scholarly journals Plasma apoC-III levels predict coronary severity and cardiovascular risks in stable coronary artery disease patients with diabetes or pre-diabetes: a prospective cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Peng ◽  
J.-J Li
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Glucose Metabolism ◽  
Cardiovascular Events ◽  
Diabetic Patients ◽  
Syntax Score ◽  
Cardiovascular Risks ◽  
Coronary Lesion ◽  
Artery Disease ◽  
Stable Cad

Abstract Background Apolipoprotein C-III (apoC-III) has been proposed to be involved in lipid and glucose metabolism and related to cardiovascular risks. The aim of this study is to investigate the association of apoC-III levels with coronary severity and cardiovascular outcomes in coronary artery disease (CAD) patients under different glucose metabolism status. Methods A total of 4342 consecutive patients with newly angiography-proven stable CAD were enrolled and categorized into three groups according to apoC-III levels and further stratified by glucose metabolism status [diabetes mellitus (DM), pre-DM, normal glucose regulation (NGR)]. Patients were followed for the occurrence of cardiovascular events (CVEs). Plasma apoC-III concentration was measured by enzyme immunoassay and coronary severity was assessed by number of diseased vessels, Gensini score and syntax score. The relationships of apoC-III levels with coronary severity and CVEs were evaluated. Results 389 (9.0%) CVEs were developed during a follow-up of 5.1 years. Plasma apoC-III levels were increased in prediabetic and diabetic patients with stable CAD. Elevated apoC-III levels were associated with more severe coronary lesion and the risk for CVEs. No significant differences in incident CVEs and coronary severity were observed between pre-DM and NGR groups. When combined glucose metabolism status and apoC-III levels as stratifying factors, patients with the highest apoC-III levels and pre-diabetic or diabetic patients with any levels of apoC-III had more sever coronary lesion and higher risk of subsequent CVEs compared to those with the lowest apoC-III levels and NGR. Conclusion Our data firstly found that elevated apoC-III levels were greatly associated with coronary severity and adverse cardiovascular events in stable CAD patients with pre-DM and DM, which suggested apoC-III may be a prognostic predictor among CAD patient with impaired glucose metabolism. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Atherogenic dyslipidaemia and cardiovascular events in patients with diabetes or pre-diabetes and stable coronary artery disease: a prospective, cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e037340
Author(s):  
Jing-Lu Jin ◽  
Ye-Xuan Cao ◽  
Li-Guo Wu ◽  
Xiang-Dong You ◽  
Na Guo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cohort Study ◽  
Coronary Artery ◽  
Glucose Metabolism ◽  
Cardiovascular Events ◽  
Stable Coronary Artery Disease ◽  
Significant Difference ◽  
Atherogenic Dyslipidaemia ◽  
Artery Disease ◽  
Stable Cad

ObjectiveThe aim of the study was to investigate the impacts of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) dyslipidaemia on prognosis in coronary artery disease (CAD) patients with different glucose metabolism status.DesignAn observational cohort study.Setting/participantsA total of 3057 patients with stable CAD were consecutively enrolled and divided into three groups according to different glucose metabolism status. Atherogenic dyslipidaemia (AD) was defined as TG ≥1.7 mmol/L and HDL-C <1.0 mmol/L for men or <1.3 mmol/L for women. The patients were further classified into six subgroups by status of AD. All subjects were followed up for the cardiovascular events (CVEs).Primary outcome measuresThe primary endpoints were cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke.ResultsDuring a median follow-up of 6.1 years, 308 (10.1%) CVEs occurred. No significant difference in the occurrence of CVEs was observed between normal glucose regulation (NGR) and pre-diabetes (pre-DM) groups (HR: 1.25, 95% CI 0.89 to 1.76) while DM group presented 1.45-fold higher risk of CVEs (HR: 1.45, 95% CI 1.02 to 2.05). When the participants were categorised according to combined status of two parameters, the cardiovascular risk was significantly elevated in pre-DM or DM plus AD group compared with the NGR plus non-AD group (HR: 1.76, 95% CI 1.10 to 2.80 and HR: 1.87, 95% CI 1.17 to 2.98).ConclusionsThe present study suggested that the presence of AD might affect the prognosis in patients with DM or pre-DM and stable CAD.

Concentrations of circulating adiponectin and adipocyte-fatty acid binding protein in patients with three-vessel coronary artery disease: a comparison with coronary lesion complexity as characterized by syntax score

2017 ◽  
Vol 43 (1) ◽  
pp. 30-39
Author(s):  
Cihan Coşkun ◽  
Alper Gümüş ◽  
Hümeyra Öztürk Emre ◽  
Birol Özkan ◽  
Selçuk Pala ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Fatty Acid ◽  
Coronary Artery ◽  
Fatty Acid Binding Protein ◽  
Syntax Score ◽  
Fatty Acid Binding ◽  
Coronary Lesion ◽  
Acid Binding Protein ◽  
Artery Disease ◽  
Stable Cad

AbstractObjective:In this study, we investigated the correlation between coronary lesion complexity as characterized by syntax score (SS) with circulating adiponectin and adipocyte-fatty acid binding protein (A-FABP4) concentrations in the presence of stable coronary artery disease affecting three coronary vessels (three-vessel stable CAD).Methods:The study groups consisted of 41 control subjects (28 males and 13 females, non-CAD group) and 115 affected subjects (79 males and 36 females, three-vessel stable CAD group). We divided into tertiles the three-vessel stable CAD group according to SS and estimated circulating concentrations of adiponectin and A-FABP4.Results:We did not find any correlation between the coronary lesion complexity with either the adiponectin and/or A-FABP4. We found lower the A-FABP4 of the non-CAD group than those of the groups with three-vessel stable CAD (p<0.001). Adiponectin were lower in DM subjects (p<0.05 for each group); though A-FABP4 were found to be higher (p<0.05 for each group) according to non-DM subjects in intra-group comparisons.Conclusion:Adiponectin is not a suitable parameter for demonstrating the existence of CAD or predicting coronary lesion complexity. A-FABP4 is more useful for the proof of the presence of CAD but A-FABP4 are not correlated with the severity of CAD.

Diabetes and outcomes following personalized antiplatelet therapy in coronary artery disease patients who underwent PCI

2021 ◽  
Author(s):  
Ying-Ying Zheng ◽  
Ting-Ting Wu ◽  
Yi Yang ◽  
Xian-Geng Hou ◽  
You Chen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Therapy ◽  
Bleeding Event ◽  
Diabetic Patients ◽  
Ischemic Event ◽  
Artery Disease ◽  
Stable Cad ◽  
Event Rates ◽  
Diabetes Patients

Abstract Background A personalized antiplatelet therapy guided by a novel platelet function testing (PFT), PL-12, is considered an optimized treatment strategy in stable coronary artery disease (CAD) patients undergoing PCI. However, the safety and efficacy of any dual antiplatelet therapy (DAPT) strategy may differ in relation to diabetes status. The aim of this study was to compare the outcomes of PFT-guided personalized DAPT in stable CAD patients with and without diabetes mellitus. Methods and results The PATH-PCI trial randomized 2285 stable CAD patients to either personalized antiplatelet therapy or standard antiplatelet treatment. We investigated the association and interaction of diabetes on clinical outcomes across two treatment groups. We did not find significant difference between the personalized group and the standard group in net adverse clinical events either in diabetes patients (10.3% vs. 13.4%, P=0.224) or in non-diabetic group (3.1% vs. 5.0%, P=0.064). In diabetes patients (n=646, 28.3%), the overall ischemic event rates were significantly low (6.8% vs. 11.3%, HR=0.586, 95%CI: 0.344-0.999, P=0.049) and the bleeding event rates did not differ between the two groups (3.5% vs. 3.3%, HR=1.066, 95%CI: 0.462-2.458, P=0.882). Similarly, in non-diabetic patients, the overall ischemic event rates were significantly low (1.8% vs. 4.2%, HR=0.428, 95%CI: 0.233-0.758, P=0.006) and the bleeding event rates did not differ between the two groups (1.6% vs. 0.9%, HR=1.802, 95%CI: 0.719-4.516, P=0.209). Conclusions The present study suggests that personalized antiplatelet therapy according to PFT can reduce ischemic events but not increase bleedings in stable CAD patients with or without diabetes who underwent PCI.

scholarly journals Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuai Chen ◽  
Ying Shen ◽  
Yong-Hua Liu ◽  
Yang Dai ◽  
Zhi-Ming Wu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Glycemic Control ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Syntax Score ◽  
Gensini Score ◽  
Artery Disease

Abstract Background We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM). Methods In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c). Results The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056–0.915, P = 0.037), Gensini score (β =  − 0.470, P < 0.001) and SYNTAX score (β =  − 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05). Conclusion Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.

scholarly journals The severity of coronary artery disease was not associated with non-alcoholic fatty liver disease in a series of 264 non-diabetic patients who underwent coronary angiography

2018 ◽  
Vol 56 (3) ◽  
pp. 167-172
Author(s):  
Taraneh Faghihi Langroudi ◽  
Habib Haybar ◽  
Saeed Alipour Parsa ◽  
Mohamad Mahjoorian ◽  
Isa Khaheshi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diabetic Patients ◽  
Syntax Score ◽  
Alcoholic Fatty Liver ◽  
Artery Disease ◽  
Alcoholic Fatty Liver Disease

Abstract Background. It is now suggested an association between non-alcoholic fatty liver disease (NAFLD) and the occurrence of coronary artery disease even in non-diabetic patients. We will determine the rate of NAFLD and its main determinants in non-diabetic patients undergoing coronary angiography. Methods. This cross-sectional study was accomplished on 264 patients who were candidates for coronary angiography during the year 2016. Coronary angiography has been done to depict the presence or absence of coronary involvement, and the severity of coronary artery disease by determining the number of vessels involved and also the SYNTAX score. During 48 hours after coronary angiography, the patients underwent abdominal ultrasonography for detection of NAFLD. Results. The overall prevalence of NAFLD in the patients was 72.3%. The prevalence of NAFLD in those with and without coronary involvement was 71.9% and 73.1% respectively, with no notable difference (p = 0.837). The mean SYNTAX score in the patients with and without NAFLD was 22.32 ± 11.10 and 21.75 ± 10.71 respectively with no difference (p = 0.702). According to the multivariable regression models, the presence of NAFLD could not predict the likelihood of coronary artery disease (OR = 0.879, p = 0.669) or its severity assessed by the SYNTAX score (beta = 0.046, p = 0.456). NAFLD grade was also not a determinant for coronary artery disease (OR = 1.139, p = 0.178) or its severity (beta = 0.058, p = 0.165). Conclusion. It seems that the presence and grade of NAFLD may not be correlated with atherosclerotic involvement of coronary arteries and its severity in non-diabetic patients. Future large studies and trials could elucidate the independent role of fatty liver in nondiabetic non-alcoholic patients.

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