title: Impact of glucose fluctuation and monocyte subsets on coronary plaque rupture.
abstract: OBJECTIVE
  It remains unclear whether glycemic fluctuation can affect plaque rupture in acute myocardial infarction (AMI). Here we investigate the impact of glucose fluctuation on plaque rupture, as observed by optical coherence tomography (OCT), and monocyte subsets in patients with AMI.
  
  
  RESULTS
  We studied 37 consecutive patients with AMI. All patients underwent OCT examination, which revealed 24 patients with plaque rupture and 13 patients without plaque rupture at the culprit site. Peripheral blood sampling was performed on admission. Three monocyte subsets (CD14(+)CD16(-), CD14(bright)CD16(+), and CD14(dim)CD16(+)) were assessed by flow cytometry. Glycemic variability, expressed as the mean amplitude of glycemic excursion (MAGE), was determined by a continuous glucose monitoring system 7 days after the onset of AMI. MAGE was significantly higher in the rupture patients than in the non-rupture patients (P=0.036). Levels of CD14(bright)CD16(+) monocytes from the rupture patients were significantly higher than those from the non-rupture patients (P=0.042). Of interest, levels of CD14(bright)CD16(+) monocytes correlated positively and significantly with MAGE (r=0.39, P=0.02).
  
  
  CONCLUSIONS
  Dynamic glucose fluctuation may be associated with coronary plaque rupture, possibly through the preferential increase in CD14(bright)CD16(+) monocyte levels.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Teraguchi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan. Electronic address: t-imani@wakayama-med.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Imanishi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tanimoto
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Orii
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shiono
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ishibashi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamano
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ino
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hirata
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology*; D009203:Myocardial Infarction / Q000097:blood / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000473:pathology; D011446:Prospective Studies; D041623:Tomography, Optical Coherence
chemical_list: D001786:Blood Glucose
keywords: Acute myocardial infarction; Coronary plaque rupture; Glucose fluctuation; Monocyte; Optical coherence tomography