Abstract 14500: Impact of Glucose Variability on Vulnerability of Non-Culprit Plaque in Non-Diabetic Patients With Acute Coronary Syndrome
Background: Attention has been paid to the effect of glucose variability on cardiovascular disease. The present study evaluated relation between glucose variability and plaque composition of nonculprit lesions in nondiabetic patients with acute coronary syndrome (ACS).
Methods: A total of 75 ACS patients (25 patients with diabetes mellitus (DM) and 50 patients without DM) who underwent intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were enrolled. IVUS and integrated backscatter (IB)-IVUS measurements were performed in the 10-mm segment with largest plaque volume in nonculprit lesion. Tissue components were classified into 4 categories: calcification, dense fibrosis, fibrosis, and lipid according to signal level. During hospitalization, all patients were equipped with a continuous glucose monitoring device while they were in stable condition, and were monitored at least 48 hours. Nondiabetic patients were classified into 2 groups according to above or below median of the mean amplitude of glycemic excursions (MAGE).
Results: As compared to the low MAGE group, glycosylated hemoglobin (HbA1c) level was significantly higher in the DM group (7.7 ± 1.1% vs. 5.6 ± 0.4%, p < 0.001), but the difference was not significant in the high MAGE group (5.8 ± 0.3% vs. 5.6 ± 0.4%, p = 0.06). There was no significant difference in grayscale IVUS measurements among the 3 groups. In the IB-IVUS analysis, greater lipid component (49.0 ± 11.7% vs. 52.2 ± 11.3% vs. 41.3 ± 12.7%, p = 0.007) and less fibrous component (44.1 ± 8.7% vs. 41.1 ± 7.3% vs. 48.3 ± 7.6%, p = 0.009) were observed in the high MAGE group and the DM group compared to the low MAGE group.
Conclusion: Plaque vulnerability in non-diabetic ACS patients with greater glucose variability may be equal to that in diabetic ACS patients and higher compared to that in non-diabetic ACS patients with lower glucose variability.
- © 2013 by American Heart Association, Inc.