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January 1, 2004Japanese Heart JournalOpen Access

The Influence of Diabetes Mellitus on Plaque Volume and Vessel Size in Patients Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study

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Why the study?

Does diabetes mellitus influence plaque volume and vessel size at reference segments in patients undergoing percutaneous coronary intervention?

Population

344 patients with 449 de novo coronary lesions undergoing elective percutaneous coronary intervention under…

Comparison

Diabetes mellitus vs Non-diabetic patients

Design

Cohort

Key result

Diabetes mellitus was associated with a significantly larger percentage of plaque area (50.4% vs 46.5%) and smaller lumen area at reference segments compared to non-diabetic patients undergoing percutaneous coronary intervention.

Authors

SIShigenori ItoTSTakahiko SuzukiOKOsamu Katoh

Discussion

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Overview

May prompt closer reference segment evaluation in diabetic PCI; leaves open effects on procedural and long-term outcomes.

Study Design

Type

Observational (n=344)

Multicenter

No

Structured PICO

Does diabetes mellitus influence plaque volume and vessel size at reference segments in patients undergoing percutaneous coronary intervention?

P
Population
344 patients (mean age 68.1 years, 18.9% female) undergoing elective percutaneous coronary intervention for de novo coronary lesions evaluated by intravascular ultrasound.
E
Exposure
Diabetes mellitus (including subgroups on insulin, oral hypoglycemic drugs, or diet/exercise therapy alone)
C
Comparator
Non-diabetic patients
O
Outcome
Vessel area (VA), lumen area (LA), plaque area, and % plaque area at proximal and distal reference segments measured by intravascular ultrasoundsurrogate

Main Result

Absolute Event Rate: 50.4% vs 46.5%

p-value: p=<0.001

Diabetic patients have smaller lumen areas and larger plaque burdens at reference segments, which may lead to undersized device selection if intravascular ultrasound guidance is not used during PCI.

Limitations

  • Quantitative coronary angiography was performed from a single view, leading to potential discrepancies with ultrasound measurements.
  • Retrospective study design with exclusion of some consecutive patients.
  • Inability to evaluate exact disease duration in all patients.
  • Exclusion of very long diffuse lesions may have underestimated plaque area in the diabetic group.

Cite This Study

Ito et al. (2004) conducted an observational in Coronary artery disease requiring percutaneous coronary intervention (n=344). Diabetes Mellitus vs. Non-diabetic patients was evaluated on Percentage plaque area (%PA) at reference segment (p=<0.001). Diabetes mellitus was associated with a significantly larger percentage of plaque area (50.4% vs 46.5%) and smaller lumen area at reference segments compared to non-diabetic patients undergoing percutaneous coronary intervention.

synapsesocial.com/papers/6aa9400907f6ffa79a0c0fe0https://doi.org/10.1536/jhj.45.573
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