The purpose of this study is to develop and field-test new tools for diagnosis and hazard assessment of cardiometabolic risk (CMR) in people with chronic spinal cord injury (SCI) and to advance the evidence base with much needed information on CMR and cardiovascular disease (CVD) burden in people with SCI. These data can be used to develop screening guidelines for early identification and prevention of CMR in SCI, as well as targeted approaches to primary disease management.
Unlike current assessments utilizing lipid scores, the new system will be anchored in more reliable measurements of cardiovascular disease (CVD) burden using contemporary surrogate end points of coronary artery calcium (CAC) score, coronary CT angiography and carotid intima media thickness (CIMT). By the end of the 5-year funding cycle we will develop an updatable web-based cardiometabolic risk assessment tool (RISK) that will allow clinicians and SCI consumers to quantify risk for a cardiovascular sentinel event (stroke, non-fatal heart attack, or death) and will also provide a body mass index (BMI) table adjusted for SCI. Specific Aims: 1. Examine the relationships among surrogates of cardiovascular disease burden in persons with SCI and established cardiometabolic risks. 2. Identify significant predictors of cardiometabolic risk (CMR) that are unique to persons with specific levels of SCI. 3. Develop and validate SCI CMR assessment tool (RISK) based on cardiometabolic risk scores. 4. Develop and validate an adjusted BMI table for SCI.
Study Type
OBSERVATIONAL
Enrollment
74
The Miami Project to Cure Paralysis
Miami, Florida, United States
Body composition
The percent of muscle and fat in each participants' body will be measured by dual x-ray absorptiometry (DEXA) scan.
Time frame: 1 visit
Carotid Intima-Media Thickness
Carotid intima-media thickness (IMT) measurements will be generated using B-mode external vascular ultrasound.
Time frame: 1 visit
Coronary Artery Calcium
Non-contrast cardiac CT will be used to measure coronary artery calcium, as the presence of any calcium detected in the coronary tree is diagnostic of atherosclerosis. The volume of calcium is quantified, providing a score of plaque burden analogous to a physiologic stress test. Coronary calcium scores directly correlate with risk of cardiac events, with higher scores indicating greater plaque burden and greater risk of cardiac events.
Time frame: 1 visit
Atherosclerotic plaques
Noninvasive CT angiography will be used in visualizing both calcified and non-calcified atherosclerotic plaques. This technique provides much finer anatomic detail and provides an opportunity to further identify latent atherosclerosis risk through the detection of both calcified and noncalcified atherosclerosis.
Time frame: 1 visit
Area Under the Curve (AUC)for lipemia
Lipemia is assessed by the AUC for triglycerides during an oral glucose tolerance test.
Time frame: 1 visit
Area Under the Curve (AUC) for glycemia
Glycemia is assessed by the AUC for glucose and insulin during an oral glucose tolerance test.
Time frame: 1 visit
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Area Under the Curve (AUC)for vascular inflammation
The pro-atherogenic inflammatory mediators are AUCs for C-reactive protein and Interleukin-6 during an oral glucose tolerance test.
Time frame: 1 visit