scholarly journals Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Pham Viet Thai ◽  
Hoang Anh Tien ◽  
Huynh Van Minh ◽  
Paul Valensi
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Epidemiologic Transition ◽  
Tyg Index ◽  
Asymptomatic Patients ◽  
Increased Risk

Abstract Background Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed. Results The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p < 0.05 to < 0.0001). TyG index correlated with logHOMA-IR (p < 0.0001). CS ≥ 50% were present in 60 participants and 32 had coronary artery stenosis ≥ 70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥ 70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p = 0.04 and < 0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy. Conclusion More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.

scholarly journals Triglyceride Glucose Index for the Detection of Asymptomatic Coronary Artery Stenosis in Patients With Type 2 Diabetes

2020 ◽  
Author(s):  
Pham Viet Thai ◽  
Hoang Anh Tien ◽  
Huynh Van Minh ◽  
Paul Valensi
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Epidemiologic Transition ◽  
Tyg Index ◽  
Asymptomatic Patients ◽  
Increased Risk

Abstract Background: Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods: This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed.Results: The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p<0.05 to <0.0001). TyG index correlated with logHOMA-IR (p<0.0001). CS ≥50% were present in 60 participants and 32 had coronary artery stenosis ≥70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p=0.04 and <0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy.Conclusion: More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.

scholarly journals Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

2020 ◽  
Author(s):  
Pham Viet Thai ◽  
Hoang Anh Tien ◽  
Huynh Van Minh ◽  
Paul Valensi
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Epidemiologic Transition ◽  
Asymptomatic Patients ◽  
Triglyceride Glucose Index ◽  
Increased Risk ◽  
Coronary Stenoses

Abstract Background Triglyceride Glucose index (TyG) was associated with an increased risk of cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing in parallel to the epidemiologic transition. The aim was in patients with type 2 diabetes and no history or symptom of cardiovascular disease, to assess the prevalence of coronary stenoses (CS) and investigate the association between TyG and cardiovascular risk factors and the presence and severity of CS. Methods We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed. Results The population was separated according to tertiles of TyG. Patients with highest TyG had higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose and HbA1c levels, lower HDL-cholesterol; more of them had a metabolic syndrome and less practiced physical activity (p<0.05 to <0.001). TyG correlated with HOMA-IR (p<0.001). CS ≥50% were present in 60 patients, with a coronary artery narrowing ≥70% in 32 of them. The patients with CS had higher TyG (p<0.05). The association of TyG with CS remained significant in a multivariate analysis including confounding risk factors. The number of narrowed vessels and the degree of stenosis were associated with higher TyG levels (p=0.04 and <0.005). TyG was significant in identifying patients with CS with an area under the ROC curve of 0.678 (95%CI: 0.582-0.775, p=0.002), a cut-off point of 9.63 offering 75% sensitivity and 44% specificity. In subgroup analysis the association TyG-CS was stronger in patients ≥60 yrs, with HbA1c≥7%, on statin or anti-platelet therapy. The AROC was higher with the triple criterion age-HbA1c-TyG than with age or HbA1c alone (p<0.001 for both comparisons). Conclusion More than one third of asymptomatic patients with type 2 diabetes had CS on CCTA. TyG may be considered as a marker of insulin resistance and allows to identify patients with high risk of coronary stenoses, particularly in those ≥ 60 yrs with poor glycemic control, and is associated with the number and the severity of narrowed branches.

scholarly journals Circulating Malondialdehyde-Modified LDL-Related Variables and Coronary Artery Stenosis in Asymptomatic Patients with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Kazuya Fujihara ◽  
Hiroaki Suzuki ◽  
Akira Sato ◽  
Satoru Kodama ◽  
Yoriko Heianza ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Characteristic Curve ◽  
Artery Stenosis ◽  
Related Variable ◽  
Modified Ldl ◽  
Luminal Narrowing ◽  
Asymptomatic Patients

Aims. To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM).Methods. Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis.Results. Seventeen patients had CAS. Each MDA-LDL-related variable was an independent predictor of CAS (P=0.039for MDALDL,P=0.013for MDA-LDL/LDL-C,P=0.047for MDA-LDL/HDL-C, andP=0.013for (MDA-LDL/LDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C were 0.675 (95% CI 0.496–0.854), 0.765 (0.602–0.927), 0.752 (0.592–0.913), and 0.799 (0.643–0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between MDA-LDL/LDL-C, MDA-LDL/HDL-C, or (MDALDL/LDL-C)/HDL-C and CAS (P=0.003for MDA-LDL/LDL-C,P=0.042for MDA-LDL/HDL-C, andP=0.001for (MDA-LDL/LDL-C)/HDL-C).Conclusions. Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MDA-LDL/LDL-C)/HDL-C are useful for predicting CAS.

scholarly journals The C allele of the reactive oxygen species modulator 1 (ROMO1) polymorphism rs6060566 is a biomarker predicting coronary artery stenosis in Slovenian subjects with type 2 diabetes mellitus

2020 ◽  
Author(s):  
Miha Tibaut ◽  
Sara Mankoč Ramuš ◽  
Daniel Petrovic
Keyword(s):  
Reactive Oxygen Species ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Stenosis ◽  
Reactive Oxygen ◽  
Artery Stenosis ◽  
Oxygen Species ◽  
Increased Risk

Abstract Background: We aimed to examine the role of the rs6060566 polymorphism of the reactive oxygen species modulator 1 (ROMO1) gene in the development of myocardial infarction (MI) in Caucasians with type 2 diabetes (T2DM).Methods: A total of 1072 subjects with T2DM were enrolled in this cross-sectional case-control study: 335 subjects with MI and 737 subjects without clinical signs of coronary artery disease (CAD). The genetic analysis of the rs6060566 polymorphism was performed in all subjects. To assess the degree of coronary artery obstruction, a subpopulation of 128 subjects with T2DM underwent coronary computed tomography angiography. Next, endarterectomy samples were obtained during myocardial revascularization from diffusely diseased coronary arteries in 40 cases, which were analysed for ROMO1 expression according to their genotype.Results: There were no statistically significant associations between different genotypes or alleles of the rs6060566 polymorphism and MI in subjects with T2DM. The carriers of the C allele of the ROMO1 rs6060566 had a threefold increased likelihood of having 50%-75% coronary artery stenosis (AOR= 3.27, 95% CI 1.16 – 9.20). Subjects with two affected coronary arteries had a 3.72 fold higher prevalence of MI (OR= 3.72, 95% CI 1.27 – 10.84). With CAD in LMCA or LAD, MI prevalence was about 3.5-fold higher (p=0.07 for LMCA and p=0.01 for LAD). Furthermore, the carriers of the rs6060566 C allele showed higher number of positive cells for ROMO1 expression in endarterectomy samples of coronary arteries.Conclusions: According to our study, the rs6060566 polymorphism of the ROMO1 gene is not a risk factor for MI in Caucasians with T2DM. However, we found that subjects carrying the C allele were at a 3.27-fold increased risk of developing severe CAD compared with those who had non-obstructive CAD. Moreover, C allele carriers showed a statistically higher number of cells positive for ROMO1 compared with T allele carriers in coronary endarterectomy samples.

scholarly journals The C Allele of the Reactive Oxygen Species Modulator 1 (ROMO1) Polymorphism Rs6060566 is a Biomarker Predicting Coronary Artery Stenosis in Slovenian Subjects With Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Miha Tibaut ◽  
Sara Mankoč Ramuš ◽  
Daniel Petrovic
Keyword(s):  
Reactive Oxygen Species ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Stenosis ◽  
Reactive Oxygen ◽  
Artery Stenosis ◽  
Oxygen Species ◽  
Increased Risk

Abstract Background: We aimed to examine the role of the rs6060566 polymorphism of the reactive oxygen species modulator 1 (ROMO1) gene in the development of myocardial infarction (MI) in Caucasians with type 2 diabetes (T2DM).Methods: A total of 1072 subjects with T2DM were enrolled in this cross-sectional case-control study: 335 subjects with MI and 737 subjects without clinical signs of coronary artery disease (CAD). The genetic analysis of the rs6060566 polymorphism was performed in all subjects. To assess the degree of coronary artery obstruction, a subpopulation of 128 subjects with T2DM underwent coronary computed tomography angiography. Next, endarterectomy samples were obtained during myocardial revascularization from diffusely diseased coronary arteries in 40 cases, which were analysed for ROMO1 expression according to their genotype.Results: There were no statistically significant associations between different genotypes or alleles of the rs6060566 polymorphism and MI in subjects with T2DM. The carriers of the C allele of the ROMO1 rs6060566 had a threefold increased likelihood of having 50%-75% coronary artery stenosis (Adjusted OR= 3.27, 95% CI 1.16 – 9.20). Subjects with two affected coronary arteries had a 3.72 fold higher prevalence of MI (OR= 3.72, 95% CI 1.27 – 10.84). With CAD in LMCA or LAD, MI prevalence was about 3.5-fold higher (p=0.07 for LMCA and p=0.01 for LAD). Furthermore, the carriers of the rs6060566 C allele showed higher number of positive cells for ROMO1 expression in endarterectomy samples of coronary arteries.Conclusions: According to our study, the rs6060566 polymorphism of the ROMO1 gene is not a risk factor for MI in Caucasians with T2DM. However, we found that subjects carrying the C allele were at a 3.27-fold increased risk of developing severe CAD compared with those who had non-obstructive CAD. Moreover, C allele carriers showed a statistically higher number of cells positive for ROMO1 compared with T allele carriers in coronary endarterectomy samples.

scholarly journals The C allele of the reactive oxygen species modulator 1 (ROMO1) polymorphism rs6060566 is a biomarker predicting coronary artery stenosis in Slovenian subjects with type 2 diabetes mellitus

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Miha Tibaut ◽  
Sara Mankoč Ramuš ◽  
Daniel Petrovič
Keyword(s):  
Reactive Oxygen Species ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Stenosis ◽  
Reactive Oxygen ◽  
Artery Stenosis ◽  
Oxygen Species ◽  
Increased Risk

Abstract Background We aimed to examine the role of the rs6060566 polymorphism of the reactive oxygen species modulator 1 (ROMO1) gene in the development of myocardial infarction (MI) in Caucasians with type 2 diabetes (T2DM). Methods A total of 1072 subjects with T2DM were enrolled in this cross-sectional case–control study: 335 subjects with MI and 737 subjects without clinical signs of coronary artery disease (CAD). The genetic analysis of the rs6060566 polymorphism was performed in all subjects. To assess the degree of coronary artery obstruction, a subpopulation of 128 subjects with T2DM underwent coronary computed tomography angiography. Next, endarterectomy samples were obtained during myocardial revascularization from diffusely diseased coronary arteries in 40 cases, which were analysed for ROMO1 expression according to their genotype. Results There were no statistically significant associations between different genotypes or alleles of the rs6060566 polymorphism and MI in subjects with T2DM. The carriers of the C allele of the ROMO1 rs6060566 had a threefold increased likelihood of having 50–75% coronary artery stenosis (Adjusted OR = 3.27, 95% CI 1.16–9.20). Subjects with two affected coronary arteries had a 3.72 fold higher prevalence of MI (OR = 3.72, 95% CI 1.27–10.84). With CAD in LMCA or LAD, MI prevalence was about 3.5-fold higher (p = 0.07 for LMCA and p = 0.01 for LAD). Furthermore, the carriers of the rs6060566 C allele showed higher number of positive cells for ROMO1 expression in endarterectomy samples of coronary arteries. Conclusions According to our study, the rs6060566 polymorphism of the ROMO1 gene is not a risk factor for MI in Caucasians with T2DM. However, we found that subjects carrying the C allele were at a 3.27-fold increased risk of developing severe CAD compared with those who had non-obstructive CAD. Moreover, C allele carriers showed a statistically higher number of cells positive for ROMO1 compared with T allele carriers in coronary endarterectomy samples.

scholarly journals Fractional Flow Reserve Derived from Computer Tomography in Asymptomatic Patients with Type 2 Diabetes and Albuminuria without Significant Coronary Artery Stenosis—A Surrogate for Coronary Microvascular Dysfunction?

Hearts ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 369-378
Author(s):  
Jess Lambrechtsen ◽  
Laurits Juhl Heinsen ◽  
Johanna Larsson ◽  
Gokulan Pararajasingam ◽  
Kenneth Egstrup
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Coronary Artery Stenosis ◽  
Microvascular Dysfunction ◽  
Coronary Microvascular Dysfunction ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Asymptomatic Patients

Background: Type 2 diabetes mellitus (T2D) patients with albuminuria have coronary microvascular dysfunction (CMD). Fractional flow reserve assessed by coronary computed tomography angiography (FFRct) is dependent on the structure and function of the microcirculation and is likely influenced by CMD. We aimed to evaluate if asymptomatic patients with T2D who had no significant coronary artery stenosis but had been diagnosed with albuminuria had lower value of nadir FFRct compared to asymptomatic patients with T2D and no albuminuria. Methods and results: This was a cross-sectional study which compared the mean nadir FFRct values in coronary arteries in patients with T2D who had no symptoms of angina. The T2D patients were divided into two groups (albuminuria and no albuminuria) with albuminuria being defined as albumin–creatinine-ratio (ACR) ≥30 milligram per gram. The nadir FFRct values were compared between the two groups for left anterior descendent artery (FFRct-LAD), circumflex artery (FFRct-CX), and right coronary artery (FFRct-RCA) by using a two-sample Wilcoxon rank-sum (Mann–Whitney) test. Ninety-eight patients without albuminuria and 26 patients with albuminuria were included. No significant differences in mean values were detected for FFRct-CX 0.86 ± 0.07 and 0.88 ± 0.0, FFRct-RCA 0.88 ± 0.05 and 0.88 ± 0.07, or for FFRct-LAD 0.82 ± 0.07 and 0.82 ± 0.07 in patients with albuminuria and without albuminuria, respectively. Conclusion: In this observational study, we did not find that FFRct was affected by CMD. Therefore, it is not a surrogate for microvascular dysfunction in asymptomatic T2D patients with albuminuria.

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