Diabetes, Atherosclerosis, and Stenosis by AI

Author:

Jonas Rebecca A.1ORCID,Crabtree Tami R.2,Jennings Robert S.2,Marques Hugo3,Katz Richard J.4,Chang Hyuk-Jae5,Stuijfzand Wijnand J.6,van Rosendael Alexander R.7,Choi Jung Hyun8,Doh Joon-Hyung9,Her Ae-Young10,Koo Bon-Kwon11,Nam Chang-Wook12,Park Hyung-Bok13,Shin Sang-Hoon14,Cole Jason15,Gimelli Alessia16,Khan Muhammad Akram17,Lu Bin18,Gao Yang18,Nabi Faisal19,Nakazato Ryo20,Schoepf U. Joseph21,Driessen Roel S.6,Bom Michiel J.6,Thompson Randall C.22,Jang James J.23,Ridner Michael24,Rowan Chris25,Avelar Erick26,Généreux Philippe27,Knaapen Paul6,de Waard Guus A.6,Pontone Gianluca28,Andreini Daniele28,Al-Mallah Mouaz H.19,Guglielmo Marco28,Bax Jeroen J.7,Earls James P.2,Min James K.2,Choi Andrew D.4,Villines Todd C.29

Affiliation:

1. 1Department of Internal Medicine, Thomas Jefferson University Medical Center; Philadelphia, PA

2. 2Cleerly, Inc., New York, NY

3. 3Faculdade de Medicina da Universidade Católica Portuguesa, Lisboa, Portugal

4. 4The George Washington University School of Medicine & Health Sciences, Washington, DC

5. 5Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea

6. 6Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands

7. 7Department of Cardiology, Leiden University Medical Center, Amsterdam, the Netherlands

8. 8Ontact Health, Inc., Seoul, South Korea

9. 9Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, South Korea

10. 10Kang Won National University Hospital, Chuncheon, South Korea

11. 11Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea

12. 12Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, South Korea

13. 13Division of Cardiology, Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea

14. 14Division of Cardiology, Department of Internal Medicine, Ewha Women’s University Seoul Hospital, Seoul, South Korea

15. 15Mobile Cardiology Associates, Mobile, AL

16. 16Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy

17. 17Cardiac Center of Texas, McKinney, TX

18. 18State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China

19. 19Houston Methodist Hospital, Houston, TX

20. 20Cardiovascular Center, St. Luke’s International Hospital, Tokyo, Japan

21. 21Medical University of South Carolina, Charleston, SC

22. 22St. Luke’s Mid America Heart Institute, Kansas City, MO

23. 23Kaiser Permanente San Jose Medical Center, San Jose, CA

24. 24Heart Center Research, LLC, Huntsville, AL

25. 25Renown Heart and Vascular Institute, Reno, NV

26. 26Oconee Heart and Vascular Center at St Mary’s Hospital, Athens, GA

27. 27Gagnon Cardiovascular Institute at Morristown Medical Center, Morristown, NJ

28. 28Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy

29. 29Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, VA

Abstract

OBJECTIVE This study evaluates the relationship between atherosclerotic plaque characteristics (APCs) and angiographic stenosis severity in patients with and without diabetes. Whether APCs differ based on lesion severity and diabetes status is unknown. RESEARCH DESIGN AND METHODS We retrospectively evaluated 303 subjects from the Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia (CREDENCE) trial referred for invasive coronary angiography with coronary computed tomographic angiography (CCTA) and classified lesions as obstructive (≥50% stenosed) or nonobstructive using blinded core laboratory analysis of quantitative coronary angiography. CCTA quantified APCs, including plaque volume (PV), calcified plaque (CP), noncalcified plaque (NCP), low-density NCP (LD-NCP), lesion length, positive remodeling (PR), high-risk plaque (HRP), and percentage of atheroma volume (PAV; PV normalized for vessel volume). The relationship between APCs, stenosis severity, and diabetes status was assessed. RESULTS Among the 303 patients, 95 (31.4%) had diabetes. There were 117 lesions in the cohort with diabetes, 58.1% of which were obstructive. Patients with diabetes had greater plaque burden (P = 0.004). Patients with diabetes and nonobstructive disease had greater PV (P = 0.02), PAV (P = 0.02), NCP (P = 0.03), PAV NCP (P = 0.02), diseased vessels (P = 0.03), and maximum stenosis (P = 0.02) than patients without diabetes with nonobstructive disease. APCs were similar between patients with diabetes with nonobstructive disease and patients without diabetes with obstructive disease. Diabetes status did not affect HRP or PR. Patients with diabetes had similar APCs in obstructive and nonobstructive lesions. CONCLUSIONS Patients with diabetes and nonobstructive stenosis had an association to similar APCs as patients without diabetes who had obstructive stenosis. Among patients with nonobstructive disease, patients with diabetes had more total PV and NCP.

Funder

Heart and Vascular Institute

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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