In her PhD thesis, Mona Svanteson has evaluated the characteristics and prevalence of coronary artery plaques verified by coronary CT angiography in patients with inflammatory joint diseases and type 1 diabetes


MAIN RESULTS:

  1. A high amount of patients with type 1 diabetes and inflammatory joint diseases have coronary plaques.
  2. Epicardial adipose tissue and coronary plaques are not associated in persons with type 1-diabetes.
  3. Long-term statin therapy might stabilize plaques in patients with inflammatory joint diseases.

THESIS DEFENCE:

Thesis: Evaluation of coronary artery disease using coronary CT angiography in high risk patient cohorts
Candidate: Mona Svanteson
Time: June 16, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website


SUMMARY:

(1) Coronary artery disease was found in two thirds of 86 study participants with rheumatoid arthritis, ankylosing spondylitis or psoriatic arthritis who were referred to coronary CT angiography due to carotid artery plaques. 13% had obstructive coronary artery disease, and in almost half of the patients with coronary artery disease the coronary plaques were either mixed or soft. Carotid plaques alone were not sufficient to identify patients with coronary artery disease.

(4) After a median of 4.7 years of statin treatment, mean total plaque volume had increased in patients with inflammatory joint diseases. However, soft and mixed plaques decreased while there was an increase in the more stable calcified plaques. Moreover, patients who reached the LDL-cholesterol treatment target of maximum 1.8 mmol/L had reduced plaque progression at follow-up. Thus, long-term statin treatment might stabilize plaques in patients with inflammatory joint diseases. 68 patients were included in the study.

(2/3) 24% of 88 patients with type 1 diabetes of at least 45 years duration had undiagnosed coronary artery disease. In matched controls, the prevalence was 10%. Further, Svanteson and her co-workers identified coronary plaques in 85% in the diabetes group, compared to 47% in the control group. Both median total and calcified plaque volumes were substantially higher in the diabetes group.

Patients with the lowest LDL-cholesterol and HbA1c over 30 years had less plaque and lower prevalence of undiagnosed obstructive coronary artery disease. Epicardial adipose tissue volume was not associated with coronary atherosclerosis.


REFERENCES:

(1) Svanteson, M., Rollefstad, S., Kløw, N. E., Hisdal, J., Ikdahl, E., Semb, A. G., & Haig, Y. (2017). Associations between coronary and carotid artery atherosclerosis in patients with inflammatory joint diseasesRMD open3(2), e000544.

(2) Holte, K. B., Svanteson, M., Hanssen, K. F., Haig, Y., Solheim, S., & Berg, T. J. (2019). Undiagnosed coronary artery disease in long-term type 1 diabetes. The Dialong study. Journal of diabetes and its complications33(5), 383-389.

(3) Svanteson, M., Holte, K. B., Haig, Y., Kløw, N. E., & Berg, T. J. (2019). Coronary plaque characteristics and epicardial fat tissue in long term survivors of type 1 diabetes identified by coronary computed tomography angiographyCardiovascular diabetology18(1), 58.

(4) Svanteson, M., Rollefstad, S., Kløw, N. E., Hisdal, J., Ikdahl, E., Sexton, J., Haig, Y., & Semb, A. G. (2019). Effects of long-term statin-treatment on coronary atherosclerosis in patients with inflammatory joint diseases. PloS one14(12), e0226479.

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