title: Relation between aortic knob calcium observed by simple chest x-ray or fluoroscopy and plaque components in patients with diabetes mellitus.
abstract: We used virtual histology and intravascular ultrasound (VH-IVUS) to evaluate the relation between aortic knob calcium (AKC) and plaque components in diabetic patients. The presence of AKC was assessed by posteroanterior view of chest x-ray or fluoroscopy at the time of coronary angiography. A total of 137 de novo coronary culprit lesions in 137 consecutive diabetic patients were studied and coronary plaque components were analyzed using VH-IVUS according to the presence (n = 45) or absence (n = 92) of AKC. Patients with AKC were significantly older (68 +/- 8 vs 62 +/- 9 years, p <0.001) and had significantly higher high-sensitivity C-reactive protein levels (1.97 +/- 1.33 vs 0.48 +/- 1.35 mg/dl, p = 0.005) compared to patients without AKC. Absolute and percent necrotic core (NC) volumes (30 +/- 26 vs 20 +/- 19 mm(3), p = 0.003; 23.4 +/- 10.3% vs 17.4 +/- 8.9%, p = 0.005, respectively) and absolute and percent dense calcium (DC) volumes (17 +/- 12 vs 11 +/- 12 mm(3), p = 0.010; 13.3 +/- 7.3% vs 9.6 +/- 7.9%, p = 0.011, respectively) were significantly greater in lesions with AKC compared to those without AKC. Multivariable analysis showed that age (odds ratio [OR] 1.233, 95% confidence interval [CI] 1.121 to 1.355, p <0.001), high-sensitivity C-reactive protein (OR 1.871, 95% CI 1.090 to 2.943, p = 0.007), absolute DC volume (OR 1.020, 95% CI 1.050 to 1.178, p = 0.003), and absolute NC volume (OR 1.026, 95% CI 1.057 to 1.199, p <0.001) were independent predictors of AKC. In conclusion, diabetic patients with AKC were older, had greater NC- and DC-containing plaques, and higher inflammatory status compared to diabetic patients without AKC.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Yun Ha
authors.initials: YH
authors.lastname: Choi
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Ma
authors.forename: Jum Suk
authors.initials: JS
authors.lastname: Ko
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Youn
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003920:Diabetes Mellitus; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional