Abstract 13243: Difference in Non-Culprit Coronary Plaque Composition Between Diabetic and Non-Diabetic With Acute Myocardial Infarction.
Objectives: Diabetes Mellitus (DM) is considered one of the most important cardiovascular risks, and a previous report showed the difference in coronary plaque composition between diabetic and non-diabetic patients with stable angina pectoris. The purpose of this study was to clarify the difference in non-culprit coronary plaque composition between diabetic and non-diabetic patients with acute myocardial infarction (AMI).
Methods: Non-culprit coronary plaque of 60 patients (DM16, non-DM 44) with AMI were imaged by intravascular ultrasound (Volcano therapeutics) during 0.5mm/sec motorized auto-pullback of the imaging catheter. Analyzed sites were located about 10mm proximal to the culprit lesion. Excluding cross sectional areas (CSAs) with plaque burden < 30%, totally 477 CSAs were analyzed. At each cross section, external elastic membrane cross sectional areas (EEM-CSA), lumen cross sectional areas (lumen-CSA), and the maximum and minimum plaque thicknesses were measured, and plaque burden and eccentricity index (EI); (maximum - minimum plaque thickness)/maximum plaque thickness were calculated. Plaque + Media CSA(P+M CSA); (EEM-CSA)-(lumen CSA). Color tissue maps were reconstructed from radio frequency data using IVUS-Virtual Histology software, and classified into 4 plaque compositions: Fibrous (F), Fibro-fatty (FF), Dense calcium (DC) and Necrotic core (NC)
Results: There was no difference about plaque burden between 2 groups, however, EEM-CSA and P+M CSA were significantly larger in DM group than non-DM group (19.2±5.0 vs 17.2±4.9, p<0.0001; 11.0±3.6 vs 9.8±2.7, p<0.0001). EI was significantly larger in non-DM group than DM group (0.65±0.15 vs 0.59±0.15, p=0.0014). Regarding plaque composition, F area, DC area and NC area were significantly larger in DM than non-DM group(4.0±3.9 vs 3.2±1.4, p=0.0004; 1.1±1.1 vs 0.8±0.7, p=0.0002; 1.6±1.4 vs 1.3±0.9, p=0.01)
Conclusions: In patients with AMI, non-culprit coronary plaques of diabetic patients were more concentric, had larger EEM-CSA and P+M CSA and more abundant in fibrous tissue, dense calcium and necrotic core compared with non-diabetic patients.
- © 2010 by American Heart Association, Inc.