Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomographyReport as inadecuate




Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomography - Download this document for free, or read online. Document in PDF available to download.

Cardiovascular Diabetology

, 14:78

First Online: 11 June 2015Received: 05 March 2015Accepted: 28 May 2015

Abstract

BackgroundGlucose fluctuation has been recognized as a residual risk apart from dyslipidemia for the development of coronary artery disease CAD. This study aimed to investigate the association between glucose fluctuation and coronary plaque morphology in CAD patients.

MethodsThis prospective study enrolled 72 consecutive CAD patients receiving adequate lipid-lowering therapy. They were divided into 3 tertiles according to the mean amplitude of glycemic excursions MAGE, which represents glucose fluctuation, measured by continuous glucose monitoring tertile 1; <49.1, tertile 2; 49.1 ~ 85.3, tertile 3; >85.3. Morphological feature of plaques were evaluated by optical coherence tomography. Lipid index LI mean lipid arc × length, fibrous cap thickness FCT, and the prevalence of thin-cap fibroatheroma TCFA were assessed in both culprit and non-culprit lesions.

ResultsIn total, 166 lesions were evaluated. LI was stepwisely increased according to the tertile of MAGE 1958 ± 974 tertile 1 vs. 2653 ± 1400 tertile 2 vs. 4362 ± 1858 tertile 3, p <0.001, whereas FCT was the thinnest in the tertile 3 157.3 ± 73.0 μm vs. 104.0 ± 64.1 μm vs. 83.1 ± 34.7 μm, p <0.001, respectively. The tertile 3 had the highest prevalence of TCFA. Multiple linear regression analysis showed that MAGE had the strongest effect on LI and FCT standardized coefficient β = 0.527 and −0.392, respectively, both P <0.001. Multiple logistic analysis identified MAGE as the only independent predictor of the presence of TCFA odds ratio 1.034; P <0.001.

ConclusionsGlucose fluctuation and hypoglycemia may impact the formation of lipid-rich plaques and thinning of fibrous cap in CAD patients with lipid-lowering therapy.

KeywordsGlucose fluctuation Continuous glucose monitoring Mean amplitude of glycemic excursion Optical coherence tomography Thin-cap fibroatheroma AbbreviationsCADCoronary artery disease

CGMContinuous glucose monitoring

DMDiabetes mellitus

FCTFibrous cap thickness

LILipid index

MAGEMean amplitude of glycemic excursion

OCTOptical coherence tomography

PCIPercutaneous coronary intervention

TCFAThin-cap fibroatheroma

Download fulltext PDF



Author: Masaru Kuroda - Toshiro Shinke - Kazuhiko Sakaguchi - Hiromasa Otake - Tomofumi Takaya - Yushi Hirota - Tsuyoshi Osue - Hir

Source: https://link.springer.com/article/10.1186/s12933-015-0236-x



DOWNLOAD PDF




Related documents