2018 年 4 巻 1 号 p. 33-38
Diabetes is characterized by hyperglycemia and certainly indicates various micro- and macro-vascular complications. Macro-vascular complications include ischemic coronary artery disease due to atherosclerosis, which is a leading cause of mortality in diabetic patients. Diabetic retinopathy (DR) is considered as a specific marker of micro-vascular complications and is included in the criteria for diagnosis of diabetes. The ultimate goal of diabetes treatment is to inhibit the progression of systemic atherosclerosis and prevent fatal cardiovascular events like acute coronary syndrome (ACS). Although diabetes involves both micro- and macro-vascular diseases, the relationship between DR and severity of coronary atherosclerosis, fundamental to ACS, is unclear. Moreover, the correlation of the degree of glucose metabolism disorder with coronary atherosclerosis remains unclear. The American Diabetes Association considers prediabetes as a high risk for diabetes and cardiovascular events in the future. However, coronary atherosclerosis in prediabetic patients has not been fully investigated.
Coronary angioscopy (CAS) is a useful intravascular imaging modality for assessing the characteristics of atherosclerotic plaques and its severity in vivo. Recently, CAS has shown the above relationships. Herein, we review the angioscopic findings and subsequent therapeutic implications in patients with glucose metabolism disorders.
