Ung Kim1, Jonathon A Leipsic2, Stephanie L Sellers3, Michael Shao4, Philipp Blanke4, Martin Hadamitzky5, Yong-Jin Kim6, Edoardo Conte7, Daniele Andreini7, Gianluca Pontone7, Matthew J Budoff8, Ilan Gottlieb9, Byoung Kwon Lee10, Eun Ju Chun11, Filippo Cademartiri12, Erica Maffei13, Hugo Marques14, Sanghoon Shin15, Jung Hyun Choi16, Renu Virmani17, Habib Samady18, Peter H Stone19, Daniel S Berman20, Jagat Narula21, Leslee J Shaw18, Jeroen J Bax22, James K Min23, Hyuk-Jae Chang24. 1. Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada; Yeungnam University Medical Center, Daegu, South Korea. 2. Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address: jleipsic@providencehealth.bc.ca. 3. Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada. 4. Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada. 5. Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany. 6. Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany; Seoul National University Hospital, Seoul, South Korea. 7. Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy. 8. Department of Medicine, Harbor UCLA Medical Center, Los Angeles, California. 9. Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil. 10. Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 11. Seoul National University Bundang Hospital, South Korea. 12. Cardiovascular Imaging Center, SDN Foundation IRCCS, Naples, Italy. 13. Department of Radiology, Area Vasta 1/Azienda Sanitaria Unica Regionale (ASUR) Marche, Urbino, Italy. 14. Hospital da Luz, Lisbon, Portugal. 15. National Health Insurance Service Ilsan Hospital, Goyang, South Korea. 16. Busan University Hospital, Busan, South Korea. 17. Department of Pathology, CVPath Institute, Gaithersburg, Maryland. 18. Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. 19. Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 20. Department of Imaging, Cedars-Sinai Medical Center, Cedars-Sinai Heart Institute, Los Angeles, California. 21. Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, New York, New York. 22. Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands. 23. Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and Weill Cornell Medical College, New York, New York. 24. Division of Cardiology, Severance Cardiovascular Hospital, Integrative Cardiovascular Imaging Center, Yonsei University College of Medicine, Seoul, South Korea.
Abstract
OBJECTIVES: This study aimed to determine the rate and extent of plaque progression (PP), changes in plaque features, and clinical predictors of PP in patients with diabetes mellitus (DM). BACKGROUND: The natural history of coronary PP in patients with DM is not well established. METHODS: A total of 1,602 patients (age 61.3 ± 9.0 years; 60.3% men; median scan interval 3.8 years) who underwent serial coronary computed tomography angiography over a period of at least 24 months were enrolled and analyzed from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) trial. Study endpoints were changes in plaque features in diabetics with PP and risk factors for PP by serial coronary computed tomography angiography between patients with and without DM. PP was defined if plaque volume at follow-up minus plaque volume at baseline was >0. RESULTS: DM was an independent risk factor for PP (84.6%; 276 of 326 patients with PP) in multivariate analysis (odds ratio [OR]: 1.526; 95% confidence interval [CI]: 1.100 to 2.118; p = 0.011). Independent risk factors for PP in patients with DM were male sex (OR: 1.485; 95% CI: 1.003 to 2.199; p = 0.048) and mean plaque burden at baseline ≥75% (OR: 3.121; 95% CI: 1.701 to 5.725; p ≤0.001). After propensity matching, percent changes in overall plaque volume (30.3 ± 36.9% in patients without DM and 36.0 ± 29.7% in those with DM; p = 0.032) and necrotic core volume (-7.0 ± 35.8% in patients without DM and 21.5 ± 90.5% in those with DM; p = 0.007) were significantly greater in those with DM. The frequency of spotty calcification, positive remodeling, and burden of low-attenuation plaque were significantly greater in patients with DM. CONCLUSIONS: People with DM experience greater PP, particularly significantly greater progression in adverse plaque, than those without DM. Male sex and mean plaque burden >75% at baseline were identified as independent risk factors for PP.
OBJECTIVES: This study aimed to determine the rate and extent of plaque progression (PP), changes in plaque features, and clinical predictors of PP in patients with diabetes mellitus (DM). BACKGROUND: The natural history of coronary PP in patients with DM is not well established. METHODS: A total of 1,602 patients (age 61.3 ± 9.0 years; 60.3% men; median scan interval 3.8 years) who underwent serial coronary computed tomography angiography over a period of at least 24 months were enrolled and analyzed from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) trial. Study endpoints were changes in plaque features in diabetics with PP and risk factors for PP by serial coronary computed tomography angiography between patients with and without DM. PP was defined if plaque volume at follow-up minus plaque volume at baseline was >0. RESULTS:DM was an independent risk factor for PP (84.6%; 276 of 326 patients with PP) in multivariate analysis (odds ratio [OR]: 1.526; 95% confidence interval [CI]: 1.100 to 2.118; p = 0.011). Independent risk factors for PP in patients with DM were male sex (OR: 1.485; 95% CI: 1.003 to 2.199; p = 0.048) and mean plaque burden at baseline ≥75% (OR: 3.121; 95% CI: 1.701 to 5.725; p ≤0.001). After propensity matching, percent changes in overall plaque volume (30.3 ± 36.9% in patients without DM and 36.0 ± 29.7% in those with DM; p = 0.032) and necrotic core volume (-7.0 ± 35.8% in patients without DM and 21.5 ± 90.5% in those with DM; p = 0.007) were significantly greater in those with DM. The frequency of spotty calcification, positive remodeling, and burden of low-attenuation plaque were significantly greater in patients with DM. CONCLUSIONS:People with DM experience greater PP, particularly significantly greater progression in adverse plaque, than those without DM. Male sex and mean plaque burden >75% at baseline were identified as independent risk factors for PP.
Authors: Gianluca Pontone; Alexia Rossi; Marco Guglielmo; Marc R Dweck; Oliver Gaemperli; Koen Nieman; Francesca Pugliese; Pal Maurovich-Horvat; Alessia Gimelli; Bernard Cosyns; Stephan Achenbach Journal: Eur Heart J Cardiovasc Imaging Date: 2022-03-22 Impact factor: 9.130
Authors: Daniel S Berman; Piotr J Slomka; Donghee Han; Alan Rozanski; Heidi Gransar; Evangelos Tzolos; Robert J H Miller; Tali Sharir; Andrew J Einstein; Mathews B Fish; Terrence D Ruddy; Philipp A Kaufmann; Albert J Sinusas; Edward J Miller; Timothy M Bateman; Sharmila Dorbala; Marcelo Di Carli; Joanna X Liang; Lien-Hsin Hu; Damini Dey Journal: J Nucl Cardiol Date: 2021-11-10 Impact factor: 3.872
Authors: Ki-Bum Won; Byoung Kwon Lee; Hyung-Bok Park; Ran Heo; Sang-Eun Lee; Asim Rizvi; Fay Y Lin; Amit Kumar; Martin Hadamitzky; Yong-Jin Kim; Ji Min Sung; Edoardo Conte; Daniele Andreini; Gianluca Pontone; Matthew J Budoff; Ilan Gottlieb; Eun Ju Chun; Filippo Cademartiri; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Jonathon A Leipsic; Sanghoon Shin; Jung Hyun Choi; Renu Virmani; Habib Samady; Kavitha Chinnaiyan; Gilbert L Raff; Peter H Stone; Daniel S Berman; Jagat Narula; Leslee J Shaw; Jeroen J Bax; James K Min; Hyuk-Jae Chang Journal: Cardiovasc Diabetol Date: 2020-07-18 Impact factor: 9.951
Authors: Donghee Han; Daniel S Berman; Robert J H Miller; Daniele Andreini; Matthew J Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Edoardo Conte; Hugo Marques; Pedro de Araújo Gonçalves; Ilan Gottlieb; Martin Hadamitzky; Jonathon Leipsic; Erica Maffei; Gianluca Pontone; Sangshoon Shin; Yong-Jin Kim; Byoung Kwon Lee; Eun Ju Chun; Ji Min Sung; Sang-Eun Lee; Renu Virmani; Habib Samady; Peter Stone; Jagat Narula; Jeroen J Bax; Leslee J Shaw; Fay Y Lin; James K Min; Hyuk-Jae Chang Journal: JAMA Netw Open Date: 2020-07-01
Authors: Junjie Yang; Guanhua Dou; Christian Tesche; Carlo N De Cecco; Brian E Jacobs; U Joseph Schoepf; Yundai Chen Journal: BMC Cardiovasc Disord Date: 2019-02-11 Impact factor: 2.298
Authors: Rami M Abazid; Jonathan G Romsa; Cigdem Akincioglu; James C Warrington; Yves Bureau; Bob Kiaii; William C Vezina Journal: Open Heart Date: 2021-06