Intravascular Profile of Coronary Artery Disease in Diabetic Patients with Acute Coronary Syndrome: Results of the Saudi Coronary Athero-Thrombotic Disease (SAUDICAT)

Abstract

Cardiovascular disease is the leading cause of mortality in patients with diabetes mellitus (DM). We sought to establish for the first time in Saudi Arabia an intravascular ultrasound (IVUS) profile of DM patients with acute coronary syndrome (ACS). Patients and methods: We retrospectively analyzed 210 IVUS studies in 181 patients hospitalized in King Salman Heart Centre for ACS. IVUS was performed to guide percutaneous coronary interventions (PCI) of borderline moderate lesions. Results: Mean age was 58 ± 10 years, 78% (n = 163) of IVUS studies were performed in men. There were 71% (n = 128) patients with DM. ST elevation myocardial infarction (STEMI) was the most common clinical presentation (47%, n = 88 patients , p < 0.01) and longer lesions (37 ± 12 mm versus 30 ± 8 mm, p < 0.01). A positive remodelling index was observed for patients with and without DM, without significant difference (1.4 versus 1.3 respectively, p = 0.7). Percent plaque volume and obstruction were not different. Conclusion: IVUS demonstrates longer lesions to be treated in DM patients with ACS in Saudi Arabia, however no difference in average plaque burden or remodelling index. These findings are likely to impact our understanding of optimal PCI strategies in DM patients.

Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes

“…Lawand et al 19 demonstrated longer lesions and increased plaque volumes in diabetic patients admitted with acute coronary syndrome as compared to non-diabetic patients.…”