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Plaque characterisation by Virtual Histology intravascular ultrasound analysis in patients with type 2 diabetes

Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan

Correspondence to:
Dr K Nasu, Department of Cardiology, Toyohashi Heart Center, 21-1, Gobudori, Oyama, Toyohashi, Aichi, 441-8530 Japan; nasu{at}heart-center.or.jp

Objectives: To evaluate the in-vivo plaque composition and characteristics in patients with type 2 diabetes mellitus (DM) using Virtual Histology intravascular ultrasound (VH IVUS).

Methods: In 90 patients with stable angina pectoris, de novo target vessels were studied and plaque components were analysed. Patients were divided into two groups: a diabetic group (36 vessels) and a non-diabetic group (54 vessels).

Results: The percentage area of necrotic core and dense calcium were significantly larger in the DM group than the non-DM group (necrotic core: 11.0% (interquartile range (IQR): 7.2–15.2%) vs 7.6% (IQR 5.6–13.2%), p = 0.03; dense calcium: 5.6% (IQR: 2.3–7.3%) vs 2.9% (IQR: 1.7–4.9%), 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.