Plaque characterization of non-culprit lesions by virtual histology intravascular ultrasound in diabetic patients: impact of renal function.
BACKGROUND
The aim of this study was to characterize coronary plaque composition of non-target lesions in diabetic patients using virtual histology intravascular ultrasound (VH-IVUS).


RESULTS
In 134 stable angina pectoris patients, plaque components of non-culprit (< 50% in diameter stenosis) lesions in de novo target vessels were analyzed by VH-IVUS. Plaque characterization was compared between diabetic (n=65) and non-diabetic groups (n=69). Diabetic patients were further divided into four groups according to estimated glomerular filtration rate (eGFR, ml/min): eGFR > or = 70 (n=20), 50 < or = eGFR < 70 (n=19), GFR < 50 (n=18), and end stage renal disease (ESRD) on hemodialysis (HD) (n=11). There was no significant difference in plaque composition between the diabetic and the non-diabetic patients except for the percentage of dense calcium (8.9% vs. 6.2%; p<0.05). In the diabetic patients, the percent volume of necrotic core was 9.6%, 11.4%, 14.8%, and 20.8% in the eGFR > or = 70, 50 < or = eGFR < 70, eGFR < 50, and the ESRD on HD groups, respectively, showing significantly higher percentage in eGFR < 50 (p<0.05 vs. eGFR > or = 70) and ESRD on HD group (p<0.001).


CONCLUSIONS
Diabetic patients have significantly larger amount of dense calcium than non-diabetic patients in non-culprit coronary artery segments, and the plaque components of non-culprit lesions in diabetes are significantly different according to the decline in renal function.
Ogita
Manabu
M
Department of Integrated Medicine 1, Cardiovascular Division, Jichi Medical University, Saitama Medical Center, 1-847, Amanuma, Omiya, Saitama 330-8503, Japan.
Funayama
Hirosihi
H
Nakamura
Tomohiro
T
Sakakura
Kenichi
K
Sugawara
Yoshitaka
Y
Kubo
Norifumi
N
Ako
Junya
J
Ishikawa
San-e
SE
Momomura
Shin-ichi
S
D000368:Aged; D002118:Calcium / Q000032:analysis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000473:pathology; D003930:Diabetic Retinopathy / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology; D008297:Male; D018084:Ultrasonography, Interventional; D014584:User-Computer Interface
D002118:Calcium