Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes

Yıl: 2021 Cilt: 49 Sayı: 2 Sayfa Aralığı: 127 - 134 Metin Dili: İngilizce DOI: 10.5543/tkda.2021.65635 İndeks Tarihi: 24-01-2022

Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes

Öz:
Objective: Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot that plays an important role in coronary atherosclerosis. In this study, our aim was to investigate the relationship between long-term major adverse cardiovascular events (MACEs) and EAT volume detected by coronary computed tomography angiography (CCTA) in patients with Type 2 diabetes mellitus (T2-DM) without previous coronary events. Methods: A total of 127 patients with diabetes who underwent CCTA between 2012 and 2014 were enrolled retrospectively. The study population was divided into 2 groups according to whether they experienced or did not experience MACE, which was defined as cardiac death, non-fatal myocardial infarction or unstable angina requiring hospitalization, coronary revascularizations (percutaneous coronary intervention or coronary artery bypass grafting surgery), heart failure, peripheral arterial disease, or ischemic stroke. In both groups, EAT volumes were measured by CCTA. Results: During 60±7 months follow-up period, 22 participants experienced MACEs. Data were evaluated with univariate and multivariate analyses and receiver operating characteristic (ROC) analysis. Age, male sex, coronary artery disease, hemoglobin A1c, glucose, creatinine, C- reactive protein, and cholesterol levels were found to be associated with MACE. EAT volume (odds ratio [OR]: 1.027; 95% confidence interval [CI]: 1.010‒1.044, p=0.002) and low-density lipoprotein (OR: 1.015; 95% CI: 1.000‒1.030, p=0.050) were found to be independent predictors for MACE. ROC analysis indicated that EAT volumes >123.2 mL had a 72.7% sensitivity and a 77.1% specificity for predicting long-term MACE in patients with T2-DM (area under the curve: 0.820; 95% CI: 0.733–0.908). Conclusion: EAT volume is an independent predictor of long-term MACE in patients with T2-DM without previous coronary events. EAT volume may be used additionally in risk stratification for MACE besides the well-known vascular risk factors in patients with T2-DM.
Anahtar Kelime:

Epikardiyal yağ dokusu hacmi tip 2 diyabetik hastalarda uzun dönem major istenmeyen kardiyovasküler olayları predikte eder

Öz:
Amaç: Epikardiyal yağ dokusu (EYD) koroner aterosklerozda önemli rol oynayan metabolik olarak aktif viseral yağ deposudur. Çalışmamızda amacımız koroner olay geçirmemiş tip 2 diyabetik (T2-DM) hastalarda uzun dönem majör istenmeyen kardiyovasküler olay (MİKO) ile koroner bilgisayarlı tomografi anjiyografi (KBTA) ile ölçülen EYD hacim ilişkisini değerlendirmektir. Yöntemler: 2012-2014 yılları arasında KBTA yapılmış toplam 127 diyabetik hasta retrospektif olarak çalışmaya dahil edildi. Hastalar MİKO varlığına göre iki gruba ayrıldı. MİKO kardiyak ölüm, hastane yatışı gerektiren ölümcül olmayan miyokart enfarktüsü ya da kararsız angina, koroner revaskülarizasyon (perkütan koroner girişim, koroner arter baypas greftleme cerrahisi), kalp yetersizliği, periferik arter hastalığı, iskemik inme olarak tanımlandı. İki grubun EYD hacmi KBTA ile ölçüldü. Bulgular: 60±7 aylık takip süresinde 22 MİKO tespit edildi. Tek ve çok değişkenli analizler ve alıcı işlem karakteristiği (ROC) analizi ile veriler değerlendirildi. Yaş, erkek cinsiyet, koroner arter hastalığı, hemoglobin A1c, glukoz, kreatinin, C-reaktif protein (CRP) ve kolesterol kan düzeyleri MİKO ile ilişkili bulundu. EYD hacmi (OR: 1.027; %95 GA: 1.010- 1.044, p: 0.002) ve düşük dansiteli (yoğunluklu) lipoprotein (OR: 1.015; 95% CI: 1.000-1.030, p: 0.050) MİKO için bağımsız öngördürücü olarak bulundu. ROC analiz sonucuna göre 123.2 mL üzerinde EYD hacmi, %72.7 duyarlılık ve %77.1 özgüllük ile T2-DM hastalarında uzun dönem MİKO’yu öngördürür (Eğri altındaki alan: 0.820; %95 CI: 0.733–0.908). Sonuç: EYD hacmi, öncesinde koroner olay geçirmemiş T2-DM hastalarda uzun dönem MİKO’yu bağımsız olarak öngördürebilmektedir. EYD hacmi T2-DM hastalarda iyi bilinen vasküler risk faktörleri yanı sıra risk sınıflamasında ek olarak kullanılabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Uygur B, ÇELIK O, demir a, Karakayalı M, ARSLAN Ç, Otcu Temur H, Alis D, Yıldırım Karakan C, Çörekcioğlu B, erturk m (2021). Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. , 127 - 134. 10.5543/tkda.2021.65635
Chicago Uygur Begum,ÇELIK OMER,demir ali rıza,Karakayalı Muammer,ARSLAN Çağdaş,Otcu Temur Hafize,Alis Deniz,Yıldırım Karakan Ceren,Çörekcioğlu Büşra,erturk mehmet Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. (2021): 127 - 134. 10.5543/tkda.2021.65635
MLA Uygur Begum,ÇELIK OMER,demir ali rıza,Karakayalı Muammer,ARSLAN Çağdaş,Otcu Temur Hafize,Alis Deniz,Yıldırım Karakan Ceren,Çörekcioğlu Büşra,erturk mehmet Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. , 2021, ss.127 - 134. 10.5543/tkda.2021.65635
AMA Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. . 2021; 127 - 134. 10.5543/tkda.2021.65635
Vancouver Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. . 2021; 127 - 134. 10.5543/tkda.2021.65635
IEEE Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m "Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes." , ss.127 - 134, 2021. 10.5543/tkda.2021.65635
ISNAD Uygur, Begum vd. "Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes". (2021), 127-134. https://doi.org/10.5543/tkda.2021.65635
APA Uygur B, ÇELIK O, demir a, Karakayalı M, ARSLAN Ç, Otcu Temur H, Alis D, Yıldırım Karakan C, Çörekcioğlu B, erturk m (2021). Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. Türk Kardiyoloji Derneği Arşivi, 49(2), 127 - 134. 10.5543/tkda.2021.65635
Chicago Uygur Begum,ÇELIK OMER,demir ali rıza,Karakayalı Muammer,ARSLAN Çağdaş,Otcu Temur Hafize,Alis Deniz,Yıldırım Karakan Ceren,Çörekcioğlu Büşra,erturk mehmet Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. Türk Kardiyoloji Derneği Arşivi 49, no.2 (2021): 127 - 134. 10.5543/tkda.2021.65635
MLA Uygur Begum,ÇELIK OMER,demir ali rıza,Karakayalı Muammer,ARSLAN Çağdaş,Otcu Temur Hafize,Alis Deniz,Yıldırım Karakan Ceren,Çörekcioğlu Büşra,erturk mehmet Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. Türk Kardiyoloji Derneği Arşivi, vol.49, no.2, 2021, ss.127 - 134. 10.5543/tkda.2021.65635
AMA Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. Türk Kardiyoloji Derneği Arşivi. 2021; 49(2): 127 - 134. 10.5543/tkda.2021.65635
Vancouver Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes. Türk Kardiyoloji Derneği Arşivi. 2021; 49(2): 127 - 134. 10.5543/tkda.2021.65635
IEEE Uygur B,ÇELIK O,demir a,Karakayalı M,ARSLAN Ç,Otcu Temur H,Alis D,Yıldırım Karakan C,Çörekcioğlu B,erturk m "Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes." Türk Kardiyoloji Derneği Arşivi, 49, ss.127 - 134, 2021. 10.5543/tkda.2021.65635
ISNAD Uygur, Begum vd. "Epicardial adipose tissue volume predicts long term major adverse cardiovascular events in patients with Type 2 diabetes". Türk Kardiyoloji Derneği Arşivi 49/2 (2021), 127-134. https://doi.org/10.5543/tkda.2021.65635