Abstract 11731: Impact of Fasting Plasma Glucagon-like Peptide-1 Levels and Tissue Characteristics of Coronary Plaque in Patients with Coronary Artery Disease
Background: Incretin is a gut-derived peptide and one of the enhancers of insulin secretion. Previous studies have reported that a major incretin, glucagon-like peptide-1 (GLP-1), is decreased in patients with Diabetes Mellitus (DM). GLP-1 analogue is widely used to treat DM in the clinical setting, and is expected to reduce the incidence of CAD. Recently, it has been reported that a significant inverse correlation between plasma GLP-1 levels and the area of atherosclerosis lesions in the apolipoprotein E-deficient mice. However, there is no evidence regarding the association between plasma GLP-1 levels and coronary plaque characteristics. We sought to assess whether plasma GLP-1 levels are associated with coronary plaque characteristics.
Methods: A total of 78 culprit coronary vessels in patients with CAD who underwent percutaneous coronary intervention (PCI) were examined by integrated backscatter intravascular ultrasound (IB-IVUS) before PCI, using a 40-MHz intravascular catheter. Patients with previous diagnosis of DM and HbA1c of more than 6.5% were excluded. We evaluated plaque components for all available frames (mean length of 68mm) in the target vessel prior to PCI by IB-IVUS analysis at 1-mm intervals. Fasting plasma GLP-1(7-36) amide, the active form of GLP-1, were measured by immunoassay in all patients. The patients were divided into 2 groups: those with the limit of detection of fasting plasma GLP-1 levels (< 2 pmol/L) and those with the detectable level of fasting plasma GLP-1 (3.0 ± 1.1 pmol/L).
Results: Patients with the detection limit of fasting GLP-1 (n=33) had a significantly greater percentage lipid area than those with the detectable level of fasting GLP-1 (55.9 ± 13.5% vs. 47.9 ± 11.3%, p < 0.01) and a smaller percentage fibrosis area (38.2 ± 10.5% vs. 44.9 ± 9.5%, p < 0.01). Multiple regression analysis showed that the limit detection of fasting GLP-1 was associated with percentage lipid area independent of age, gender, DM, and other coronary risk factors (p < 0.05).
Conclusions: The detection limit of fasting plasma GLP-1 is associated with an increased lipid content in patients with CAD, suggesting that plaque vulnerability is increased in this subgroup of patients.
- © 2012 by American Heart Association, Inc.