Abstract 3209: Impaired Glucose Tolerance is Associated With Positive Coronary Artery Remodeling in Non-diabetic Patients with ST-elevation Acute Myocardial Infarction

Previous studies in non-diabetic subjects have shown that impaired glucose tolerance (IGT), rather than abnormal fasting glucose, is associated with a higher incidence of acute myocardial infarction (AMI). Positive remodeling of coronary artery is a compensatory response to atherosclerotic plaque accumulation and is associated with plaque instability. We hypothesized that IGT, pre-stage of diabetes, is associated with positive coronary artery remodeling in non-diabetic patients with AMI. Intravascular ultrasound interrogation of culprit vessel was performed before percutaneous coronary intervention in 113 non-diabetic patients (94 men) with ST-elevation AMI. All patients underwent a 75g oral glucose tolerance test before discharge. Remodeling was defined as positive when external elastic membrane area (EEM) at the lesion site was greater than EEM for proximal and distal reference sites. Remodeling index was defined as lesion EEM divided by proximal EEM. Patients with IGT (n=75, 70%) had higher body mass index (25.1 vs 23.0 kg/m 2 , p=0.003), higher triglyceride levels (126 vs 90 mg/dL, p=0.015), and lower high-density lipoprotein cholesterol levels (45 vs 50 mg/dL, p=0.026) than those with normal glucose tolerance (NGT). The incidence of positive remodeling (61 vs 24 %, p