Universität zu Köln

Milzi, Andrea ORCID: 0000-0001-7580-8029, Burgmaier, Mathias, Burgmaier, Kathrin, Hellmich, Martin, Marx, Nikolaus and Reith, Sebastian (2017). Type 2 diabetes mellitus is associated with a lower fibrous cap thickness but has no impact on calcification morphology: an intracoronary optical coherence tomography study. Cardiovasc. Diabetol., 16. LONDON: BIOMED CENTRAL LTD. ISSN 1475-2840

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Abstract

Background: Patients with type 2 diabetes (T2DM) are at high risk for cardiovascular events, which usually arise from the rupture of a vulnerable coronary plaque. The minimal fibrous cap thickness (FCT) overlying a necrotic lipid core is an established predictor for plaque rupture. Recently, coronary calcification has emerged as a relevant feature of plaque vulnerability. However, the impact of T2DM on these morphological plaque parameters is largely unexplored. Therefore, this study aimed to compare differences of coronary plaque morphology in patients with and without T2DM with a particular focus on coronary calcification. Methods: In 91 patients (T2DM = 56, non-T2DM = 35) with 105 coronary de novo lesions (T2DM = 56, non-T2DM = 49) plaque morphology and calcification were analyzed using optical coherence tomography (OCT) prior to coronary intervention. Results: Patients with T2DM had a lower minimal FCT (80.4 +/- 27.0 mu m vs. 106.8 +/- 27.8 mu m, p < 0.001) and a higher percent area stenosis (77.9 +/- 8.1% vs. 71.7 +/- 11.2%, p = 0.001) compared to non-diabetic subjects. However, patients with and without T2DM had a similar total number of calcifications (4.0 +/- 2.6 vs. 4.2 +/- 3.1, p = ns) and no significant difference was detected in the number of micro- (0.34 +/- 0.79 vs. 0.31 +/- 0.71), spotty (2.11 +/- 1.77 vs. 2.37 +/- 1.89) or macro-calcifications (1.55 +/- 1.13 vs. 1.53 +/- 0.71, all p = ns). The mean calcium arc (82.3 +/- 44.8 degrees vs. 73.7 +/- 31.6), the mean thickness of calcification (0.54 +/- 0.13 mm vs. 0.51 +/- 0.15 mm), the mean calcified area (0.99 +/- 0.72 mm(2) vs. 0.78 +/- 0.49 mm(2)), the mean depth of calcification (172 +/- 192 mu m vs. 160 +/- 76 mu m) and the cap thickness overlying the calcification (50 +/- 71 mu m vs. 62 +/- 61 mu m) did not differ between the diabetic and non-diabetic groups (all p = ns). Conclusion: T2DM has an impact on the minimal FCT of the coronary target lesion, but not on localization, size, shape or extent of calcification. Thus, the minimal FCT overlying the necrotic lipid core but not calcification is likely to contribute to the increased plaque vulnerability observed in patients with T2DM.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Milzi, Andrea UNSPECIFIED orcid.org/0000-0001-7580-8029 UNSPECIFIED Burgmaier, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgmaier, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-210034
DOI:	10.1186/s12933-017-0635-2
Journal or Publication Title:	Cardiovasc. Diabetol.
Volume:	16
Date:	2017
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1475-2840
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE CORONARY SYNDROME; ACUTE MYOCARDIAL-INFARCTION; FRACTIONAL FLOW RESERVE; SPOTTY CALCIFICATION; INTRAVASCULAR ULTRASOUND; PLAQUE CHARACTERISTICS; COMPUTED-TOMOGRAPHY; METABOLIC SYNDROME; VULNERABLE PLAQUE; CULPRIT LESIONS Multiple languages Cardiac & Cardiovascular Systems; Endocrinology & Metabolism Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21003