Plaque characterization of non-culprit lesions by virtual histology intravascular ultrasound in diabetic patients: Impact of renal function

SummaryBackgroundThe aim of this study was to characterize coronary plaque composition of non-target lesions in diabetic patients using virtual histology intravascular ultrasound (VH-IVUS).Methods and resultsIn 134 stable angina pectoris patients, plaque components of non-culprit (<50% in diameter stenosis) lesions in de novo target vessels were analyzed by VH-IVUS. Plaque characterization was compared between diabetic (n = 65) and non-diabetic groups (n = 69). Diabetic patients were further divided into four groups according to estimated glomerular filtration rate (eGFR, ml/min): eGFR ≥70 (n = 20), 50 ≤ eGFR < 70 (n = 19), GFR < 50 (n = 18), and end stage renal disease (ESRD) on hemodialysis (HD) (n = 11). There was no significant difference in plaque composition between the diabetic and the non-diabetic patients except for the percentage of dense calcium (8.9% vs. 6.2%; p < 0.05). In the diabetic patients, the percent volume of necrotic core was 9.6%, 11.4%, 14.8%, and 20.8% in the eGFR ≥70, 50 ≤ eGFR < 70, eGFR < 50, and the ESRD on HD groups, respectively, showing significantly higher percentage in eGFR < 50 (p < 0.05 vs. eGFR ≥ 70) and ESRD on HD group (p < 0.001).ConclusionsDiabetic patients have significantly larger amount of dense calcium than non-diabetic patients in non-culprit coronary artery segments, and the plaque components of non-culprit lesions in diabetes are significantly different according to the decline in renal function.