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Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study
- Title
- Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study
- Authors
- Ilan; Hadamitzky; Martin; Jin Kim; Yong; Kwon Lee; Byoung; Leipsic; Jonathon A.; Marques; Hugo; Gonçalves; Pedro de Araújo; Pontone; Gianluca; Shin; Sanghoon; Stone; Peter H.; Samady; Habib; Virmani; Renu; Narula; Jagat; Shaw; Leslee J.; Bax; Jeroen J.; Lin; Fay Y.; Min; James K.; Chang; Hyuk-Jae; Neglia; Danilo; Caselli; Chiara; Maffei; Erica; Cademartiri; Filippo; Meloni; Antonella; Bossone; Eduardo; Saba; Luca; Lee; Sang-Eun; Min Sung; Ji; Andreini; Daniele; Al-Mallah; Mouaz H.; Budoff; Matthew J.; Chinnaiyan; Kavitha; Choi; Jung Hyun; Chun; Eun Ju; Conte; Edoardo; Gottlieb
- Ewha Authors
- 이상은
- SCOPUS Author ID
- 이상은
![scopus](/images/layout/icon2.png)
- Issue Date
- 2024
- Journal Title
- Circulation: Cardiovascular Imaging
- ISSN
- 1941-9651
- Citation
- Circulation: Cardiovascular Imaging vol. 17, no. 7, pp. e016481
- Keywords
- cardiometabolic risk factors; cholesterol; computed tomography angiography; coronary artery disease; HDL; hyperglycemia; hypertension; metabolic syndrome
- Indexed
- SCIE; SCOPUS
![scopus](/images/layout/scopus2.gif)
- Document Type
- Article
- Abstract
- BACKGROUND: We assessed whether combinations of cardiometabolic risk factors independently predict coronary plaque progression (PP) and major adverse cardiovascular events in patients with stable coronary artery disease. METHODS: Patients with known or suspected stable coronary artery disease (60.9±9.3 years, 55.4% male) undergoing serial coronary computed tomography angiographies (≥2 years apart), with clinical characterization and follow-up (N=1200), were analyzed from the PARADIGM study (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging). Plaque volumes measured in coronary segments (≥2 mm in diameter) were summed to provide whole heart plaque volume (mm3) and percent atheroma volume (plaque volume/vessel volume×100; %) per patient at baseline and follow-up. Rapid PP was defined as a percent atheroma volume increase of ≥1.0%/y. Major adverse cardiovascular events included nonfatal myocardial infarction, death, and unplanned coronary revascularization. RESULTS: In an interscan period of 3.2 years (interquartile range, 1.9), rapid PP occurred in 341 patients (28%). At multivariable analysis, the combination of cardiometabolic risk factors defined as metabolic syndrome predicted rapid PP (odds ratio, 1.51 [95% CI, 1.12–2.03]; P=0.007) together with older age, smoking habits, and baseline percent atheroma volume. Among single cardiometabolic variables, high fasting plasma glucose (diabetes or fasting plasma glucose >100 mg/dL) and low HDL-C (high-density lipoprotein cholesterol; <40 mg/dL in males and <50 mg/dL in females) were independently associated with rapid PP, in particular when combined (odds ratio, 2.37 [95% CI, 1.56–3.61]; P<0.001). In a follow-up of 8.23 years (interquartile range, 5.92–9.53), major adverse cardiovascular events occurred in 201 patients (17%). At multivariable Cox analysis, the combination of high fasting plasma glucose with high systemic blood pressure (treated hypertension or systemic blood pressure >130/85 mm Hg) was an independent predictor of events (hazard ratio, 1.79 [95% CI, 1.10–2.90]; P=0.018) together with family history, baseline percent atheroma volume, and rapid PP. CONCLUSIONS: In patients with stable coronary artery disease, the combination of hyperglycemia with low HDL-C is associated with rapid PP independently of other risk factors, baseline plaque burden, and treatment. The combination of hyperglycemia with high systemic blood pressure independently predicts the worse outcome beyond PP. © 2024 American Heart Association, Inc.
- DOI
- 10.1161/CIRCIMAGING.123.016481
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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