Highlights
- •Fibrous cap thickness was negatively correlated with CD14++CD16+ monocyte levels.
- •CD14++CD16+ monocyte levels was an independent predictor for TCFA.
- •MAGE scores were significantly higher in patients with TCFA than in those without.
- •CD14++CD16+ monocyte levels correlated with MAGE score in non-DM patients.
Abstract
Background and aims
This study examined the impact of CD14++CD16+ monocytes on coronary plaque vulnerability, as assessed by optical coherence tomography
(OCT), and investigated their association with daily glucose fluctuation. Although
increased CD14++CD16+ monocyte levels have been reported to increase cardiovascular events, their impact
on coronary plaque vulnerability in coronary artery disease (CAD) patients with or
without diabetes mellitus (DM) remains unclear.
Methods
This prospective observational study included 50 consecutive patients with CAD, receiving
lipid-lowering therapy and undergoing coronary angiography and OCT. Patients were
divided into 3 tertiles according to the CD14++CD16+ monocyte percentages assessed by flow cytometry. Standard OCT parameters were assessed
for 97 angiographically intermediate lesions (diameter stenosis: 30–70%). Daily glucose
fluctuation was analyzed by measuring the mean amplitude of glycemic excursion (MAGE).
Results
CD14++CD16+ monocytes negatively correlated with fibrous cap thickness (r = −0.508, p < 0.01). The presence of thin-cap fibroatheroma (TCFA) was increased stepwise according
to the tertile of CD14++CD16+ monocytes (0 [tertile 1] vs. 5 [tertile 2] vs. 10 [tertile 3], p < 0.01). CD14++CD16+ monocytes were a significant determinant of TCFA (OR 1.279, p = 0.001). In non-DM patients, a significant relationship was found between CD14++CD16+ monocytes and MAGE (r = 0.477, p = 0.018).
Conclusions
CD14++CD16+ monocytes were associated with coronary plaque vulnerability in CAD patients with
well-regulated lipid levels both in DM and non-DM patients. Cross-talk between glucose
fluctuation and CD14++CD16+ monocytes may enhance plaque vulnerability, particularly in non-DM patients. CD14++CD16+ monocytes could be a possible therapeutic target for coronary plaque stabilization.
Keywords
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Article info
Publication history
Published online: January 15, 2018
Accepted:
January 11,
2018
Received in revised form:
November 17,
2017
Received:
September 7,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
