Comparison of coronary plaque characteristics between diabetic and non-diabetic subjects: An in vivo optical coherence tomography study.

AIMS

Postmortem series have reported that subjects with diabetes mellitus have coronary plaques with larger necrotic cores and increased macrophage infiltration. Optical coherence tomography (OCT) is a high-resolution imaging modality that allows in vivo characterization of atherosclerotic plaques. Using OCT imaging, we compared in vivo plaque characteristics between diabetic and non-diabetic subjects.

METHODS

Sixty-three patients undergoing cardiac catheterization were enrolled. OCT imaging was performed in culprit coronary arteries. Assessment of plaque lipid content, fibrous cap thickness and frequency of thin-cap fibroatheroma were made independently. Macrophage density was determined from the optical signal within fibrous cap.

RESULTS

Eighty-two plaques in total were imaged (19 diabetic vs. 63 non-diabetic). There were no significant differences in frequency of lipid-rich plaques (68% vs. 71%; P=0.78), thin-cap fibroatheroma (29% vs. 36%; P=0.76) or minimum fibrous cap thickness (66.6microm vs. 62.9microm; P=0.87) between diabetic and non-diabetic patients. Fibrous cap macrophage density was higher in lipid-rich plaques (P=0.01) but showed no difference between diabetic and non-diabetic patients (5.94% vs. 5.94%; P=0.37).

CONCLUSIONS

There were no significant differences in culprit vessel plaque characteristics between diabetic and non-diabetic patients presenting with coronary artery disease. This represents the first study to characterize coronary plaques in diabetic patients using OCT.