title: The impact of glucose control on coronary plaque composition in patients with diabetes mellitus.
abstract: BACKGROUND
  Patients with diabetes mellitus (DM) are known to have large necrotic core in their coronary plaque compared to non-DM patients. We assessed coronary plaque composition in patients with angina and with/without DM according to glucose control.
  
  
  METHODS
  Study subjects consisted of 114 non-DM patients, 14 well-controlled DM patients (hemoglobin A1c [HbA1c] <7.0%), and 37 poorly controlled DM patients (HbA1c ≥ 7%) who underwent virtual histology intravascular ultrasound (VH-IVUS) examinations of culprit lesions.
  
  
  RESULTS
  The DM patients had longer lesion length (20.2 ± 7.8 mm vs 17.0 ± 7.3 mm; P=.013) than non-DM patients. The plaque volume was highest in the poorly-controlled DM patients (188.9 ± 92.6 mm(3)) compared with the non-DM patients (144.1 ± 92.3 mm(3); P=.011) and the well-controlled DM patients (151.7 ± 82.4 mm(3); P=.194). The well-controlled DM patients had less dense calcium (0.33 ± 0.14 mm(3)/mm vs 0.71 ± 0.60 mm(3)/mm; P=.020) and less necrotic core (0.71 ± 0.48 mm(3)/mm vs 1.30 ± 0.94 mm(3)/mm; P=.029) than the poorly-controlled DM patients and had similar amounts of dense calcium and necrotic core with non-DM patients, whereas fibrous and fibro-fatty volume showed no significant differences among the groups.
  
  
  CONCLUSIONS
  Coronary plaque composition and plaque volume in well-controlled DM patients are similar to those in non-DM patients and both groups had less dense calcium and necrotic core volume than the poorly-controlled DM patients. These findings suggest hyperglycemia control is important in DM patients with angina.
authors.affiliation: Division of Cardiology, Heart Center Konyang University Hospital, 685 Gasuwon-dong, Seo-gu, Daejon City, South Korea. janghobae@yahoo.co.kr
authors.forename: Dong Ju
authors.initials: DJ
authors.lastname: Yang
authors.forename: Moo-Sik
authors.initials: MS
authors.lastname: Lee
authors.forename: Wan Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Park
authors.forename: Ki-Hong
authors.initials: KH
authors.lastname: Kim
authors.forename: Taek-Geun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000453:epidemiology / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism*; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000378:metabolism*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D001786:Blood Glucose; D002118:Calcium; D006442:Glycated Hemoglobin