Impact of glucose fluctuation and monocyte subsets on coronary plaque rupture

Background and aims It remains unclear whether glycemic fluctuation can affect plaque rupture in acute myocardial infarction (AMI). Here we investigate the impact of glucose fluctuation on plaque rupture, as observed by optical coherence tomography (OCT), and monocyte subsets in patients with AMI. Methods and results We studied 37 consecutive patients with AMI. All patients underwent OCT examination, which revealed 24 patients with plaque rupture and 13 patients without plaque rupture at the culprit site. Peripheral blood sampling was performed on admission. Three monocyte subsets (CD14 + CD16 − , CD14 bright CD16 + , and CD14 dim CD16 + ) were assessed by flow cytometry. Glycemic variability, expressed as the mean amplitude of glycemic excursion (MAGE), was determined by a continuous glucose monitoring system 7 days after the onset of AMI. MAGE was significantly higher in the rupture patients than in the non-rupture patients ( P =0.036). Levels of CD14 bright CD16 + monocytes from the rupture patients were significantly higher than those from the non-rupture patients ( P =0.042). Of interest, levels of CD14 bright CD16 + monocytes correlated positively and significantly with MAGE ( r =0.39, P =0.02). Conclusion Dynamic glucose fluctuation may be associated with coronary plaque rupture, possibly through the preferential increase in CD14 bright CD16 + monocyte levels.