Abstract
Objective: By applying Intravascular Ultrasound (IVUS) to patients with mild-to-moderate coronary stenosis defined by Coronary Angiography (CAG), it is analyzed on the features of coronary artery atheromatous plaque for patients with impaired glucose tolerance and discussed about the clinical significance as well as the relationship between HbA1c levels and coronary artery lesion. Methods: HbA1c testing was applied to 85 patients (a total of 96 lesions) with 46 cases in Group of Impaired Glucose Tolerance (IGT Group) and 39 cases in Group of Normal Blood Glucose (NBG Group). IVUS was applied to qualitatively and quantitatively analyse the lesion vessel of both groups. Measurement was done both to target lesion for data of External Elastic Membrane Area (EEMA), Minimal Lumen Area (MLA), Plaque Area (PA), Plaque Burden (PB), and to the reference segments for data of Reference External Elastic Membrane Area (REEMA), Minimal Lumen Area (RMLA), Plaque Area (RPA), Plaque Burden (RPB). Results: The level of HbA1c in IGT Group was significantly higher than that in NBG Group (P < 0.05). For IGT Group, there were more soft plaque, eccentric plaque, positive remodeling and less calcification while for NBG Group, there were more performance for the hard plaque, calcification, no reconstruction and negative remodeling (P < 0.05). For IGT Group, MLA was less than NBG Group while EEMA, PA and PB were obviously higher than NBG Group (P < 0.05). In the meantime, RMAL was clearly less than NBG Group while RPA and RPB were higher than NBG Group (P < 0.05). HbA1c levels was positively correlated with PA, PB, but negatively correlated with MLA. Conclusion: IVUS shows a higher value to the evaluation of mild-to-moderate coronary lesions. The coronary artery lesions of IGT Group were more serious and widespread than that of NBG Group, and the level of HbA1c might provide some value for the judgment of the severity of coronary artery lesion.
Highlights
“Normal” reference segment was defined to vessel without pathological changes within 5 mm ~ 10 mm apart from the proximal or distal of the target lesion vessel, while the lesion segment refers to the most stenosis according to angiography images from different projected position, which was called Quantitative Coronary Angiography (QCA) [5,6,7,8]
Following up 96 pathologic changes, for Impaired Glucose Tolerance (IGT) Group, Minimal Lumen Area (MLA) was less than NBG Group while Elastic Membrane Area (EEMA), Plaque Area (PA) and Plaque Burden (PB) were obviously higher than NBG Group (P < 0.05)
Similar conclusion was drawn in IGT Group: by following pathological changes, it was found that the Minimal Lumen Area (MLA) of IGT Group was remarkably lower than that of NBG Group while the External Elastic Membrane Area (EEMA) was notably higher than NBG Group
Summary
HbA1c testing was applied to 85 patients (a total of 96 lesions) with 46 cases in Group of Impaired Glucose Tolerance (IGT Group) and 39 cases in Group of Normal Blood Glucose (NBG Group). IVUS was applied to qualitatively and quantitatively analyse the lesion vessel of both groups. Subjects from July 2009 to December 2010, 85 cases were collected including 46 cases of impaired glucose tolerance (IGT Group) and 39 cases of Normal Blood Glucose (NBG Group), a total of 96 lesions. Both groups were taken CAG and confirmed that the stenosis rate of at least one epicardial coronary and its main branch vessel diameter was. Pearson correlative analysis was adopted to show the correlation between those two factors, and P < 0.05 presented the significant difference
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