TY - JOUR
T1 - Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients
T2 - A propensity-score matching study
AU - Nakanishi, Rine
AU - Ceponiene, Indre
AU - Osawa, Kazuhiro
AU - Luo, Yanting
AU - Kanisawa, Mitsuru
AU - Megowan, Nichelle
AU - Nezarat, Negin
AU - Rahmani, Sina
AU - Broersen, Alexander
AU - Kitslaar, Pieter H.
AU - Dailing, Christopher
AU - Budoff, Matthew J.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background and aims We aimed at investigating whether diabetes is associated with progression in coronary plaque components. Methods We identified 142 study subjects undergoing serial coronary computed tomography angiography. The resulting propensity score was applied 1:1 to match diabetic patients to non-diabetic patients for clinical risk factors, prior coronary stenting, coronary artery calcium (CAC) score and the serial scan interval, resulting in the 71 diabetes and 71 non-diabetes patients. Coronary plaque (total, calcified, non-calcified including fibrous, fibrous-fatty and low attenuation plaque [LAP]) volume normalized by total coronary artery length was measured using semi-automated plaque software and its change overtime between diabetic and non-diabetic patients was evaluated. Results The matching was successful without significant differences between the two groups in all matched variables. The baseline volumes in each plaque also did not differ. During a mean scan interval of 3.4 ± 1.8 years, diabetic patients showed a 2-fold greater progression in normalized total plaque volume (TPV) than non-diabetes patients (52.8 mm3 vs. 118.3 mm3, p = 0.005). Multivariable linear regression model revealed that diabetes was associated with normalized TPV progression (β 72.3, 95%CI 24.3–120.3). A similar trend was observed for the non-calcified components, but not calcified plaque (β 3.8, 95%CI −27.0–34.7). Higher baseline CAC score was found to be associated with total, non-calcified and calcified plaque progression. However, baseline non-calcified volume but not CAC score was associated with LAP progression. Conclusions The current study among matched patients indicates diabetes is associated with a greater plaque progression. Our results show the need for strict adherence of diabetic patients to the current preventive guidelines.
AB - Background and aims We aimed at investigating whether diabetes is associated with progression in coronary plaque components. Methods We identified 142 study subjects undergoing serial coronary computed tomography angiography. The resulting propensity score was applied 1:1 to match diabetic patients to non-diabetic patients for clinical risk factors, prior coronary stenting, coronary artery calcium (CAC) score and the serial scan interval, resulting in the 71 diabetes and 71 non-diabetes patients. Coronary plaque (total, calcified, non-calcified including fibrous, fibrous-fatty and low attenuation plaque [LAP]) volume normalized by total coronary artery length was measured using semi-automated plaque software and its change overtime between diabetic and non-diabetic patients was evaluated. Results The matching was successful without significant differences between the two groups in all matched variables. The baseline volumes in each plaque also did not differ. During a mean scan interval of 3.4 ± 1.8 years, diabetic patients showed a 2-fold greater progression in normalized total plaque volume (TPV) than non-diabetes patients (52.8 mm3 vs. 118.3 mm3, p = 0.005). Multivariable linear regression model revealed that diabetes was associated with normalized TPV progression (β 72.3, 95%CI 24.3–120.3). A similar trend was observed for the non-calcified components, but not calcified plaque (β 3.8, 95%CI −27.0–34.7). Higher baseline CAC score was found to be associated with total, non-calcified and calcified plaque progression. However, baseline non-calcified volume but not CAC score was associated with LAP progression. Conclusions The current study among matched patients indicates diabetes is associated with a greater plaque progression. Our results show the need for strict adherence of diabetic patients to the current preventive guidelines.
KW - Coronary computed tomography angiography
KW - Diabetes
KW - Plaque progression
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U2 - 10.1016/j.atherosclerosis.2016.11.004
DO - 10.1016/j.atherosclerosis.2016.11.004
M3 - Article
C2 - 27835741
AN - SCOPUS:84994614298
SN - 0021-9150
VL - 255
SP - 73
EP - 79
JO - Atherosclerosis
JF - Atherosclerosis
ER -