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Introduction According to CDC there are 88.0 million Americans aged 18 years or older with prediabetes. Cardiovascular disease is the primary cause of morbidity and mortality in diabetes. The relationship between prediabetes and coronary atherosclerosis is not well established. We evaluated the association between prediabetes and coronary atherosclerosis and compared it to non-diabetic population. Methods In this retrospective study all patients who underwent CCTA and coronary artery calcium (CAC) testing at our outpatient imaging center for the past 5 years were screened. 253 patients had recorded HbA1c values and were included in the study. 256 slice multi detector CT (GE Revolution, Milwaukee WI) scanner was used for imaging. CAC was scored using non-contrast CT. Total plaque score (TPS) and total stenosis score (TSS) were quantified using coronary CTA. Each of the scores were compared between prediabetic (125) and non-diabetic groups (128). Results Mean age of the study cohort was 53.2 ± 17.1 years, 66% were males, 114 had hyperlipidemia (45%), 108 had hypertension (43%), 96 were present smokers (38%) and the mean HbA1c was 5.6 ±0.4. In multivariate adjusted regression models, the odds of TPS (OR:2.93; CI: 1.54,5.57) P Conclusion Our findings suggest that prediabetics have higher atherosclerotic plaque burden compared to non-diabetics. In prediabetes, increased plaque burden most likely contributes to cardiovascular events. The application of these findings may guide early screening and pharmacological prevention strategies for atherosclerosis in patients with prediabetes.

Background HbA1c is a biomarker of the presence and severity of diabetes mellitus (DM). High sensitivity serum C-reactive protein (hs-CRP) is a marker of systemic inflammation. Elevated levels of both have been shown to be independently associated with cardiovascular disease. Methods The STOP trial randomized patients with Type II-DM and presence of coronary plaque on CCTA to Semaglutide/placebo. Baseline HbA1c and CRP were measured. Multivariate linear regression analysis was used to examine the association of baseline HbA1C with hs-CRP. Results In 107 subjects, mean age was 56.5±8.3 yrs, 67 (63%) were male. Mean duration of diabetes was 16.1±7.5 years, mean HbA1C was 9±1.90, 89 subjects (83%) were on lipid-lowering medications, and 89 (83%) were on antihypertensives. 14 (13%) were current smokers and 41 (38%) were former smokers. Spearman correlation demonstrated a significant correlation between A1C and hs-CRP at baseline (R=0.28 p=0.0036). In unadjusted linear regression analysis, compared to subjects with a CRP of 1 had 1-unit higher A1C levels (p=0.02) and those with CRP >3 had 1.2-unit higher A1C (p=0.01). When adjusting for age, gender, BMI, hyperlipidemia, hypertension, and smoking, the association was no longer significant in CRP 1 (p=0.21) and CRP 3 (p=.099), suggesting a trend towards an association. Conclusion Higher HbA1c levels were associated with increased hs-CRP, demonstrating that poorly-controlled DM is associated with increased systemic inflammation. The lack of statistical significance on multivariate adjusted analysis with a trend towards an association could be due to the relatively small sample size.

Introduction Cardio‐ankle vascular index(CAVI) is a novel index that measures arterial stiffness noninvasively. Recent studies demonstrated CAVI to be a predictor for coronary artery disease(CAD). Patients with Type-2 diabetes mellitus(DM) develop arterial stiffening which contributes to the CAD complications associated with DM. However, a comprehensive assessment of the association of CAVI and DM has not been reported. Methods The STOP trial randomized patients with DM and presence of coronary plaque on CCTA to Semaglutide 1mg once weekly or placebo. CAVI was measured using the VaSera(Fukuda Denshi, Tokyo, Japan). Non-invasive blood pressure, Pulse Wave Velocity and Heart Sound Measuring were integrated to compute CAVI. Multivariate linear regression was used to examine the association of baseline CAVI and duration of diabetes. Results In 98 randomized STOP subjects, mean age was 56.8±8.3 yrs and 60 (61%) were male. Of these, 81 (83%) had hyperlipidemia, 81 (83%) had hypertension, 13 (13%) were current-smokers, and 31 (32%) were former-smokers. The mean duration of DM was 16.3±7.5 yrs. In an unadjusted linear regression analysis, there was a positive linear relationship between duration of DM and CAVI (p=0.036). However, upon further analysis with adjustment for age, gender, body mass index, HLD, HTN, and past smoking, the association was no longer significant (p=0.189). Conclusion CAVI has a linear association with the duration of Diabetes. The lack of statistical significance on multivariate adjusted analysis could be due to the small sample size. Future studies should assess the prognostic role of CAVI in patients with DM.