Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Cardiovasc Diabetol. 2018 Jun 15;17(1):90. doi: 10.1186/s12933-018-0729-5.
Raised hemoglobinA1c (HbA1c) is an indicator of pre-diabetes, which is associated with increased risk of coronary artery disease. However, the detailed morphological characteristics of non-culprit plaques in acute coronary syndrome (ACS) patients remain largely unknown.
A total of 305 non-culprit plaques from 216 ACS patients were analyzed by intravascular optical coherence tomography. These patients were divided into three groups according to the serum glycosylated hemoglobin level: normal HbA1c (< 5.7%), pre-diabetes with raised HbA1c (5.7-6.4%) and diabetes mellitus (DM).
Plaques in patients with raised HbA1c had a longer lipid length (17.0 ± 8.3 mm vs. 13.9 ± 7.2 mm, P = 0.004) and greater lipid index (2775.0 ± 1694.0 mm° vs. 1592.1 ± 981.2 mm°, P = 0.001) than those with normal HbA1c but were similar to DM. The prevalence of calcification in patients with raised HbA1c was significantly higher (38.7% vs. 26.3%, P = 0.048) than normal HbA1c but was similar to DM. The percentage of macrophage infiltration in the DM group was higher than that in the normal HbA1c group (20.5% vs. 7.4%, P = 0.005).
Compared to patients with normal HbA1c, the non-culprit plaques in ACS patients with raised HbA1c had more typical vulnerable features but were similar to DM.
升高的糖化血红蛋白（HbA1c）是糖尿病前期的一个指标，与冠心病风险增加相关。然而，急性冠脉综合征（ACS）患者非罪犯斑块的详细形态特征在很大程度上仍不清楚。
对 216 例 ACS 患者的 305 个非罪犯斑块进行了血管内光学相干断层扫描分析。这些患者根据血清糖化血红蛋白水平分为三组：正常 HbA1c（<5.7%）、HbA1c 升高的糖尿病前期（5.7-6.4%）和糖尿病（DM）。
HbA1c 升高的患者斑块的脂质长度（17.0±8.3 mm 比 13.9±7.2 mm，P=0.004）和脂质指数（2775.0±1694.0 mm°比 1592.1±981.2 mm°，P=0.001）均较长，与 DM 相似。HbA1c 升高的患者钙化的发生率明显高于正常 HbA1c（38.7%比 26.3%，P=0.048），但与 DM 相似。DM 组巨噬细胞浸润的百分比高于正常 HbA1c 组（20.5%比 7.4%，P=0.005）。
与正常 HbA1c 患者相比，HbA1c 升高的 ACS 患者的非罪犯斑块具有更典型的易损特征，但与 DM 相似。
