Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Egyptian Heart Journal Pub Date : 2018-12-01 DOI:10.1016/j.ehj.2018.10.003
Mohamed Laimoud (MD), Farouk Faris (MD), Helmy Elghawaby (MD)
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引用次数: 3

Abstract

Background

Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).

Aim of work

Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.

Methodology

IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).

Results

As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p = 0.001) with higher total cholesterol level (194.6 ± 35.3 vs 174.4 ± 28.5 mg/dl, p = 0.001) and higher LDL-C (145.3 ± 27.1 vs 123.2 ± 31.4, p = 0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4 ± 7.4 vs 16.3 ± 7.9 mm, p = 0.002) with higher plaque burden (60.8 ± 15.3 vs 54.8 ± 14.0, p 0.002) and more area stenosis percentage (60.8 ± 15.6 vs 55.6 ± 14.1, p = 0.008). Structurally, the diabetic group lesions had more lipid content (19.8 ± 8.8 vs 16.8 ± 8.7, p = 0.008) and more necrotic core (17.6 ± 7.4 vs 14.7 ± 4.8, p = 0.008) but less calcification (6.9 ± 3.6 vs 11.8 ± 6.3, p = 0.001). The RI was negative in both groups, 0.95 ± 0.13 in the diabetic group vs 0.98 ± 0.19 in non-diabetic group (p = 0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23. ± 5.2 vs 14.6 ± 8.6, p = 0.01) but less fibrotic component (48.6 ± 4.7 vs 59.1 ± 13.6%, p = 0.01) and less calcification (10.9 ± 6.8% vs 14.07 ± 3.8%, p = 0.02) as compared to the nondyslipidaemic subgroup.

Conclusions

Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification.

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埃及糖尿病患者合并急性冠脉综合征的冠状动脉粥样硬化病变的血管内评价
背景冠状动脉疾病是糖尿病(DM)患者死亡的主要原因之一。埃及被国际糖尿病联合会(IDF)列为世界糖尿病患者数量前10位的国家之一。研究目的:比较埃及糖尿病患者与非糖尿病患者的冠状动脉粥样硬化病变程度和病变组织特征。方法对116例不稳定型心绞痛患者272例冠状动脉病变进行静脉造影检查。患者分为两组:糖尿病组(50例,117个病变)和非糖尿病组(66例,155个病变)。ResultsAs与非糖尿病组相比,糖尿病患者更dyslipidemic(84%比39.4%,p = 0.001)与高总胆固醇水平(194.6 ±35.3 vs 174.4  ±28.5  mg / dl, p = 0.001)和更高的密度(145.3 ±27.1 vs 123.2  ± 31.4,p = 0.001)。对于病变特征,糖尿病组病变较长(19.4 ± 7.4 vs 16.3 ±7.9  mm, p = 0.002)较高的斑块负担(60.8 ±15.3 vs 54.8  ± 14.0,p 0.002)和更多的区域狭窄百分比( 60.8±15.6 vs 55.6  ± 14.1,p = 0.008)。从结构上讲,糖尿病组病变有更多的脂质含量(19.8 ±8.8 vs 16.8  ± 8.7,p = 0.008)和坏死核心( 17.6±7.4 vs 14.7  ± 4.8,p = 0.008)但不钙化(6.9 ±3.6 vs 11.8  ± 6.3,p = 0.001)。两组的RI均为阴性,糖尿病组为0.95 ± 0.13,非糖尿病组为0.98 ± 0.19 (p = 0.5)。在糖尿病组病变,dyslipidaemic子群有更多的脂质含量(23。 ±5.2 vs 14.6  ± 8.6,p = 0.01)但不纤维组件( 48.6±4.7 vs 59.1  ± 13.6%,p = 0.01)和更少的钙化(10.9 ± 6.8% vs 14.07 ± 3.8%,p = 0.02)相比nondyslipidaemic子群。结论埃及糖尿病合并冠状动脉粥样硬化患者病变时间长,斑块负荷高,斑块狭窄率高,重构指数为负。糖尿病病变有更多的脂质含量和更多的坏死核心,但较少钙化。
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来源期刊
Egyptian Heart Journal
Egyptian Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.10
自引率
0.00%
发文量
82
审稿时长
9 weeks
期刊介绍: The Egyptian Heart Journal is the official journal of the Egyptian Society of Cardiology. It is an international journal that publishes peer-reviewed articles on all aspects of cardiovascular disease, including original clinical studies and translational investigations. The journal publishes research, review articles, case reports and commentary articles, as well as editorials interpreting and commenting on the research presented. In addition, it provides a forum for the exchange of information on all aspects of cardiovascular medicine, including educational issues.
期刊最新文献
Renal artery embolism successfully managed by ultrasound enhanced catheter directed thrombolysis Congenital atresia of left main coronary artery Late presenting complete heart block after surgical repair of ventricular septal defect Risk factors for acute coronary syndrome in patients below the age of 40 years Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
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