Coronary artery plaque volume and obesity in patients with diabetes: The factor-64 study1

Alan C. Kwan, Heidi T. May, George Cater, Christopher Sibley, Boaz D. Rosen, João A C Lima, Karen Rodriguez, Donald L. Lappe, Joseph B. Muhlestein, Jeffrey L. Anderson, David A. Bluemke

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Abstract

Purpose: To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes. Materials and Methods: All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.8 years; mean duration of diabetes, 10.4 years) underwent coronary CT angiography. Total coronary artery wall volume in all three vessels was measured by using semiautomated software. The coronary plaque volume index (PVI) was determined by dividing the wall volume by the coronary length. The relationship between the PVI and cardiovascular risk factors was determined with multivariable analysis. Results: The mean PVI (±standard deviation) was 11.2 mm2 6 2.7. The mean coronary artery calcium (CAC) score (determined with the Agatston method) was 382; 67% of total plaque was noncalcified. The PVI was related to age (standardized β = 0.32, P <.001), male sex (standardized β = 0.36, P <.001), body mass index (BMI) (standardized β = 0.26, P <.001), and duration of diabetes (standardized β = 0.14, P = .03). A greater percentage of soft plaque was present in younger individuals with a shorter disease duration (P = .02). The soft plaque percentage was directly related to BMI (P = .002). Patients with discrepancies between CAC score and PVI rank quartiles had a higher percentage of soft and fibrous plaque (18.7% ± 3.3 vs 17.4% ± 3.5 [P = .008] and 52.2% ± 7.2 vs 47.2% ± 8.8 [P <.0001], respectively). Conclusion: In asymptomatic diabetic patients, BMI was the primary modifiable risk factor that was associated with total and soft coronary plaque as assessed with coronary CT angiography.

Original languageEnglish (US)
Pages (from-to)690-699
Number of pages10
JournalRadiology
Volume272
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

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Coronary Vessels
Obesity
Angiography
Body Mass Index
Consent Forms
Calcium
Research Ethics Committees
Software

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Kwan, A. C., May, H. T., Cater, G., Sibley, C., Rosen, B. D., Lima, J. A. C., ... Bluemke, D. A. (2014). Coronary artery plaque volume and obesity in patients with diabetes: The factor-64 study1. Radiology, 272(3), 690-699. https://doi.org/10.1148/radiol.14140611

Coronary artery plaque volume and obesity in patients with diabetes : The factor-64 study1. / Kwan, Alan C.; May, Heidi T.; Cater, George; Sibley, Christopher; Rosen, Boaz D.; Lima, João A C; Rodriguez, Karen; Lappe, Donald L.; Muhlestein, Joseph B.; Anderson, Jeffrey L.; Bluemke, David A.

In: Radiology, Vol. 272, No. 3, 2014, p. 690-699.

Research output: Contribution to journalArticle

Kwan, AC, May, HT, Cater, G, Sibley, C, Rosen, BD, Lima, JAC, Rodriguez, K, Lappe, DL, Muhlestein, JB, Anderson, JL & Bluemke, DA 2014, 'Coronary artery plaque volume and obesity in patients with diabetes: The factor-64 study1', Radiology, vol. 272, no. 3, pp. 690-699. https://doi.org/10.1148/radiol.14140611
Kwan, Alan C. ; May, Heidi T. ; Cater, George ; Sibley, Christopher ; Rosen, Boaz D. ; Lima, João A C ; Rodriguez, Karen ; Lappe, Donald L. ; Muhlestein, Joseph B. ; Anderson, Jeffrey L. ; Bluemke, David A. / Coronary artery plaque volume and obesity in patients with diabetes : The factor-64 study1. In: Radiology. 2014 ; Vol. 272, No. 3. pp. 690-699.
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abstract = "Purpose: To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes. Materials and Methods: All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.8 years; mean duration of diabetes, 10.4 years) underwent coronary CT angiography. Total coronary artery wall volume in all three vessels was measured by using semiautomated software. The coronary plaque volume index (PVI) was determined by dividing the wall volume by the coronary length. The relationship between the PVI and cardiovascular risk factors was determined with multivariable analysis. Results: The mean PVI (±standard deviation) was 11.2 mm2 6 2.7. The mean coronary artery calcium (CAC) score (determined with the Agatston method) was 382; 67{\%} of total plaque was noncalcified. The PVI was related to age (standardized β = 0.32, P <.001), male sex (standardized β = 0.36, P <.001), body mass index (BMI) (standardized β = 0.26, P <.001), and duration of diabetes (standardized β = 0.14, P = .03). A greater percentage of soft plaque was present in younger individuals with a shorter disease duration (P = .02). The soft plaque percentage was directly related to BMI (P = .002). Patients with discrepancies between CAC score and PVI rank quartiles had a higher percentage of soft and fibrous plaque (18.7{\%} ± 3.3 vs 17.4{\%} ± 3.5 [P = .008] and 52.2{\%} ± 7.2 vs 47.2{\%} ± 8.8 [P <.0001], respectively). Conclusion: In asymptomatic diabetic patients, BMI was the primary modifiable risk factor that was associated with total and soft coronary plaque as assessed with coronary CT angiography.",
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T1 - Coronary artery plaque volume and obesity in patients with diabetes

T2 - The factor-64 study1

AU - Kwan, Alan C.

AU - May, Heidi T.

AU - Cater, George

AU - Sibley, Christopher

AU - Rosen, Boaz D.

AU - Lima, João A C

AU - Rodriguez, Karen

AU - Lappe, Donald L.

AU - Muhlestein, Joseph B.

AU - Anderson, Jeffrey L.

AU - Bluemke, David A.

PY - 2014

Y1 - 2014

N2 - Purpose: To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes. Materials and Methods: All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.8 years; mean duration of diabetes, 10.4 years) underwent coronary CT angiography. Total coronary artery wall volume in all three vessels was measured by using semiautomated software. The coronary plaque volume index (PVI) was determined by dividing the wall volume by the coronary length. The relationship between the PVI and cardiovascular risk factors was determined with multivariable analysis. Results: The mean PVI (±standard deviation) was 11.2 mm2 6 2.7. The mean coronary artery calcium (CAC) score (determined with the Agatston method) was 382; 67% of total plaque was noncalcified. The PVI was related to age (standardized β = 0.32, P <.001), male sex (standardized β = 0.36, P <.001), body mass index (BMI) (standardized β = 0.26, P <.001), and duration of diabetes (standardized β = 0.14, P = .03). A greater percentage of soft plaque was present in younger individuals with a shorter disease duration (P = .02). The soft plaque percentage was directly related to BMI (P = .002). Patients with discrepancies between CAC score and PVI rank quartiles had a higher percentage of soft and fibrous plaque (18.7% ± 3.3 vs 17.4% ± 3.5 [P = .008] and 52.2% ± 7.2 vs 47.2% ± 8.8 [P <.0001], respectively). Conclusion: In asymptomatic diabetic patients, BMI was the primary modifiable risk factor that was associated with total and soft coronary plaque as assessed with coronary CT angiography.

AB - Purpose: To determine the relationship between coronary plaque detected with coronary computed tomographic (CT) angiography and clinical parameters and cardiovascular risk factors in asymptomatic patients with diabetes. Materials and Methods: All patients signed institutional review board-approved informed consent forms before enrollment. Two hundred twenty-four asymptomatic diabetic patients (121 men; mean patient age, 61.8 years; mean duration of diabetes, 10.4 years) underwent coronary CT angiography. Total coronary artery wall volume in all three vessels was measured by using semiautomated software. The coronary plaque volume index (PVI) was determined by dividing the wall volume by the coronary length. The relationship between the PVI and cardiovascular risk factors was determined with multivariable analysis. Results: The mean PVI (±standard deviation) was 11.2 mm2 6 2.7. The mean coronary artery calcium (CAC) score (determined with the Agatston method) was 382; 67% of total plaque was noncalcified. The PVI was related to age (standardized β = 0.32, P <.001), male sex (standardized β = 0.36, P <.001), body mass index (BMI) (standardized β = 0.26, P <.001), and duration of diabetes (standardized β = 0.14, P = .03). A greater percentage of soft plaque was present in younger individuals with a shorter disease duration (P = .02). The soft plaque percentage was directly related to BMI (P = .002). Patients with discrepancies between CAC score and PVI rank quartiles had a higher percentage of soft and fibrous plaque (18.7% ± 3.3 vs 17.4% ± 3.5 [P = .008] and 52.2% ± 7.2 vs 47.2% ± 8.8 [P <.0001], respectively). Conclusion: In asymptomatic diabetic patients, BMI was the primary modifiable risk factor that was associated with total and soft coronary plaque as assessed with coronary CT angiography.

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