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

Abstract

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 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, noncalcified 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 mm 3 vs. 118.3 mm 3 , p ¼ 0.005). Multivariable linear regression model revealed that diabetes was associated with normalized TPV progression (b 72.3, 95%CI 24.3e120.3). A similar trend was observed for the non-calcified components, but not calcified plaque (b 3.8, 95%CI À27.0e34.7). 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.

Rationale and design of a randomized trial of apixaban vs warfarin to evaluate atherosclerotic calcification and vulnerable plaque progression

“…In contrast, CCTA can assess coronary artery plaque composition in a noninvasive manner. Several studies have revealed the potential of CCTA in quantifying plaque burden to quantify progression or regression of coronary artery disease . CCTA has been shown to accurately determine atherosclerotic plaque size, remodeling, and plaque morphology compared with IVUS as a reference standard .…”

“…Several studies have revealed the potential of CCTA in quantifying plaque burden to quantify progression or regression of coronary artery disease. 18,36 CCTA has been shown to accurately determine atherosclerotic plaque size, remodeling, and plaque morphology compared with IVUS as a reference standard. 37 For quantitative atherosclerotic plaque analysis, we will use a semiautomated method with novel plaque-analysis software for the assessment of progression/regression of CAC and noncalcified plaques.…”

“…Studies were blind to warfarin or apixaban use, and expert readers assessed all coronary arteries. The protocol for quantitative plaque assessment has been previously published . According to a modified 17‐segment American Heart Association coronary tree model, detected plaques were allocated according to plaque location .…”

“…The protocol for quantitative plaque assessment has been previously published. 18 According to a modified 17-segment American Heart Association coronary tree model, detected plaques were allocated according to plaque location. 19 Vessel and plaque volumes were measured in segments with sufficient image quality and ≥1.5 mm in lumen diameter.…”

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200–499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study

“…The initial study sample size was estimated based on MDCTA data showing 24% ± 13% reduction in coronary artery plaque volume with moderate‐dose statin therapy . It is assumed that an 8% reduction in plaque volume (one‐third that seen with statin therapy) would be the minimally important change in noncalcified plaque volume based on past data; multiple studies have shown similar progression/regression rates with different therapies . Further data have been obtained using low‐attenuation plaque volume in both MDCTA and intravascular ultrasound (IVUS) studies.…”