Digital Trial Lecture – time and place
- First opponent: Professor Jess Lambrechtsen, University of Southern Denmark
- Second opponent: Professor Ellen Margrethe Hauge, Aarhus University Hospital
- Third member and chair of the evaluation committee: Professor Mona Beyer, University of Oslo
Chair of the Defence
Professor Pål Aksel Næss, University of Oslo
Senior Consultant Ylva Haig, Oslo University Hospital
Coronary CT angiography (CCTA) is an established method for ruling out coronary artery stenoses in symptomatic patients with low to intermediate risk for cardiovascular events. Patients with inflammatory joint diseases and type 1 diabetes have an increased risk for coronary events, but cardiovascular disease prevention is clinically challenging as chest pain often may be absent or unspecific in these patients.
The overall aim of the thesis was to evaluate the prevalence and characteristics of CCTA-verified plaques in patients with inflammatory joint diseases and type 1 diabetes, and further to assess associations between CCTA findings and clinical variables. Additionally, the long-term effect of statins on plaque morphology was evaluated in the patients with inflammatory joint diseases, and the associations between coronary atherosclerosis and epicardial adipose tissue were assessed in the patients with type 1 diabetes.
This thesis shows a high prevalence of coronary plaques in both cohorts. In statin-naïve patients with inflammatory joint diseases, 1/3 of the plaques were characterized as soft or mixed. After 5 years of statin treatment, we found a decrease in soft/mixed plaques and an increase in calcified plaques, which may imply a plaque-stabilizing effect. We found no association between epicardial adipose tissue and coronary atherosclerosis in patients with type 1 diabetes.
Low density lipoprotein-cholesterol level was identified as an important factor for the atherosclerotic development in both cohorts, with long-term glycemic control (HbA1c) as an additional factor in patients with type 1 diabetes. This thesis adds documentation of coronary atherosclerosis in patients with inflammatory joint diseases and type 1 diabetes, and may contribute to improve cardiovascular disease prevention strategies in these patients.
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