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. 2023 Sep 21;15(9):e45721.
doi: 10.7759/cureus.45721. eCollection 2023 Sep.

Comparison of Atherosclerotic Plaque Compositions in Diabetic and Non-diabetic Patients

Mustafa Ozan Çakır  1 , Mustafa Taner Gören  2
Affiliations

Comparison of Atherosclerotic Plaque Compositions in Diabetic and Non-diabetic Patients

Mustafa Ozan Çakır et al. Cureus. .

Abstract

Introduction: Diabetes mellitus is one of the major risk factors for coronary artery disease. Intravascular ultrasound (IVUS) imaging has an important role in the evaluation of atherosclerotic coronary artery disease. The aim of the study was to investigate the potential link between diabetes mellitus and plaque vulnerability in patients with coronary artery disease.

Methods: In total, 26 patients with acute coronary syndrome (eight with diabetes mellitus) and 34 with stable angina pectoris (16 with diabetes mellitus) constituted the study population. Patients underwent IVUS ultrasound and virtual histology (VH)-IVUS imaging during routine diagnostic catheterization procedures. A total of 70 plaques in 60 patients were examined.

Results: Patients with diabetes mellitus had a significantly greater percentage of fibrofatty components in the minimal lumen area (MLA) (17 ± 12 in diabetics; 12 ± 6 in non-diabetics; p=0.06). Thin-cap fibroatheromas were more frequent in patients with diabetes mellitus (72% versus 45%; p=0.012). There was a positive correlation between the presence of attenuated plaque and hemoglobin A1C (HbA1c) levels as well (7.09 ± 1.66 versus 6.02 ± 1.00; p=0.011). Patients with HbA1C ≥7.5% also had the highest prevalence of attenuated plaque.

Conclusion: As shown by VH-IVUS, the prevalence of vulnerable plaques in patients with diabetes mellitus was much higher than that in non-diabetic patients. The presence of attenuated plaque detected in grayscale intravascular ultrasonography was associated with high HbA1C levels in diabetic patients. Diabetes mellitus may cause cardiovascular vulnerability by changing the plaque morphology.

Keywords: atherosclerosis; atherosclerotic plaque; coronary artery disease; diabetes mellitus; hemoglobin a1c protein.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. HbA1C value and attenuated plaque-ROC curve
Based on the HbA1C level of 7.5, the area under the curve was found to be 0.83 in the evaluation made with the ROC curve. HbA1C: hemoglobin A1C; ROC curve: receiver operating characteristic curve
See this image and copyright information in PMC

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