Author + information
- Received March 14, 2012
- Revision received June 14, 2012
- Accepted June 21, 2012
- Published online November 1, 2012.
- Koji Kato, MD, PhD⁎,
- Taishi Yonetsu, MD⁎,
- Soo-Joong Kim, MD, PhD⁎,†,
- Lei Xing, MD⁎,
- Hang Lee, PhD‡,
- Iris McNulty, RN⁎,
- Robert W. Yeh, MD, MSc⁎,
- Rahul Sakhuja, MD, MPP, MSc§,
- Shaosong Zhang, MD, PhD∥,¶,
- Shiro Uemura, MD, PhD#,
- Bo Yu, MD, PhD††,
- Kyoichi Mizuno, MD, PhD⁎,⁎⁎ and
- Ik-Kyung Jang, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Ik-Kyung Jang, Massachusetts General Hospital, Cardiology Division, 55 Fruit Street GRB 800, Boston, Massachusetts 02114
Objectives 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 (A1C) 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 [A1C ≤7.9%] vs. 1,638.5 ± 1,173.8 [A1C ≥8%], p value for linear trend = 0.005), and fibrous cap thickness was inversely correlated with the A1C level (99.4 ± 46.7 μm [non-DM] vs. 91.7 ± 29.6 μm [A1C ≤7.9%] vs. 72.9 ± 22.7 μm [A1C ≥8%], p value for linear trend = 0.014). Patients with A1C ≥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 A1C ≥8%.
This study was supported by research grants from St. Jude Medical, the Cardiology Division of Massachusetts General Hospital, and a Dr. John Nam fellowship grant. Dr. Kato received a grant from Japan Heart Foundation/Bayer Yakuhin Research Grant Abroad. Dr. Zhang is an employee of LightLab Imaging/St Jude Medical. Dr. Jang received a research grant and consulting fee from LightLab Imaging/St. Jude Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 14, 2012.
- Revision received June 14, 2012.
- Accepted June 21, 2012.
- American College of Cardiology Foundation