title: Impact of type 2 diabetes on serial changes in tissue characteristics of coronary plaques: an integrated backscatter intravascular ultrasound analysis.
abstract: OBJECTIVE
  Several studies have demonstrated that type 2 diabetes mellitus (T2DM) is associated with accelerated atherosclerosis, which results in an increased risk of coronary vascular events. However, serial changes in plaque characteristics have not been reported in vivo. We evaluated the progression of coronary atherosclerosis in patients with T2DM using an integrated backscatter intravascular ultrasound (IB-IVUS) examination.
  
  
  RESULTS
  Forty-two T2DM and 48 non-diabetic patients who underwent percutaneous coronary intervention were enrolled in the study. Non-culprit 20-mm length coronary lesions with mild-to-moderate stenosis were measured using a 40-MHz (motorized pullback of 0.5 mm/s) IVUS catheter. IVUS examinations were performed on one target lesion in each patient. Six months later, a follow-up IVUS examination was repeated in the same coronary segment imaged at the baseline examination. T2DM patients demonstrated a greater total plaque volume (TPV; 139 ± 53 vs. 114 ± 45 mm(3), P = 0.02) and total lipid volume (TLV; 67 ± 26 vs. 55 ± 30 mm(3), P = 0.039) at the baseline examination. The progression of TPV (8.6 ± 15.4 vs. -2.2 ± 16.0%, P < 0.01) and TLV (10.8 ± 28.8 vs. -2.5 ± 20.0%, P < 0.05) from the baseline was observed in T2DM patients, but not in non-diabetic patients. The increase in TLV was blunted in T2DM patients who achieved HbA1c levels of <6.5%.
  
  
  CONCLUSIONS
  Accelerated plaque progression with an increase in the lipid-rich component of non-culprit plaques was observed in T2DM, despite the use of standard medical treatment. Better glycaemic control ameliorated the worsening of plaque characteristics in T2DM.
authors.affiliation: Division of Cardiology, Department of Integrated Medicine and Informatics,  Ehime University Graduate School of Medicine, Toon, Ehime,  Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Inaba
authors.forename: Hideki
authors.initials: H
authors.lastname: Okayama
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Funada
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Higashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Saito
authors.forename: Toyofumi
authors.initials: T
authors.lastname: Yoshii
authors.forename: Go
authors.initials: G
authors.lastname: Hiasa
authors.forename: Takumi
authors.initials: T
authors.lastname: Sumimoto
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Takata
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Nishimura
authors.forename: Katsuji
authors.initials: K
authors.lastname: Inoue
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D015203:Reproducibility of Results; D012307:Risk Factors; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional / Q000379:methods*