Abstract 20455: Cholesterol Crystal as an Important Contributor to Plaque Instability in Type2 Diabetic Patients With Coronary Artery Disease: Insights From Optical Coherence Tomography Imaging Analysis

Background: Patients with type 2 diabetes mellitus (DM) exhibit a higher frequency of atherosclerotic cardiovascular events. Their atherosclerotic feature is characterized as the presence of large lipid core. Given that the accumulation of excessive lipids within vessel wall promotes cholesterol crystallization, leading to the upregulation of atherogenic inflammatory cascades, cholesterol crystal may be another important feature associated with vulnerable disease substrate in diabetic patients. We investigated the features of atherosclerotic plaques harbouring cholesterol crystal in patients with and without DM by optical coherence tomography (OCT). Methods: Culprit lesions in 99 patients with coronary artery disease (CAD) were imaged by OCT prior to percutaneous coronary intervention. Cholesterol crystal was defined as a thin, linear region with high signal intensity and backscattering. OCT-derived plaque features were compared in diabetic and non-diabetic subjects stratified according to the presence of...