Plaque volume and plaque risk profile in diabetic vs. non-diabetic patients undergoing lipid-lowering therapy: a study based on 3D intravascular ultrasound and virtual histology

Tomas Kovarnik; Zhi Chen; Gary S Mintz; Andreas Wahle; Kristyna Bayerova; Ales Kral; Martin Chval; Karel Kopriva; John Lopez; Milan Sonka; Ales Linhart

doi:10.1186/s12933-017-0637-0

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Plaque volume and plaque risk profile in diabetic vs. non-diabetic patients undergoing lipid-lowering therapy: a study based on 3D intravascular ultrasound and virtual histology

Tomas Kovarnik, Zhi Chen, Gary S Mintz, Andreas Wahle, Kristyna Bayerova, Ales Kral, Martin Chval, Karel Kopriva, John Lopez, Milan Sonka, …

Cardiovascular diabetology, Vol.16(1), pp.156-156

12/07/2017

DOI: 10.1186/s12933-017-0637-0

PMCID: PMC5719721

PMID: 29212544

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Abstract

Background: Coronary atherosclerosis progresses faster in patients with diabetes mellitus (DM) and causes higher morbidity and mortality in such patients compared to non-diabetics ones (non-DM). We quantify changes in plaque volume and plaque phenotype during lipid-lowering therapy in DM versus non-DM patients using advanced intracoronary imaging. Methods: We analyzed data from 61 patients with stable angina pectoris included to the PREDICT trial searching for prediction of plaque changes during intensive lipid-lowering therapy (40 mg rosuvastatin daily). Geometrically correct, fully 3-D representation of the vascular wall surfaces and intravascular ultrasound virtual histology (IVUS-VH) defined tissue characterization was obtained via fusion of two-plane angiography and IVUS-VH. Frame-based indices of plaque morphology and virtual histology analyses were computed and averaged in 5 mm long baseline/follow-up registered vessel segments covering the entire length of the two sequential pullbacks (baseline, 1-year). We analyzed 698 5-mm-long segments and calculated the Liverpool active plaque score (LAPS). Results: Despite reaching similar levels of LDL cholesterol (DM 2.12 ± 0.91 mmol/l, non-DM 1.8 ± 0.66 mmol/l, p = 0.21), DM patients experienced, compared to non-DM ones, higher progression of mean plaque area (0.47 ± 1.15 mm2 vs. 0.21 ± 0.97, p = 0.001), percent atheroma volume (0.7 ± 2.8% vs. - 1.4 ± 2.5%, p = 0.007), increase of LAPS (0.23 ± 1.66 vs. 0.13 ± 1.79, p = 0.018), and exhibited more locations with TCFA (Thin-Cap Fibro-Atheroma) plaque phenotype in 5 mm vessel segments (20.3% vs. 12.5%, p = 0.01). However, only non-DM patients reached significant decrease of LDL cholesterol. Plaque changes were more pronounced in PIT (pathologic intimal thickening) compared to TCFA with increased plaque area in both phenotypes in DM patients. Conclusion: Based on detailed 3D analysis, we found advanced plaque phenotype and further atherosclerosis progression in DM patients despite the same reached levels of LDLc as in non-DM patients. Trial registration ClinicalTrials.gov identifier: NCT01773512. Keywords: Atherosclerosis; Diabetes mellitus; Intravascular ultrasound; Statins.

Intravascular ultrasound

Diabetes mellitus

Original Investigation

Statins

Atherosclerosis

Details

Title: Subtitle: Plaque volume and plaque risk profile in diabetic vs. non-diabetic patients undergoing lipid-lowering therapy: a study based on 3D intravascular ultrasound and virtual histology
Creators: Tomas Kovarnik - 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, II. interni klinika VFN a 1. LF UK, U nemocnice 2, 128 08 Praha 2, Czech Republic
Zhi Chen - Iowa City, IA USA
Gary S Mintz - New York, USA
Andreas Wahle - Iowa City, IA USA
Kristyna Bayerova - 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, II. interni klinika VFN a 1. LF UK, U nemocnice 2, 128 08 Praha 2, Czech Republic
Ales Kral - 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, II. interni klinika VFN a 1. LF UK, U nemocnice 2, 128 08 Praha 2, Czech Republic
Martin Chval - Prague, Czech Republic
Karel Kopriva - Prague, Czech Republic
John Lopez - Maywood, IL USA
Milan Sonka - Iowa City, IA USA
Ales Linhart - 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, II. interni klinika VFN a 1. LF UK, U nemocnice 2, 128 08 Praha 2, Czech Republic
Resource Type: Journal article
Publication Details: Cardiovascular diabetology, Vol.16(1), pp.156-156
DOI: 10.1186/s12933-017-0637-0
PMID: 29212544
PMCID: PMC5719721
NLM abbreviation: Cardiovasc Diabetol
ISSN: 1475-2840
eISSN: 1475-2840
Publisher: BioMed Central
Grant note: LH12053 / ; R01-HL63373 / ; R01-EB004640 / ;
Language: English
Date published: 12/07/2017
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Radiation Oncology; The Iowa Institute for Biomedical Imaging; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Ophthalmology and Visual Sciences
Record Identifier: 9984102310302771

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