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European Heart Journal Advance Access originally published online on July 21, 2005
European Heart Journal 2005 26(21):2307-2312; doi:10.1093/eurheartj/ehi420
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

LDL-cholesterol predicts negative coronary artery remodelling in diabetic patients: an intravascular ultrasound study

Pilar Jiménez-Quevedo, Manel Sabaté*, Dominick Angiolillo, Fernando Alfonso, Rosana Hernández-Antolín, Camino Bañuelos, Esther Bernardo, Celia Ramirez, Raúl Moreno, Cristina Fernández, Javier Escaned and Carlos Macaya

Interventional Cardiology Unit, Cardiovascular Institute, Hospital Clínico San Carlos, C/Prof. Martín Lagos s/n, 28040 Madrid, Spain

Received 28 March 2005; revised 17 June 2005; accepted 23 June 2005; online publish-ahead-of-print 21 July 2005.

* Corresponding author. Tel: +34 91 3303283; fax: +34 91 3303289. E-mail address: manelsabate{at}telefonica.net

Aims To investigate the relationship between coronary artery remodelling and glycaemic and lipid profiles in diabetic patients.

Methods and results Intravascular ultrasound analyses of 131 angiographically non-significant coronary stenoses in 80 diabetic patients were performed. The remodelling index (RI) was calculated as the ratio between total vessel area at target site and total vessel area at proximal reference, and was assessed in two ways: as a continuous variable, and as a binary categorical variable: RI<1 namely, negative remodelling (group I), or RI≥1 (group II). Percentage cross-sectional narrowing was 57±13%. On average, RI was 0.93±0.13. Coronary shrinkage was found in 94 (71.7%) lesions. Significant inverse correlations were demonstrated between RI and total cholesterol (r=–0.26, P=0.003), apolipoprotein-B (r=–0.23, P=0.01) and LDL-cholesterol (r=–0.3, P=0.001) levels. Multivariable lineal regression analysis identified LDL-cholesterol as the only independent predictor of RI (P=0.001).

Conclusion Negative remodelling is a frequent finding in diabetics and it is associated with LDL-cholesterol levels. This may contribute to the diffuse coronary artery disease observed in diabetic patients.

Key Words: Coronary remodelling • Intravascular ultrasound • Diabetes mellitus • LDL-cholesterol • High-sensitivity C-reactive protein


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