Diabetes mellitus is associated with plaque classified as thin cap fibroatheroma: an intravascular ultrasound study.
We compared measures of ID coronary atherosclerosis between diabetic and non-diabetic patients enrolled in a prospective multinational IVUS registry. The region of interest was the most diseased 10 mm segment of a single coronary artery. Coronary plaque was quantified using greyscale IVUS and further classified by phenotype (ID-adaptive intimal thickening, ID-pathological intimal thickening, ID-TCFA, ID-fibroatheroma, or ID-fibrocalcific) using VH-IVUS. There was a non-significant trend for greater total plaque volume in diabetic (n=191) compared with non-diabetic (n=584) patients (94.8 vs. 88.1 mm(3), p=0.36, adjusted for multiple comparisons). There was a greater proportion of ID-TCFA among diabetic patients (21.6 vs. 13.6%, p=0.01 after adjustment for multiple comparisons; p=0.08 following multivariable adjustment for age and clinical demographics), while differences in pathological intimal thickening, fibroatheroma and fibrocalcific plaque were not significant between groups. ID-TCFA was more common in the most diseased 10 mm segment of diabetic than in non-diabetic coronary arteries. Multivariable adjustment demonstrated age and possibly the presence of diabetes to be independent predictors of ID-TCFA.
Marso
Steven P
SP
Mid America Heart Institute, Professor of Medicine, University of Missouri Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA. smarso@saint-lukes.org
House
John A
JA
Klauss
Volker
V
Lerman
Amir
A
Margolis
Pauliina
P
Leon
Martin B
MB
D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012042:Registries; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional