Coronary Plaque Morphology And Characteristics In Patients With Raised Haemoglobin A1c: An Intravascular Ultrasound...

Area of Science:

• Cardiology
• Vascular Biology
• Metabolic Syndrome

Background:

• Elevated glycated haemoglobin (HbA1c) is a marker for diabetes and prediabetes, conditions linked to increased cardiovascular disease risk.
• Coronary plaque morphology plays a critical role in the pathophysiology of acute coronary syndrome (ACS).
• Intravascular ultrasound (IVUS) is a key imaging modality for assessing coronary plaque characteristics.

Purpose of the Study:

• To investigate coronary plaque morphology using grayscale and virtual histology intravascular ultrasound (IVUS).
• To compare plaque characteristics in patients with and without elevated HbA1c undergoing catheterization for ACS.
• To identify differences in plaque vulnerability based on glycemic status.

Main Methods:

• A cross-sectional study involving 52 adult patients with ACS undergoing coronary angiography and IVUS.
• Patients were categorized into three groups: diabetic (Group A), prediabetic with elevated HbA1c (Group B), and normal HbA1c (Group C).
• Analysis of Variance (ANOVA) was used to compare intergroup differences in clinical and IVUS-derived plaque characteristics.

Main Results:

• Thin-cap fibroatheroma (TCFA) was significantly more prevalent in patients with elevated HbA1c (Groups A and B) compared to those with normal HbA1c (Group C) (p=0.045).
• No significant differences in age or gender distribution were observed across the three groups.
• The study included 34.6% diabetic, 32.7% prediabetic, and 32.7% normal HbA1c patients.

Conclusions:

• Patients with elevated HbA1c, even in the prediabetic range, exhibit a higher proportion of vulnerable coronary plaque types.
• These findings suggest that elevated HbA1c is associated with increased plaque instability in ACS patients.
• Glycemic control may be a crucial factor in mitigating vulnerable plaque formation and reducing ACS risk.