Background
Methods
Study population
CGMS
Laboratory evaluation
IVUS procedure
IVUS analysis
Statistical analysis
Results
Patient characteristics
Variables | All (n = 57) |
---|---|
Age (years) | 65 ± 12 |
Male (%) | 78.9 |
Body mass index (kg/m2) | 24.2 ± 4.1 |
STEMI (%) | 77.2 |
Multivessel disease (%) | 35.1 |
Culprit vessel | |
Left anterior descending artery (%) | 52.6 |
Left circumflex coronary artery (%) | 14.0 |
Right coronary artery (%) | 33.3 |
Current smoking (%) | 54.4 |
Hypertension (%) | 61.4 |
Diabetes mellitus (%) | 49.1 |
Lipid parameters at admission | |
Total cholesterol (mg/dl) | 201 ± 37 |
LDL-C (mg/dl) | 128 ± 36 |
HDL-C (mg/dl) | 46 ± 12 |
Triglycerides (mg/dl) | 129 ± 96 |
eGFR at admission (ml/min/1.73 m2) | 75.2 ± 18.2 |
Urinary L-FABP (μg/g creatinine) | 20.3 ± 58.0 |
hs-CRP at 7 days after admission (mg/dl) | 1.56 ± 1.72 |
Medications before admission | |
Statin (%) | 21.1 |
ACEI/ARB (%) | 21.1 |
Oral anti-diabetic drugs (%) | 17.5 |
Conventional glucose indicators | |
HbA1c at admission (%) | 6.1 ± 1.0 |
FPGa (mg/dl) | 109 ± 17 |
HOMA-IRa
| 2.1 ± 1.4 |
CGMS parametersa
| |
Maximum blood glucose (mg/dl) | 184 ± 48 |
Minimum blood glucose (mg/dl) | 90 ± 21 |
Mean blood glucose (mg/dl) | 126 ± 27 |
SD around mean blood glucose (mg/dl) | 22 ± 12 |
MAGE (blood glucose variability) (mg/dl) | 48 ± 26 |
Hyperglycemia ≥200 mg/dl (%) | 29.8 |
Hypoglycemia <60 mg/dl (%) | 7.0 |
CGMS parameters
Relationships between conventional glucose indicators and CGMS parameters
Variables (mg/dl) | HbA1c (%) | FPG (mg/dl) | HOMA-IR |
---|---|---|---|
MAGE (glucose variability) | r = 0.36 p = 0.0065 | r = 0.47, p = 0.0002 | r = −0.07, p = 0.59 |
Mean blood glucose | r = 0.63, p < 0.0001 | r = 0.84, p < 0.0001 | r = −0.0003, p = 0.998 |
Maximum blood glucose | r = 0.48, p = 0.0002 | r = 0.69, p < 0.0001 | r = −0.05, p = 0.73 |
Minimum blood glucose | r = 0.57, p < 0.0001 | r = 0.60, p < 0.0001 | r = 0.07, p = 0.61 |
Relationships of glucose indicators to oxidative stress and inflammation
Factors associated with gray-scale IVUS indices
Variables | All (n = 57) | DM (n = 28) | Non DM (n = 29) | p value* |
---|---|---|---|---|
Vessel volume (mm3/mm) | 14.3 ± 4.6 | 14.4 ± 4.7 | 14.2 ± 4.7 | 0.89 |
Lumen volume (mm3/mm) | 5.9 ± 2.1 | 5.8 ± 2.1 | 6.0 ± 2.1 | 0.68 |
Plaque volume (mm3/mm) | 8.4 ± 3.3 | 8.6 ± 3.1 | 8.2 ± 3.5 | 0.51 |
Percent plaque volume (%) | 57.9 ± 9.6 | 59.3 ± 8.9 | 56.6 ± 10.1 | 0.29 |
Remodeling index | 1.08 ± 0.17 | 1.10 ± 0.16 | 1.05 ± 0.17 | 0.27 |
Lipid volume (mm3/mm) | 5.1 ± 2.6 | 5.3 ± 2.5 | 4.9 ± 2.7 | 0.45 |
Fibrous volume (mm3/mm) | 2.9 ± 0.9 | 2.9 ± 0.9 | 2.9 ± 1.0 | 0.96 |
Percent lipid volume (%) | 58.9 ± 10.9 | 59.7 ± 11.6 | 58.1 ± 10.4 | 0.57 |
Percent fibrous volume (%) | 36.1 ± 8.7 | 35.2 ± 8.9 | 37.0 ± 8.5 | 0.44 |
Factors associated with percent lipid and fibrous volumes
Variables | Univariable | Multivariable | ||
---|---|---|---|---|
r | p value | β | p value | |
Age (years) | 0.26 | 0.055 | 0.13 | 0.30 |
STEMI | 0.05 | 0.73 | ||
Statin before admission | −0.07 | 0.57 | ||
Anti-diabetic drugs before admission | 0.18 | 0.18 | ||
LDL-C (mg/dl) | −0.17 | 0.21 | ||
HDL-C (mg/dl) | 0.24 | 0.07 | 0.14 | 0.26 |
hs-CRP (mg/dl) | 0.16 | 0.24 | ||
eGFR (ml/min/1.73 m2) | −0.19 | 0.16 | ||
HbA1c (%) | −0.02 | 0.86 | ||
FPG (mg/dl) | −0.02 | 0.88 | ||
HOMA-IR | 0.02 | 0.90 | ||
MAGE (glucose variability) (mg/dl) | 0.44 | 0.0006 | 0.80 | 0.0035 |
Mean blood glucose (mg/dl) | 0.001 | 0.99 | ||
Maximum blood glucose (mg/dl) | 0.29 | 0.03 | −0.25 | 0.44 |
Hyperglycemia (≥200 mg/dl) | 0.21 | 0.12 | −0.25 | 0.28 |
Hypoglycemia (<60 mg/dl) | 0.19 | 0.16 |
Variables | Univariable | Multivariable | ||
---|---|---|---|---|
r | p value | β | p value | |
Age (years) | −0.27 | 0.04 | −0.14 | 0.25 |
STEMI | −0.03 | 0.80 | ||
Statin before admission | 0.08 | 0.56 | ||
Anti-diabetic drugs before admission | −0.19 | 0.16 | ||
LDL-C (mg/dl) | 0.18 | 0.19 | ||
HDL-C (mg/dl) | −0.27 | 0.04 | −0.17 | 0.17 |
hs-CRP (mg/dl) | −0.19 | 0.153 | ||
eGFR (ml/min/1.73 m2) | 0.16 | 0.25 | ||
HbA1c (%) | 0.05 | 0.73 | ||
FPG (mg/dl) | 0.02 | 0.87 | ||
HOMA-IR | −0.004 | 0.97 | ||
MAGE (glucose variability) (mg/dl) | −0.45 | 0.0005 | −0.79 | 0.0034 |
Mean blood glucose (mg/dl) | 0.002 | 0.99 | ||
Maximum blood glucose (mg/dl) | −0.29 | 0.03 | 0.24 | 0.44 |
Hyperglycemia (≥200 mg/dl) | −0.21 | 0.12 | 0.26 | 0.27 |
Hypoglycemia (<60 mg/dl) | −0.18 | 0.17 |
Subgroup | Percent lipid volumes | Percent fibrous volumes |
---|---|---|
DM | r = 0.29, p = 0.13 | r = −0.26, p = 0.18 |
Non DM | r = 0.67, p < 0.0001 | r = −0.68, p < 0.0001 |
STEMI | r = 0.41, p = 0.006 | r = −0.41, p = 0.006 |
NSTE-ACS | r = 0.73, p = 0.005 | r = −0.76, p = 0.003 |
No treatment with statins before admission | r = 0.50, p = 0.0005 | r = −0.51, p = 0.0004 |
No treatment with anti-diabetic drugs before admission | r = 0.50, p = 0.0004 | r = −0.50, p = 0.0004 |
LDL-C ≥140 mg/dl | r = 0.48, p = 0.02 | r = −0.51, p = 0.01 |
LDL-C <140 mg/dl | r = 0.44, p = 0.01 | r = −0.42, p = 0.01 |