title: Statin-induced improvements in vulnerable plaques are attenuated in poorly controlled diabetic patients with coronary atherosclerosis disease: a serial optical coherence tomography analysis.
abstract: OBJECTIVE
  The incidence of cardiac events is increased in diabetic patients even after lipid-lowering therapy. This study aimed to compare the statin-induced changes in the characteristics of vulnerable plaques in patients without diabetes mellitus (DM) and in those with better- or poorly controlled DM, measured by optical coherence tomography (OCT).
  
  
  METHODS
  This was a retrospective study of 99 non-culprit lipid-rich plaques from 75 patients who underwent intensive OCT imaging examination. Thirty-four non-diabetic patients were assigned to Group A. According to the average HbA1c level, 22 diabetic patients were assigned to Group B, and 19, to Group C (average HbA1c < 8 and ≥8 %, respectively).
  
  
  RESULTS
  Following 12 months of statin therapy, similar improvements in serum lipid levels were observed in the three groups. However, the increase in fibrous-cap thickness of plaques was the highest in Group A (Group A, 183 %; Group B, 104 %; and Group C, 53 %). Significant reductions in lipid volume index were observed in Groups A and B (Group A: -12 %, P < 0.001; Group B: -13 %, P = 0.038; Group C: 7 %, P = 0.948). Percent changes in OCT measurements were significantly correlated with average HbA1c in patients.
  
  
  CONCLUSIONS
  Improved glucose control may enhance the statin-induced reduction in characteristics of vulnerable plaque in diabetic patients.
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.|The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Nana
authors: N
authors: Dong
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Zulong
authors: Z
authors: Xie
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Jiannan
authors: J
authors: Dai
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Wei
authors: W
authors: Wang
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Rong
authors: R
authors: Sun
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Yefei
authors: Y
authors: Zhan
authors: The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, 246 Xuefu Road, Nangang District, Harbin, 150086, China.
authors: Meng
authors: M
authors: Sun
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China. Tianjinweidr2009@163.com.
authors: Jinwei
authors: J
authors: Tian
authors: Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China. dryu_hmu@163.com.|The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, 246 Xuefu Road, Nangang District, Harbin, 150086, China. dryu_hmu@163.com.
authors: Bo
authors: B
authors: Yu
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D004351:Drug Resistance; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents
keywords: Atherosclerosis; Coronary artery disease; HbA1c; Optical coherence tomography; Statin