Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Angiology ◽  
2018 ◽  
Vol 70 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Burak Açar ◽  
Ozcan Ozeke ◽  
Mustafa Karakurt ◽  
Yasin Ozen ◽  
Mustafa Bilal Özbay ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Coronary Atherosclerosis ◽  
Scoring Systems ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Atherosclerotic Burden ◽  
First Occurrence ◽  
And Control ◽  
The Impact

Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

scholarly journals The assessment of atherosclerosis on vascular structures in patients with acute coronary syndrome

2010 ◽  
Vol 33 (1) ◽  
pp. 36 ◽  
Author(s):  
Nihat Kalay ◽  
Mikail Yarlioglues ◽  
Idris Ardic ◽  
Mustafa Duran ◽  
Mehmet Gungor Kaya ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Brachial Artery ◽  
Coronary Atherosclerosis ◽  
Early Stage ◽  
Coronary Vessels ◽  
Gensini Score ◽  
Noninvasive Methods ◽  
Stenotic Lesion ◽  
Coronary Syndrome

Introduction: Endothelial dysfunction plays a crucial role in the process of atherosclerotic diseases and has been accepted as an early stage of atherosclerosis. Carotid intima-media-thickness (CIMT) and flow-mediated-dilatation (FMD) of the brachial artery have been recommended as noninvasive methods to assess endothelial structure and function. Angiographic properties of patients with acute coronary syndrome (ACS) are closely associated with cardiovascular events. In this study, we investigated the relation of atherosclerotic properties of coronary, brachial and carotid arteries with CIMT, FMD and coronary angiography in patients with ACS. Methods: We enrolled 133 patients who were diagnosed with ACS into this study. Exclusion criteria were known coronary artery disease, diabetes mellitus and hypertension. Coronary angiography, CIMT and FMD were measured in all patients. The numbers of major stenotic coronary vessels with ?50% or ?70% were defined as diseased vessel. Gensini score was used to evaluate the severity of atherosclerosis. Morphologic properties of stenotic lesion were defined. Cutoff levels were 7% for FMD and 0.9 mm for CIMT. Results: Mean age was 59.7±11.8 years. FMD, CIMT and Gensini score were 8.3±5.9%, 0.80±0.19 mm and 7.8±3.5, respectively. Only 44% of patients with ACS had impaired FMD. Gensini score, number of diseased vessels and number of critical lesions were higher in patients with impaired FMD. (Gensini: 8.7±3.6 vs. 7.0±3.1, p=0.009, diseased vessels: 2.7±0.4 vs. 2.3±0.7, p < 0.0001, critical lesions: 3.0±2.1 vs. 2.2±1.4, p=0.02). Increased CIMT was found in only 33% of patients. Gensini score and number of diseased vessels were significantly higher in patients with increased CIMT. Significant but weak correlations were found between CIMT, FMD and angiographic severity of coronary atherosclerosis. Angiographic properties and lesion morphology were similar between CIMT and FMD groups. Conclusion: There appears to be a relationship between CIMT, FMD and severity of coronary atherosclerosis in patients with ACS. However, in patients with ACS, morphologic properties of stenotic lesions are not associated with CIMT and FMD in brachial artery.

scholarly journals Polymorphism of Interleukin-1 Gene Cluster in Polish Patients with Acute Coronary Syndrome

2021 ◽  
Vol 10 (5) ◽  
pp. 990
Author(s):  
Tomasz Rechciński ◽  
Bożena Szymańska ◽  
Karina Wierzbowska-Drabik ◽  
Magdalena Chmiela ◽  
Agnieszka Matusiak ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Gene Cluster ◽  
Coronary Atherosclerosis ◽  
Age Of Onset ◽  
Interleukin 1 ◽  
Experimental Studies ◽  
Common Variants ◽  
Coronary Syndrome ◽  
The Impact ◽  
Il1b Gene

Background and objectives: Some experimental studies demonstrated adverse modulation of atherothrombosis by interleukin-1beta (IL-1b). To assess the relationship between the five most common variants of three polymorphisms of the IL1b gene cluster and the complexity of coronary atherosclerosis expressed in Gensini Score (GS), and the age of onset of the first acute coronary syndrome (ACS), we assessed the patients (pts) hospitalized due to ACS in this aspect. Materials and Methods: 250 individuals were included. The single nucleotide polymorphisms of IL1b gene: transition T/C at -31 position, C/T at -511, and those of IL1 receptor antagonist gene (IL1RN)—variable number of tandem repeats allele 1, 2, 3, or 4—were determined by PCR. GS was calculated from the coronary angiogram performed at the index ACS. The impact of the presence of T or C and allele 1 to 4 at the investigated loci on the mean GS, GS greater than 40, mean age of onset of ACS, and the fraction of pts over 60 years of age at ACS were compared between the five most common genotype variants. Results: The five most common variants were present in 203 pts (81.2%). Patients with pair 22 in ILRN had the lowest rate and those with pair 12 had the highest rate of ACS before 60 years of age (29.4 vs. 67.8%; p = 0.004). GS > 40 entailed an eight-fold increase of risk, as observed when pts with one T allele at locus -31 were compared with carriers of 2 or no T allele at this locus: OR 8.73 [CI95 4.26–70.99] p = 0.04. Conclusion: Interleukin-1 beta is subject to frequent genetic variability and our results show a potential relationship of this polymorphism with the extent of coronary atherosclerosis and age at the first ACS.

P6439Clinical outcomes of acute coronary syndrome with intact-fibrous cap plaque at the culprit lesions in diabetic and non-diabetic patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Niida ◽  
T Yonetsu ◽  
T Lee ◽  
M Nakao ◽  
S Nakagama ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Clinical Outcomes ◽  
Diabetic Patients ◽  
Culprit Lesion ◽  
Coronary Syndrome ◽  
Fibrous Cap ◽  
Significant Difference ◽  
The Impact ◽  
Lesion Morphology

Abstract Background Previous studies revealed that the morphological substrates of the culprit lesion assessed by optical coherence tomography (OCT) in acute coronary syndrome (ACS), which includes ruptured plaque (RP) and intact fibrous cap (IFC) plaque, are associated with subsequent clinical outcomes. Nevertheless, the impact of culprit morphology on clinical outcomes has not been evaluated in patients with diabetes mellitus (DM), which is one of the major determinants of clinical prognosis. Purpose We sought to investigate the association of the culprit lesion morphology with clinical outcomes in patients with DM and those without DM. Methods We retrospectively investigated a total of 508 patients with acute myocardial infarction (AMI) experiencing their first episode of ACS in whom OCT-guided, primary percutaneous coronary intervention (PCI) was performed and a culprit lesion was observed by OCT with sufficient image quality. Patients were divided into two groups according to the culprit lesion morphology into patients with RP (RP group) and those without RP (IFC group). The rate of major adverse cardiac events (MACE) including death, myocardial infarction, target or non-target lesion revascularizations were compared between RP and IFC groups in patients with DM (DM) and those without DM (non-DM), separately. Results MACE was captured in 80 patients during the median follow-up of 505 (IQR 274–1300) days. In non-DM, RP group showed significantly worse MACE-free rate than in IFC group (Figure), In DM, there was no significant difference between RP and IFC groups (Figure). Figure 1 Conclusion Culprit lesion morphology assessed by OCT was not associated with clinical outcomes in DM patients unlike non-DM patients. Distinct strategy for secondary prevention may be required for DM patients.

scholarly journals Takotsubo Cardiomyopathy Coexisting with Acute Pericarditis and Myocardial Bridge

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Seyed Hashem Sezavar ◽  
Neda Toofaninejad ◽  
Shokoufeh Hajsadeghi ◽  
Hassan Riahi Beni ◽  
Reza Ghanavati ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Takotsubo Cardiomyopathy ◽  
Unusual Case ◽  
Apical Ballooning ◽  
Signs And Symptoms ◽  
Myocardial Bridge ◽  
Acute Pericarditis ◽  
Coronary Syndrome ◽  
The Impact

Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy that occurs primarily in postmenopausal women. It mimics clinical picture of acute coronary syndrome with nonobstructive coronary arteries and a characteristic transient left (or bi-) ventricular apical ballooning at angiography. The exact pathogenesis of TCM is not well recognized. Hereby we present an unusual case of TCM that presents with signs and symptoms of acute pericarditis and was also found to have a coexisting coronary muscle bridge on coronary angiography. We discuss the impact of these associations in better understanding of the pathogenesis of TCM.

The Impact of Diabetes on Outcomes of Coronary Angiography in Patients with Low-risk Acute Coronary Syndrome

2011 ◽  
Vol 20 (6) ◽  
pp. 410
Author(s):  
J. Swampillai ◽  
M. Liang ◽  
R. Aspden ◽  
R. Fisher ◽  
G. Devlin
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Low Risk ◽  
Coronary Syndrome ◽  
The Impact
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