Diabetes, Atherosclerosis, and Stenosis by AI
Rebecca A. Jonas, Department of Internal Medicine, Thomas Jefferson University Medical Center; Philadelphia, PA.
James P. Earls, Cleerly, Inc., New York, NY.
Hugo Marques, Faculdade de Medicina da Universidade Católica Portuguesa, Lisboa, Portugal.
Richard J. Katz, The George Washington University School of Medicine & Health Sciences, Washington, DC.
Hyuk-Jae Chang, Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
Wijnand J. Stuijfzand, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands.
Alexander R. van Rosendael, Department of Cardiology, Leiden University Medical Center, Amsterdam, the Netherlands.
Jung Hyun Choi, Ontact Health, Inc., Seoul, South Korea.
Joon-Hyung Doh, Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, South Korea.
Ae-Young Her, Kang Won National University Hospital, Chuncheon, South Korea.
Bon-Kwon Koo, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Chang-Wook Nam, Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, South Korea.
Hyung-Bok Park, Division of Cardiology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea.
Sang-Hoon Shin, Division of Cardiology, Department of Internal Medicine, Ewha Women's University Seoul Hospital, Seoul, South Korea.
Jason Cole, Mobile Cardiology Associates, Mobile, AL.
Alessia Gimelli, Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
Muhammad Akram Khan, Cardiac Center of Texas, McKinney, TX.
Bin Lu, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China.
Yang Gao, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China.
Faisal Nabi, Houston Methodist Hospital, Houston, TX.
Ryo Nakazato, Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.
U Joseph Schoepf, Medical University of South Carolina, Charleston, SC.
Roel S. Driessen, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands.
Michiel J. Bom, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands.
Randall C. Thompson, St. Luke's Mid America Heart Institute, Kansas City, MO.
James J. Jang, Kaiser Permanente San Jose Medical Center, San Jose, CA.
Michael Ridner, Heart Center Research, LLC, Huntsville, AL.
Chris Rowan, Renown Heart and Vascular Institute, Reno, NV.
Erick Avelar, Oconee Heart and Vascular Center at St Mary's Hospital, Athens, GA.
Philippe Généreux, Gagnon Cardiovascular Institute at Morristown Medical Center, Morristown, NJ.
Paul Knaapen, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands.
Guus A. de Waard, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands.
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.
Jonas, Rebecca A.; Earls, James P.; Marques, Hugo; Katz, Richard J.; Chang, Hyuk-Jae; Stuijfzand, Wijnand J.; van Rosendael, Alexander R.; Choi, Jung Hyun; Doh, Joon-Hyung; Her, Ae-Young; Koo, Bon-Kwon; Nam, Chang-Wook; Park, Hyung-Bok; Shin, Sang-Hoon; Cole, Jason; Gimelli, Alessia; Khan, Muhammad Akram; Lu, Bin; Gao, Yang; Nabi, Faisal; Nakazato, Ryo; Schoepf, U Joseph; Driessen, Roel S.; Bom, Michiel J.; Thompson, Randall C.; Jang, James J.; Ridner, Michael; Rowan, Chris; Avelar, Erick; Généreux, Philippe; Knaapen, Paul; and de Waard, Guus A., "Diabetes, Atherosclerosis, and Stenosis by AI" (2022). GW Authored Works. Paper 2050.