Non-culprit plaque characteristics in acute coronary syndrome patients with raised hemoglobinA1c: an intravascular optical coherence tomography study
Tóm tắt
Raised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease. However, the detailed morphological characteristics of non-culprit plaques in acute coronary syndrome (ACS) patients remain largely unknown. A total of 305 non-culprit plaques from 216 ACS patients were analyzed by intravascular optical coherence tomography. These patients were divided into three groups according to the serum glycosylated hemoglobin level: normal HbA1c (< 5.7%), pre-diabetes with raised HbA1c (5.7–6.4%) and diabetes mellitus (DM). Plaques in patients with raised HbA1c had a longer lipid length (17.0 ± 8.3 mm vs. 13.9 ± 7.2 mm, P = 0.004) and greater lipid index (2775.0 ± 1694.0 mm° vs. 1592.1 ± 981.2 mm°, P = 0.001) than those with normal HbA1c but were similar to DM. The prevalence of calcification in patients with raised HbA1c was significantly higher (38.7% vs. 26.3%, P = 0.048) than normal HbA1c but was similar to DM. The percentage of macrophage infiltration in the DM group was higher than that in the normal HbA1c group (20.5% vs. 7.4%, P = 0.005). Compared to patients with normal HbA1c, the non-culprit plaques in ACS patients with raised HbA1c had more typical vulnerable features but were similar to DM.
Tài liệu tham khảo
Diabetes Canada Clinical Practice Guidelines Expert C, Punthakee Z, Goldenberg R, Katz P. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes. 2018;42(Suppl 1):S10–5.
Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016;355:i5953.
American Diabetes A. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):S81–90.
Yun KH, Mintz GS, Farhat N, Marso SP, Taglieri N, Verheye S, Foster MC, Margolis MP, Templin B, Xu K, et al. Relation between angiographic lesion severity, vulnerable plaque morphology and future adverse cardiac events (from the Providing Regional Observations to Study Predictors of Events in the Coronary Tree study). Am J Cardiol. 2012;110(4):471–7.
Xing L, Higuma T, Wang Z, Aguirre AD, Mizuno K, Takano M, Dauerman HL, Park SJ, Jang Y, Kim CJ, et al. Clinical significance of lipid-rich plaque detected by optical coherence tomography: a 4-year follow-up study. J Am Coll Cardiol. 2017;69(20):2502–13.
Tearney GJ, Yabushita H, Houser SL, Aretz HT, Jang IK, Schlendorf KH, Kauffman CR, Shishkov M, Halpern EF, Bouma BE. Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography. Circulation. 2003;107(1):113–9.
Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012;59(12):1058–72.
Jang IK, Tearney GJ, MacNeill B, Takano M, Moselewski F, Iftima N, Shishkov M, Houser S, Aretz HT, Halpern EF, et al. In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography. Circulation. 2005;111(12):1551–5.
Reith S, Battermann S, Hoffmann R, Marx N, Burgmaier M. Optical coherence tomography derived differences of plaque characteristics in coronary culprit lesions between type 2 diabetic patients with and without acute coronary syndrome. Catheter Cardiovasc Interv. 2014;84(5):700–7.
Reith S, Battermann S, Hellmich M, Marx N, Burgmaier M. Correlation between optical coherence tomography-derived intraluminal parameters and fractional flow reserve measurements in intermediate grade coronary lesions: a comparison between diabetic and non-diabetic patients. Clin Res Cardiol. 2015;104(1):59–70.
Milzi A, Burgmaier M, Burgmaier K, Hellmich M, Marx N, Reith S. Type 2 diabetes mellitus is associated with a lower fibrous cap thickness but has no impact on calcification morphology: an intracoronary optical coherence tomography study. Cardiovasc Diabetol. 2017;16(1):152.
Suzuki K, Takano H, Kubota Y, Inui K, Nakamura S, Tokita Y, Kato K, Asai K, Shimizu W. Plaque characteristics in coronary artery disease patients with impaired glucose tolerance. PLoS ONE. 2016;11(12):e0167645.
Kato K, Yonetsu T, Kim SJ, Xing L, Lee H, McNulty I, Yeh RW, Sakhuja R, Zhang S, Uemura S, et al. Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study. JACC Cardiovasc Interv. 2012;5(11):1150–8.
Kuroda M, Shinke T, Sakaguchi K, Otake H, Takaya T, Hirota Y, Osue T, Kinutani H, Konishi A, Takahashi H, et al. Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomography. Cardiovasc Diabetol. 2015;14:78.
Feng T, Yundai C, Lian C, Zhijun S, Changfu L, Jun G, Hongbin L. Assessment of coronary plaque characteristics by optical coherence tomography in patients with diabetes mellitus complicated with unstable angina pectoris. Atherosclerosis. 2010;213(2):482–5.
Burke AP, Kolodgie FD, Zieske A, Fowler DR, Weber DK, Varghese PJ, Farb A, Virmani R. Morphologic findings of coronary atherosclerotic plaques in diabetics: a postmortem study. Arterioscler Thromb Vasc Biol. 2004;24(7):1266–71.
De Rosa R, Vasa-Nicotera M, Leistner DM, Reis SM, Thome CE, Boeckel JN, Fichtlscherer S, Zeiher AM. Coronary atherosclerotic plaque characteristics and cardiovascular risk factors—insights from an optical coherence tomography study. Circ J. 2017;81(8):1165–73.
Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287(19):2570–81.
Rato L, Duarte AI, Tomas GD, Santos MS, Moreira PI, Socorro S, Cavaco JE, Alves MG, Oliveira PF. Pre-diabetes alters testicular PGC1-alpha/SIRT3 axis modulating mitochondrial bioenergetics and oxidative stress. Biochim Biophys Acta. 2014;1837(3):335–44.
Kakuta K, Dohi K, Miyoshi M, Yamanaka T, Kawamura M, Masuda J, Kurita T, Ogura T, Yamada N, Sumida Y, et al. Impact of renal function on the underlying pathophysiology of coronary plaque composition in patients with type 2 diabetes mellitus. Cardiovasc Diabetol. 2017;16(1):131.
Hosoi M, Sato T, Yamagami K, Hasegawa T, Yamakita T, Miyamoto M, Yoshioka K, Yamamoto T, Ishii T, Tanaka S, et al. Impact of diabetes on coronary stenosis and coronary artery calcification detected by electron-beam computed tomography in symptomatic patients. Diabetes Care. 2002;25(4):696–701.
Raggi P, Shaw LJ, Berman DS, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol. 2004;43(9):1663–9.
Kim LK, Yoon JW, Lee DH, Kim KM, Choi SH, Park KS, Jang HC, Kim MK, Park HE, Choi SY, et al. Impact of metabolic syndrome on the progression of coronary calcium and of coronary artery disease assessed by repeated cardiac computed tomography scans. Cardiovasc Diabetol. 2016;15:92.
Nicoll R, Zhao Y, Wiklund U, Diederichsen A, Mickley H, Ovrehus K, Zamorano J, Gueret P, Schmermund A, Maffei E, et al. Diabetes and male sex are key risk factor correlates of the extent of coronary artery calcification: a Euro-CCAD study. J Diabetes Complications. 2017;31(7):1096–102.
Mizukoshi M, Kubo T, Takarada S, Kitabata H, Ino Y, Tanimoto T, Komukai K, Tanaka A, Imanishi T, Akasaka T. Coronary superficial and spotty calcium deposits in culprit coronary lesions of acute coronary syndrome as determined by optical coherence tomography. Am J Cardiol. 2013;112(1):34–40.
Fujii K, Carlier SG, Mintz GS, Takebayashi H, Yasuda T, Costa RA, Moussa I, Dangas G, Mehran R, Lansky AJ, et al. Intravascular ultrasound study of patterns of calcium in ruptured coronary plaques. Am J Cardiol. 2005;96(3):352–7.
Krishnamoorthy P, Vengrenyuk Y, Ueda H, Yoshimura T, Pena J, Motoyama S, Baber U, Hasan C, Kesanakurthy S, Sweeny JM, et al. Three-dimensional volumetric assessment of coronary artery calcification in patients with stable coronary artery disease by OCT. EuroIntervention. 2017;13(3):312–9.
Ong DS, Lee JS, Soeda T, Higuma T, Minami Y, Wang Z, Lee H, Yokoyama H, Yokota T, Okumura K, et al. Coronary calcification and plaque vulnerability: an optical coherence tomographic study. Circ Cardiovasc Imaging. 2016;9(1):e003929.
Niccoli G, Giubilato S, Di Vito L, Leo A, Cosentino N, Pitocco D, Marco V, Ghirlanda G, Prati F, Crea F. Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox. Eur Heart J. 2013;34(10):729–41.
Moreno PR, Murcia AM, Palacios IF, Leon MN, Bernardi VH, Fuster V, Fallon JT. Coronary composition and macrophage infiltration in atherectomy specimens from patients with diabetes mellitus. Circulation. 2000;102(18):2180–4.
Mita T, Otsuka A, Azuma K, Uchida T, Ogihara T, Fujitani Y, Hirose T, Mitsumata M, Kawamori R, Watada H. Swings in blood glucose levels accelerate atherogenesis in apolipoprotein E-deficient mice. Biochem Biophys Res Commun. 2007;358(3):679–85.
Torres-Castro I, Arroyo-Camarena UD, Martinez-Reyes CP, Gomez-Arauz AY, Duenas-Andrade Y, Hernandez-Ruiz J, Bejar YL, Zaga-Clavellina V, Morales-Montor J, Terrazas LI, et al. Human monocytes and macrophages undergo M1-type inflammatory polarization in response to high levels of glucose. Immunol Lett. 2016;176:81–9.
Thanopoulou A, Karamanos B, Archimandritis A. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362(21):2030–1 (author reply 2031).
Timmer JR, Hoekstra M, Nijsten MW, van der Horst IC, Ottervanger JP, Slingerland RJ, Dambrink JH, Bilo HJ, Zijlstra F, van ‘t Hof AW. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention. Circulation. 2011;124(6):704–11.
Goldfine AB, Phua EJ, Abrahamson MJ. Glycemic management in patients with coronary artery disease and prediabetes or type 2 diabetes mellitus. Circulation. 2014;129(24):2567–73.
Khetan AK, Rajagopalan S. Prediabetes. Can J Cardiol. 2018;34(5):615–23.
Li G, Zhang P, Wang J, An Y, Gong Q, Gregg EW, Yang W, Zhang B, Shuai Y, Hong J, et al. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study. Lancet Diabetes Endocrinol. 2014;2(6):474–80.
Aroda VR, Knowler WC, Crandall JP, Perreault L, Edelstein SL, Jeffries SL, Molitch ME, Pi-Sunyer X, Darwin C, Heckman-Stoddard BM, et al. Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study. Diabetologia. 2017;60(9):1601–11.