Early improvement in carotid plaque Echogenicity by Acarbose in patients with acute coronary syndromes

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Abstract

Background: The resolution of hyperglycemia is associated with suppression of in-hospital cardiac complications in patients with acute coronary syndromes (ACS). This study evaluated carotid artery plaque echolucency using ultrasound in patients with ACS and type 2 diabetes mellitus (DM) to determine whether acarbose, an α-glucosidase inhibitor, may rapidly stabilize unstable atherosclerotic plaques. Methods and Results: ACS patients with type 2 DM and carotid plaques (n=44) were randomly assigned to treatment with acarbose (150 or 300 mg/day, n=22) or a control group (no acarbose, n=22). Acarbose treatment was initiated within 5 days after the onset of ACS. Unstable carotid plaques were assessed by measuring plaque echolucency using carotid ultrasound with integrated backscatter (IBS) before, and at 2 weeks, 1 and 6 months after the initiation of treatment. An increase in the IBS value reflected an increase in carotid plaque ech ogenicity. As results,the IBS value of echolucent carotid plaques showed a significant increase at 1 month and a further increase at 6 months after treatment in the acarbose group, but there was minimal change in the control group. The increase in IBS values was significantly correlated with a decrease in C-reactive protein levels. Conclusions: Acarbose rapidly improved carotid plaque echolucency within 1 month of therapy in patients with ACS and type 2 DM.

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Hirano, M., Nakamura, T., Obata, J. ei, Fujioka, D., Saito, Y., Kawabata, K. ichi, … Kugiyama, K. (2012). Early improvement in carotid plaque Echogenicity by Acarbose in patients with acute coronary syndromes. Circulation Journal, 76(6), 1452–1460. https://doi.org/10.1253/circj.CJ-11-1524

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