title: Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study.
abstract: OBJECTIVE
  The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging.
  
  
  BACKGROUND
  DM patients have a higher recurrent cardiovascular event rate.
  
  
  METHODS
  Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients.
  
  
  RESULTS
  A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596.1 vs. 1358.3 ± 939.2, p < 0.001) and higher prevalence of calcification (48.4% vs. 72.2%, p = 0.034) and thrombus (0% vs. 8.3%, p = 0.047). DM patients were divided into 2 groups based on glycated hemoglobin (A(1C)) levels of ≤7.9% and ≥8.0%. LI was significantly correlated with diabetic status (778.6 ± 596.1 [non-DM] vs. 1,171.5 ± 708.1 [A(1C) ≤7.9%] vs. 1,638.5 ± 1,173.8 [A(1C) ≥8%], p value for linear trend = 0.005), and fibrous cap thickness was inversely correlated with the A(1C) level (99.4 ± 46.7 μm [non-DM] vs. 91.7 ± 29.6 μm [A(1C) ≤7.9%] vs. 72.9 ± 22.7 μm [A(1C) ≥8%], p value for linear trend = 0.014). Patients with A(1C) ≥8% also had the highest prevalence of thin-cap fibroatheroma (TCFA) and macrophage infiltration.
  
  
  CONCLUSIONS
  Compared with non-DM patients, DM patients have a larger LI and a higher prevalence of calcification and thrombus. The LI was larger and TCFA and macrophage infiltration were frequent in patients with A(1C) ≥8%.
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Taishi
authors.initials: T
authors.lastname: Yonetsu
authors.forename: Soo-Joong
authors.initials: SJ
authors.lastname: Kim
authors.forename: Lei
authors.initials: L
authors.lastname: Xing
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.forename: Iris
authors.initials: I
authors.lastname: McNulty
authors.forename: Robert W
authors.initials: RW
authors.lastname: Yeh
authors.forename: Rahul
authors.initials: R
authors.lastname: Sakhuja
authors.forename: Shaosong
authors.initials: S
authors.lastname: Zhang
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis*; D003925:Diabetic Angiopathies / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence