Literature DB >> 23174639

Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study.

Koji Kato1, Taishi Yonetsu, Soo-Joong Kim, Lei Xing, Hang Lee, Iris McNulty, Robert W Yeh, Rahul Sakhuja, Shaosong Zhang, Shiro Uemura, Bo Yu, Kyoichi Mizuno, Ik-Kyung Jang.   

Abstract

OBJECTIVES: The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging.
BACKGROUND: DM patients have a higher recurrent cardiovascular event rate.
METHODS: Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients.
RESULTS: A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596.1 vs. 1358.3 ± 939.2, p < 0.001) and higher prevalence of calcification (48.4% vs. 72.2%, p = 0.034) and thrombus (0% vs. 8.3%, p = 0.047). DM patients were divided into 2 groups based on glycated hemoglobin (A(1C)) levels of ≤7.9% and ≥8.0%. LI was significantly correlated with diabetic status (778.6 ± 596.1 [non-DM] vs. 1,171.5 ± 708.1 [A(1C) ≤7.9%] vs. 1,638.5 ± 1,173.8 [A(1C) ≥8%], p value for linear trend = 0.005), and fibrous cap thickness was inversely correlated with the A(1C) level (99.4 ± 46.7 μm [non-DM] vs. 91.7 ± 29.6 μm [A(1C) ≤7.9%] vs. 72.9 ± 22.7 μm [A(1C) ≥8%], p value for linear trend = 0.014). Patients with A(1C) ≥8% also had the highest prevalence of thin-cap fibroatheroma (TCFA) and macrophage infiltration.
CONCLUSIONS: Compared with non-DM patients, DM patients have a larger LI and a higher prevalence of calcification and thrombus. The LI was larger and TCFA and macrophage infiltration were frequent in patients with A(1C) ≥8%.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 23174639     DOI: 10.1016/j.jcin.2012.06.019

Source DB:  PubMed          Journal:  JACC Cardiovasc Interv        ISSN: 1936-8798            Impact factor:   11.195


  42 in total

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