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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.
Atherosclerosis. 2016 12; 255:73-79.A

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 mm3vs. 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.

Authors+Show Affiliations

Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA. Electronic address: rnakanishi@labiomed.org.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands.Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands; Medis Medical Systems bv, Leiden, 2316 XG, The Netherlands.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27835741

Citation

Nakanishi, Rine, et al. "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." Atherosclerosis, vol. 255, 2016, pp. 73-79.
Nakanishi R, Ceponiene I, Osawa K, et al. 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. Atherosclerosis. 2016;255:73-79.
Nakanishi, R., Ceponiene, I., Osawa, K., Luo, Y., Kanisawa, M., Megowan, N., Nezarat, N., Rahmani, S., Broersen, A., Kitslaar, P. H., Dailing, C., & Budoff, M. J. (2016). 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. Atherosclerosis, 255, 73-79. https://doi.org/10.1016/j.atherosclerosis.2016.11.004
Nakanishi R, et al. 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. Atherosclerosis. 2016;255:73-79. PubMed PMID: 27835741.
* Article titles in AMA citation format should be in sentence-case
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: 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, Y1 - 2016/11/03/ PY - 2016/09/09/received PY - 2016/10/26/revised PY - 2016/11/02/accepted PY - 2016/11/12/pubmed PY - 2017/11/7/medline PY - 2016/11/12/entrez KW - Coronary computed tomography angiography KW - Diabetes KW - Plaque progression SP - 73 EP - 79 JF - Atherosclerosis JO - Atherosclerosis VL - 255 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 mm3vs. 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. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/27835741/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(16)31472-1 DB - PRIME DP - Unbound Medicine ER -