Macrophage accumulation within coronary arterial wall in diabetic patients with acute coronary syndrome: a study with in
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ORIGINAL INVESTIGATION
Cardiovascular Diabetology Open Access
Macrophage accumulation within coronary arterial wall in diabetic patients with acute coronary syndrome: a study with in‑vivo intravascular imaging modalities Takaaki Kogo, Takafumi Hiro* , Daisuke Kitano, Tadateru Takayama, Daisuke Fukamachi, Tomoyuki Morikawa, Mitsumasa Sudo and Yasuo Okumura This work was partly presented in the Annual Scientific Session of European Society of Cardiology, Barcelona, 2017.8
Abstract Background and aims: Macrophage accumulation in arteriosclerotic plaque of coronary arteries is involved in plaque destabilization. Atherosclerosis has been known to be progressive in patients with type 2 diabetes mellitus (DM). This study compared the features of 3-dimensional (3D) spatial distribution of macrophage accumulation within coronary artery wall between acute coronary syndrome (ACS) patients with DM (n = 20) and those without (non-DM, n = 20) by using intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Methods: The OCT-derived macrophage accumulation was measured within the proximal left anterior-descending artery. This measurement was performed for the whole vessel segment of interest, higher shear stress region (flow divider side) and lower shear stress region (the opposite side). Results: Normalized macrophage accumulation per unit length of the whole segment of interest was significantly larger in ACS patients with DM than without. In non-DM patients, macrophage density per IVUS-derived plaque volume was significantly higher in high shear stress region compared to low shear stress region, however, there was no significant difference between the two regions in DM patients. The macrophage density in the low shear stress region was significantly higher in the DM group than in the non-DM group. A multivariate analysis showed that the presence of DM was a major determinant for macrophage distribution. Conclusions: Macrophage accumulation was more abundant and homogeneous within coronary arterial wall in DM patients with ACS compared to non-DM patients, suggesting that plaque destabilization may occur more widely throughout coronary wall in DM patients. Keywords: Acute coronary syndrome, Diabetes mellitus, Macrophage, Optical coherence tomography, Shear stress
*Correspondence: hiro.takafumi@nihon‑u.ac.jp Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30‑1 Oyaguchi‑Kamicho Itabashi‑ku, Tokyo 173‑8610, Japan
Background The main cause of acute coronary syndrome (ACS) is rupture of coronary plaque followed by thrombus formation [1]. Macrophage has been reported to play an important role during various steps of atherosclerosis up
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