Document Detail


Relationship Between Microalbuminuria and Vulnerable Plaque Components in Patients With Acute Coronary Syndrome and With Diabetes Mellitus.
MedLine Citation:
PMID:  21946357     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: The purpose of the present study was to use virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relationship between microalbuminuria and plaque components in 920 patients. Methods and Results: Patients with albumin levels <30mg/g creatinine were defined as having normoalbuminuria (n=824), and those with albumin levels 30-300mg/g as having microalbuminuria (n=96). The microalbuminuria group contained more patients with acute coronary syndrome (ACS; 72% vs. 61%, P=0.018) and more patients with diabetes (53% vs. 26%, P<0.001). In ACS patients, %necrotic core (NC) volume was significantly greater in the microalbuminuria group compared with the normoalbuminuria group (19±10% vs. 15±9%, P=0.019), but not in patients with stable angina. In ACS patients, thin-cap fibroatheroma (TCFA) was observed more frequently in the microalbuminuria group (36% vs. 18%, P=0.008), and microalbuminuria was the independent predictor of TCFA (odds ratio [OR], 1.106; 95% confidence interval [CI]: 1.025-1.144, P=0.018). In diabetic patients, %NC volume was significantly greater in the microalbuminuria group compared with the normoalbuminuria group (20±9% vs. 16±10%, P=0.017), but not in non-diabetic patients. In diabetic patients, TCFA was observed more frequently in the microalbuminuria group (38% vs. 17%, P=0.002) and microalbuminuria was the independent predictor of TCFA (OR, 1.120; 95%CI: 1.038-1.204, P=0.012). Conclusions: Microalbuminuria was associated with a higher number of vulnerable plaque components in ACS and diabetic patients. More intensive medical therapy is needed to stabilize the vulnerable plaque if microalbuminuria is observed in diabetic ACS patients.
Authors:
Young Joon Hong; Myung Ho Jeong; Yun Ha Choi; Jin A Song; Khurshid Ahmed; Dong Han Kim; Ki Hong Lee; Min Goo Lee; Keun Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Yoon; Kye Hun Kim; Hyung Wook Park; Ju Han Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-23
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Heart Center of Chonnam National University Hospital.
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