Longitudinal assessment of coronary plaque volume change related to glycemic status using serial coronary computed tomography angiography: A PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging)substudy

Ki Bum Won, University of Ulsan, College of Medicine
Sang Eun Lee, Severance Hospital
Byoung Kwon Lee, Severance Hospital
Hyung Bok Park, Yonsei University College of Medicine
Ran Heo, Yonsei University College of Medicine
Asim Rizvi, New York Presbyterian Hospital
Fay Y. Lin, New York Presbyterian Hospital
Amit Kumar, New York Presbyterian Hospital
Martin Hadamitzky, Deutsches Herzzentrum München
Yong Jin Kim, Seoul National University Hospital
Ji Min Sung, Severance Hospital
Edoardo Conte, IRCCS Centro Cardiologico Monzino
Daniele Andreini, IRCCS Centro Cardiologico Monzino
Gianluca Pontone, IRCCS Centro Cardiologico Monzino
Matthew J. Budoff, The Lundquist Institute
Ilan Gottlieb
Eun Ju Chun, Seoul National University Bundang Hospital
Filippo Cademartiri, IRCCS Fondazione SDN
Erica Maffei
Hugo Marques, Hospital da Luz
Jonathon A. Leipsic, The University of British Columbia
Sanghoon Shin, National Health Insurance Service Ilsan Hospital
Jung Hyun Choi, Pusan National University
Renu Virmani, CVPath Institute, Inc.
Habib Samady, Emory University School of Medicine
Kavitha Chinnaiyan, William Beaumont Hospital
Gilbert L. Raff, William Beaumont Hospital
Peter H. Stone, Brigham and Women's Hospital
Daniel S. Berman, Cedars-Sinai Medical Center
Jagat Narula, Icahn School of Medicine at Mount Sinai
Leslee J. Shaw, New York Presbyterian Hospital
Jeroen J. Bax, Leiden University Medical Center - LUMC
James K. Min, New York Presbyterian Hospital


© 2018 Background: Data on the impact of glycemic status on coronary plaque progression have been limited. This study evaluated the association between glycemic status and coronary plaque volume change (PVC)using coronary computed tomography angiography (CCTA). Methods: A total of 1296 subjects (61 ± 9, 56.9% male)who underwent serial CCTA with available glycemic status were enrolled and analyzed from the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM)registry. The median inter-scan period was 3.2 (2.6–4.4)years. Quantitative assessment of coronary plaques was performed at both scans. All participants were categorized into the following groups according to glycemic status: normal, pre-diabetes (pre-DM), and diabetes mellitus (DM). Results: During the follow-up, significant differences in PVC (normal: 51.3 ± 83.3 mm3 vs. pre-DM: 51.0 ± 84.3 mm3 vs. DM: 72.6 ± 95.0 mm3; p < 0.001)and annualized PVC (normal: 14.9 ± 24.9 mm3 vs. pre-DM: 15.7 ± 23.8 mm3 vs. DM: 21.0 ± 27.7 mm3; p = 0.001)were observed among the 3 groups. Compared with normal individuals, individuals with pre-DM showed no significant differences in the adjusted odds ratio (OR)for plaque progression (PP)(1.338, 95% confidence interval [CI]0.967–1.853; p = 0.079). However, the adjusted OR for PP was higher in DM individuals than in normal individuals (1.635, 95% CI 1.126–2.375; p = 0.010). Conclusion: DM had an incremental impact on coronary PP, but pre-DM appeared to have no significant association with an increased risk of coronary PP after adjusting for confounding factors. Clinical trial registration: ClinicalTrials.gov NCT02803411.