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Statin-induced improvements in vulnerable plaques are attenuated in poorly controlled diabetic patients with coronary atherosclerosis disease: a serial optical coherence tomography analysis

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Abstract

Aims

The incidence of cardiac events is increased in diabetic patients even after lipid-lowering therapy. This study aimed to compare the statin-induced changes in the characteristics of vulnerable plaques in patients without diabetes mellitus (DM) and in those with better- or poorly controlled DM, measured by optical coherence tomography (OCT).

Methods

This was a retrospective study of 99 non-culprit lipid-rich plaques from 75 patients who underwent intensive OCT imaging examination. Thirty-four non-diabetic patients were assigned to Group A. According to the average HbA1c level, 22 diabetic patients were assigned to Group B, and 19, to Group C (average HbA1c < 8 and ≥8 %, respectively).

Results

Following 12 months of statin therapy, similar improvements in serum lipid levels were observed in the three groups. However, the increase in fibrous-cap thickness of plaques was the highest in Group A (Group A, 183 %; Group B, 104 %; and Group C, 53 %). Significant reductions in lipid volume index were observed in Groups A and B (Group A: −12 %, P < 0.001; Group B: −13 %, P = 0.038; Group C: 7 %, P = 0.948). Percent changes in OCT measurements were significantly correlated with average HbA1c in patients.

Conclusions

Improved glucose control may enhance the statin-induced reduction in characteristics of vulnerable plaque in diabetic patients.

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Funding

The author Nana Dong has received a Grant from the Open Foundation in China’s Ministry of Education (KF201401) and a Grant from the Graduate Student Innovation Foundation of Heilongjiang Province (YJSCX2012-217HLJ). This study was also supported by National Natural Science Foundation of China (Grant NO.81571749 to J.T. and Grant NO.81330033 to B.Y.), and the National Youth Top-notch Talent Support Program of China (J.T.).

Authors’ contribution

All authors were involved in reporting the results of this study. YB and TJ made substantial contributions to conception, design, and planning of the study. SR, DJ, XZ, and ZY conducted the study and were involved in recruiting patients and keeping the patient database. DN, WW, and SM participated in interpretation of data and statistical analyses. YB and DN wrote the manuscript. YB was responsible for the overall content and served as guarantor. All authors read and approved the final version of the submitted manuscript.

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Authors and Affiliations

  1. Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, 150086, China

    Nana Dong, Zulong Xie, Jiannan Dai, Wei Wang, Rong Sun, Yefei Zhan, Jinwei Tian & Bo Yu

  2. The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, 246 Xuefu Road, Nangang District, Harbin, 150086, China

    Nana Dong, Meng Sun & Bo Yu

Authors
  1. Nana Dong
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  2. Zulong Xie
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  4. Wei Wang
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  8. Jinwei Tian
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  9. Bo Yu
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Corresponding authors

Correspondence to Jinwei Tian or Bo Yu.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical standard

The study was approved by the Ethics Committee of the Second Affiliated Hospital of Harbin Medical University (Harbin, China).

Human and Animal Rights

All patients provided written informed consent.

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Participants expressed their informed consent for participation in the study.

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Dong, N., Xie, Z., Dai, J. et al. Statin-induced improvements in vulnerable plaques are attenuated in poorly controlled diabetic patients with coronary atherosclerosis disease: a serial optical coherence tomography analysis. Acta Diabetol 53, 999–1008 (2016). https://doi.org/10.1007/s00592-016-0902-9

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  • DOI: https://doi.org/10.1007/s00592-016-0902-9

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