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Impact of diabetes mellitus on carotid atherosclerotic plaque inflammatory status in patients with coronary artery disease

Session Poster session 3

Speaker Konstantinos Toutouzas

Event : ESC Congress 2014

  • Topic : preventive cardiology
  • Sub-topic : Metabolic Syndrome, Insulin, Insulin Resistance
  • Session type : Poster Session

Authors : G Benetos (Athens,GR), K Toutouzas (Athens,GR), M Drakopoulou (Athens,GR), P Bounas (Athens,GR), A Katsaros (Athens,GR), A Michelongona (Athens,GR), H Grassos (Athens,GR), E Tsiamis (Athens,GR), E Siores (Bolton,GB), C Stefanadis (Athens,GR)

G. Benetos1 , K. Toutouzas1 , M. Drakopoulou1 , P. Bounas1 , A. Katsaros2 , A. Michelongona1 , H. Grassos1 , E. Tsiamis1 , E. Siores3 , C. Stefanadis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2Hippokration General Hospital, Deparment of Cardiothoracic Surgery - Athens - Greece , 3University of Bolton, Centre for Material Research and Innovation - Bolton - United Kingdom ,

European Heart Journal ( 2014 ) 35 ( Abstract Supplement ), 392

Purpose: Patients with diabetes mellitus (DM) are more prone to stroke than non-DM patients. Carotid atherosclerosis is a major cause of stroke. Although inflammation that is implicated in the progression of atherosclerosis seems to be pronounced in patients with DM, similar carotid plaque ultrasound characteristics and distributions have been shown in both patient-groups. The aim of this study was to evaluate the impact of DM on morphological and functional carotid artery characteristics in patients with documented coronary artery disease (CAD).

Methods: Consecutive patients (n=333) with significant CAD documented by coronary angiography were evaluated by: 1) ultra-sound echo-color Doppler (US-ECD) study of both carotid arteries, and 2) microwave radiometry (MR), a new noninvasive method, which allows the in vivo measurement of the internal temperature of tissues reflecting local inflammation. During ultrasound, intima-media thickness of common carotid arteries (ccIMT) was evaluated. Carotid plaques were identified as focal intima-media thickening ≥1.2mm and were evaluated for their thickness. ΔT by MR was defined as the maximum temperature difference of both carotid arteries. Vessel- and patient based analysis were performed to determine the impact of DM on morphological and functional carotid artery characteristics.

Results: Hundred-twenty seven patients had DM (38.1%). Carotid plaques were identified in 110 patients with DM and in 179 patients without DM (86.6 vs 86.9%, p=0.94). Patients with DM had similar ccIMT in both vessel- and patient-based analysis (0.97±0.20 versus 1.00±0.12mm, p=0.06; 0.94±0.02 versus 0.94±0.01 mm, p=0.93, respectively). Patients with DM had similar carotid plaque thickness in both vessel- and patient-based analysis (1.97±0.97 versus 2.07±1.10mm, p=0.23; 2.22±0.99 versus 2.47±1.23mm, p=0.06, respectively). Interestingly, patients with DM exhibited higher ΔT in both vessel- and patient-based analysis (0.81±0.66 versus 0.61±0.64°C, p<0.001; 1.05±0.62 versus 0.84±0.62°C, p=0.003, respectively).

Conclusions: Functional abnormalities may be more profound to structural changes in patients with non-significant carotid artery stenosis and DM. The impact of these functional carotid artery characteristics on patient prognosis still remains to be elucidated.

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