Plaque characterization of non-culprit lesions by virtual histology intravascular ultrasound in diabetic patients: impact of renal function.

BACKGROUND: The aim of this study was to characterize coronary plaque composition of non-target lesions in diabetic patients using virtual histology intravascular ultrasound (VH-IVUS). METHODS AND
RESULTS: In 134 stable angina pectoris patients, plaque components of non-culprit (< 50% in diameter stenosis) lesions in de novo target vessels were analyzed by VH-IVUS. Plaque characterization was compared between diabetic (n=65) and non-diabetic groups (n=69). Diabetic patients were further divided into four groups according to estimated glomerular filtration rate (eGFR, ml/min): eGFR > or = 70 (n=20), 50 < or = eGFR < 70 (n=19), GFR < 50 (n=18), and end stage renal disease (ESRD) on hemodialysis (HD) (n=11). There was no significant difference in plaque composition between the diabetic and the non-diabetic patients except for the percentage of dense calcium (8.9% vs. 6.2%; p<0.05). In the diabetic patients, the percent volume of necrotic core was 9.6%, 11.4%, 14.8%, and 20.8% in the eGFR > or = 70, 50 < or = eGFR < 70, eGFR < 50, and the ESRD on HD groups, respectively, showing significantly higher percentage in eGFR < 50 (p<0.05 vs. eGFR > or = 70) and ESRD on HD group (p<0.001).
CONCLUSIONS: Diabetic patients have significantly larger amount of dense calcium than non-diabetic patients in non-culprit coronary artery segments, and the plaque components of non-culprit lesions in diabetes are significantly different according to the decline in renal function.