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European Heart Journal Advance Access published online on July 21, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi420
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received March 28, 2005
Revised June 17, 2005
Accepted June 23, 2005

Clinical research

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

Pilar Jiménez-Quevedo 1, Manel Sabaté 1*, Dominick Angiolillo 1, Fernando Alfonso 1, Rosana Hernández-Antolín 1, Camino Bañuelos 1, Esther Bernardo 1, Celia Ramirez 1, Raúl Moreno 1, Cristina Fernández 1, Javier Escaned 1, and Carlos Macaya 1

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

* To whom correspondence should be addressed.
Manel Sabaté, E-mail: manelsabate{at}telefonica.net


  Abstract

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.

Keywords: Coronary remodelling; Intravascular ultrasound; Diabetes mellitus; LDL-cholesterol; High-sensitivity C-reactive protein.
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