Plaque characterisation by Virtual Histology intravascular ultrasound analysis in patients with type 2 diabetes.
OBJECTIVE
To evaluate the in-vivo plaque composition and characteristics in patients with type 2 diabetes mellitus (DM) using Virtual Histology intravascular ultrasound (VH IVUS).


METHODS
In 90 patients with stable angina pectoris, de novo target vessels were studied and plaque components were analysed. Patients were divided into two groups: a diabetic group (36 vessels) and a non-diabetic group (54 vessels).


RESULTS
The percentage area of necrotic core and dense calcium were significantly larger in the DM group than the non-DM group (necrotic core: 11.0% (interquartile range (IQR): 7.2-15.2%) vs 7.6% (IQR 5.6-13.2%), p = 0.03; dense calcium: 5.6% (IQR: 2.3-7.3%) vs 2.9% (IQR: 1.7-4.9%), p = 0.01). The DM group presented with a significantly higher presence of at least one VH IVUS-derived thin-cap fibroatheroma (VHD-TCFA) (75% vs 41%, p = 0.001) and VH IVUS-derived fibrocalcific atheroma (VHD-FCA) (75% vs 40%, p = 0.001). In the DM group, 53% of the vessels had both VHD-TCFA and VHD-FCA, which was significantly higher than non-DM group (17%, p = 0.0004).


CONCLUSIONS
Coronary plaque characteristics in DM patients showed an increased amount of dense calcium and necrotic core, as well as a higher frequency of VHD-TCFA and VHD-FCA. Atherosclerosis of the target vessel was more advanced in diabetic patients.
Nasu
K
K
Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama, Toyohashi, Aichi, 441-8530 Japan. nasu@heart-center.or.jp
Tsuchikane
E
E
Katoh
O
O
Fujita
H
H
Surmely
J-F
JF
Ehara
M
M
Kinoshita
Y
Y
Tanaka
N
N
Matsubara
T
T
Asakura
Y
Y
Asakura
K
K
Terashima
M
M
Suzuki
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D018084:Ultrasonography, Interventional / Q000379:methods