Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study

Rine Nakanishi, Indre Ceponiene, Kazuhiro Osawa, Yanting Luo, Mitsuru Kanisawa, Nichelle Megowan, Negin Nezarat, Sina Rahmani, Alexander Broersen, Pieter H. Kitslaar, Christopher Dailing, Matthew J. Budoff

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)73-79
Number of pages7
JournalAtherosclerosis
Volume255
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • Coronary computed tomography angiography
  • Diabetes
  • Plaque progression

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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