Non-culprit plaque characteristics in acute coronary syndrome patients with raised hemoglobinA1c: an intravascular optical coherence tomography study

Shaotao Zhang,Rong Sun,Haibo Jia,Ning Li,Jiannan Dai,Yongpeng Zou,Sining Hu,Yan Wang,Shenhong Jing,Yanan Zou,Bo Yu,Hongwei Du

doi:10.1186/s12933-018-0729-5

Shaotao Zhang, Rong Sun + Show 10 more

Open Access

https://doi.org/10.1186/s12933-018-0729-5

Copy DOI

Journal: Cardiovascular Diabetology	Publication Date: Jun 15, 2018
Citations: 20	License type: open-access

Affiliation: Harbin Medical University

Abstract

BackgroundRaised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease. However, the detailed morphological characteristics of non-culprit plaques in acute coronary syndrome (ACS) patients remain largely unknown.MethodsA total of 305 non-culprit plaques from 216 ACS patients were analyzed by intravascular optical coherence tomography. These patients were divided into three groups according to the serum glycosylated hemoglobin level: normal HbA1c (< 5.7%), pre-diabetes with raised HbA1c (5.7–6.4%) and diabetes mellitus (DM).ResultsPlaques in patients with raised HbA1c had a longer lipid length (17.0 ± 8.3 mm vs. 13.9 ± 7.2 mm, P = 0.004) and greater lipid index (2775.0 ± 1694.0 mm° vs. 1592.1 ± 981.2 mm°, P = 0.001) than those with normal HbA1c but were similar to DM. The prevalence of calcification in patients with raised HbA1c was significantly higher (38.7% vs. 26.3%, P = 0.048) than normal HbA1c but was similar to DM. The percentage of macrophage infiltration in the DM group was higher than that in the normal HbA1c group (20.5% vs. 7.4%, P = 0.005).ConclusionsCompared to patients with normal HbA1c, the non-culprit plaques in ACS patients with raised HbA1c had more typical vulnerable features but were similar to DM.

Highlights

Raised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease
Pre-Diabetes mellitus (DM) is a risk factor for future diabetes and cardiovascular disease, which is associated with increased risk of major adverse cardiovascular events (MACEs) [2]
A recent intravascular optical coherence tomography (OCT) study reported that the presence of lipid-rich plaques in non-culprit regions increases risk for future MACEs [5]

Summary

Introduction

Raised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease. The detailed morphological characteristics of non-culprit plaques in acute coronary syndrome (ACS) patients remain largely unknown. Pre-DM is a risk factor for future diabetes and cardiovascular disease, which is associated with increased risk of major adverse cardiovascular events (MACEs) [2]. According to the diagnostic criteria of American Diabetes Association (ADA), raised hemoglobinA1c (HbA1c) is defined as a glycosylated hemoglobin (Hb) value that varies from 5.7 to 6.4%, which integrates plasma glucose over time and is promoted as an indicator of pre-DM [3]. A recent intravascular optical coherence tomography (OCT) study reported that the presence of lipid-rich plaques in non-culprit regions increases risk for future MACEs [5]. The plaque morphology in acute coronary syndrome (ACS) patients with pre-DM has not been fully illustrated.

Objectives

Methods

Results

Discussion

Conclusion