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
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
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DOI：
10.1016/j.atherosclerosis.2016.11.004
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发表时间：
2016-12-01
期刊：
影响因子：
5.3
通讯作者：
Budoff, Matthew J.
中科院分区：
文献类型：
--
作者：
Nakanishi, Rine;Ceponiene, Indre;Budoff, Matthew J.
背景和目的：我们的目的是调查糖尿病是否与冠状动脉斑块成分的进展有关。方法：我们确定了142名接受连续冠状动脉CT血管成像的研究对象。应用1：1的倾向性评分，将糖尿病患者和非糖尿病患者在临床危险因素、冠状动脉支架植入前、冠状动脉钙化(CAC)评分和序列扫描间隔等方面进行匹配，得出71名糖尿病患者和71名非糖尿病患者。使用半自动斑块软件测量冠状动脉总长度归一化的冠状动脉斑块(总斑块、钙化斑块、非钙化斑块，包括纤维斑块、纤维脂肪斑块和低密度斑块[LAP])的体积，并对其在糖尿病和非糖尿病患者之间的时间变化进行评估。结果：两组患者匹配成功，所有匹配变量无显著差异。每个斑块的基线体积也没有不同。在3.4年+/-1.8年的平均扫描间隔中，糖尿病患者的标准化总斑块体积(TPV)的进展是非糖尿病患者的两倍(52.8mM(3)vs.118.3 mm(3)，p=0.005)。多变量线性回归模型显示糖尿病与标准化的TPV进展相关(Beta72.3，95%CI24.3-120.3)。未钙化的成分也有类似的趋势，但没有钙化斑块(b3.8，95%CI-27.0-34.7)。基线CAC评分较高与总斑块、非钙化斑块和钙化斑块进展相关。然而，基线非钙化体积而不是CAC评分与LAP的进展相关。结论：目前在匹配的患者中的研究表明，糖尿病与更大的斑块进展相关。我们的结果表明，糖尿病患者需要严格遵守当前的预防指南。(C)2016爱思唯尔爱尔兰有限公司。保留所有权利。
Background and aims: We aimed at investigating whether diabetes is associated with progression in coronary plaque components.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 = 0.005). Multivariable linear regression model revealed that diabetes was associated with normalized TPV progression (beta 72.3, 95%CI 24.3-120.3). A similar trend was observed for the non-calcified components, but not calcified plaque (b 3.8, 95%CI -27.0-34.7). 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.