Abstract 16411: Impact of Prediabetic Status on Coronary Atherosclerosis: A Multi-Vessel Angioscopic Study
Background: Although diabetes mellitus is a major risk factor of coronary artery disease (CAD), there is no evidence that pre-diabetes including impaired fasting glucose and impaired glucose tolerance is associated with atherosclerosis of coronary artery. Angioscopy can identify vulnerable plaques as intense yellow plaques.
Methods and Results: Sixty-seven patients with angina pectoris who undergoing angioscopic observation for plural main trunks of coronary arteries were enrolled. According to the American Diabetes Association guideline, patients were divided into 3 groups; non-diabetes(n=16), pre-diabetes (n=28) or diabetes (n=23). Color grade of coronary plaque was defined as grade 1 (light yellow), grade 2 (yellow), and grade 3 (intense yellow) based on angioscopic findings. Number of yellow plaque per vessel and maximum yellow grade were evaluated. There were no significant difference of baseline characteristics including low-density lipoprotein cholesterol among non-diabetes, pre-diabetes, and diabetes. Total number of yellow plaque significantly differed between the three groups (0.80±0.64, 1.45±0.81, and 1.63±0.99; P=0.01, respectively). Similarly, maximum yellow grade was different (1.44±1.03, 2.00±0.86, and 2.30±0.70; P<0.05, respectively). The two indexes of pre-diabetes were higher than those of non-diabetes (P=0.02, and P=0.04, respectively), while they were similar between pre-diabetes and diabetes (P=0.44, and P=0.21, respectively). Multivariate logistic regression analysis showed that not only diabetes but also pre-diabetes were independent predictors of multiple yellow plaques [OR: 12.8, 95% CI: 2.26-72.2, P=0.004 and OR: 4.86, 95% CI: 1.11-21.3, P=0.04, respectively].
Conclusions: The degree of coronary atherosclerosis in patients with pre-diabetes patients was more advanced than those with non-diabetes, and plaque vulnerability on angioscopy was similar between pre-diabetes and diabetes. Slight or mild disorder of glucose metabolism, such as pre-diabetes may be a risk factor of CAD as well as diabetes.
- © 2012 by American Heart Association, Inc.