Universität zu Köln

Burgmaier, Mathias, Hellmich, Martin, Marx, Nikolaus and Reith, Sebastian (2014). A score to quantify coronary plaque vulnerability in high-risk patients with type 2 diabetes: an optical coherence tomography study. Cardiovasc. Diabetol., 13. LONDON: BIOMED CENTRAL LTD. ISSN 1475-2840

Full text not available from this repository.

Abstract

Background: Patients with type 2 diabetes are at a high risk for acute cardiovascular events, which usually arise from the rupture of a vulnerable coronary lesion characterized by specific morphological plaque features. Thus, the identification of vulnerable plaques is of utmost clinical importance in patients with type 2 diabetes. However, there is currently no scoring system available to identify vulnerable lesions based on plaque characteristics. Thus, we aimed to characterize the diagnostic value of optical coherence tomography (OCT) - derived lesion characteristics to quantify plaque vulnerability both as individual parameters and when combined to a score in patients with type 2 diabetes. Methods: OCT was performed in the coronary culprit lesions of 112 patients with type 2 diabetes. The score, which quantifies plaque vulnerability, was defined as the predicted probability that a lesion is the cause for an acute coronary syndrome (ACS) (vs. stable angina (SAP)) based on its specific plaque morphology. Results: Multivariable logistic regression analysis demonstrated that plaque vulnerability was independently predicted by the minimal fibrous cap thickness overlying a lesion's lipid core (odds ratio (OR) per 10 mu m 0.478, p = 0.002), the medium lipid arc (OR per 90 degrees 13.997, p < 0.001), the presence of macrophages (OR 4.797, p = 0.015) and the lipid plaque length (OR 1.290, p = 0.098). Receiver-operating-characteristics (ROC) analyses demonstrated that these parameters combined to a score demonstrate an excellent diagnostic efficiency to identify culprit lesions of patients with ACS (vs. SAP, AUC 0.90, 95% CI 0.84-0.96). Conclusion: This is the first study to present a score to quantify lesion vulnerability in patients with type 2 diabetes. This score may be a valuable adjunct in decision-making and useful in guiding coronary interventions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-431890
DOI:	10.1186/s12933-014-0117-8
Journal or Publication Title:	Cardiovasc. Diabetol.
Volume:	13
Date:	2014
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1475-2840
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FRACTIONAL FLOW RESERVE; HISTOLOGY INTRAVASCULAR ULTRASOUND; THIN-CAP FIBROATHEROMA; MYOCARDIAL-INFARCTION; ATHEROSCLEROTIC PLAQUE; ANGIOGRAPHY; PATHOGENESIS; FEATURES; CALCIUM; DISEASE Multiple languages Cardiac & Cardiovascular Systems; Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43189