Effect of Diabetes on Progression of Coronary Atherosclerosis and Arterial Remodeling

• Published in: Journal of the American College of Cardiology 2008-07, Vol.52 (4), p.255-262
• Main Authors: Nicholls, Stephen J., MBBS, PhD, Tuzcu, E. Murat, MD, Kalidindi, Srinivasa, MD, MPH, Wolski, Kathy, MPH, Moon, Keon-W., MD, Sipahi, Ilke, MD, Schoenhagen, Paul, MD, Nissen, Steven E., MD
• Format: Article
• Language: English
• Subjects: atherosclerosis; Cardiovascular; coronary artery disease; diabetes; Internal Medicine; intravascular ultrasound; risk factors
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2008.03.051

Effect of Diabetes on Progression of Coronary Atherosclerosis and Arterial Remodeling: A Pooled Analysis of 5 Intravascular Ultrasound Trials Stephen J. Nicholls, E. Murat Tuzcu, Srinivasa Kalidindi, Kathy Wolski, Keon-W Moon, Ilke Sipahi, Paul Schoenhagen, Steven E. Nissen A systematic analysis was performed of 2,237 subjects in randomized controlled studies of atherosclerosis progression. In association with more risk factors, diabetic patients demonstrated more extensive atherosclerosis on multivariate analysis. Diabetic patients also exhibited a smaller lumen, but no difference in external elastic membrane volume, consistent with impaired compensatory arterial remodeling. This remodeling pattern was more notable in patients treated with insulin. More rapid atheroma progression was observed in diabetic patients, despite the use of medical therapies, which supports the need to develop new antiatherosclerotic strategies in diabetic patients.