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Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes.
Cardiovasc Diabetol. 2019 09 24; 18(1):123.CD

Abstract

BACKGROUND

Patients with Diabetes mellitus (DM) are susceptible to coronary artery disease (CAD). However, the impact of DM on plaque progression in the non-stented segments of stent-implanted patients has been rarely reported. This study aimed to evaluate the impact of DM on the prevalence, characteristics and severity of coronary computed tomography angiography (CCTA) verified plaque progression in stented patients. A comparison between diabetic and non-diabetic patients was performed.

METHODS

A total of 98 patients who underwent clinically indicated serial CCTAs arranged within 1 month before and at least 6 months after percutaneous coronary intervention (PCI) were consecutively included. All the subjects were categorized into diabetic group (n = 36) and non-diabetic groups (n = 62). Coronary stenosis extent scores, segment involvement scores (SIS), segment stenosis scores (SSS) at baseline and follow-up CCTA were quantitatively assessed. The prevalence, characteristics and severity of plaque progression was evaluated blindly to the clinical data and compared between the groups.

RESULTS

During the median 1.5 year follow up, a larger number of patients (72.2% vs 40.3%, P = 0.002), more non-stented vessels (55.7% vs 23.2%, P < 0.001) and non-stented segments (10.3% vs 4.4%, P < 0.001) showed plaque progression in DM group, compared to non-DM controls. More progressive lesions in DM patients were found to be non-calcified plaques (31.1% vs 12.8%, P = 0.014) or non-stenotic segments (6.6% vs 3.0%, p = 0.005) and were more widely distributed on left main artery (24.2% vs 5.2%, p = 0.007), the right coronary artery (50% vs 21.1%, P = 0.028) and the proximal left anterior artery (33.3% vs 5.1%, P = 0.009) compared to non-DM patients. In addition, DM patients possessed higher numbers of progressive segments per patient, ΔSIS and ΔSSS compared with non-DM individuals (P < 0.001, P = 0.029 and P < 0.001 respectively). A larger number of patients with at least two progressive lesions were found in the DM group (P = 0.006). Multivariate logistic regression analysis demonstrated that DM (OR: 4.81; 95% CI 1.64-14.07, P = 0.004) was independently associated with plaque progression.

CONCLUSIONS

DM is closely associated with the prevalence and severity of CCTA verified CAD progression. These findings suggest that physicians should pay attention to non-stent segments and the management of non-stent segment plaque progression, particularly to DM patients.

Authors+Show Affiliations

Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China. yangzg666@163.com.Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. gykpanda@163.com.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31551077

Citation

Shi, Rui, et al. "Serial Coronary Computed Tomography Angiography-verified Coronary Plaque Progression: Comparison of Stented Patients With or Without Diabetes." Cardiovascular Diabetology, vol. 18, no. 1, 2019, p. 123.
Shi R, Shi K, Yang ZG, et al. Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes. Cardiovasc Diabetol. 2019;18(1):123.
Shi, R., Shi, K., Yang, Z. G., Guo, Y. K., Diao, K. Y., Gao, Y., Zhang, Y., & Huang, S. (2019). Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes. Cardiovascular Diabetology, 18(1), 123. https://doi.org/10.1186/s12933-019-0924-z
Shi R, et al. Serial Coronary Computed Tomography Angiography-verified Coronary Plaque Progression: Comparison of Stented Patients With or Without Diabetes. Cardiovasc Diabetol. 2019 09 24;18(1):123. PubMed PMID: 31551077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes. AU - Shi,Rui, AU - Shi,Ke, AU - Yang,Zhi-Gang, AU - Guo,Ying-Kun, AU - Diao,Kai-Yue, AU - Gao,Yue, AU - Zhang,Yi, AU - Huang,Shan, Y1 - 2019/09/24/ PY - 2019/06/26/received PY - 2019/09/06/accepted PY - 2019/9/26/entrez PY - 2019/9/26/pubmed PY - 2020/5/12/medline KW - Coronary artery computed tomography KW - Coronary plaques KW - Percutaneous coronary intervention KW - Type 2 diabetes mellitus SP - 123 EP - 123 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 18 IS - 1 N2 - BACKGROUND: Patients with Diabetes mellitus (DM) are susceptible to coronary artery disease (CAD). However, the impact of DM on plaque progression in the non-stented segments of stent-implanted patients has been rarely reported. This study aimed to evaluate the impact of DM on the prevalence, characteristics and severity of coronary computed tomography angiography (CCTA) verified plaque progression in stented patients. A comparison between diabetic and non-diabetic patients was performed. METHODS: A total of 98 patients who underwent clinically indicated serial CCTAs arranged within 1 month before and at least 6 months after percutaneous coronary intervention (PCI) were consecutively included. All the subjects were categorized into diabetic group (n = 36) and non-diabetic groups (n = 62). Coronary stenosis extent scores, segment involvement scores (SIS), segment stenosis scores (SSS) at baseline and follow-up CCTA were quantitatively assessed. The prevalence, characteristics and severity of plaque progression was evaluated blindly to the clinical data and compared between the groups. RESULTS: During the median 1.5 year follow up, a larger number of patients (72.2% vs 40.3%, P = 0.002), more non-stented vessels (55.7% vs 23.2%, P < 0.001) and non-stented segments (10.3% vs 4.4%, P < 0.001) showed plaque progression in DM group, compared to non-DM controls. More progressive lesions in DM patients were found to be non-calcified plaques (31.1% vs 12.8%, P = 0.014) or non-stenotic segments (6.6% vs 3.0%, p = 0.005) and were more widely distributed on left main artery (24.2% vs 5.2%, p = 0.007), the right coronary artery (50% vs 21.1%, P = 0.028) and the proximal left anterior artery (33.3% vs 5.1%, P = 0.009) compared to non-DM patients. In addition, DM patients possessed higher numbers of progressive segments per patient, ΔSIS and ΔSSS compared with non-DM individuals (P < 0.001, P = 0.029 and P < 0.001 respectively). A larger number of patients with at least two progressive lesions were found in the DM group (P = 0.006). Multivariate logistic regression analysis demonstrated that DM (OR: 4.81; 95% CI 1.64-14.07, P = 0.004) was independently associated with plaque progression. CONCLUSIONS: DM is closely associated with the prevalence and severity of CCTA verified CAD progression. These findings suggest that physicians should pay attention to non-stent segments and the management of non-stent segment plaque progression, particularly to DM patients. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/31551077/Serial_coronary_computed_tomography_angiography_verified_coronary_plaque_progression:_comparison_of_stented_patients_with_or_without_diabetes_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-019-0924-z DB - PRIME DP - Unbound Medicine ER -