The influence of diabetes mellitus on plaque volume and vessel size in patients undergoing percutaneous coronary intervention.
We evaluated the influence of diabetes on plaque volume and vessel size at a reference segment in diabetic patients undergoing percutaneous coronary intervention using both angiograms and quantitative intravascular ultrasound. A total of 344 patients with 449 de novo coronary lesions including 97 diabetics (133 lesions) who underwent elective percutaneous coronary intervention under intravascular ultrasound guidance were included in this study. Eleven diabetic patients (19 lesions) received insulin and 52 patients (77 lesions) oral hypoglycemic drugs. The other 34 patients (37 lesions) received diet/exercise therapy alone. We measured vessel area (VA) and lumen area (LA) at proximal and distal reference segments by intravascular ultrasound, which were averaged. Plaque area (VA-LA) and % plaque area (100 x plaque area/VA) were subsequently calculated. Although VA was similar between diabetic and non-diabetic patients (13.46 +/- 4.49 mm2 in diabetics versus 14.11 +/- 5.24 mm2 in non-diabetics, P = 0.214), LA was smaller (6.51 +/- 2.63 mm2 versus 7.38 +/- 3.08 mm2, P = 0.004) and % PA was larger (50.4 +/- 11.7 versus 46.5 +/- 11.3, P < 0.001) in diabetic patients, especially the group receiving a hypoglycemic drug or insulin. VA, LA, and % PA were similar between patients with and without insulin treatment. These results potentially might cause undersized device selection without intravascular ultrasound guidance.
Ito
Shigenori
S
Division of Cardiovascular Medicine, Toyohashi Heart Center, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
Suzuki
Takahiko
T
Katoh
Osamu
O
Ojio
Shinsuke
S
Sato
Hidetoshi
H
Ehara
Mariko
M
Ito
Tatsuya
T
Myoishi
Masafumi
M
Kawase
Yoshiaki
Y
Kurokawa
Ryohei
R
Suzuki
Yasuyuki
Y
Sato
Koyo
K
Toyama
Junji
J
Fukutomi
Tatsuya
T
Itoh
Makoto
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001837:Body Weights and Measures / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D048909:Diabetes Complications; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D015607:Stents; D018084:Ultrasonography, Interventional / Q000379:methods*