Key result
Lower GLP-1 response is linked to higher coronary plaque lipid content in non-diabetic ACS.
Why the study?
The relationship between plasma glucagon-like peptide-1 and coronary plaque characteristics in humans remains unclear.
Is plasma GLP-1 response associated with vulnerable coronary plaque characteristics in non-diabetic patients with acute coronary syndrome?
Observational (n=85)
No
Is plasma GLP-1 response associated with vulnerable coronary plaque characteristics in non-diabetic patients with acute coronary syndrome?
Absolute Event Rate: 57.3% vs 46.3%
p-value: p=<0.01
Low plasma GLP-1 response during an oral glucose tolerance test is associated with increased coronary plaque lipid content in non-diabetic ACS patients, suggesting increased plaque vulnerability.
Should not yet change practice in non-diabetic ACS; hypothesis-generating for GLP-1 response and plaque vulnerability.
BACKGROUND: The relationship between plasma glucagon-like peptide-1 (GLP-1) and coronary plaque characteristics in humans remains unclear. METHODS AND RESULTS: A total of 85 culprit coronary vessels excluding the 10-mm culprit segments in non-diabetic patients with acute coronary syndrome (ACS) were examined using integrated backscatter intravascular ultrasound, performed using a 40-MHz intravascular catheter before PCI. All patients underwent 75-g oral glucose tolerance test (OGTT), and the plasma GLP-1 response was evaluated on the basis of the area under the GLP-1 concentration-time curve (GLP-1 AUC) from 0 to 120 min. Patients in the low GLP-1 AUC tertile had a significantly greater percentage lipid area than did patients in the intermediate and high tertiles (low tertile vs. intermediate tertile vs. high tertile: 57.3 ± 12.1% vs. 47.2 ± 15.4% vs. 46.3 ± 12.7%, P<0.01, ANOVA) and a smaller percentage fibrosis area (38.1 ± 9.4% vs. 44.6 ± 11.5% vs. 45.7 ± 9.0%; P=0.01, ANOVA). On multiple regression analysis, low GLP-1 AUC tertile was independently associated with percentage lipid area. CONCLUSIONS: Low plasma GLP-1 during 75-g OGTT is associated with increased lipid content in non-diabetic patients with ACS, suggesting that plaque vulnerability is increased in this subgroup of patients.
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Mitsuhashi et al. (2015) conducted an observational in Non-diabetic acute coronary syndrome (n=85). Low plasma GLP-1 AUC vs. Intermediate and high plasma GLP-1 AUC was evaluated on Percentage lipid area of coronary plaque (p=<0.01). Low plasma GLP-1 levels during an oral glucose tolerance test were associated with a significantly greater percentage lipid area in coronary plaques (57.3% vs. 46.3% in the high tertile, P<0.01) in non-diabetic patients with acute coronary syndrome.
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