Introduction: Diabetes mellitus (DM) and pre-DM are associated with elevated risk of atherosclerotic cardiovascular disease events. However, characterization of coronary plaque and stenosis across glycemic states among asymptomatic adults has not been fully evaluated.

Methods: Adults enrolled in the community-based Miami Heart Study with available data on glycemic status and coronary CTA were included. Among individuals with DM, pre-DM, and euglycemia, the prevalence of coronary plaque (any, any non-calcified, any high-risk) and stenosis ≥50% was assessed overall and stratified by coronary artery calcium (CAC) categories (0, 1-99, ≥100) .

Results: Among 2,359 participants (49.6% women, 47.0% Hispanic/Latino) , the prevalence of DM, pre-DM, and euglycemia was 7%, 30%, and 63%, respectively. Participants with DM had the highest prevalence of any plaque (68%) followed by those with prediabetes (58%) and euglycemia (43%) . A similar graded association was observed across glycemic states with other plaque features and stenosis ≥50% (Figure) . In analyses stratified by baseline CAC burden, the prevalence of plaque features and stenosis ≥50% was low in those with CAC zero.

Conclusions: Among asymptomatic individuals from the general US population, worse glycemic status is associated with greater burden of coronary atherosclerosis and high-risk features.


K.Patel: None. M.Cainzos-achirica: None. J.Valero-elizondo: None. S.S.Ali: None. M.D.Shapiro: Advisory Panel; Amgen Inc., ESPERION Therapeutics, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk, Consultant; Regeneron Pharmaceuticals Inc. A.Pandey: Advisory Panel; Lilly, Consultant; Tricog, Research Support; Applied Therapeutics, Gilead Sciences, Inc. L.L.Arias: None. M.Budoff: Research Support; Amarin Corporation, Novo Nordisk, Speaker's Bureau; Boehringer Ingelheim International GmbH, Lilly. K.Nasir: Advisory Panel; Novartis AG, Novo Nordisk, Research Support; ESPERION Therapeutics, Inc., Novartis AG, Speaker's Bureau; Amgen Inc.

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