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Diabetes accompanied by more extensive atherosclerosis
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Diabetes was accompanied by inadequate compensatory remodeling, and accelerated plaque progression supported the need to develop new atherosclerotic strategies in patients with diabetes, according to findings from a new study.
Cleveland Clinic researchers conducted a randomized, controlled study comparing the pattern of arterial remodeling, extent of coronary atherosclerosis and disease progression in 2,237 patients with and without diabetes.
Patients with diabetes had a greater atheroma volume (40.2%) than patients without diabetes (37.5%; P<.0001), as well as greater total atheroma volume (199.4 mm3 vs. 189.4 mm3; P=.03).
Percent atheroma volume was more strongly correlated with HbA1c (r=0.22; P=.0003) than with fasting glucose (r=0.09; P<.0001). However, after controlling the study, the difference did not meet statistical significance, according to the researchers.
Patients with diabetes had an average lumen size of 291.1 mm3 compared with 306.5 mm3 in patients without diabetes (P=.005). The external elastic membrane volume was similar in patients with diabetes (494.9 mm3) and patients without diabetes (498.8 mm3).
There was more rapid progression of percent atheroma volume (0.6% vs. 0.05%; P=.0001) and total atheroma volume (–0.6 mm3 vs. –2.7 mm3; P=.03) in patients with diabetes, according to the researchers.
Smaller external elastic membrane volume (482.5 mm3 vs. 519.9 mm3; P=.03) and lumen volume (276.0 mm3 vs. 310.1 mm3; P=.001) were observed in patients with diabetes who were treated with insulin, according to the researchers; however, total atheroma volume was similar (206.5 mm3 vs. 209.9 mm3; P=.84).
For more information:
- J Am Coll Cardiol. 2008;52:255-262.