Widespread coronary inflammation is found in patients with diabetes and correlates with systemic inflammation, but not in patients with low systemic inflammation, researchers report.

Local coronary inflammation and systemic inflammation are increased in patients with diabetes. Konstantinos Toutouzas and co-workers (Athens Medical School, Greece) investigated whether there is a correlation between the two.

The study population comprised 104 consecutive patients undergoing percutaneous coronary intervention who had one angiographically determined coronary lesion and at least one angiographic noncoronary lesion, both less than 20 mm in diameter. Of these patients, 32 had diabetes (64 lesions) and 72 did not (144 lesions).

Intracoronary thermography was used to measure the temperature difference between the lesion and proximal vessel wall, as a measure of local inflammation, and C-reactive protein (CRP) levels as a measure of systemic inflammation.

Reporting in the journal Diabetes & Metabolism, the authors say that thermal heterogeneity was increased in both coronary and noncoronary lesions in patients with diabetes compared with the nondiabetic controls. In contrast, patients with diabetes had no difference in heat production for either coronary and noncoronary lesions, indicating widespread coronary inflammation.

CRP levels were higher in patients with diabetes compared with nondiabetic controls. Subgroup analysis revealed that patients with diabetes had a positive correlation between temperature difference and CRP, whereas in the nondiabetic patients there was no such correlation.

Among patients with low CRP, all the lesions in the patients with diabetes but only 66.1% of lesions in nondiabetic patients had a significant temperature difference in one or both lesions.

“Low systemic inflammatory activation in diabetes, as reflected by CRP levels, does not always predict local inflammatory activation in coronary and noncoronary lesions,” comment the authors.

“This means that extensive evaluation of atheromatous plaques, using interventional techniques, is required for patients with diabetes, as the systemic indices do not provide significant information in terms of the susceptibility of coronary lesions,” they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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