Association between daily glucose fluctuation and coronary plaque properties in patients receiving adequate lipid-lowering therapy assessed by continuous glucose monitoring and optical coherence tomography
作者： Masaru Kuroda , Toshiro Shinke , Kazuhiko Sakaguchi , Hiromasa Otake , Tomofumi Takaya
DOI: 10.1186/S12933-015-0236-X
关键词: Coronary artery disease 、 Endocrinology 、 Medicine 、 Odds ratio 、 Fibrous cap 、 Hypoglycemia 、 Internal medicine 、 Diabetes mellitus 、 Dyslipidemia 、 Percutaneous coronary intervention 、 Cardiology 、 Prospective cohort study
摘要: Background: Glucose fluctuation has been recognized as a residual risk apart from dyslipidemia for the development of coronary artery disease (CAD). This study aimed to investigate association between glucose and plaque morphology in CAD patients. Methods: prospective enrolled 72 consecutive patients receiving adequate lipid-lowering therapy. They were divided into 3 tertiles according mean amplitude glycemic excursions (MAGE), which represents fluctuation, measured by continuous monitoring (tertile 1; 85.3). Morphological feature plaques evaluated optical coherence tomography. Lipid index (LI) (mean lipid arc × length), fibrous cap thickness (FCT), prevalence thin-cap fibroatheroma (TCFA) assessed both culprit non-culprit lesions. Results: In total, 166 lesions evaluated. LI was stepwisely increased tertile MAGE (1958±974 [tertile 1] vs. 2653±1400 2] 4362±1858 3], p <0.001), whereas FCT thinnest (157.3±73.0 μm 104.0±64.1 83.1±34.7 μm, <0.001, respectively). The had highest TCFA. Multiple linear regression analysis showed that strongest effect on (standardized coefficient β=0.527 −0.392, respectively, P <0.001). logistic identified only independent predictor presence TCFA (odds ratio 1.034; Conclusions: hypoglycemia may impact formation lipid-rich thinning with
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