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Review
. 2025 Sep 15;16(9):107693.
doi: 10.4239/wjd.v16.i9.107693.

Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism

Shi-Qi Liu  1   2 , Dong Wang  3 , Cheng-Chun Tang  1   2
Affiliations
Review

Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism

Shi-Qi Liu et al. World J Diabetes. .

Abstract

The introduction of drug-eluting stents has significantly reduced the incidence of in-stent restenosis. Despite this, recurrent cardiovascular events related to untreated nontarget lesions (NTLs) are becoming more common and accounting for more than 50% of all recurrent cardiovascular events. In patients with diabetes, factors such as prolonged disease duration, poor glycemic control, insulin use, and inadequate lipid management may exacerbate the progression of NTLs and adverse cardiovascular events. Additionally, glycemic fluctuations have been linked to an increased risk of future cardiovascular events in patients with early glucose metabolism abnormalities and acute hyperglycemia. In this review, we explored the clinical and plaque characteristics of patients with diabetes and early glucose metabolism disorders, the percutaneous coronary intervention strategies for NTLs, and their prognostic implications. Furthermore, we investigated the mechanistic links between adverse cardiovascular outcomes and elevated inflammation, oxidative stress, hypercoagulability, and endothelial dysfunction.

Keywords: Diabetes mellitus; Endothelial dysfunction; Glucose metabolism abnormalities; Nonculprit lesion; Nontarget lesion; Oxidative stress.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
A transient increase in blood glucose can cause epigenetic changes by increasing oxidative stress, initiating the process of atherosclerosis.
See this image and copyright information in PMC

References

    1. Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R. In-stent restenosis in the drug-eluting stent era. J Am Coll Cardiol. 2010;56:1897–1907. - PubMed
    1. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, Mehran R, McPherson J, Farhat N, Marso SP, Parise H, Templin B, White R, Zhang Z, Serruys PW PROSPECT Investigators. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226–235. - PubMed
    1. Tan Y, Zhou J, Zhou Y, Yang X, Yang J, Chen Y. Characteristics Detected on Computed Tomography Angiography Predict Coronary Artery Plaque Progression in Non-Culprit Lesions. Korean J Radiol. 2017;18:487–497. - PMC - PubMed
    1. Montone RA, Niccoli G, Crea F, Jang IK. Management of non-culprit coronary plaques in patients with acute coronary syndrome. Eur Heart J. 2020;41:3579–3586. - PubMed
    1. Park DW, Clare RM, Schulte PJ, Pieper KS, Shaw LK, Califf RM, Ohman EM, Van de Werf F, Hirji S, Harrington RA, Armstrong PW, Granger CB, Jeong MH, Patel MR. Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction. JAMA. 2014;312:2019–2027. - PubMed

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