Kidney Week

Abstract: FR-OR97

Increased Coronary Artery Pathology in Type 2 Diabetes Without Cardiovascular Disease but with Albuminuria

Session Information

• Novel Clinical Impacts on Cardiorenal Disease
  November 03, 2023 | Location: Room 103, Pennsylvania Convention Center
  Abstract Time: 05:24 PM - 05:33 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Hansen, Tine, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark

Tine Hansen, MD

• Rasmussen, Ida, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark

Ida Rasmussen,

• Skriver-Møller, Anne-Cathrine, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark

Anne-Cathrine Skriver-Møller,

• Ripa, Rasmus S., Department of Clinical Physiology & Nuclear Medicine, Copenhagen, Denmark

Rasmus S. Ripa,

• Hasbak, Philip, Department of Clinical Physiology & Nuclear Medicine, Copenhagen, Denmark

Philip Hasbak,

• Wasehuus, Victor, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark

Victor Wasehuus,

• Hadji-Turdeghal, Katra, Rigshospitalet, Kobenhavn, Denmark

Katra Hadji-Turdeghal,

• Zobel, Emilie, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark

Emilie Zobel,

• Lassen, Martin Lyngby, Department of Clinical Physiology & Nuclear Medicine, Copenhagen, Denmark

Martin Lyngby Lassen,

• Slomka, Piotr, Departments of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States

Piotr Slomka,

• Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Denmark

Peter Rossing,

• Kjaer, Andreas, Department of Clinical Physiology & Nuclear Medicine, Copenhagen, Denmark

Andreas Kjaer,

Background

Advances in non-invasive imaging enables combined structural and functional assessment of coronary artery pathophysiology. We evaluated sub-clinical coronary artery pathology using multimodal imaging in persons with type 2 diabetes.

Methods

Cross-sectional study including persons with type 2 diabetes, without known cardiovascular disease or symptoms. Coronary microcalcification activity was measured using ¹⁸F-sodium fluoride positron emission tomography/computed tomography (PET/CT). Plaque inflammation was measured using ⁶⁴Cu-DOTATATE PET/CT and estimated as coronary inflammation activity. Myocardial flow reserve was calculated using ⁸²Rubidium PET/CT, and the coronary artery calcium score was quantified using CT.

Results

We included 90 participants, 30 had normoalbuminuria (urine albumin creatinine ratio (UACR) <30 mg/g) and 60 had current albuminuria or a history of albuminuria (UACR ≥ 30 mg/g). Mean age was 65 (SD 7.5) years, 19 % were females. Participants with albuminuria had increased microcalcification activity (median 0.75 [IQR: 0.30 -1.85]) compared to normoalbuminuria (0.43 [0.24 - 0.87]; p=0.04), but not after adjustment for clinical risk factors for cardiovascular disease (p=0.09). Microcalcification activity was positively associated with the current level of UACR (standardized β=0.53, p=0.008), and a trend remained after adjustment (β=0.44, p=0.05). Mean myocardial flow reserve was lower in participants with albuminuria (2.5 (SD 0.7)) compared to normoalbuminuria (2.9 (0.7); p=0.02), but not after adjustment (p=0.07). Coronary inflammation activity and coronary artery calcium score were similar between albuminuria groups (p≥0.40). Higher current level of UACR was associated with lower myocardial flow reserve (β=-0.42, p=0.03) and higher coronary artery calcium score (β=0.40, p=0.03) in unadjusted analysis. Current level of UACR was not associated with coronary inflammation activity (p=0.74).

Conclusion

In persons with type 2 diabetes, without cardiovascular disease, the presence of albuminuria was associated with sub-clinical coronary artery pathology and microcalcifications when compared to normoalbuminuria.

Funding

• Private Foundation Support