American Diabetes Association
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DB23-0529 online_appendix_110923.pdf (177.11 kB)

Increased sub-clinical coronary artery pathology in type 2 diabetes with albuminuria.

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posted on 2023-11-22, 18:49 authored by Ida Bull Rasmussen, Anne-Cathrine Skriver-Moeller, Rasmus Ripa, Philip Hasbak, Victor Wasehuus, Katra Hadji-Turdeghal, Emilie Zobel, Martin Lassen, Lene Holmvang, Piotr Slomka, Peter Rossing, Andreas Kjaer, Tine W. Hansen

Abstract Diabetes affects the kidneys, and presence of albuminuria reflects widespread vascular damage and is a risk factor for cardiovascular disease (CVD). Still, the pathophysiological association between albuminuria and CVD remains incompletely understood. Recent advantages in non-invasive imaging enable functional assessment of coronary artery pathology and present an opportunity to explore the association between albuminuria and CVD. In this cross-sectional study, we evaluated the presence of sub-clinical coronary artery pathology in people with type 2 diabetes, free of overt CVD. Using multimodal imaging, we assessed the coronary microcalcification activity (18F-sodium fluoride positron emission tomography/computed tomography (PET/CT), plaque inflammation (64Cu-DOTATATE PET/CT) and myocardial flow reserve (82Rubidium PET/CT). The study population consisted of 90 participants, stratified by albuminuria; 60 had historic or current albuminuria (urine albumin creatinine ratio (UACR) ≥ 30 mg/g)), and 30 had normoalbuminuria (UACR < 30 mg/g). We demonstrated that any albuminuria (historic or current) was associated with a more severe phenotype, in particularly higher levels of microcalcifications and impaired myocardial microvascular function, however, coronary inflammation activity was similar in people with and without albuminuria. Our findings establish a potential underlying mechanism connecting cardiovascular and kidney diseases and could indicate the initial stages of the cardiorenal syndrome. Article Highlights · Why did we undertake this study? to explore the pathophysiological association between albuminuria and CVD. · What is the specific question we wanted to answer? Is albuminuria related to a more severe phenotype of sub-clinical coronary pathology? · What did we find? Albuminuria was associated with higher levels of coronary microcalcification activity and impaired myocardial microvascular function. · What are the implications of our findings? This establishes a potential underlying mechanism connecting cardiovascular and kidney diseases and could indicate the initial stages of the cardiorenal syndrome

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The Novo Nordisk NNF19OC0054674

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