statin duration (days) | ||||
Total statin duration | 1248 (984, 1800) | 1348 (983, 1827) | 1237 (984, 1800) | 0.293 |
High intensity statin duration | 930 (541, 1216) | 963 (785, 1322) | 922 (500, 1210) | 0.297 |
Predictors of NODM
Factor | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
HR (95% CI)* | P value | HR (95% CI)* | P value | |
Age | 0.999 (0.975–1.023) | 0.909 | 0.978 (0.950–1.007) | 0.130 |
Male sex | 1.029 (0.502–2.108) | 0.938 | 1.220 (0.539–2.765) | 0.633 |
BMI | 1.062 (0.956–1.179) | 0.263 | 0.996 (0.877–1.131) | 0.996 |
Diagnosis as acute coronary syndrome | 0.954 (0.497–1.830) | 0.888 | – | – |
Hypertension | 1.524 (0.818–2.838) | 0.184 | 1.727 (0.872–3.420) | 0.117 |
Current smoking | 1.030 (0.503–2.109) | 0.935 | – | – |
Dyslipidemia | 1.114 (0.530–2.341) | 0.775 | – | – |
Prediabetes at baseline | 5.503 (2.619–11.564) | < 0.001 | 4.321 (1.998–9.349) | < 0.001 |
Anemia (Hemoglobin < 12 g/dL) | 2.745 (0.377–19.985) | 0.319 | – | – |
TG level (per mg/dL) | 1.001 (0.999–1.004) | 0.309 | – | – |
LDL-cholesterol level (per mg/dL) | 1.002 (0.993–1.011) | 0.703 | – | – |
LV ejection fraction < 40% | 2.153 (0.296–15.672) | 0.449 | – | – |
EAT thickness at diastole (per mm) | 1.625 (1.353–1.950) | < 0.001 | ||
EAT thickness at systole (per mm) | 1.611 (1.388–1.870) | < 0.001 | 1.580 (1.346–1.854) | < 0.001 |
Total statin duration (per year) | 0.916 (0.716–1.171) | 0.482 | 0.876 (0.733–1.048) | 0.147 |
High intensity statin duration | 0.989 (0.804–1.217) | 0.918 | – | – |
Risk factors of NODM
HR | 95% CI | P value | |
---|---|---|---|
EAT thickness < 5 mm and no prediabetes | Reference | ||
EAT thickness ≥ 5 mm and no prediabetes | 3.481 | 0.934–12.972 | 0.063 |
EAT thickness < 5 mm and prediabetes | 5.011 | 1.805–13.916 | 0.002 |
EAT thickness ≥ 5 mm and prediabetes | 14.702 | 5.336–40.503 | < 0.001 |