BACKGROUND: Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and a higher incidence of myocardial infarction than the general population. Diabetic patients also have several hematologic, rheologic, and metabolic abnormalities not present in their nondiabetic counterparts that may predispose them to atherosclerotic plaque rupture and intraluminal thrombosis and consequently may lead to the formation of morphologically complex plaques and the development of acute coronary syndromes. METHODS AND RESULTS: Percutaneous coronary angioscopy was performed in 55 consecutive patients with unstable angina. We observed plaque color, texture, and the incidence of intracoronary thrombus associated with the culprit lesions of these patients. The population consisted of 17 (31%) diabetic and 38 (69%) nondiabetic patients. The presence of coronary risk factors was not significantly different between the two populations. Ulcerated plaque was found in 16 of 17 (94%) diabetic patients versus 23 of 38 (60%) nondiabetic patients (P = .01). Intracoronary thrombi were seen in 16 of 17 (94%) diabetic patients versus 21 of 38 (55%) nondiabetic patients (P = .004). CONCLUSIONS: The results of the angioscopic examination show that diabetic patients with unstable angina have a higher incidence of plaque ulceration and intracoronary thrombus formation than nondiabetic patients. This increased frequency of complex lesion morphology is consistent with the disproportionately higher risk for development of acute coronary syndromes in these patients.
BACKGROUND:Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and a higher incidence of myocardial infarction than the general population. Diabeticpatients also have several hematologic, rheologic, and metabolic abnormalities not present in their nondiabetic counterparts that may predispose them to atherosclerotic plaque rupture and intraluminal thrombosis and consequently may lead to the formation of morphologically complex plaques and the development of acute coronary syndromes. METHODS AND RESULTS: Percutaneous coronary angioscopy was performed in 55 consecutive patients with unstable angina. We observed plaque color, texture, and the incidence of intracoronary thrombus associated with the culprit lesions of these patients. The population consisted of 17 (31%) diabetic and 38 (69%) nondiabetic patients. The presence of coronary risk factors was not significantly different between the two populations. Ulcerated plaque was found in 16 of 17 (94%) diabeticpatients versus 23 of 38 (60%) nondiabetic patients (P = .01). Intracoronary thrombi were seen in 16 of 17 (94%) diabeticpatients versus 21 of 38 (55%) nondiabetic patients (P = .004). CONCLUSIONS: The results of the angioscopic examination show that diabeticpatients with unstable angina have a higher incidence of plaque ulceration and intracoronary thrombus formation than nondiabetic patients. This increased frequency of complex lesion morphology is consistent with the disproportionately higher risk for development of acute coronary syndromes in these patients.
Authors: Stanley Chia; O Christopher Raffel; Masamichi Takano; Guillermo J Tearney; Brett E Bouma; Ik-Kyung Jang Journal: Diabetes Res Clin Pract Date: 2008-05-05 Impact factor: 5.602
Authors: Suzhao Li; Yu Sun; Chien-Ping Liang; Edward B Thorp; Seongah Han; Andreas W Jehle; Viswanathan Saraswathi; Brian Pridgen; Jenny E Kanter; Rong Li; Carrie L Welch; Alyssa H Hasty; Karin E Bornfeldt; Jan L Breslow; Ira Tabas; Alan R Tall Journal: Circ Res Date: 2009-10-15 Impact factor: 17.367
Authors: Michael Pignone; Mark J Alberts; John A Colwell; Mary Cushman; Silvio E Inzucchi; Debabrata Mukherjee; Robert S Rosenson; Craig D Williams; Peter W Wilson; M Sue Kirkman Journal: Diabetes Care Date: 2010-06 Impact factor: 19.112