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Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes

BACKGROUND: Diabetes mellitus (DM) is a major risk factor for cardiovascular events. We aimed to investigate the coronary plaque phenotype of diabetic patients who presented with acute coronary syndromes by optical coherence tomography. METHODS AND RESULTS: A total of 322 patients with acute coronar...

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Autores principales: Sugiyama, Tomoyo, Yamamoto, Erika, Bryniarski, Krzysztof, Xing, Lei, Fracassi, Francesco, Lee, Hang, Jang, Ik‐Kyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064844/
https://www.ncbi.nlm.nih.gov/pubmed/30006490
http://dx.doi.org/10.1161/JAHA.118.009245
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author Sugiyama, Tomoyo
Yamamoto, Erika
Bryniarski, Krzysztof
Xing, Lei
Fracassi, Francesco
Lee, Hang
Jang, Ik‐Kyung
author_facet Sugiyama, Tomoyo
Yamamoto, Erika
Bryniarski, Krzysztof
Xing, Lei
Fracassi, Francesco
Lee, Hang
Jang, Ik‐Kyung
author_sort Sugiyama, Tomoyo
collection PubMed
description BACKGROUND: Diabetes mellitus (DM) is a major risk factor for cardiovascular events. We aimed to investigate the coronary plaque phenotype of diabetic patients who presented with acute coronary syndromes by optical coherence tomography. METHODS AND RESULTS: A total of 322 patients with acute coronary syndromes who underwent preintervention optical coherence tomography imaging of the culprit lesion were included. Culprit plaque characteristics were compared between patients with DM (n=95) and those without DM (n=227). In the subgroup of 250 patients in whom sufficient length of nonculprit region in the culprit vessel was imaged by optical coherence tomography, the characteristics of nonculprit plaques were also evaluated. Patients with DM had a higher prevalence of lipid‐rich plaque (58.9% versus 44.9%, P=0.030) and macrophage accumulation (60.0% versus 44.9%, P=0.019) in the culprit lesion compared with patients without DM. The prevalence of plaque rupture (33.7% versus 30.4%, P=0.896) and plaque erosion (21.1% versus 22.0%, P=0.458) was similar. In the nonculprit lesions, the DM group had greater maximal lipid arc (248.9°±83.9° versus 179.9°±58.3°, P=0.006), thinner fibrous cap thickness (103.3±56.2 μm versus 140.7±70.0 μm, P=0.013), and a higher prevalence of thin‐cap fibroatheroma (17.2% versus 6.3%, P=0.031), compared with the non‐DM group. CONCLUSIONS: Compared with patients without DM, those with DM had more vulnerable features in both culprit and nonculprit lesions, thus indicating a higher level of panvascular instability. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01110538.
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spelling pubmed-60648442018-08-07 Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes Sugiyama, Tomoyo Yamamoto, Erika Bryniarski, Krzysztof Xing, Lei Fracassi, Francesco Lee, Hang Jang, Ik‐Kyung J Am Heart Assoc Original Research BACKGROUND: Diabetes mellitus (DM) is a major risk factor for cardiovascular events. We aimed to investigate the coronary plaque phenotype of diabetic patients who presented with acute coronary syndromes by optical coherence tomography. METHODS AND RESULTS: A total of 322 patients with acute coronary syndromes who underwent preintervention optical coherence tomography imaging of the culprit lesion were included. Culprit plaque characteristics were compared between patients with DM (n=95) and those without DM (n=227). In the subgroup of 250 patients in whom sufficient length of nonculprit region in the culprit vessel was imaged by optical coherence tomography, the characteristics of nonculprit plaques were also evaluated. Patients with DM had a higher prevalence of lipid‐rich plaque (58.9% versus 44.9%, P=0.030) and macrophage accumulation (60.0% versus 44.9%, P=0.019) in the culprit lesion compared with patients without DM. The prevalence of plaque rupture (33.7% versus 30.4%, P=0.896) and plaque erosion (21.1% versus 22.0%, P=0.458) was similar. In the nonculprit lesions, the DM group had greater maximal lipid arc (248.9°±83.9° versus 179.9°±58.3°, P=0.006), thinner fibrous cap thickness (103.3±56.2 μm versus 140.7±70.0 μm, P=0.013), and a higher prevalence of thin‐cap fibroatheroma (17.2% versus 6.3%, P=0.031), compared with the non‐DM group. CONCLUSIONS: Compared with patients without DM, those with DM had more vulnerable features in both culprit and nonculprit lesions, thus indicating a higher level of panvascular instability. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01110538. John Wiley and Sons Inc. 2018-07-13 /pmc/articles/PMC6064844/ /pubmed/30006490 http://dx.doi.org/10.1161/JAHA.118.009245 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Sugiyama, Tomoyo
Yamamoto, Erika
Bryniarski, Krzysztof
Xing, Lei
Fracassi, Francesco
Lee, Hang
Jang, Ik‐Kyung
Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title_full Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title_fullStr Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title_full_unstemmed Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title_short Coronary Plaque Characteristics in Patients With Diabetes Mellitus Who Presented With Acute Coronary Syndromes
title_sort coronary plaque characteristics in patients with diabetes mellitus who presented with acute coronary syndromes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064844/
https://www.ncbi.nlm.nih.gov/pubmed/30006490
http://dx.doi.org/10.1161/JAHA.118.009245
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