Diabetes, Atherosclerosis, and Stenosis by AI

Rebecca A. Jonas, Tami R. Crabtree, Robert S. Jennings, Hugo Marques, Richard J. Katz, Hyuk Jae Chang, Wijnand J. Stuijfzand, Alexander R. van Rosendael, Jung Hyun Choi, Joon Hyung Doh, Ae Young Her, Bon Kwon Koo, Chang Wook Nam, Hyung Bok Park, Sang Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang GaoFaisal Nabi, Ryo Nakazato, U. Joseph Schoepf, Roel S. Driessen, Michiel J. Bom, Randall C. Thompson, James J. Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Genereux, Paul Knaapen, Guus A. de Waard, Gianluca Pontone, Daniele Andreini, Mouaz H. Al-Mallah, Marco Guglielmo, Jeroen J. Bax, James P. Earls, James K. Min, Andrew D. Choi, Todd C. Villines

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


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), dis-eased 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.

Original languageEnglish
Pages (from-to)416-424
Number of pages9
JournalDiabetes Care
Issue number2
Publication statusPublished - 2023 Feb

Bibliographical note

Publisher Copyright:
© 2023 by the American Diabetes Association.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing


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