Plaque characteristics in culprit lesions and inflammatory status in diabetic acute coronary syndrome patients
| Autor: | Hyung Wook Park, Shin Eun Lee, Jum Suk Ko, Myung Ho Jeong, Kye Hun Kim, Doo Sun Sim, Jung Chaee Kang, Jong Chun Park, Youngkeun Ahn, Nam Sik Yoon, Young Joon Hong, Jeong Gwan Cho, Won Yu Kang, Min Goo Lee, Ju Han Kim, Soo Hyun Kim, Keun Ho Park, Yun Ha Choi, Hyun Ju Yoon |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Coronary Artery Disease Diabetic angiopathy Coronary Angiography Culprit Risk Assessment intravascular ultrasound Coronary artery disease plaque Necrosis User-Computer Interface Predictive Value of Tests Diabetes mellitus Internal medicine Intravascular ultrasound Odds Ratio Medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Myocardial infarction Acute Coronary Syndrome Ultrasonography Interventional Aged Retrospective Studies Inflammation Rupture medicine.diagnostic_test biology business.industry C-reactive protein Middle Aged medicine.disease C-Reactive Protein Radiology Nuclear Medicine and imaging diabetes mellitus Cardiology biology.protein Female Inflammation Mediators Cardiology and Cardiovascular Medicine business Biomarkers Diabetic Angiopathies |
| Zdroj: | JACC. Cardiovascular imaging. 2(3) |
| ISSN: | 1876-7591 |
| Popis: | ObjectivesThe aim of this study was to assess the plaque characteristics in culprit lesions in diabetic patients with acute coronary syndrome (ACS).BackgroundData of the relationship between diabetes mellitus and plaque characteristics in patients with ACS are lacking.MethodsWe performed grayscale intravascular ultrasound (IVUS) analysis in 422 ACS patients and virtual histology (VH)-IVUS in 310 ACS patients. By subgroup analysis, 112 patients with acute myocardial infarction (AMI) with plaque ruptures also were evaluated.ResultsIn the diabetic subgroup, high-sensitivity C-reactive protein (hs-CRP) was significantly increased (p = 0.008), multivessel disease was more common (65% vs. 29%, p < 0.001), and plaque burden was greater (79.7 ± 9.8 mm2 vs. 74.2 ± 8.9 mm2, p < 0.001). In the subgroup analysis of 112 AMI patients with plaque ruptures, the presence of multiple plaque ruptures (60% vs. 29%, p = 0.001) and thrombus (72% vs. 52%, p = 0.032) were more common in diabetic group. Diabetes mellitus was the independent predictor of hs-CRP elevation (odds ratio [OR]: 3.030, 95% confidence interval [CI]: 1.204 to 7.623, p = 0.019), and multiple plaque ruptures (OR: 2.984, 95% CI: 1.311 to 6.792, p = 0.009) by multivariable analysis. In 310 VH-IVUS subsets, the absolute and percent necrotic core volumes were significantly greater (16.9 ± 15.1 mm3 vs. 11.5 ± 11.4 mm3, p < 0.001, and 17.3 ± 9.4% vs. 13.7 ± 7.5%, p < 0.001, respectively), and the presence of at least one thin-cap fibroatheroma (TCFA) (60% vs. 42%, p = 0.003) and multiple TCFAs (28% vs. 11%, p < 0.001) were more common in the diabetic group. Diabetes mellitus was the only independent predictor of TCFA by multivariable analysis (OR: 2.139, 95% CI: 1.266 to 3.613, p = 0.004).ConclusionsDiabetic patients with ACS have more plaques with characteristics of plaque vulnerability, different composition of plaques, and have increased inflammatory status compared with nondiabetic patients with ACS. |
| Databáze: | OpenAIRE |
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