Plaque Characterization by Virtual Histology Intravascular Ultrasound Analysis in Type II Diabetic Patients.
Heart (British Cardiac Society) 2007 Jul 23; In press
Nasu K K, Tsuchikane E E, Katoh O O, Fujita H H, Surmely J JF, Ehara M M, Kinoshita Y Y
Toyohashi Heart Center, Japan.
Objectives The purpose of this study was to evaluate the in-vivo plaque composition and characteristics in type II diabetes mellitus (DM) patients using Virtual HistologyTM intravascular ultrasound (VH IVUS). Methods and Results In 90 stable angina pectoris patients, de novo target vessels were studied and plaque components were analyzed. Patients were divided into two groups: a diabetic group (36 vessels) and a non-diabetic group (54 vessels). The percent area of necrotic core and dense calcium were significantly larger in the DM group compared with the non-DM group [Necrotic core: 11.0% (interquartile range (IQR): 7.2 to 15.2%) vs. 7.6% (IQR: 5.6 to 13.2%), p = 0.03; Dense calcium: 5.6% (IQR: 2.3 to 7.3%) vs. 2.9% (IQR: 1.7 to 4.9%), p = 0.01]. The DM group presented with a significantly higher presence of at least one VH IVUS-derived thin-cap fibroatheroma (VHD-TCFA) [75% vs. 41%, p = 0.001] and VH IVUS-derived fibrocalcific atheroma (VHD-FCA) [75% vs. 40%, p = 0.001]. In the DM group, 53% of the vessels had both VHD-TCFA and VHD-FCA, which was significantly higher than non DM group (17%, p = 0.0004). Conclusions Coronary plaque characteristics in DM patients showed an increased amount of dense calcium and necrotic core, as well as a higher frequency of VHD-TCFA and VHD-FCA. Atherosclerosis of the target vessel was more advanced in diabetic patients.