Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study
Background. Hyperglycemia is frequently observed in acute myocardial infarction (AMI). Diabetes mellitus (DM) patients and non-DM patients have different culprit lesion phenotypes and few data are available on non-DM patients with admission hyperglycemia. Therefore, we aimed to investigate the assoc...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/1763567 |
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| author | Jinying Zhou Zhaoxue Sheng Chen Liu Peng Zhou Jiannan Li Runzhen Chen Li Song Hanjun Zhao Hongbing Yan |
| author_facet | Jinying Zhou Zhaoxue Sheng Chen Liu Peng Zhou Jiannan Li Runzhen Chen Li Song Hanjun Zhao Hongbing Yan |
| author_sort | Jinying Zhou |
| collection | DOAJ |
| description | Background. Hyperglycemia is frequently observed in acute myocardial infarction (AMI). Diabetes mellitus (DM) patients and non-DM patients have different culprit lesion phenotypes and few data are available on non-DM patients with admission hyperglycemia. Therefore, we aimed to investigate the association between admission hyperglycemia and culprit lesion characteristics using optical coherence tomography (OCT) in AMI patients. Methods and Results. We consecutively enrolled 434 patients with AMI, and 277 patients were included in analysis: 65.7% (n=182) non-DM patients and 34.3% (n=95) DM patients. We measured acute blood glucose (ABG) and hemoglobin A1c to calculate the acute-to-chronic glycemic ratio (A/C). Then, we grouped non-DM patients into tertiles of A/C. OCT-based culprit lesion characteristics were compared across A/C tertiles in non-DM patients and between DM and non-DM patients. Non-DM patients had fewer lipid-rich plaques (52.7% versus 68.4%, p=0.012) and thin-cap fibroatheroma (TCFA) (19.8% versus 34.7%, p=0.006) than DM patients but similar prevalence of plaque rupture (47.3% versus 56.8%, p=0.130). Non-DM patients with the highest A/C tertile had the highest prevalence of plaque rupture (pfor trend=0.002), lipid-rich plaque (pfor trend=0.001), and TCFA (pfor trend=0.003). A/C>1.22 but not ABG>140 mg/dl predicted a high prevalence of plaque rupture, lipid-rich plaque, and TCFA in non-DM patients. Conclusions. In AMI patients without DM, admission hyperglycemia is associated with vulnerable culprit lesion characteristics, and A/C is a better predictor for vulnerable culprit plaque characteristics than ABG. These results call for a tailored evaluation and management of glucose metabolism in nondiabetic AMI patients. This trial is registered with NCT03593928. |
| format | Article |
| id | doaj-art-4a45354ba7d44bd3903a3cda43b7089f |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-4a45354ba7d44bd3903a3cda43b7089f2025-02-03T00:58:49ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/17635671763567Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography StudyJinying Zhou0Zhaoxue Sheng1Chen Liu2Peng Zhou3Jiannan Li4Runzhen Chen5Li Song6Hanjun Zhao7Hongbing Yan8Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaBackground. Hyperglycemia is frequently observed in acute myocardial infarction (AMI). Diabetes mellitus (DM) patients and non-DM patients have different culprit lesion phenotypes and few data are available on non-DM patients with admission hyperglycemia. Therefore, we aimed to investigate the association between admission hyperglycemia and culprit lesion characteristics using optical coherence tomography (OCT) in AMI patients. Methods and Results. We consecutively enrolled 434 patients with AMI, and 277 patients were included in analysis: 65.7% (n=182) non-DM patients and 34.3% (n=95) DM patients. We measured acute blood glucose (ABG) and hemoglobin A1c to calculate the acute-to-chronic glycemic ratio (A/C). Then, we grouped non-DM patients into tertiles of A/C. OCT-based culprit lesion characteristics were compared across A/C tertiles in non-DM patients and between DM and non-DM patients. Non-DM patients had fewer lipid-rich plaques (52.7% versus 68.4%, p=0.012) and thin-cap fibroatheroma (TCFA) (19.8% versus 34.7%, p=0.006) than DM patients but similar prevalence of plaque rupture (47.3% versus 56.8%, p=0.130). Non-DM patients with the highest A/C tertile had the highest prevalence of plaque rupture (pfor trend=0.002), lipid-rich plaque (pfor trend=0.001), and TCFA (pfor trend=0.003). A/C>1.22 but not ABG>140 mg/dl predicted a high prevalence of plaque rupture, lipid-rich plaque, and TCFA in non-DM patients. Conclusions. In AMI patients without DM, admission hyperglycemia is associated with vulnerable culprit lesion characteristics, and A/C is a better predictor for vulnerable culprit plaque characteristics than ABG. These results call for a tailored evaluation and management of glucose metabolism in nondiabetic AMI patients. This trial is registered with NCT03593928.http://dx.doi.org/10.1155/2020/1763567 |
| spellingShingle | Jinying Zhou Zhaoxue Sheng Chen Liu Peng Zhou Jiannan Li Runzhen Chen Li Song Hanjun Zhao Hongbing Yan Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study Journal of Diabetes Research |
| title | Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study |
| title_full | Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study |
| title_fullStr | Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study |
| title_full_unstemmed | Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study |
| title_short | Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study |
| title_sort | association between admission hyperglycemia and culprit lesion characteristics in nondiabetic patients with acute myocardial infarction an intravascular optical coherence tomography study |
| url | http://dx.doi.org/10.1155/2020/1763567 |
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