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Erschienen in: Acta Diabetologica 6/2016

02.09.2016 | Original Article

Statin-induced improvements in vulnerable plaques are attenuated in poorly controlled diabetic patients with coronary atherosclerosis disease: a serial optical coherence tomography analysis

verfasst von: Nana Dong, Zulong Xie, Jiannan Dai, Wei Wang, Rong Sun, Yefei Zhan, Meng Sun, Jinwei Tian, Bo Yu

Erschienen in: Acta Diabetologica | Ausgabe 6/2016

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Abstract

Aims

The incidence of cardiac events is increased in diabetic patients even after lipid-lowering therapy. This study aimed to compare the statin-induced changes in the characteristics of vulnerable plaques in patients without diabetes mellitus (DM) and in those with better- or poorly controlled DM, measured by optical coherence tomography (OCT).

Methods

This was a retrospective study of 99 non-culprit lipid-rich plaques from 75 patients who underwent intensive OCT imaging examination. Thirty-four non-diabetic patients were assigned to Group A. According to the average HbA1c level, 22 diabetic patients were assigned to Group B, and 19, to Group C (average HbA1c < 8 and ≥8 %, respectively).

Results

Following 12 months of statin therapy, similar improvements in serum lipid levels were observed in the three groups. However, the increase in fibrous-cap thickness of plaques was the highest in Group A (Group A, 183 %; Group B, 104 %; and Group C, 53 %). Significant reductions in lipid volume index were observed in Groups A and B (Group A: −12 %, P < 0.001; Group B: −13 %, P = 0.038; Group C: 7 %, P = 0.948). Percent changes in OCT measurements were significantly correlated with average HbA1c in patients.

Conclusions

Improved glucose control may enhance the statin-induced reduction in characteristics of vulnerable plaque in diabetic patients.
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Literatur
1.
Zurück zum Zitat Pedersen TR, Kjekshus J, Berg K et al (2004) Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Atheroscler Suppl 5(3):81–87CrossRefPubMed Pedersen TR, Kjekshus J, Berg K et al (2004) Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Atheroscler Suppl 5(3):81–87CrossRefPubMed
2.
Zurück zum Zitat Wei L, Ebrahim S, Bartlett C, Davey PD, Sullivan FM, MacDonald TM (2005) Statin use in the secondary prevention of coronary heart disease in primary care: cohort study and comparison of inclusion and outcome with patients in randomised trials. BMJ 330(7495):821CrossRefPubMedPubMedCentral Wei L, Ebrahim S, Bartlett C, Davey PD, Sullivan FM, MacDonald TM (2005) Statin use in the secondary prevention of coronary heart disease in primary care: cohort study and comparison of inclusion and outcome with patients in randomised trials. BMJ 330(7495):821CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Sinclair H, Bourantas C, Bagnall A, Mintz GS, Kunadian V (2015) OCT for the identification of vulnerable plaque in acute coronary syndrome. JACC Cardiovasc Imaging 8(2):198–209CrossRefPubMed Sinclair H, Bourantas C, Bagnall A, Mintz GS, Kunadian V (2015) OCT for the identification of vulnerable plaque in acute coronary syndrome. JACC Cardiovasc Imaging 8(2):198–209CrossRefPubMed
4.
Zurück zum Zitat Hattori K, Ozaki Y, Ismail TF et al (2012) Impact of statin therapy on plaque characteristics as assessed by serial OCT, grayscale and integrated backscatter-IVUS. JACC Cardiovasc Imaging 5(2):169–177CrossRefPubMed Hattori K, Ozaki Y, Ismail TF et al (2012) Impact of statin therapy on plaque characteristics as assessed by serial OCT, grayscale and integrated backscatter-IVUS. JACC Cardiovasc Imaging 5(2):169–177CrossRefPubMed
5.
Zurück zum Zitat Hirayama A, Saito S, Ueda Y et al (2009) Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy. Circ J 73(4):718–725CrossRefPubMed Hirayama A, Saito S, Ueda Y et al (2009) Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy. Circ J 73(4):718–725CrossRefPubMed
6.
Zurück zum Zitat Takarada S, Imanishi T, Kubo T et al (2009) Effect of statin therapy on coronary fibrous-cap thickness in patients with acute coronary syndrome: assessment by optical coherence tomography study. Atherosclerosis 202(2):491–497CrossRefPubMed Takarada S, Imanishi T, Kubo T et al (2009) Effect of statin therapy on coronary fibrous-cap thickness in patients with acute coronary syndrome: assessment by optical coherence tomography study. Atherosclerosis 202(2):491–497CrossRefPubMed
7.
Zurück zum Zitat Burgmaier M, Hellmich M, Marx N, Reith S (2014) A score to quantify coronary plaque vulnerability in high-risk patients with type 2 diabetes: an optical coherence tomography study. Cardiovasc Diabetol 13:117CrossRefPubMedPubMedCentral Burgmaier M, Hellmich M, Marx N, Reith S (2014) A score to quantify coronary plaque vulnerability in high-risk patients with type 2 diabetes: an optical coherence tomography study. Cardiovasc Diabetol 13:117CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Worthley SG, Helft G, Zaman AG, Fuster V, Badimon JJ (2000) Atherosclerosis and the vulnerable plaque–imaging: part II. Aust N Z J Med 30(6):704–710CrossRefPubMed Worthley SG, Helft G, Zaman AG, Fuster V, Badimon JJ (2000) Atherosclerosis and the vulnerable plaque–imaging: part II. Aust N Z J Med 30(6):704–710CrossRefPubMed
9.
Zurück zum Zitat Yonetsu T, Bouma BE, Kato K, Fujimoto JG, Jang IK (2013) Optical coherence tomography-15 years in cardiology. Circ J 77(8):1933–1940CrossRefPubMed Yonetsu T, Bouma BE, Kato K, Fujimoto JG, Jang IK (2013) Optical coherence tomography-15 years in cardiology. Circ J 77(8):1933–1940CrossRefPubMed
10.
Zurück zum Zitat Wijns W, Shite J, Jones MR et al (2015) Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study. Eur Heart J 36(47):3346–3355CrossRefPubMedPubMedCentral Wijns W, Shite J, Jones MR et al (2015) Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study. Eur Heart J 36(47):3346–3355CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Jang IK, Bouma BE, Kang DH et al (2002) Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound. J Am Coll Cardiol 39(4):604–609CrossRefPubMed Jang IK, Bouma BE, Kang DH et al (2002) Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound. J Am Coll Cardiol 39(4):604–609CrossRefPubMed
13.
Zurück zum Zitat Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20(5):1262–1275CrossRefPubMed Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20(5):1262–1275CrossRefPubMed
14.
Zurück zum Zitat Quinones A, Lobach I, Maduro GA Jr, Smilowitz NR, Reynolds HR (2015) Diabetes and ischemic heart disease death in people age 25–54: a multiple-cause-of-death analysis based on over 400 000 deaths from 1990 to 2008 in New York City. Clin Cardiol 38(2):114–120CrossRefPubMed Quinones A, Lobach I, Maduro GA Jr, Smilowitz NR, Reynolds HR (2015) Diabetes and ischemic heart disease death in people age 25–54: a multiple-cause-of-death analysis based on over 400 000 deaths from 1990 to 2008 in New York City. Clin Cardiol 38(2):114–120CrossRefPubMed
15.
Zurück zum Zitat Colayco DC, Niu F, McCombs JS, Cheetham TC (2011) A1C and cardiovascular outcomes in type 2 diabetes: a nested case-control study. Diabetes Care 34(1):77–83CrossRefPubMed Colayco DC, Niu F, McCombs JS, Cheetham TC (2011) A1C and cardiovascular outcomes in type 2 diabetes: a nested case-control study. Diabetes Care 34(1):77–83CrossRefPubMed
16.
Zurück zum Zitat Daida H, Takayama T, Hiro T et al (2012) High HbA1c levels correlate with reduced plaque regression during statin treatment in patients with stable coronary artery disease: results of the coronary atherosclerosis study measuring effects of rosuvastatin using intravascular ultrasound in Japanese subjects (COSMOS). Cardiovasc Diabetol 11:87CrossRefPubMedPubMedCentral Daida H, Takayama T, Hiro T et al (2012) High HbA1c levels correlate with reduced plaque regression during statin treatment in patients with stable coronary artery disease: results of the coronary atherosclerosis study measuring effects of rosuvastatin using intravascular ultrasound in Japanese subjects (COSMOS). Cardiovasc Diabetol 11:87CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Bayturan O, Kapadia S, Nicholls SJ et al (2010) Clinical predictors of plaque progression despite very low levels of low-density lipoprotein cholesterol. J Am Coll Cardiol 55(24):2736–2742CrossRefPubMed Bayturan O, Kapadia S, Nicholls SJ et al (2010) Clinical predictors of plaque progression despite very low levels of low-density lipoprotein cholesterol. J Am Coll Cardiol 55(24):2736–2742CrossRefPubMed
18.
Zurück zum Zitat Tian J, Dauerman H, Toma C et al (2014) Prevalence and characteristics of TCFA and degree of coronary artery stenosis: an OCT, IVUS, and angiographic study. J Am Coll Cardiol 64(7):672–680CrossRefPubMed Tian J, Dauerman H, Toma C et al (2014) Prevalence and characteristics of TCFA and degree of coronary artery stenosis: an OCT, IVUS, and angiographic study. J Am Coll Cardiol 64(7):672–680CrossRefPubMed
19.
Zurück zum Zitat Sato A, Hoshi T, Kakefuda Y et al (2015) In vivo evaluation of fibrous cap thickness by optical coherence tomography for positive remodeling and low-attenuation plaques assessed by computed tomography angiography. Int J Cardiol 182:419–425CrossRefPubMed Sato A, Hoshi T, Kakefuda Y et al (2015) In vivo evaluation of fibrous cap thickness by optical coherence tomography for positive remodeling and low-attenuation plaques assessed by computed tomography angiography. Int J Cardiol 182:419–425CrossRefPubMed
20.
Zurück zum Zitat Yonetsu T, Kato K, Uemura S et al (2013) Features of coronary plaque in patients with metabolic syndrome and diabetes mellitus assessed by 3-vessel optical coherence tomography. Circ Cardiovasc Imaging 6(5):665–673CrossRefPubMed Yonetsu T, Kato K, Uemura S et al (2013) Features of coronary plaque in patients with metabolic syndrome and diabetes mellitus assessed by 3-vessel optical coherence tomography. Circ Cardiovasc Imaging 6(5):665–673CrossRefPubMed
21.
Zurück zum Zitat Kato K, Yonetsu T, Kim SJ et al (2012) Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study. JACC Cardiovasc Interv 5(11):1150–1158CrossRefPubMed Kato K, Yonetsu T, Kim SJ et al (2012) Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study. JACC Cardiovasc Interv 5(11):1150–1158CrossRefPubMed
22.
Zurück zum Zitat Virmani R, Burke AP, Farb A, Kolodgie FD (2006) Pathology of the vulnerable plaque. J Am Coll Cardiol 47(8 Suppl):C13–C18CrossRefPubMed Virmani R, Burke AP, Farb A, Kolodgie FD (2006) Pathology of the vulnerable plaque. J Am Coll Cardiol 47(8 Suppl):C13–C18CrossRefPubMed
23.
Zurück zum Zitat Tearney GJ, Yabushita H, Houser SL et al (2003) Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography. Circulation 107(1):113–119CrossRefPubMed Tearney GJ, Yabushita H, Houser SL et al (2003) Quantification of macrophage content in atherosclerotic plaques by optical coherence tomography. Circulation 107(1):113–119CrossRefPubMed
24.
Zurück zum Zitat Kataoka Y, Puri R, Hammadah M et al (2014) Spotty calcification and plaque vulnerability in vivo: frequency-domain optical coherence tomography analysis. Cardiovasc Diagn Ther 4(6):460–469PubMedPubMedCentral Kataoka Y, Puri R, Hammadah M et al (2014) Spotty calcification and plaque vulnerability in vivo: frequency-domain optical coherence tomography analysis. Cardiovasc Diagn Ther 4(6):460–469PubMedPubMedCentral
25.
Zurück zum Zitat Tian J, Ren X, Uemura S et al (2014) Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: optical coherence tomography study. Am Heart J 167(6):884–892CrossRefPubMed Tian J, Ren X, Uemura S et al (2014) Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: optical coherence tomography study. Am Heart J 167(6):884–892CrossRefPubMed
26.
Zurück zum Zitat Berry C, Noble S, Gregoire JC et al (2010) Glycaemic status influences the nature and severity of coronary artery disease. Diabetologia 53(4):652–658CrossRefPubMed Berry C, Noble S, Gregoire JC et al (2010) Glycaemic status influences the nature and severity of coronary artery disease. Diabetologia 53(4):652–658CrossRefPubMed
27.
Zurück zum Zitat Eeg-Olofsson K, Cederholm J, Nilsson PM et al (2010) New aspects of HbA1c as a risk factor for cardiovascular diseases in type 2 diabetes: an observational study from the Swedish National Diabetes Register (NDR). J Intern Med 268(5):471–482CrossRefPubMed Eeg-Olofsson K, Cederholm J, Nilsson PM et al (2010) New aspects of HbA1c as a risk factor for cardiovascular diseases in type 2 diabetes: an observational study from the Swedish National Diabetes Register (NDR). J Intern Med 268(5):471–482CrossRefPubMed
28.
Zurück zum Zitat Zitkus BS (2014) Update on the American Diabetes Association standards of medical care. Nurse Pract 39(8):22–32CrossRefPubMed Zitkus BS (2014) Update on the American Diabetes Association standards of medical care. Nurse Pract 39(8):22–32CrossRefPubMed
29.
Zurück zum Zitat Hou J, Xing L, Jia H et al (2016) Comparison of intensive versus moderate lipid-lowering therapy on fibrous cap and atheroma volume of coronary lipid-rich plaque using serial optical coherence tomography and intravascular ultrasound imaging. Am J Cardiol 117(5):800–806CrossRefPubMed Hou J, Xing L, Jia H et al (2016) Comparison of intensive versus moderate lipid-lowering therapy on fibrous cap and atheroma volume of coronary lipid-rich plaque using serial optical coherence tomography and intravascular ultrasound imaging. Am J Cardiol 117(5):800–806CrossRefPubMed
30.
Zurück zum Zitat Chia S, Raffel OC, Takano M, Tearney GJ, Bouma BE, Jang IK (2008) Association of statin therapy with reduced coronary plaque rupture: an optical coherence tomography study. Coron Artery Dis 19(4):237–242CrossRefPubMedPubMedCentral Chia S, Raffel OC, Takano M, Tearney GJ, Bouma BE, Jang IK (2008) Association of statin therapy with reduced coronary plaque rupture: an optical coherence tomography study. Coron Artery Dis 19(4):237–242CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Kataoka Y, Puri R, Hammadah M et al (2014) Frequency-domain optical coherence tomographic analysis of plaque microstructures at nonculprit narrowings in patients receiving potent statin therapy. Am J Cardiol 114(4):549–554CrossRefPubMed Kataoka Y, Puri R, Hammadah M et al (2014) Frequency-domain optical coherence tomographic analysis of plaque microstructures at nonculprit narrowings in patients receiving potent statin therapy. Am J Cardiol 114(4):549–554CrossRefPubMed
32.
Zurück zum Zitat Nasu K, Tsuchikane E, Katoh O et al (2008) Plaque characterisation by Virtual Histology intravascular ultrasound analysis in patients with type 2 diabetes. Heart 94(4):429–433CrossRefPubMed Nasu K, Tsuchikane E, Katoh O et al (2008) Plaque characterisation by Virtual Histology intravascular ultrasound analysis in patients with type 2 diabetes. Heart 94(4):429–433CrossRefPubMed
33.
Zurück zum Zitat Hong YJ, Jeong MH, Choi YH et al (2009) Plaque characteristics in culprit lesions and inflammatory status in diabetic acute coronary syndrome patients. JACC Cardiovasc Imaging 2(3):339–349CrossRefPubMed Hong YJ, Jeong MH, Choi YH et al (2009) Plaque characteristics in culprit lesions and inflammatory status in diabetic acute coronary syndrome patients. JACC Cardiovasc Imaging 2(3):339–349CrossRefPubMed
34.
Zurück zum Zitat Matsui T, Oda E, Higashimoto Y, Yamagishi S (2015) Glyceraldehyde-derived pyridinium (GLAP) evokes oxidative stress and inflammatory and thrombogenic reactions in endothelial cells via the interaction with RAGE. Cardiovasc Diabetol 14:1CrossRefPubMedPubMedCentral Matsui T, Oda E, Higashimoto Y, Yamagishi S (2015) Glyceraldehyde-derived pyridinium (GLAP) evokes oxidative stress and inflammatory and thrombogenic reactions in endothelial cells via the interaction with RAGE. Cardiovasc Diabetol 14:1CrossRefPubMedPubMedCentral
35.
36.
Zurück zum Zitat Yan SF, Ramasamy R, Schmidt AM (2010) The RAGE axis: a fundamental mechanism signaling danger to the vulnerable vasculature. Circ Res 106(5):842–853CrossRefPubMedPubMedCentral Yan SF, Ramasamy R, Schmidt AM (2010) The RAGE axis: a fundamental mechanism signaling danger to the vulnerable vasculature. Circ Res 106(5):842–853CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Shiomi M, Ito T, Tsukada T et al (1995) Reduction of serum cholesterol levels alters lesional composition of atherosclerotic plaques. Effect of pravastatin sodium on atherosclerosis in mature WHHL rabbits. Arterioscler Thromb Vasc Biol 15(11):1938–1944CrossRefPubMed Shiomi M, Ito T, Tsukada T et al (1995) Reduction of serum cholesterol levels alters lesional composition of atherosclerotic plaques. Effect of pravastatin sodium on atherosclerosis in mature WHHL rabbits. Arterioscler Thromb Vasc Biol 15(11):1938–1944CrossRefPubMed
38.
Zurück zum Zitat Ishigaki Y, Katagiri H, Gao J et al (2008) Impact of plasma oxidized low-density lipoprotein removal on atherosclerosis. Circulation 118(1):75–83CrossRefPubMed Ishigaki Y, Katagiri H, Gao J et al (2008) Impact of plasma oxidized low-density lipoprotein removal on atherosclerosis. Circulation 118(1):75–83CrossRefPubMed
39.
Zurück zum Zitat Hiro T, Kimura T, Morimoto T et al (2010) Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome-serial intravascular ultrasound observations from the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial). Circ J 74(6):1165–1174CrossRefPubMed Hiro T, Kimura T, Morimoto T et al (2010) Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome-serial intravascular ultrasound observations from the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial). Circ J 74(6):1165–1174CrossRefPubMed
Metadaten
Titel
Statin-induced improvements in vulnerable plaques are attenuated in poorly controlled diabetic patients with coronary atherosclerosis disease: a serial optical coherence tomography analysis
verfasst von
Nana Dong
Zulong Xie
Jiannan Dai
Wei Wang
Rong Sun
Yefei Zhan
Meng Sun
Jinwei Tian
Bo Yu
Publikationsdatum
02.09.2016
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 6/2016
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-016-0902-9

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