Association of pericoronary inflammation with atherosclerotic plaque progression in diabetic patients with improved modifiable cardiovascular risk factors: a longitudinal CCTA cohort study

作者：Tianhao Zhang, Hongkai Zhang, Xuelian Gao, Ping’an Peng, Tianlong Chen, Xiaoming Zhang, Jingyao Yang, Yang Zheng, Yulu Peng, Xiaonan Ma, Dongmei Shi, Zhijian Wang, Lei Xu, Yujie Zhou, Yu Du · 发表于：Diabetology & Metabolic Syndrome · 年份：2025 · DOI：10.1186/s13098-025-01645-4 · 被引用次数：3 · 研究领域：Cardiovascular Disease and Adiposity、Adipokines, Inflammation, and Metabolic Diseases、Cerebrovascular and Carotid Artery Diseases

BACKGROUND: Pericoronary adipose tissue (PCAT) attenuation, as assessed by coronary computed tomography angiography (CCTA), has been identified as a marker of pericoronary inflammation and a predictor of future adverse atherosclerotic events. However, the impact of changes in PCAT attenuation, as evaluated by consecutive CCTAs, on plaque progression in high-risk atherosclerotic patients with improved modifiable cardiovascular risk factors (mCRFs) remains unclear. METHODS: Consecutive patients with type 2 diabetes mellitus (T2DM) who had improved mCRFs and underwent serial, clinically indicated CCTA examinations (time interval ≥ 12 months) at our center between July 2019 and July 2022 were screened. Eligible participants had at least one study plaque, defined as a plaque without significant anatomic stenosis, located in one of the major coronary arteries, which had not been intervened upon or caused adverse events between serial CCTA scans. Percent atheroma volume (PAV) and PCAT attenuation were measured for each study plaque at baseline and follow-up using CCTA plaque analysis software. Changes in PAV (δPAV = follow-up PAV - baseline PAV) were compared based on changes in PCAT attenuation [δPCAT attenuation] (> 0 or ≤ 0). Multivariate linear regression models were used to evaluate the relationship between δPCAT attenuation and δPAV. RESULTS: A total of 98 T2DM patients (mean age: 59.9 years; 75.3% men; 152 plaques) had mCRFs that reached therapeutic targets at follow-up CCTA....