Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes
Background High cardiovascular mortality has been reported in young patients with diabetes. However, the underlying pathology in different age groups of patients with diabetes has not been studied. Methods and Results The aim of this study was to investigate the plaque characteristics and underlying...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| 格式: | Article |
| 語言: | English |
| 出版: |
Wiley
2023-12-01
|
| 叢編: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| 主題: | |
| 在線閱讀: | https://www.ahajournals.org/doi/10.1161/JAHA.123.031474 |
| _version_ | 1827594800029761536 |
|---|---|
| author | Keishi Suzuki Takayuki Niida Haruhito Yuki Daisuke Kinoshita Daichi Fujimoto Hang Lee Iris McNulty Masamichi Takano Sunao Nakamura Tsunekazu Kakuta Kyoichi Mizuno Ik‐Kyung Jang |
| author_facet | Keishi Suzuki Takayuki Niida Haruhito Yuki Daisuke Kinoshita Daichi Fujimoto Hang Lee Iris McNulty Masamichi Takano Sunao Nakamura Tsunekazu Kakuta Kyoichi Mizuno Ik‐Kyung Jang |
| author_sort | Keishi Suzuki |
| collection | DOAJ |
| description | Background High cardiovascular mortality has been reported in young patients with diabetes. However, the underlying pathology in different age groups of patients with diabetes has not been studied. Methods and Results The aim of this study was to investigate the plaque characteristics and underlying pathology of acute coronary syndrome in different age groups of patients with or without diabetes in a large cohort. Patients who presented with acute coronary syndrome and underwent preintervention optical coherence tomography imaging were included. Culprit plaque was classified as plaque rupture, plaque erosion, or calcified plaque and stratified into 5 age groups. Plaque characteristics including features of vulnerability were examined by optical coherence tomography. Among 1394 patients, 482 (34.6%) had diabetes. Patients with diabetes, compared with patients without diabetes, had a higher prevalence of lipid‐rich plaque (71.2% versus 64.8%, P=0.016), macrophage (72.0% versus 62.6%, P<0.001), and cholesterol crystal (27.6% versus 19.7%, P<0.001). Both diabetes and nondiabetes groups showed a decreasing trend in plaque erosion with age (patients with diabetes, P=0.020; patients without diabetes, P<0.001). Patients without diabetes showed an increasing trend with age in plaque rupture (P=0.004) and lipid‐rich plaque (P=0.018), whereas patients with diabetes had a high prevalence of these vulnerable features at an early age that remained high across age groups. Conclusions Patients without diabetes showed an increasing trend with age in plaque rupture and lipid‐rich plaque, whereas patients with diabetes had a high prevalence of these vulnerable features at an early age. These results suggest that atherosclerotic vascular changes with increased vulnerability start at a younger age in patients with diabetes. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04523194, NCT03479723. URL: https://www.umin.ac.jp/ctr/. Unique identifier: UMIN000041692. |
| first_indexed | 2024-03-09T02:42:32Z |
| format | Article |
| id | doaj.art-a75612a9ac1549c0878422dd5602c49a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-09T02:42:32Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-a75612a9ac1549c0878422dd5602c49a2023-12-06T02:49:39ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-12-01122310.1161/JAHA.123.031474Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With DiabetesKeishi Suzuki0Takayuki Niida1Haruhito Yuki2Daisuke Kinoshita3Daichi Fujimoto4Hang Lee5Iris McNulty6Masamichi Takano7Sunao Nakamura8Tsunekazu Kakuta9Kyoichi Mizuno10Ik‐Kyung Jang11Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MABiostatistics Center Massachusetts General Hospital Harvard Medical School Boston MACardiology Division Massachusetts General Hospital Harvard Medical School Boston MACardiovascular Center Nippon Medical School Chiba Hokusoh Hospital Inzai, Chiba JapanInterventional Cardiology Unit New Tokyo Hospital Chiba JapanDepartment of Cardiology Tsuchiura Kyodo General Hospital, Tsuchiura Ibaraki JapanMitsukoshi Health and Welfare Foundation Tokyo JapanCardiology Division Massachusetts General Hospital Harvard Medical School Boston MABackground High cardiovascular mortality has been reported in young patients with diabetes. However, the underlying pathology in different age groups of patients with diabetes has not been studied. Methods and Results The aim of this study was to investigate the plaque characteristics and underlying pathology of acute coronary syndrome in different age groups of patients with or without diabetes in a large cohort. Patients who presented with acute coronary syndrome and underwent preintervention optical coherence tomography imaging were included. Culprit plaque was classified as plaque rupture, plaque erosion, or calcified plaque and stratified into 5 age groups. Plaque characteristics including features of vulnerability were examined by optical coherence tomography. Among 1394 patients, 482 (34.6%) had diabetes. Patients with diabetes, compared with patients without diabetes, had a higher prevalence of lipid‐rich plaque (71.2% versus 64.8%, P=0.016), macrophage (72.0% versus 62.6%, P<0.001), and cholesterol crystal (27.6% versus 19.7%, P<0.001). Both diabetes and nondiabetes groups showed a decreasing trend in plaque erosion with age (patients with diabetes, P=0.020; patients without diabetes, P<0.001). Patients without diabetes showed an increasing trend with age in plaque rupture (P=0.004) and lipid‐rich plaque (P=0.018), whereas patients with diabetes had a high prevalence of these vulnerable features at an early age that remained high across age groups. Conclusions Patients without diabetes showed an increasing trend with age in plaque rupture and lipid‐rich plaque, whereas patients with diabetes had a high prevalence of these vulnerable features at an early age. These results suggest that atherosclerotic vascular changes with increased vulnerability start at a younger age in patients with diabetes. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT04523194, NCT03479723. URL: https://www.umin.ac.jp/ctr/. Unique identifier: UMIN000041692.https://www.ahajournals.org/doi/10.1161/JAHA.123.031474acute coronary syndromeagediabetesoptical coherence tomography |
| spellingShingle | Keishi Suzuki Takayuki Niida Haruhito Yuki Daisuke Kinoshita Daichi Fujimoto Hang Lee Iris McNulty Masamichi Takano Sunao Nakamura Tsunekazu Kakuta Kyoichi Mizuno Ik‐Kyung Jang Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute coronary syndrome age diabetes optical coherence tomography |
| title | Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes |
| title_full | Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes |
| title_fullStr | Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes |
| title_full_unstemmed | Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes |
| title_short | Coronary Plaque Characteristics and Underlying Mechanism of Acute Coronary Syndromes in Different Age Groups of Patients With Diabetes |
| title_sort | coronary plaque characteristics and underlying mechanism of acute coronary syndromes in different age groups of patients with diabetes |
| topic | acute coronary syndrome age diabetes optical coherence tomography |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.031474 |
| work_keys_str_mv | AT keishisuzuki coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT takayukiniida coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT haruhitoyuki coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT daisukekinoshita coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT daichifujimoto coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT hanglee coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT irismcnulty coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT masamichitakano coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT sunaonakamura coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT tsunekazukakuta coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT kyoichimizuno coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes AT ikkyungjang coronaryplaquecharacteristicsandunderlyingmechanismofacutecoronarysyndromesindifferentagegroupsofpatientswithdiabetes |