Intracoronary ultrasound examinations reveal significantly more advanced coronary atherosclerosis in people with type 1 diabetes than in age- and sex-matched non-diabetic controls

Larsen, J; Tsunoda, Taro; Tuzcu, E. Murat; Schoenhagen, Paul; Brekke, Magne; Arnesen, Harald; Hanssen, Kristian F.; Nissen, Steven E.; Dahl‐Jørgensen, Knut

doi:10.3132/dvdr.2007.009

Cited by 23 publications

(16 citation statements)

References 33 publications

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“…To date, most imaging studies relating glycaemic status to CAD have lacked information on serial examinations [2,11,12,19,20], diabetes treatment [3,5,[10][11][12]19], FBG [5,10,11,19,20] or a non-diabetic control group [11,20]. Our investigation provides more detailed information than these previous reports, helps clarify some of the outstanding questions on this subject and complements the results from a recent pooled analysis of five randomised clinical trials [3].…”

Section: Discussionmentioning

confidence: 69%

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Glycaemic status influences the nature and severity of coronary artery disease

et al. 2010

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Aims/hypothesis We sought to understand the relationships between glycaemic status and both severity and progression of coronary artery disease (CAD), the leading cause of death in diabetes. Methods Baseline fasting blood glucose (FBG) and HbA 1c (%) were measured in 426 patients with known or suspected stable CAD, who underwent coronary artery intravascular ultrasound (IVUS) at baseline and after a mean follow-up period of 664 days (range 257 to 961). The patients were categorised as normoglycaemic (n=226, 53%), or as having impaired fasting glucose (n=118, 28%) or diabetes (n=82, 19%). Results The maximum percentage coronary atheroma area at baseline was greater in diabetic patients (73.33±8.86%) than in those with normoglycaemia (69.08±10.43%; p=0.001) and impaired fasting glucose (69.32±9.59%; p=0.0031). In averaged IVUS measurements of the 30-mm target segment (n=332 participants), change in percentage atheroma area during follow-up was also greater in the diabetes (1.86± 3.90%) than in other groups (0.28±3.32% and 0.56±2.96%, p=0.0047 global). FBG correlated with maximum percentage atheroma area at baseline (r=0.17; p=0.0003). HbA 1c also correlated with maximum percentage atheroma area at baseline (r=0.26; p=0.0001) and with change in maximum plaque area (r=0.16; p=0.016). A similar pattern of results occurred with plaque volume. The relationships between diabetes or HbA 1c and both IVUS measurements of plaque burden and remodelling persisted after adjustment. Conclusions/interpretation Fasting blood glucose, HbA 1c and the presence of diabetes are associated with the severity and progression of coronary atherosclerosis. These observations support the hypothesis that better glycaemic control may favourably influence CAD in patients with abnormal glucose tolerance or diabetes.

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Section: Discussionmentioning

confidence: 69%

“…IVUS also characterises coronary artery remodelling [10]. However, IVUS studies of glycaemic status and CAD have been limited by small sample size and lack of serial imaging [2,11,12].…”

Section: Introductionmentioning

confidence: 99%

Glycaemic status influences the nature and severity of coronary artery disease

et al. 2010

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“…Intravascular ultrasound shows that the degree of subclinical CAD is more severe in T1DM than in nondiabetic control subjects, which supports the autopsy data described above. 76 However, another study using angiography and intravascular ultrasound suggested patients treated with insulin had less plaque burden than either patients with DM not treated with insulin or nondiabetic individuals, and the use of insulin was negatively associated with plaque area (less plaque area with insulin use). 77 In that study, DM type was defined by insulin use only, which makes it difficult to interpret these findings.…”

Section: Pathology Of the Arterial Wall In T1dmmentioning

confidence: 99%

Type 1 Diabetes Mellitus and Cardiovascular Disease

Ferranti¹,

Boer²,

Fonseca³

et al. 2014

Circulation

300

126

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“…Larsen et al 18 showed that the degree of subclinical coronary atherosclerosis was significantly more severe in patients with type 1 diabetes than in controls. The mean plaque area (by IVUS) was ≥ 40% in 71% of diabetic arteries when compared to 33% of control arteries (p < 0.001).…”

Section: Discussionmentioning

confidence: 99%