Key result
Post-discharge ambulatory glucose variability correlates with higher LCBI in non-target vessels.
Why the study?
The impact of in-hospital and ambulatory glucose variability on lipid core plaques in patients with coronary artery disease was unclear.
Does ambulatory glucose variability correlate more strongly with coronary plaque vulnerability than in-hospital glucose variability in patients undergoing PCI?
Observational (n=35)
Does ambulatory glucose variability correlate more strongly with coronary plaque vulnerability than in-hospital glucose variability in patients undergoing PCI?
Ambulatory glucose variability after discharge is significantly associated with higher coronary lipid core burden, suggesting a close link to coronary atherosclerosis vulnerability.
May signal higher non-target plaque vulnerability post-PCI; hypothesis-generating, needs prospective validation before practice implications.
The impact of in-hospital and ambulatory glucose variability (GV) on lipid core plaques (LCP) is unclear. We evaluated the relation of GV during hospitalization and after discharge to LCPs. A total of 35 patients undergoing percutaneous coronary intervention (PCI) under near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) guidance for acute myocardial infarction (MI) and stable coronary artery disease were prospectively included. LCP was evaluated with a lipid core burden index (LCBI) and a maximum LCBI in 4 mm (max LCBI4mm) in the non-target vessel using NIRS-IVUS. GV was measured by a flush glucose monitoring system. In-hospital mean amplitude of glucose excursion (MAGE) was significantly higher than that after discharge (73.4±26.8 vs. 66.0±22.8 mg/dl, p=0.03). In the entire study population, LCBI and maxLCBI4mm in the non-target vessel were correlated with MAGE after discharge (r=0.51, p=0.002 and r=0.39, p=0.02), but not significantly correlated with in-hospital MAGE. The relations of MAGE to higher LCBI and maxLCBI4mm were more evident in patients with acute MI. GV was greater during hospitalization than after discharge in patients undergoing PCI. Greater GV after discharge was significantly associated with higher LCBI and maxLCBI4mm, suggesting that ambulatory GV may be closely link to coronary atherosclerosis.
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Tateishi et al. (2022) conducted an observational in Coronary artery disease (n=35). Ambulatory glucose variability vs. In-hospital glucose variability was evaluated on Lipid core burden index (LCBI) and maximum LCBI in 4 mm (max LCBI4mm) in the non-target vessel (r=0.51 for LCBI, p=0.002). Ambulatory glucose variability after discharge was significantly correlated with higher lipid core burden index (r=0.51, p=0.002) and maxLCBI4mm (r=0.39, p=0.02) in the non-target vessel.
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