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Coronary Heart DiseasePARADIGMNCT02803411

Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging(PARADIGM)

An observational study of Coronary Heart Disease, run by Yonsei University.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

To describe the natural history of the coronary atherosclerotic plaque development and progression over time by CCTA with demographic and laboratory data for refinement of risk stratification of patients referred for CCTA. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coronary Heart Disease
How many people
2,000 participants
Where
No sites listed yet
Study dates
Mar 2003to Jan 2026
How long will I take part?
12 Months
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Study population is patients with suspected or known CAD who had undergone serial CCTA by physician referral. Sites that had collected cohorts of CCTA patients with symptoms, risk factors, CCTA image data, and outcomes were invited to contribute data for a merged database. This sample includes patients with suspected or known CAD, and asymptomatic subjects undergoing CCTA for risk stratification to evaluate the significance of changes in CCTA findings in different clinical contexts.

Who may be able to join

  • patients underwent two or more clinically indicated CCTA with 64-detector rows or greater for CAD evaluation
  • patients underwent at least 2 year interval between the baseline and follow-up CCTA

Who cannot join

  • poor image quality of CCTA

About this study

To describe the natural history of the coronary atherosclerotic plaque development and progression over time by CCTA with demographic and laboratory data for refinement of risk stratification of patients referred for CCTA.

Read the detailed description

All PARADIGM study patients underwent initial and follow-up CCTA based on order from their primary physician. Demographic data, targeted medical history, cardiovascular risk factors, and laboratory data was prospectively collected in electronic case report forms (eCRFs) at the time of the initial CCTA and at the time of follow-up CCTA.

Keywords
Coronary Heart Disease, Coronary Computed Tomography Angiography (CCTA), Coronary Atherosclerotic Plaque, coronary atherosclerosis
Medical subject headings
Coronary Disease, Coronary Artery Disease

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in plaque volume and composition detected by follow up CCTA

    Measured: 2 years

Secondary outcomes (4)
  1. Cardiac mortality (yes or no)

    Measured: 2 years

  2. Myocardial infarction (yes or no)

    Measured: 2 years

  3. Unstable angina requiring hospitalization (yes or no)

    Measured: 2 years

  4. Revascularization (yes or no)

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jun 2016 (estimated)
  2. Study startMar 2003
  3. Primary completionJan 2026 (estimated)
  4. Study completionJan 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
2,000 participants (estimated)
Target duration
12 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT02803411
Sponsor's protocol ID
4-2016-0263
Acronym
PARADIGM
Status last verified
Jun 2018
First submitted
3 Jun 2016
Last updated
29 Jun 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Lee SE, Chang HJ, Rizvi A, Hadamitzky M, Kim YJ, Conte E, Andreini D, Pontone G, Volpato V, Budoff MJ, Gottlieb I, Lee BK, Chun EJ, Cademartiri F, Maffei E, Marques H, Leipsic JA, Shin S, Choi JH, Chung N, Min JK. Rationale and design of the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry: A comprehensive exploration of plaque progression and its impact on clinical outcomes from a multicenter serial coronary computed tomographic angiography study. Am Heart J. 2016 Dec;182:72-79. doi: 10.1016/j.ahj.2016.09.003. Epub 2016 Sep 22.

    PubMed 27914502
  • Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Maffei E, Marques H, de Araujo Goncalves P, Pontone G, Stone PH, Virmani R, Narula J, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Patient-Level Perivascular Adipose Tissue Density Aggregation and Plaque Progression: Plaque-Free vs Plaque-Adjacent Segments. JACC Cardiovasc Imaging. 2026 Oct 16:S1936-878X(26)00500-0. doi: 10.1016/j.jcmg.2026.08.018. Online ahead of print.

    PubMed 42900033
  • Won KB, Lee BK, Hadamitzky M, Kim YJ, Sung JM, Conte E, Pontone G, Andreini D, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araujo Goncalves P, Leipsic JA, Lee SE, Shin S, Choi JH, Samady H, Chinnaiyan K, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Rapid progression of coronary atherosclerosis across glycemic status: a serial coronary computed tomography angiography study from the PARADIGM registry. Cardiovasc Diabetol. 2026 Sep 5;25(1):301. doi: 10.1186/s12933-026-03355-1.

    PubMed 42850638
  • Won KB, Lee BK, Hadamitzky M, Kim YJ, Sung JM, Conte E, Pontone G, Andreini D, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araujo Goncalves P, Leipsic JA, Lee SE, Shin S, Choi JH, Samady H, Chinnaiyan K, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Association between atherogenic index of plasma and rapid progression of coronary atherosclerosis in non-diabetic and diabetic adults: Insight from the PARADIGM study. J Cardiovasc Comput Tomogr. 2026 May-Jun;20(3):272-278. doi: 10.1016/j.jcct.2026.03.011. Epub 2026 Apr 10.

    PubMed 41963235
  • Neglia D, Caselli C, Maffei E, Cademartiri F, Meloni A, Bossone E, Saba L, Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Marques H, de Araujo Goncalves P, Pontone G, Shin S, Stone PH, Samady H, Virmani R, Narula J, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Rapid Plaque Progression Is Independently Associated With Hyperglycemia and Low HDL Cholesterol in Patients With Stable Coronary Artery Disease: A PARADIGM Study. Circ Cardiovasc Imaging. 2024 Jul;17(7):e016481. doi: 10.1161/CIRCIMAGING.123.016481. Epub 2024 Jul 16.

    PubMed 39012946
  • Park HB, Arsanjani R, Sung JM, Heo R, Lee BK, Lin FY, Hadamitzky M, Kim YJ, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, Goncalves PA, Leipsic JA, Lee SE, Shin S, Choi JH, Virmani R, Samady H, Chinnaiyan K, Stone PH, Berman DS, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Impact of statins based on high-risk plaque features on coronary plaque progression in mild stenosis lesions: results from the PARADIGM study. Eur Heart J Cardiovasc Imaging. 2023 Oct 27;24(11):1536-1543. doi: 10.1093/ehjci/jead110.

    PubMed 37232393
  • Won KB, Lee BK, Lin FY, Hadamitzky M, Kim YJ, Sung JM, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araujo Goncalves P, Leipsic JA, Lee SE, Shin S, Choi JH, Virmani R, Samady H, Chinnaiyan K, Berman DS, Narula J, Shaw LJ, Bax JJ, Min JK, Chang HJ. Glycemic control is independently associated with rapid progression of coronary atherosclerosis in the absence of a baseline coronary plaque burden: a retrospective case-control study from the PARADIGM registry. Cardiovasc Diabetol. 2022 Nov 12;21(1):239. doi: 10.1186/s12933-022-01656-9.

    PubMed 36371222
  • Won KB, Lee BK, Heo R, Park HB, Lin FY, Hadamitzky M, Kim YJ, Sung JM, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araujo Goncalves P, Leipsic JA, Lee SE, Shin S, Choi JH, Virmani R, Samady H, Chinnaiyan K, Berman DS, Narula J, Bax JJ, Min JK, Chang HJ. Longitudinal Quantitative Assessment of Coronary Atherosclerotic Plaque Burden Related to Serum Hemoglobin Levels. JACC Asia. 2022 Apr 12;2(3):311-319. doi: 10.1016/j.jacasi.2021.10.010. eCollection 2022 Jun.

    PubMed 36338409
  • Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Maffei E, Marques H, de Araujo Goncalves P, Pontone G, Shin S, Kitslaar PH, Reiber JHC, Stone PH, Samady H, Virmani R, Narula J, Berman DS, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Association Between Changes in Perivascular Adipose Tissue Density and Plaque Progression. JACC Cardiovasc Imaging. 2022 Oct;15(10):1760-1767. doi: 10.1016/j.jcmg.2022.04.016. Epub 2022 Jun 15.

    PubMed 36202455
  • Takagi H, Leipsic JA, Indraratna P, Gulsin G, Khasanova E, Tzimas G, Lin FY, Shaw LJ, Lee SE, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, Marques H, de Araujo Goncalves P, Gottlieb I, Hadamitzky M, Maffei E, Pontone G, Shin S, Kim YJ, Lee BK, Chun EJ, Sung JM, Virmani R, Samady H, Stone PH, Berman DS, Narula J, Bax JJ, Chang HJ. Association of Tube Voltage With Plaque Composition on Coronary CT Angiography: Results From PARADIGM Registry. JACC Cardiovasc Imaging. 2021 Dec;14(12):2429-2440. doi: 10.1016/j.jcmg.2021.07.011. Epub 2021 Aug 18.

    PubMed 34419398
  • Hwang D, Kim HJ, Lee SP, Lim S, Koo BK, Kim YJ, Kook W, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, Marques H, de Araujo Goncalves P, Gottlieb I, Hadamitzky M, Leipsic JA, Maffei E, Pontone G, Raff GL, Shin S, Lee BK, Chun EJ, Sung JM, Lee SE, Berman DS, Lin FY, Virmani R, Samady H, Stone PH, Narula J, Bax JJ, Shaw LJ, Min JK, Chang HJ. Topological Data Analysis of Coronary Plaques Demonstrates the Natural History of Coronary Atherosclerosis. JACC Cardiovasc Imaging. 2021 Jul;14(7):1410-1421. doi: 10.1016/j.jcmg.2020.11.009. Epub 2021 Jan 13.

    PubMed 33454260
  • Jin HY, Weir-McCall JR, Leipsic JA, Son JW, Sellers SL, Shao M, Blanke P, Ahmadi A, Hadamitzky M, Kim YJ, Conte E, Andreini D, Pontone G, Budoff MJ, Gottlieb I, Lee BK, Chun EJ, Cademartiri F, Maffei E, Marques H, de Araujo Goncalves P, Shin S, Choi JH, Virmani R, Samady H, Stone PH, Berman DS, Narula J, Shaw LJ, Bax JJ, Chinnaiyan K, Raff G, Al-Mallah MH, Lin FY, Min JK, Sung JM, Lee SE, Chang HJ. The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease. JACC Cardiovasc Imaging. 2021 Jan;14(1):233-242. doi: 10.1016/j.jcmg.2020.08.036. Epub 2020 Nov 18.

    PubMed 33221216
  • Kim M, Lee SP, Kwak S, Yang S, Kim YJ, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Conte E, Marques H, de Araujo Goncalves P, Gottlieb I, Hadamitzky M, Leipsic JA, Maffei E, Pontone G, Raff GL, Shin S, Lee BK, Chun EJ, Sung JM, Lee SE, Berman DS, Lin FY, Virmani R, Samady H, Stone PH, Narula J, Bax JJ, Shaw LJ, Min JK, Chang HJ. Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy. J Cardiovasc Comput Tomogr. 2021 May-Jun;15(3):232-239. doi: 10.1016/j.jcct.2020.09.009. Epub 2020 Oct 1.

    PubMed 33032975
  • Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Maffei E, Marques H, de Araujo Goncalves P, Pontone G, Shin S, Stone PH, Samady H, Virmani R, Narula J, Berman DS, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease. JACC Cardiovasc Imaging. 2020 Nov;13(11):2386-2396. doi: 10.1016/j.jcmg.2020.06.034. Epub 2020 Aug 19.

    PubMed 32828763
  • Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Maffei E, Marques H, de Araujo Goncalves P, Pontone G, Shin S, Stone PH, Samady H, Virmani R, Narula J, Berman DS, Shaw LJ, Bax JJ, Lin FY, Min JK, Chang HJ. Per-lesion versus per-patient analysis of coronary artery disease in predicting the development of obstructive lesions: the Progression of AtheRosclerotic PlAque DetermIned by Computed TmoGraphic Angiography Imaging (PARADIGM) study. Int J Cardiovasc Imaging. 2020 Dec;36(12):2357-2364. doi: 10.1007/s10554-020-01960-z. Epub 2020 Aug 10.

    PubMed 32779077

Questions about this trial

What is this clinical trial studying?

An observational study of Coronary Heart Disease, run by Yonsei University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 29 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in plaque volume and composition detected by follow up CCTA (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02803411, which also lists 21 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2018.

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