American Diabetes Association
DM_Care_Submission_Supplemental_Material.pdf (151.44 kB)

Diabetes, Atherosclerosis and Stenosis by AI

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posted on 2022-12-28, 21:11 authored by Rebecca A. Jonas, James P. Earls, Hugo Marques, Richard J. Katz, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon-Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sang-Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U. Joseph Schoepf, Roel S. Driessen, Michiel J. Bom, Randall C. Thompson, James J. Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A. de Waard, Gianluca Pontone, Daniele Andreini, Mouaz H. Al-Mallah, Marco Guglielmo, Robert S. Jennings, Tami R. Crabtree, James K. Min, Andrew D. Choi, Todd C. Villines


Objectives: This study evaluates the relationship between atherosclerotic plaque characteristics (APCs) and angiographic stenosis severity in patients with and without diabetes. 

Background: Whether APCs differ based on lesion severity and diabetic status is unknown.

Methods: We retrospectively evaluated 303 subjects from the CREDENCE trial referred for invasive coronary angiography with coronary computed tomographic angiography (CCTA) and classified lesions as obstructive (>50% stenosed) or non-obstructive using blinded core laboratory analysis of quantitative coronary angiography. CCTA quantified APCs including plaque volume (PV), calcified plaque (CP), noncalcified plaque (NCP), low density noncalcified plaque (LD-NCP), lesion length, positive remodeling (PR), high-risk plaque (HRP) and percent atheroma volume (PAV; plaque volume normalized for vessel volume). The relationship between APCs, stenosis severity and diabetic status was assessed.

Results: Among the 303 patients, 95 (31.4%) had diabetes. There were 117 lesions in the diabetic cohort, 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 max stenosis (p=0.02) than nondiabetic patients with nonobstructive disease. APCs were similar between diabetics with non-obstructive disease and non-diabetic patients with obstructive disease. Diabetic status did not affect HRP or PR. Patients with diabetes had similar APCs in obstructive and non-obstructive lesions. 

Conclusions: Patients with diabetes and non-obstructive stenosis had an association to similar APCs as patients without diabetes who have obstructive stenosis. Among patients with non-obstructive disease, patients with diabetes had more total PV and NCP. 


ADC is supported by a grant from the GW Heart and Vascular Institute.


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