Associations among carotid plaque progression, cerebrovascular/ cardiovascular diseases and LDL-C/non-HDL-C goal achievement in diabetic patients: A retrospective cohort study

Background: Impaired glycolipid metabolism can induce vascular injury and plaque formation. It is important to investigate the associations between carotid plaque progression and lipid-lowering goal achievement and car-diovascular disease.Methods: Diabetic patients who underwent at least 2 carotid ultrasound scans with intervals >= 0.5 years and were hospitalized in the Department of Endocrinology at Sun Yat-sen Memorial Hospital were included. Patients were divided into 3 groups based on carotid plaque progression: the persistent plaque absence, new-onset plaque and persistent plaque presence groups. The primary outcomes were CHD and stroke, while the secondary outcomes were low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) goal achievement.Results: There were 304 diabetic patients included, with a median follow-up period of 2.15 years. In multivar-iable logistic regression analysis, persistent plaque presence was positively associated with a 2.285-fold increase in coronary heart disease (CHD) prevalence, while new-onset plaque was associated with a 3.225-fold increase in stroke prevalence compared to persistent plaque absence in patients with follow-up periods >= 0.5 years. The association remained significant in patients with a follow-up period >= 1 year and >= 2 years. The velocity of average plaque length change was independently associated with increased Delta LDL-C (last - goal) (beta = 0.073, P = 0.048).Conclusion: Carotid plaque progression had long-term association with CHD and stroke starting from 0.5 years, while the velocity of average plaque length associated with increased Delta LDL-C (last - goal) might reflect patient response to statins. Repeated carotid plaque measurements might guide lipid-lowering therapies.