Prevalence of normal coronary arteries by coronary computed tomography angiography (CCTA) in patients with type 2 diabetes mellitus from Semaglutide Treatment on Coronary Plaque Progression (STOP) trial

J Diabetes Complications. 2021 Mar;35(3):107840. doi: 10.1016/j.jdiacomp.2020.107840. Epub 2020 Dec 31.

Abstract

Introduction: Coronary artery disease (CAD) is leading cause of morbidity and mortality among type 2 diabetics (T2DM).

Methods: 140 T2DM will be enrolled in randomized, double blind, placebo controlled Semaglutide Treatment On Coronary Plaque Progression (STOP) trial to determine effect of weekly subcutaneous semaglutide on coronary plaque progression. All participants will undergo Coronary Artery Calcium (CAC) Scoring and Coronary Computed Tomography Angiography (CCTA) at our center. A Fisher test, ANOVA and Kruskal Wallis were used.

Results: As of May 2020, 87 patients (81%) randomized (mean age 56.4 ± 8.4 yrs. and 62% male) with documented CAD by CCTA. Approximately 20% of screened study population were screen failed due to normal coronaries (n= 14) or HbA1C<7 (n=7). Of interest, 14 persons with diabetes with normal coronaries (no calcification) were significantly more likely to be females (21% vs 62%), have higher glomerular filtration rate (106.5 ± 19.4 vs 89.9 ± 22.6 mL/min/1.73m2; p= 0.006), and younger (53.4 ± 9.0 vs 56.4 ± 8.4 yrs.; p=0.02) than those who were randomized.

Conclusion: Among T2DM, there is a significant portion who have normal coronary arteries and may have a better prognosis. Excluding these participants from cardiovascular studies may improve power and decrease sample size.

Keywords: Coronary artery disease; Normal coronaries; Type 2 diabetes mellitus.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Computed Tomography Angiography
  • Coronary Angiography
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / diagnostic imaging
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Glucagon-Like Peptides / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic* / complications
  • Plaque, Atherosclerotic* / epidemiology
  • Predictive Value of Tests
  • Prevalence

Substances

  • semaglutide
  • Glucagon-Like Peptides