scholarly journals Usefulness of MCP-1 Chemokine in the Monitoring of Patients with Coronary Artery Disease Subjected to Intensive Dietary Intervention: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3047
Author(s):  
Magdalena Makarewicz-Wujec ◽  
Jan Henzel ◽  
Cezary Kępka ◽  
Mariusz Kruk ◽  
Łukasz Wardziak ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Dietary Intervention ◽  
Coronary Plaque ◽  
Control Group ◽  
Dash Diet ◽  
Plaque Component ◽  
Calcified Plaque ◽  
Atheroma Volume ◽  
Artery Disease

Monocyte chemotactic protein-1 (MCP-1) plays an important role in the entire atherosclerotic process, from atherogenesis to destabilisation of the atherosclerotic plaque. The purpose of this study is to evaluate the effect of the dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease on the MCP-1 plasma concentration and to evaluate the potential usefulness of this chemokine as a marker of change in the volume and composition of coronary plaque. Material and method. As part of the dietary intervention to stop coronary atherosclerosis in computed tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40) in which the DASH diet was introduced, and to a control group (n = 39) with no dietary intervention. In the DASH group, dietary counselling was provided at all follow-up visits within 12 months of the follow-up period. MCP-1 plasma concentration was determined using enzyme-linked immunosorbent assay (ELISA). Coronary plaque analysis was performed using a semi-automated plaque analysis software system (QAngioCT, Medis, the Netherlands). Results. In the DASH group, MCP-1 plasma concentration significantly decreased by 34.1 pg/mL (p = 0.01), while in the control group, the change in MPC-1 was not significant. Significant inverse correlations were revealed for the change in MCP-1 plasma concentration and change in the consumption of vitamin C and dietary fibre both in the DASH (r = −0.519, p = 0.0005; r = −0.353, p = 0.025, respectively) and in the control group (r = −0.488 p = 0.001; r = −0.502, p = 0.001, respectively). In patients with the highest decrease in percent atheroma volume (PAV), a significant positive correlation was observed between the change in MCP-1 plasma concentration and changes in PAV (r = 0.428, p = 0.033) and calcified plaque component (r = 0.468, p = 0.018), while the change in noncalcified plaque component correlated inversely with change in MCP1 (r = −0.459, p = 0.021). Conclusion. Dietary intervention based on the DASH diet model reduces the MCP-1plasma concentration, mostly due to an increased intake of plant-derived, fibre-rich foods and antioxidants. The change in MCP-1 plasma concentration seems to reflect changes in the atheroma volume and proportions between the calcified and non-calcified plaque elements.

scholarly journals The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 156
Author(s):  
Magdalena Makarewicz-Wujec ◽  
Jan Henzel ◽  
Mariusz Kruk ◽  
Cezary Kępka ◽  
Łukasz Wardziak ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Dietary Intervention ◽  
Obstructive Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Pathophysiological Mechanism ◽  
Study Objective ◽  
Dash Diet ◽  
Artery Disease

Background: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. Results: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). Conclusions: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study

2021 ◽  
Author(s):  
Hideaki Ota ◽  
Hiroyuki Omori ◽  
Masanori Kawasaki ◽  
Akihiro Hirakawa ◽  
Hitoshi Matsuo
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Coronary Plaque ◽  
Lipid Lowering ◽  
Control Group ◽  
Open Label ◽  
Pcsk9 Inhibitor ◽  
Single Centre Study ◽  
Atheroma Volume

Abstract Aims This study aimed to determine the effects of a proprotein convertase subtilisin-kexin type 9 inhibitor (PCSK9i) on coronary plaque volume and lipid components in patients with a history of coronary artery disease (CAD). Methods and results This prospective, open-label, single-centre study analysed non-culprit coronary segments using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) at baseline and follow-up angiography. Following changes in the lipid-lowering treatment based on the most recent guideline, the enrolled subjects were divided into two groups: treatment with PCSK9i and statins (PCSK9i: 21 patients and 40 segments) and statins only (control: 32 patients and 50 segments). The absolute and percent LDL-C reductions were significantly greater in the PCSK9i group than in the control group (between group difference: 59.3 mg/dL and 46.4%; P < 0.001 for both). The percent reduction in normalized atheroma volume and absolute reduction in percent atheroma volume (PAV) were also significantly greater in the PCSK9i group (P < 0.001 for both). Furthermore, the PCSK9i group showed greater regression of maximal lipid core burden index for each of the 4-mm segments (maxLCBI4mm) than the control group (57.0 vs. 25.5; P = 0.010). A significant linear correlation was found between the percent changes in LDL-C and maxLCBI4mm (r = 0.318; P = 0.002), alongside the reduction in PAV (r = 0.386; P < 0.001). Conclusion The lipid component of non-culprit coronary plaques was significantly decreased by PCSK9i. The effects of statin combined with PCSK9i might be attributed to the stabilization and regression of residual vulnerable coronary plaques in patients with CAD.

scholarly journals Impact of Coronary Plaque Vulnerability on Acute Cardiovascular Events – Design of a CT-based 2-year Follow-up Study

2019 ◽  
Vol 4 (2) ◽  
pp. 64-71
Author(s):  
Noémi Mitra ◽  
Roxana Hodas ◽  
Evelin Szabó ◽  
Zsolt Parajkó ◽  
Theodora Benedek ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Plaque Rupture ◽  
Coronary Plaque ◽  
Plaque Vulnerability ◽  
Mortality And Morbidity ◽  
Diagnostic Strategies ◽  
Major Cardiovascular Events ◽  
Artery Disease ◽  
Improve Patient

Abstract With coronary artery disease (CAD) projected to remain the leading cause of global mortality, prevention strategies seem to be the only effective approach able to reduce the burden and improve mortality and morbidity. At this moment, diagnostic strategies focus mainly on symptomatic patients, ignoring the occurrence of major cardiovascular events as the only manifestation of CAD. As two thirds of fatal myocardial infarction are resulting from plaque rupture, an approach based on the “vulnerable plaque” concept is mandatory in order to improve patient diagnosis, treatment, and, by default, prognosis. Given that the main studies focus on a plaque-centered approach, this is a prospective observational study that will perform a complex assessment of the features that characterize unstable coronary lesions, in terms of both local assessment via specific coronary computed tomography angiography markers of coronary plaque vulnerability and systemic approach based on serological markers of systemic inflammation in patients proved to be “vulnerable” by developing acute cardiovascular events.

scholarly journals POS0216 GREATER HIGH-DENSITY LIPOPROTEIN LEVELS OVER TIME ARE LINKED TO DECREASED CORONARY PLAQUE FORMATION AND REGRESSION AND STABILIZATION OF HIGH-RISK LESIONS IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 325.2-326
Author(s):  
G. Karpouzas ◽  
S. Ormseth ◽  
E. Hernandez ◽  
M. Budoff
Keyword(s):  
Coronary Atherosclerosis ◽  
Density Lipoprotein ◽  
Coronary Plaque ◽  
Plaque Formation ◽  
Prednisone Dose ◽  
Calcified Plaque ◽  
Plaque Regression ◽  
Mixed Plaque ◽  
Over Time

Background:The relationship between serum lipoproteins and cardiovascular disease risk in rheumatoid arthritis (RA) is complex1. Their levels and function may vary based on disease activity and medication use. Beneficial effects on high-density lipoprotein (HDL-C) levels, structure and behavior, in response to treatment have been described. However, the impact of HDL-C levels over time on coronary atherosclerosis progression in RA is unknown.Objectives:We here evaluated the influence of HDL-C levels over time on long-term coronary plaque formation and progression in patients with RA.Methods:One hundred one RA patients without symptoms or history of cardiovascular disease who participated in a computed tomography angiography study of coronary atherosclerosis had repeat assessments after 6.9±0.3 years to evaluate plaque progression. Clinical, laboratory and medication data were recorded at baseline and regular outpatient follow-up visits thereafter. Time-averaged HDL-C was calculated for each patient using available consecutive HDL measurements between baseline and follow-up. Robust logistic regression assessed the association between time-averaged HDL-C and likelihood of new plaque formation in segments without plaque at baseline, and transition of prevalent mixed plaque to calcified plaque. Robust multinomial logistic regression evaluated the effect of time-averaged HDL-C on likelihood of new non-calcified, mixed or calcified plaque formation in segments without plaque (compared to remaining without plaque), and non-calcified plaque regression or transition to mixed or calcified plaque at follow-up (compared to remaining non-calcified). All models accounted for clustering of coronary segments within patients and adjusted for Framingham D’Agostino risk score, proximal segment location, time-averaged CRP, cumulative prednisone dose, bDMARD duration, statin duration, waist-to-height ratio, and time-averaged triglycerides.Results:Participants were mostly female (n=87, 86.1%), with a mean ± standard deviation (SD) age of 51.5±10.3 years and time-averaged HDL-C of 51.7±13.9. Ninety-seven new plaques formed in segments without plaque at baseline; 20 were noncalcified, 21 were mixed, and 56 were calcified. Time-averaged HDL-C had no effect on new total plaque formation (adjusted odds ratio-OR 0.88 [95% CI 0.64-1.21]). However, each 1-SD increase in time-averaged HDL-C associated with a 44% reduced likelihood of new non-calcified plaque formation at follow-up (adjusted OR 0.56 [95% CI 0.35-0.92], Figure 1). In contrast, there was no effect of time-averaged HDL-C on new mixed or calcified plaque formation. Of 98 non-calcified plaques at baseline, 42 did not change at follow-up, 32 regressed (disappeared), 16 transitioned to mixed and 8 to calcified plaques. Each SD increase in time-averaged HDL-C yielded a 2.2-fold greater likelihood of non-calcified plaque regression (adjusted OR 2.21 [95% CI 1.02-4.83]). Sixteen of 52 mixed plaques present at baseline transitioned to more stable calcified lesions, and time-averaged HDL-C (per 1-SD increment) predicted a 3.5-fold increased likelihood of transition of mixed to fully calcified plaque (adjusted OR 3.56 [95% CI 1.25-10.17]).Conclusion:Higher HDL-C over time predicted regression of existing and decreased formation of new higher-risk non-calcified plaque. It also associated with transition of vulnerable mixed plaque to more stable fully calcified plaque. These effects were independent of RA treatment duration, prednisone dose and statin exposure.References:[1]Toms TE et al. Curr Vasc Pharmacol. 2010;8:301–326.Figure 1.Impact of HDL-C over time on coronary plaque progression in RADisclosure of Interests:George Karpouzas Speakers bureau: Sanofi/Genzyme/Regeneron, Consultant of: Sanofi/Genzyme/Regeneron, Grant/research support from: Pfizer, Sarah Ormseth: None declared, Elizabeth Hernandez: None declared, Matthew Budoff: None declared

scholarly journals A Tailored Habits-based Dietary Intervention Combined With Oral Rehabilitation on Partially Dentate Older Adults: Nutritional Impact

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Gerry Mckenna ◽  
Jayne Woodside ◽  
Laura McGowan ◽  
Sinead Watson
Keyword(s):  
Older Adults ◽  
Dietary Intervention ◽  
Habit Formation ◽  
Dietary Habits ◽  
Intervention Group ◽  
Group Differences ◽  
Control Group ◽  
Oral Rehabilitation ◽  
Partially Dentate

AbstractIntroductionReplacing missing teeth alone is not enough to engender dietary behaviour change amongst older adults. Whilst there is a body of evidence to support oral rehabilitation in conjunction with dietary advice, this is currently limited to edentate patients even though the majority of older adults are now partially dentate. One approach proven to change long-term food behaviours but is novel in this population is habit-formation. Consequently, this study developed and tested a habit-based tailored dietary intervention, in conjunction with oral rehabilitation amongst partially dentate older adults.Materials and methodsA pilot randomised control trial was conducted on 57 partially dentate older patients. Participants were randomised to an intervention group (habits-based dietary intervention) or a control group and followed up for 8 months. The intervention group attended four meetings with a trained researcher to target habit-formation around 3 dietary domains (fruit/vegetables, wholegrains, healthy proteins). The primary outcome measure was self-reported automaticity for developing healthy habits and habit formation was assessed using the Self-Report Behavioural Automaticity Index (SRBAI). Preliminary analysis was conducted on n = 36 participants between baseline and 8 month follow up.ResultsPreliminary results showed that SRBAI scores and self-reported frequency of days doing habits in the intervention group for all tailored dietary habits was significant between baseline and follow up visits (p < 0.001). There were moderate positive correlations between automaticity and habit adherence (Fruit/vegetables rho = 0.43, p = 0.09: Wholegrains rho = 0.44, p = 0.08: Healthy Proteins rho = 0.52, p = 0.03) for the intervention group. Automaticity trends were increased in the intervention group for all 3 dietary habits compared to the control group but, other than wholegrain (p = 0.005), between group differences were non-significant (p > 0.05). BMI decreased in the intervention group (29.6 to 28.7 kg/m2) compared to a non-significant increase in the control group (27.7 to 27.8 kg/m2) (p = 0.08). There were slight increases in Mini Nutritional Assessment mean change scores (0.19 intervention: 0.32 control) for both groups, however between-group differences were not statistically significant (p = 0.9). Greater improvements in food intake around dietary habits were observed in the intervention group (Fruit/vegetables:108 g Fibre 4g: Protein 11g) compared to the control group (Fruit/vegetables -17g: Fibre 2g: Protein -4g).DiscussionPreliminary results demonstrate the success of a habit-based dietary intervention coupled with oral rehabilitation in positively influencing dietary behaviours and other nutritional outcomes in partially dentate older adults.

Abstract 17689: Omega-3 Fatty Acid Supplementation Reduces Inflammation and Improves Physical Function in Patient With Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Abdulhamied Alfaddagh ◽  
Francine K Welty
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Physical Function ◽  
Control Group ◽  
P Value ◽  
Omega 3 ◽  
Artery Disease ◽  
One Year ◽  
Wbc Count

Introduction: Poor physical function impairs fitness and is associated with worse cardiovascular outcomes and all-cause mortality. Arthritis and joint dysfunction limit physical function in coronary artery disease (CAD) patients. Hypothesis: Omega-3 fatty acids (FA) improve physical function in CAD patients through reducing inflammation. Methods: We randomized 249 subjects with stable CAD to 3.6 of omega-3 FA (1.86 g of eicosapentaenoic acid + 1.5 g of docosahexaenoic acid) per day or no omega-3 (control) for one year. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to evaluate pain, stiffness and physical function at baseline and one year follow-up. Inflammation was assessed by total white blood cell (WBC) count and its subsets as well as urine microalbumin-creatinine ratio (MCR). Results: Mean age was 63.0 ± 7.58 years; 17% were women. Controls had worsening stiffness (% Δ = 8.4%; p = 0.036) at 1 year follow-up while those on omega-3 FA had no change (% Δ = 0.4%, p = 0.886 - see Table)(a lower percent change indicates better functioning). Compared to controls, those on omega-3 FA had better physical function (% Δ = 8.5% vs. -2.8%, p = 0.011), and total WOMAC scores (% Δ = 7.8% vs. -2.5%, p = 0.011) and a significant decrease in WBC (% Δ = -3.5 vs. -9.4%; p=0.009) and neutrophils (% Δ = -3.5% vs. -11.6%; p=0.005) at one year follow-up. MCR significantly worsened only in the control group (% Δ = 53.3%, p = 0.037) at one year follow-up (p-value for control vs. omega-3 FAs groups = 0.026). Monocytes were decreased in the omega-3 FAs group at one year compared to baseline (% Δ = -11.1%, p < 0.001) and directly correlated with physical function and total scores (p = 0.033 and p = 0.024, respectively). Conclusions: Omega-3 FAs attenuate worsening of physical function over a one year period in CAD patients possibly mediated through an anti-inflammatory effect. Therefore, omega-3 FA may benefit CAD patients by improving their physical function.

Abstract 14687: Achieved Eicosapentaenoic Acid (EPA) Levels Predicts Regression of Coronary Plaque Volumes by Coronary Computed Tomography Angiography (CCTA) in the EVAPORATE Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Suvasini Lakshmanan ◽  
Chandana Shekar ◽  
April Kinninger ◽  
Ilana Golub ◽  
Suraj Dahal ◽  
...  
Keyword(s):  
Coronary Computed Tomography Angiography ◽  
Controlled Trial ◽  
Coronary Plaque ◽  
Intervention Trial ◽  
Beneficial Effects ◽  
Icosapent Ethyl ◽  
Point Analysis ◽  
Calcified Plaque ◽  
Fatty Plaque

Background: Despite the beneficial effects of statins on progression of coronary atherosclerosis and cardiovascular (CV) events, significant CV risk persists in patients with hypertriglyceridemia. In REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial), icosapent ethyl (IPE) added to statins reduced initial and total CV events by 25% and 30%, but the mechanisms of benefit are unclear. In a follow-up analysis, degree of CV benefit from IPE was predominantly related to achieved serum EPA levels. Methods: EVAPORATE is a randomized, placebo-controlled trial, using CCTA to evaluate the effects of IPE as an adjunct to statins on coronary plaque volumes in a cohort with elevated triglycerides. Here, we present the 18-month, pre-specified secondary end-point analysis on association of achieved serum EPA levels, and change in coronary plaque volumes in the pooled cohort. Results: 80 patients were enrolled, and 68 completed the 18-month visit. Median (IQR) level of serum EPA for the pooled cohort was 20.6 (13.8) ug/ml at baseline and 25.3 (55.5) ug/ml at follow up. At 18 months, EPA levels > 26 ug/ml predicted regression of fibro-fatty plaque (logβ: - 0.75± 0.36), total non-calcified plaque (TNCP) (logβ: - 0.77± 0.33), and total plaque (TP) (logβ: - 0.63± 0.28) volumes (mm3), after adjustment for age, sex, diabetes, hypertension, and baseline TGL levels (p < 0.05 for all). Conclusions: Higher serum EPA levels predict regression of prognostically relevant coronary plaque volumes, TNCP, and TP on CCTA. This provides important mechanistic correlation to the CV benefits of IPE.

scholarly journals Pericoronary adipose tissue attenuation in low-risk asymptomatic individuals, sex-differences and association with markers of cardiovascular disease

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Shanmuganathan ◽  
R Ramanathan ◽  
D Dey ◽  
M Goeller ◽  
MW Kusk ◽  
...  
Keyword(s):  
Density Lipoprotein ◽  
Coronary Plaque ◽  
Low Risk ◽  
Low Density ◽  
Ct Attenuation ◽  
Calcified Plaque ◽  
Blood Pressures ◽  
Asymptomatic Individuals ◽  
Pai 1

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Pericoronary adipose tissue (PCAT) attenuation by coronary computed tomography angiography (CCTA) is a marker of coronary inflammation and predicts clinical outcomes in symptomatic patients undergoing CCTA. Sex-differences in PCAT CT attenuation among asymptomatic individuals are not previously described. Purpose To evaluate PCAT CT attenuation according to sex and markers of cardiovascular disease (CVD). Methods Cross-sectional cohort study including asymptomatic individuals, 50- or 60-year of age, not taking any medicine and without known CVD or type-2 diabetes. At baseline and 5-year follow-up smoking habits, blood pressures and biochemistry (lipids, CRP, fibrinogen, D-dimer, t-PA, PAI-1, vWF) were recorded and Agatston Score measured. At follow-up, CCTA was achieved. Quantitative coronary plaque analysis was performed and PCAT CT attenuation within a radial distance of 3 mm from the outer vessel wall 10–50 mm distal to the origin of the right coronary artery measured. A validated PCAT CT attenuation threshold (high vs low risk) of -70.1 Hounsfield units was applied. Results Included were 123 participants (60 women). Independent of co-variation, PCAT CT attenuation (median, [IQR]) was lower in women (-71.0, [-77.2- -67.0]) vs men (-64.5, [-69.9- -57.4]), p &lt; 0.001. No associations between PCAT CT attenuation (high vs low) and risk factors of CVD, CAC or coronary plaque volumes were demonstrated (Table). Variations in blood pressures, biochemical markers and CAC over five years were not associated with PCAT CT attenuation. Conclusion In low-risk asymptomatic individuals, PCAT CT attenuation was lower in women compared to men, irrespective of markers of CVD. Table. Patient characteristics stratified by PCAT CT attenuation PCAT CT attenuation ≤ -70.1 HU (n = 49) PCAT CT attenuation &gt; -70.1 HU (n = 74) p-value Risk factors Age65-years55-years 2623 3143 0.32 SexMenWomen 1534 4826 &lt;0.001 TobaccoNeverCurrent/previous 1732 3737 0.10 Systolic BP, mmHgDiastolic BP, mmHgTotal cholesterol, mmol/lLDL-cholesterol, mmol/lHDL-cholesterol, mmol/lTriglycerides, mmol/l 137 (17)76 (10)5.61 (0.92)3.50 (0.93)1.41 (0.30)1.65 (0.99 - 2.22) 136 (16)77 (10)5.42 (0.82)3.30 (0.82)1.45 (0.35)1.35 (1.03 - 2.11) 0.660.590.230.220.570.52 Biochemistry CRP, mg/lFibrinogen, μmol/lD-dimer, mg/lvWFt-PAPAI-1 1.16 (0.99 - 2.22)9.5 (8.5 - 10.7)0.40 (0.30 - 0.49)128 (102 - 154)7.1 (5.8 - 8.8)20.5 (16.2 - 31.8) 0.61 (0.30 - 1.14)9.0 (7.8 - 10.0)0.32 (0.24 - 0.47)116 (92 - 146)6.3 (5.1 - 8.8)20.3 (14.7 - 26.3) &lt;0.010.10&lt;0.050.110.200.34 Coronary plaque data Agatston ScoreTotal plaque volume, mm&sup3;NCP volume, mm&sup3;CP volume, mm&sup3;LD-NCP volume, mm&sup3; 1 (0 - 36)15.7 (0 - 143.3)0 (0 - 128.1)0 (0 - 14.6)0.5 (0 - 18.7) 8 (0 - 115)15.6 (0 - 268.2)13.5 (0 - 220.5)1.7 (0 - 31.7)1.8 (0 - 21.8) 0.300.450.490.360.74 Values are n (%), mean (SD) or median (IQR).Abbreviations: HU =Hounsfield unit; LDL =low-density lipoprotein; HDL =high-density lipoprotein; BP =blood pressure; CRP = c-reactive protein: vWF =von-Willebrand Factor; t-PA =tissue plasminogen activator; PAI-1 =plasminogen activator inhibitor -1; NCP =non-calcified plaque; CP =calcified plaque; LD-NCP =low-density non-calcified plaque.

P2680Changes in body fat distribution after intensive dietary intervention in patients with stable coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Henzel ◽  
M Makarewicz-Wujec ◽  
L Wardziak ◽  
P Trochimiuk ◽  
C Kepka ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Body Fat ◽  
Visceral Fat ◽  
Dietary Intervention ◽  
Fat Distribution ◽  
Control Group ◽  
Total Body Fat ◽  
Artery Disease ◽  
Stable Cad ◽  
Total Body

Abstract Introduction Contradictory reports are available on the role of adipose tissue in the pathophysiology and progression of coronary artery disease (CAD). It seems accepted that local fat distribution is more relevant than the general amount of body fat. As in the case of visceral fat, pericardial adipose tissue (PEAT) has been postulated an important mediator of metabolic risk, with a special role attributed to epicardial adipose tissue (EAT). Purpose To study the effect of intensive dietary and lifestyle modification on the distribution of body fat in patients diagnosed with stable CAD qualified to conservative treatment. Methods Total body fat mass (TBF), visceral fat area (VFA), PEAT volume, and EAT volume were measured in 67 participants (43% women) of the DISCO-CT trial (Dietary Intervention to Stop COronary Atherosclerosis in Computed Tomography, NCT02571803) who completed the study by the end of 2018. All patients, randomly assigned to either experimental or control arm in a 1:1 fashion, were regularly followed-up at our site, with those in the experimental arm being strictly supervised by a dietitian to stick to Dietary Approaches to Stop Hypertension (DASH) diet and encouraged to lifestyle changes atop optimal medical therapy. Contrast-enhanced coronary computed tomography was performed at baseline and after the median time of 59 weeks (2x192-multislice scanner, temporal resolution 66 ms, Somatom Force, Siemens). PEAT and EAT volumes, expressed in mm3, were measured with a dedicated offline workstation (syngo.via Frontier, Siemens Healthcare) using a semiautomatic segmentation technique (window width range −195 to −45 Hounsfield units). TBF, expressed in kg, and VFA, expressed in cm2, were measured using the InBody S10 Body Water Analyser at baseline and completion of the study. 57% of subjects included into the analysis represented the experimental arm. Results There were no significant between-arm differences in baseline TBF, VFA, PEAT, and EAT volumes. A significant reduction by 3.7±5.0 kg in TBF (p<0.001; 95% CI 2.1, 5.3) and by 19.7±30.1 cm2 in VFA (p<0.001; 95% CI 9.8, 29.6) was observed in the experimental arm, while in the control group both TBF and VFA irrelevantly increased, by 0.6±4.7 kg (p=0.53; 95% CI −2.4, 1.3) and 2.2±27.0 cm2 (p=0.67; 95% CI −12.7, 8.2), respectively. A significant decrease in PEAT volume, by 19.9±43.0 mm3 (p=0.007; 95% CI 5.8, 34.1), was observed in the experimental group, compared to a non-significant PEAT volume reduction by 5.8±3.5.0 mm3 (p=0.38, 95% CI −7.5; 19.2) in the control group. Contrarily, no significant changes in EAT volumes were observed in either experimental (reduction by 3.8±15.2 mm3; p=0.13, 95% CI −1.2, 8.8) or control arm (reduction by 5.1±17.2 mm3; p=0.13, 95% CI −1.5, 11.6). Conclusion Intensive dietary intervention in patients with stable CAD can lead to a significant reduction in total body fat, visceral fat and pericardial fat, this effect, however, may not apply to epicardial fat. Acknowledgement/Funding This study was founded by a grant (2.15/III/15) from the Institute of Cardiology in Warsaw, Poland

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