Liu SQ, Wang D, Tang CC. Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism. World J Diabetes 2025; 16(9): 107693 [DOI: 10.4239/wjd.v16.i9.107693]
Corresponding Author of This Article
Dong Wang, Department of Cardiology, Zhongda Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing 210009, Jiangsu Province, China. wangdong_seu@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Sep 15, 2025; 16(9): 107693 Published online Sep 15, 2025. doi: 10.4239/wjd.v16.i9.107693
Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism
Shi-Qi Liu, Dong Wang, Cheng-Chun Tang
Shi-Qi Liu, Cheng-Chun Tang, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Shi-Qi Liu, Dong Wang, Cheng-Chun Tang, Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China
Co-corresponding authors: Dong Wang and Cheng-Chun Tang.
Author contributions: Liu SQ, Wang D, and Tang CC conceived, designed, and refined this review; Liu SQ drafted the manuscript; Wang D and Tang CC contributed equally to this work as co-corresponding authors. All authors approved the final version to publish.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: April 1, 2025 Revised: May 10, 2025 Accepted: July 30, 2025 Published online: September 15, 2025 Processing time: 166 Days and 8.9 Hours
Abstract
The introduction of drug-eluting stents has significantly reduced the incidence of in-stent restenosis. Despite this, recurrent cardiovascular events related to untreated nontarget lesions (NTLs) are becoming more common and accounting for more than 50% of all recurrent cardiovascular events. In patients with diabetes, factors such as prolonged disease duration, poor glycemic control, insulin use, and inadequate lipid management may exacerbate the progression of NTLs and adverse cardiovascular events. Additionally, glycemic fluctuations have been linked to an increased risk of future cardiovascular events in patients with early glucose metabolism abnormalities and acute hyperglycemia. In this review, we explored the clinical and plaque characteristics of patients with diabetes and early glucose metabolism disorders, the percutaneous coronary intervention strategies for NTLs, and their prognostic implications. Furthermore, we investigated the mechanistic links between adverse cardiovascular outcomes and elevated inflammation, oxidative stress, hypercoagulability, and endothelial dysfunction.
Core Tip: The number of nontarget-related recurrent cardiovascular events is increasing. Poor glycemic control, insulin use, and dyslipidemia contribute to high-risk plaque progression. Early glucose metabolism abnormalities and glycemic fluctuations further increase cardiovascular risk. This review examines the clinical and plaque characteristics of these patients with diabetes and early glucose metabolism abnormalities, percutaneous coronary intervention strategies for nontarget lesions, and the mechanistic roles of inflammation, hypercoagulability, oxidative stress, and endothelial dysfunction in adverse cardiovascular outcomes.
