Rapid progression of coronary atherosclerosis across glycemic status: a serial coronary computed tomography angiography study from the PARADIGM registry.

@article{won2026rapid,
  title = {{Rapid progression of coronary atherosclerosis across glycemic status: a serial coronary computed tomography angiography study from the PARADIGM registry.}},
  author = {Ki-Bum Won and Byoung Kwon Lee and Martin Hadamitzky and Yong-Jin Kim and Ji Min Sung and Edoardo Conte and Gianluca Pontone and Daniele Andreini and Matthew J Budoff and Ilan Gottlieb and Eun Ju Chun and Filippo Cademartiri and Erica Maffei and Hugo Marques and Pedro de Araújo Gonçalves and Jonathon A Leipsic and Sang-Eun Lee and Sanghoon Shin and Jung Hyun Choi and Habib Samady and Kavitha Chinnaiyan and Jagat Narula and Leslee J Shaw and Jeroen J Bax and James K Min and Hyuk-Jae Chang},
  journal = {Cardiovascular diabetology},
  year = {2026},
  month = sep,
  doi = {10.1186/s12933-026-03355-1},
  url = {https://europepmc.org/article/MED/42850638},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Rapid progression of coronary atherosclerosis across glycemic status: a serial coronary computed tomography angiography study from the PARADIGM registry.
AU  - Ki-Bum Won
AU  - Byoung Kwon Lee
AU  - Martin Hadamitzky
AU  - Yong-Jin Kim
AU  - Ji Min Sung
AU  - Edoardo Conte
AU  - Gianluca Pontone
AU  - Daniele Andreini
AU  - Matthew J Budoff
AU  - Ilan Gottlieb
AU  - Eun Ju Chun
AU  - Filippo Cademartiri
AU  - Erica Maffei
AU  - Hugo Marques
AU  - Pedro de Araújo Gonçalves
AU  - Jonathon A Leipsic
AU  - Sang-Eun Lee
AU  - Sanghoon Shin
AU  - Jung Hyun Choi
AU  - Habib Samady
AU  - Kavitha Chinnaiyan
AU  - Jagat Narula
AU  - Leslee J Shaw
AU  - Jeroen J Bax
AU  - James K Min
AU  - Hyuk-Jae Chang
PY  - 2026
DA  - 2026/09/05
JO  - Cardiovascular diabetology
DO  - 10.1186/s12933-026-03355-1
UR  - https://europepmc.org/article/MED/42850638
AB  - Background  Rapid progression of coronary atherosclerosis is associated with an increased risk of future adverse cardiovascular events. However, evidence regarding the association between glycemic status and rapid plaque progression (RPP) in the major epicardial coronary arteries remains limited.Methods  A total of 1296 subjects (mean age, 61 ± 9 years; 56.9% men) from the PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging) registry who underwent serial coronary computed tomography angiography and had available glycemic data were included. The median inter-scan interval was 3.2 (interquartile range, 2.6-4.4) years. Participants were classified according to glycemic status as having normal glycemic status, prediabetes, or diabetes. Percent atheroma volume (PAV) was calculated as plaque volume divided by vessel volume and multiplied by 100. RPP was defined as an increase in PAV of ≥ 1.0%/year.Results  Annual changes in PAV (%/year) differed significantly across glycemic groups (normal glycemic status, 0.30 [0.00-0.98]; prediabetes, 0.35 [0.04-0.98]; diabetes, 0.65 [0.19-1.54]; overall P < 0.001). Similarly, the incidence of RPP differed significantly across glycemic groups (normal glycemic status, 25.6%; prediabetes, 25.2%; diabetes, 38.5%; overall P < 0.001). In multivariable logistic regression analyses adjusting for clinical risk factors and baseline plaque burden, diabetes was independently associated with higher odds of RPP compared with normal glycemic status, whereas prediabetes was not. Among participants without diabetes at baseline, RPP was more frequent in those who developed new-onset diabetes than in those who did not (36.1% vs. 24.2%; P = 0.039).Conclusions  Diabetes, but not prediabetes, was independently associated with rapid progression of coronary atherosclerosis. Furthermore, the higher incidence of RPP among participants who developed new-onset diabetes suggests that the development of diabetes may represent an important threshold for accelerated coronary plaque progression.Trial registration  ClinicalTrials.gov (NCT02803411).
SN  - 1475-2840
ER  -