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

Background: Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF). Aim of work: Assessment of the extent of coronary atherosclero...

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Main Authors: Mohamed Laimoud, Farouk Faris, Helmy Elghawaby
Format: Article
Language:English
Published: SpringerOpen 2018-12-01
Series:The Egyptian Heart Journal
Online Access:http://www.sciencedirect.com/science/article/pii/S1110260818301273
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author Mohamed Laimoud
Farouk Faris
Helmy Elghawaby
author_facet Mohamed Laimoud
Farouk Faris
Helmy Elghawaby
author_sort Mohamed Laimoud
collection DOAJ
description Background: Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF). Aim of work: Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients. Methodology: IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions). Results: As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p = 0.001) with higher total cholesterol level (194.6 ± 35.3 vs 174.4 ± 28.5 mg/dl, p = 0.001) and higher LDL-C (145.3 ± 27.1 vs 123.2 ± 31.4, p = 0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4 ± 7.4 vs 16.3 ± 7.9 mm, p = 0.002) with higher plaque burden (60.8 ± 15.3 vs 54.8 ± 14.0, p 0.002) and more area stenosis percentage (60.8 ± 15.6 vs 55.6 ± 14.1, p = 0.008). Structurally, the diabetic group lesions had more lipid content (19.8 ± 8.8 vs 16.8 ± 8.7, p = 0.008) and more necrotic core (17.6 ± 7.4 vs 14.7 ± 4.8, p = 0.008) but less calcification (6.9 ± 3.6 vs 11.8 ± 6.3, p = 0.001). The RI was negative in both groups, 0.95 ± 0.13 in the diabetic group vs 0.98 ± 0.19 in non-diabetic group (p = 0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23. ± 5.2 vs 14.6 ± 8.6, p = 0.01) but less fibrotic component (48.6 ± 4.7 vs 59.1 ± 13.6%, p = 0.01) and less calcification (10.9 ± 6.8% vs 14.07 ± 3.8%, p = 0.02) as compared to the nondyslipidaemic subgroup. Conclusions: Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. Keywords: Diabetes mellitus (DM), Intravascular ultrasound (IVUS), Plaque burden, Remodeling index (RI), Dyslipidemia
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spelling doaj.art-d2fc39fd99774b38a375250b6cead20a2022-12-22T01:59:04ZengSpringerOpenThe Egyptian Heart Journal1110-26082018-12-01704237241Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromesMohamed Laimoud0Farouk Faris1Helmy Elghawaby2Critical Care Medicine department, Kasr Alainy Hospitals, Cairo University, EgyptCritical Care Medicine department, Kasr Alainy Hospitals, Cairo University, EgyptCritical Care Medicine department, Kasr Alainy Hospitals, Cairo University, EgyptBackground: Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF). Aim of work: Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients. Methodology: IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions). Results: As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p = 0.001) with higher total cholesterol level (194.6 ± 35.3 vs 174.4 ± 28.5 mg/dl, p = 0.001) and higher LDL-C (145.3 ± 27.1 vs 123.2 ± 31.4, p = 0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4 ± 7.4 vs 16.3 ± 7.9 mm, p = 0.002) with higher plaque burden (60.8 ± 15.3 vs 54.8 ± 14.0, p 0.002) and more area stenosis percentage (60.8 ± 15.6 vs 55.6 ± 14.1, p = 0.008). Structurally, the diabetic group lesions had more lipid content (19.8 ± 8.8 vs 16.8 ± 8.7, p = 0.008) and more necrotic core (17.6 ± 7.4 vs 14.7 ± 4.8, p = 0.008) but less calcification (6.9 ± 3.6 vs 11.8 ± 6.3, p = 0.001). The RI was negative in both groups, 0.95 ± 0.13 in the diabetic group vs 0.98 ± 0.19 in non-diabetic group (p = 0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23. ± 5.2 vs 14.6 ± 8.6, p = 0.01) but less fibrotic component (48.6 ± 4.7 vs 59.1 ± 13.6%, p = 0.01) and less calcification (10.9 ± 6.8% vs 14.07 ± 3.8%, p = 0.02) as compared to the nondyslipidaemic subgroup. Conclusions: Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. Keywords: Diabetes mellitus (DM), Intravascular ultrasound (IVUS), Plaque burden, Remodeling index (RI), Dyslipidemiahttp://www.sciencedirect.com/science/article/pii/S1110260818301273
spellingShingle Mohamed Laimoud
Farouk Faris
Helmy Elghawaby
Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
The Egyptian Heart Journal
title Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
title_full Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
title_fullStr Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
title_full_unstemmed Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
title_short Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes
title_sort intravascular evaluation of coronary atherosclerotic lesions among egyptian diabetic patients with acute coronary syndromes
url http://www.sciencedirect.com/science/article/pii/S1110260818301273
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