scholarly journals High serum levels of CML are associated with poor coronary collateralization in type 2 diabetic patients with chronic total occlusion of coronary artery

2022 ◽  
Author(s):  
Le Ying Li ◽  
Ying Shen ◽  
Shuai Chen ◽  
Fei Fei Li ◽  
Zhi Ming Wu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Roc Curve ◽  
Chronic Total Occlusion ◽  
Serum Levels ◽  
High Serum ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Total Occlusion

Abstract Background: The formation of advanced glycation end-products (AGEs) is a crucial risk factor for the pathogenesis of cardiovascular diseases. We investigated whether N-e-carboxy-methyl-lysine (CML), a major form of AGEs in vivo, was associated with poor coronary collateral vessel (CCV) formation in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) of coronary artery.Methods: This study consisted of 242 T2DM patients with angiographically documented CTO. Blood samples were obtained and demographic/clinical characteristics were documented. The collateralization of these patients was defined according to Rentrop score. Receiver operating characteristic (ROC) curve and multivariable regression analysis were performed.Results: 242 patients were categorized into poor CCV group (Rentrop score 0 and 1)(n = 107) and good CCV group (Rentrop score 2 and 3)(n = 135). Serum CML levels were significantly higher in poor CCV group (110.0 ± 83.35 ng/ml) than in good CCV group (62.95 ± 58.83 ng/ml, P<0.001). Moreover, these CML levels were also significantly different across the Rentrop score 0, 1, 2 and 3 groups (P <0.001). In ROC curve for ascertaining poor CCV, AUCs were 0.70 (95% CI 0.64-0.77) for CML. In multivariable logistic regression, CML levels (P<0.001) remained independent determinants of poor CCV after adjustment of traditional risk factors. Conclusions: This study suggests that higher CML levels are associated to poor CCV in T2DM patients with CTO. Inhibition of AGEs including CML is a strategy in antagonizing poor CCV in diabetic patients.

scholarly journals Reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Ying Shen ◽  
Feng Hua Ding ◽  
Yang Dai ◽  
Xiao Qun Wang ◽  
Rui Yan Zhang ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Total Occlusion ◽  
Type 2 Diabetic

scholarly journals Association of Circulating IgE and CML levels With in-Stent Restenosis After Drug-Eluting Stent Implantation in Type 2 Diabetic Patients With Stable Coronary Artery Disease

2021 ◽  
Author(s):  
Jing Meng Liu ◽  
Qiu Jing Chen ◽  
Lin Lu ◽  
Qi Jin ◽  
Yang Yang Bao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Coronary Artery Disease ◽  
Glycated Albumin ◽  
Serum Levels ◽  
Drug Eluting Stent ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Artery Disease

Abstract Background: We investigated whether serum levels of immunoglobin (Ig) E and Nε-carboxymethyl-lysine (CML) are related to in-stent restenosis (ISR) in patients with stable coronary artery disease and type 2 diabetes mellitus (T2DM).Methods: Serum levels of IgE and CML were measured in 416 stable angina patients with T2DM who received angiographic follow-up 12 months after percutaneous coronary intervention (PCI) with third-generation drug-eluting stent (DES) implantation for de novo lesions. Multivariate logistic regression analysis was performed to assess the association between IgE or CML and ISR. In mice models, femoral artery injury was induced in mice receiving albumin or glycated albumin injection, and immunofluorescence staining of the injured artery segment was performed 4 weeks later using CML and IgE antibodies. Results: Both IgE and CML levels were higher in patients with ISR (n=196) compared with non-ISR patients (n=220). The rate of ISR increased stepwise with increasing tertiles of IgE and CML levels, and IgE correlated significantly with CML. After adjusting for potential confounders, IgE and CML levels remained independently associated with ISR. IgE and CML levels improved the predictive capability of traditional risk factors for ISR, and there existed an interaction between IgE and CML in relation to ISR (P for interaction < 0.01). In mice models, glycated albumin induced increased CML and IgE infiltration in the injured femoral artery segment which was associated with a higher degree of neointimal hyperplasia and luminal stenosis.Conclusion: Elevated circulating IgE and CML levels confer an increased risk for ISR after DES-based PCI in type 2 diabetic patients with stable coronary artery disease.

scholarly journals Impact of coronary collateralization on long-term clinical outcomes in type 2 diabetic patients after successful recanalization of chronic total occlusion

2020 ◽  
Author(s):  
Zhen Kun Yang ◽  
Ying Shen ◽  
Yang Dai ◽  
Xiao Qun Wang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Total Occlusion ◽  
Repeat Revascularization ◽  
Type 2 Diabetic

Abstract Background: To assess the prognostic role of coronary collaterals in patients with type 2 diabetes mellitus (T2DM) after successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Methods: Coronary collateralization was graded according to Rentrop scoring system in 198 type 2 diabetic patients and 335 non-diabetics with stable angina undergoing PCI for at least one CTO lesion. Left ventricular ejection fraction (LVEF) was determined and major adverse cardio-cerebral events (MACCE) were recorded during follow-up. Results: Poor collateralization was more common in patients with T2DM than in non-diabetics (40% vs 29%, p=0.008). At 13.5±4.1 months, the rate of composite MACCE (17.3% vs 27.6%, p=0.034) and repeat revascularization (15.2% vs 25.5%, p=0.026) was lower and the increase in LVEF (3.10 % vs 1.80%, p=0.024) was greater in patients with good collaterals than in those with poor collaterals for non-diabetic group, but did not differ for T2DM group (35% vs 44%; 30% vs 36%; 2.14% vs 1.65%, respectively, all p>0.05) except for a higher all-cause mortality in diabetic patients with poor collaterals (p=0.034). Multivariable Cox proportional hazards analysis showed that coronary collateralization was an independent factor for time to MACCE (HR 2.155，95%CI 1.290-3.599, P=0.003) and repeat revascularization (HR 2.326, 95%CI 1.357-3.986, p=0.002) in non-diabetic patients, but did not enter the model in those with T2DM. Conclusions: T2DM is associated with reduced coronary collateralization. Successful revascularization of CTO lesions results in a mild improvement in left ventricular function, but t he status of coronary collaterals has no independent effect on long-term clinical outcomes in patients with T2DM.

scholarly journals Impact of coronary collateralization on long-term clinical outcomes in type 2 diabetic patients after successful recanalization of chronic total occlusion

2020 ◽  
Author(s):  
Zhen Kun Yang ◽  
Ying Shen ◽  
Yang Dai ◽  
Xiao Qun Wang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Total Occlusion ◽  
Repeat Revascularization ◽  
Type 2 Diabetic

Abstract Background: To assess the prognostic role of coronary collaterals in patients with type 2 diabetes mellitus (T2DM) after successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).Methods: Coronary collateralization was graded according to Rentrop scoring system in 198 type 2 diabetic patients and 335 non-diabetics with stable angina undergoing PCI for at least one CTO lesion. Left ventricular ejection fraction (LVEF) was determined and major adverse cardio-cerebral events (MACCE) were recorded during follow-up.Results: Poor collateralization was more common in patients with T2DM than in non-diabetics (40% vs 29%, p=0.008). At 13.5±4.1 months, the rate of composite MACCE (17.3% vs 27.6%, p=0.034) and repeat revascularization (15.2% vs 25.5%, p=0.026) was lower and the increase in LVEF (3.10 % vs 1.80%, p=0.024) was greater in patients with good collaterals than in those with poor collaterals for non-diabetic group. The associations were in the same direction for T2DM group (35% vs 44%; 30% vs 36%; 2.14% vs 1.65%, respectively) with a higher all-cause mortality in diabetic patients with poor collaterals (p=0.034). Multivariable Cox proportional hazards analysis showed that coronary collateralization was an independent factor for time to MACCE (HR 2.155，95%CI 1.290-3.599, P=0.003) and repeat revascularization (HR 2.326, 95%CI 1.357-3.986, p=0.002) in non-diabetic patients, but did not enter the model in those with T2DM.Conclusions: T2DM is associated with reduced coronary collateralization. The effects of the status of coronary collateralization on long-term clinical outcomes and left ventricular function appear to be similar in size in type 2 diabetic patients and non-diabetics after successful recanalization of CTO.

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