Author + information
- George Tzanis1,
- Maria Bonou2,
- Giorgos Benetos3,
- Smaragda Biliou4,
- Stavros Liatis5,
- Glafkos Kelepeshis6,
- Elias Sanidas7,
- George Anastasiadis8,
- Konstantinos Toutouzas9 and
- John Barbetseas2
- 1Dept. of Cardiology, Laiko General Hospital, Athens, Greece, Athens, Greece
- 2Dept. of Cardiology, Laiko General Hospital, Athens, Greece
- 3First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
- 4Cardiology Department, Laiko General Hospital, Athens, Greece
- 5First Department of Propaedeutic Internal Medicine, Diabetes Center, Athens, Greece
- 6Cardiology Department, Laiko General Hospital, Athens, Greece
- 7Dept. of Cardiology, Laiko General Hospital, Athens, Greece
- 8Department of Cardiology, Laiko General Hospital, Athens, Greece
- 9Athens Medical School, Athens, Greece
The role of vulnerable plaque inflammation seems to play a crucial role in coronary artery disease (CAD). Microwave radiometry (MWR) is a new, non-invasive, method allowing measurement of the temperature of tissues (reflecting inflammation) that designates vulnerable plaque by assessing thermal heterogeneity. Aim of this study was to evaluate the relation of carotid artery inflammation with glycemic control and with the diagnosis of CAD.
This prospective study included, with a 2:1 ratio, 69 patients (43 males, 66±9 yrs, 29±4 kg/m2) with diabetes mellitus (DM) and 31 patients without DM (20 males, 63±10 yrs, 30±5 Kg/m2) that were referred for diagnostic evaluation with coronary angiography (CA). All patients were evaluated for the temperature difference (ΔT) along each carotid artery with MWR, and the maximum temperature difference between the 2 carotid arteries (ΔTmax).
Patients with DM presented higher ΔTmax comparing to patients without DM (0.90±0.30 vs 0.74±0.26 °C, p<0.01) and glycaemia over time in patients with DM was associated with the thermal heterogeneity of carotids (Figure 1, Bars are mean±SE). Patients with CAD presented higher ΔTmax comparing to patients with normal CA (0.92±0.24 vs 0.70±0.26 °C, p<0.001), while patients that finally underwent coronary revascularization presented higher ΔTmax (0.94±0.25 vs 0.78±0.27 °C, p<0.005). Patients with 3-vessel disease had also higher ΔTmax (1.02±0.25 vs 0.85±0.22 °C, p=0.012), comparing to patients with 1-2 vessel disease. A ΔTmax>=0.9 (obtained by ROC curve analysis) was an independent predictor for revascularization, for all patients, when adjusted for sex, age and the established risk factors of CAD (odds ratio, 5.04; 95% confidence interval, 1.83–13.90; p=0.002).
Local inflammatory activation of carotid arteries is higher in patients with DM and is associated with the glycemic control. Carotids’ thermal heterogeneity is associated with the diagnosis of CAD and need for revascularization supporting its predictive value in CAD.
IMAGING: Vulnerable Plaque