Diabetes Mellitus is Associated with Plaque Classified As Thin Cap Fibroatheroma: an Intravascular Ultrasound Study

We compared measures of ID coronary atherosclerosis between diabetic and non-diabetic patients enrolled in a prospective multinational IVUS registry. The region of interest was the most diseased 10 mm segment of a single coronary artery. Coronary plaque was quantified using greyscale IVUS and further classified by phenotype (ID-adaptive intimal thickening, ID-pathological intimal thickening, ID-TCFA, ID-fibroatheroma, or ID-fibrocalcific) using VH-IVUS. There was a non-significant trend for greater total plaque volume in diabetic (n=191) compared with non-diabetic (n=584) patients (94.8 vs. 88.1 mm(3), p=0.36, adjusted for multiple comparisons). There was a greater proportion of ID-TCFA among diabetic patients (21.6 vs. 13.6%, p=0.01 after adjustment for multiple comparisons; p=0.08 following multivariable adjustment for age and clinical demographics), while differences in pathological intimal thickening, fibroatheroma and fibrocalcific plaque were not significant between groups. ID-TCFA was more common in the most diseased 10 mm segment of diabetic than in non-diabetic coronary arteries. Multivariable adjustment demonstrated age and possibly the presence of diabetes to be independent predictors of ID-TCFA.