Glucose Variation Impacts Coronary Plaque Vulnerability

Findings in patients with coronary artery disease pretreated with lipid-lowering therapy

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TUESDAY, May 19, 2015 (HealthDay News) -- For patients with coronary artery disease (CAD) pretreated with lipid-lowering therapy, daily glucose fluctuation may affect coronary plaque vulnerability, according to a study published in the May issue of JACC: Cardiovascular Interventions.

Masaru Kuroda, M.D., from the Kobe University Graduate School of Medicine in Japan, and colleagues examined the effect of daily glucose fluctuation on coronary plaque properties in patients with CAD pretreated with lipid-lowering therapy. Seventy CAD patients who were referred for percutaneous coronary intervention and whose low-density lipoprotein cholesterol level was <120 mg/dL under statin treatment or <100 mg/dL without statins were enrolled. One hundred sixty-five lesions were assessed in 70 patients (40 with and 30 without diabetes).

The researchers found that the volume percentage of necrotic core within the plaque (percent NC) correlated with mean amplitude of glycemic excursion (MAGE; r = 0.490; P < 0.001). MAGE had the strongest effect on percent NC (coefficient β = 0.080; P < 0.001). MAGE was the only independent predictor of the presence of thin-cap fibroatheroma (odds ratio, 1.037; 95 percent confidence interval, 1.010 to 1.065; P = 0.007).

"Daily glucose fluctuation may have an effect on coronary plaque vulnerability in patients with CAD pretreated with lipid-lowering therapy," the authors write. "Further investigations should address the rationale for the early detection and control of glucose fluctuation in the era of universal statin use for CAD patients."

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