Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study
Authors' conclusion
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.
Study context
- Population
- Patients with known or suspected stable CAD undergoing serial coronary CT angiography (60.9±9.3 years, 55.4% male)
- Participants
- 1,200 patients
- Exposure
- Cardiometabolic risk factor combinations vs their absence
- Outcome
- Rapid plaque progression (percent atheroma volume increase ≥1.0%/y) and MACE (nonfatal MI, death, unplanned coronary revascularization)
Methodological detailsanalysis of the PARADIGM registry, serial coronary CT angiography ≥2 years apart, multivariable analysis
- Analysis of the PARADIGM registry
- Serial coronary CT angiography ≥2 years apart
- Multivariable analysis
Main finding
As reported in the abstract
Rapid plaque progression · interscan period 3.2 years (IQR, 1.9)
Odds ratio (95% CI)P value
Metabolic syndrome
1.51(1.12–2.03)
P = 0.007High fasting plasma glucose + low HDL-C
2.37(1.56–3.61)
P < 0.001- Rapid plaque progression (PP) occurred
- 341 patients (28%)
Observational data: associations, not effects.
Further findings
MACE · follow-up 8.23 years (IQR, 5.92-9.53)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| High fasting plasma glucose + high systemic BPMultivariable Cox | 1.79 (1.10–2.90) | P = 0.018 | |
| 0.20.5125Hazard ratio (log scale) |
- MACE — MACE occurred
- 201 patients (17%)
Original publication
Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study. Circ Cardiovasc Imaging. Published 16 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it