Associations between metabolic factors and coronary plaque growth or arterial remodeling as assessed by intravascular ultrasound in patients with stable angina.

Although many clinical studies have evaluated plaque growth in response to positive or negative remodeling in coronary arteries using intravascular ultrasound (IVUS), little is known about the associations between metabolic factors and coronary plaque growth or remodeling. In this cross-sectional study, we analyzed 100 consecutive patients with stable angina who had undergone preinterventional IVUS. The characteristics of coronary plaque (plaque area [PA] and volume [PV]) and remodeling patterns were analyzed by IVUS. Patients were divided into two groups: a positive remodeling (P) group (remodeling index [RI]>1.0, n=37) and a non-positive remodeling (NP) group (RI< or =1.0, n=63). Patient characteristics, including age, gender, body mass index and angiographic variables, were similar between the two groups. Interestingly, plasma adiponectin levels in the P group were significantly lower than those in the NP group. The remodeling classification was most closely associated with plasma adiponectin levels (p=0.006) among the metabolic factors. Although there were no significant correlations between RI and %PA or %PV, and although %PA but not %PV in the P group was significantly higher than that in the NP group, %PV was significantly associated with plasma low-density lipoprotein cholesterol (LDL-C) and diastolic blood pressure, but not adiponectin, in all patients. In addition, higher %PV was most closely correlated with higher plasma LDL-C (p=0.009) among metabolic factors. In conclusion, among the metabolic factors examined, plasma adiponectin levels may be critical for arterial remodeling, while higher levels of LDL-C may be most useful for predicting PV.