ArticleQuantitative imaging in medicine and surgery2025
Long-term prognostic value of coronary atherosclerosis progression in patients with and without diabetes mellitus.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Studies of the long-term prognostic value of coronary atherosclerosis progression in patients with and without diabetes mellitus (DM) via serial coronary computed tomography angiography (CCTA) are limited. This study aimed to explore the long-term prognostic value of coronary atherosclerosis progression in patients with and without DM. Methods: Patients who had undergone serial CCTA were retrospectively enrolled and categorized into DM and non-DM groups. Coronary atherosclerosis progression was defined as any increase in the coronary artery calcium score (CACS), segment involvement score, or segment stenosis score. Major adverse cardiovascular events (MACE) comprised all-cause mortality, myocardial infarction, and coronary revascularization. Results: One hundred and fifteen DM and 410 non-DM patients were included. The median patient age was 56 (49-63) years, and 355 (67.6%) of them were men. The DM group was associated with a greater increase in CACS. During the median follow-up of 69 months, 114 MACE occurred. The Coronary Artery Disease-Reporting and Data System 4-5 [DM: hazard ratio (HR) =2.32, 95% confidence interval (CI): 1.21-4.47, P=0.012; non-DM: HR =2.03, 95% CI: 1.17-3.55, P=0.012], high-risk plaque (DM: HR =2.85, 95% CI: 1.41-5.76, P=0.004; non-DM: HR =1.99, 95% CI: 1.09-3.65, P=0.026), and atherosclerosis progression (DM: HR =3.15, 95% CI: 1.21-8.19, P=0.019; non-DM: HR =2.40, 95% CI: 1.28-4.50, P=0.006) were significant predictors of MACE in DM and non-DM groups. The event-free survival rate of the DM group with atherosclerosis progression was 49.1%. Conclusions: Atherosclerosis progression was the strongest predictor of MACE in both DM and non-DM groups. The DM group with atherosclerosis progression had the lowest event-free survival rate.
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