Utility of Platelet Indices in Assessing the Risk of Coronary Artery Disease in Patients of Diabetes Mellitus

Abstract Background: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR), are the indicators of increased platelet activity which may play a role in development of vascular complications in diabetic patients. This study was performed to evaluate and compare the platelet volume indices such as MPV, PDW, P-LCR in patients of type 2 diabetes mellitus (DM) with and without manifested coronary artery disease in order to identify their usefulness in determining the risk for development of coronary complications.Methods: Analytical cross - sectional study included 150 patients of which 100 patients were diagnosed as type 2 DM and 50 apparently healthy controls. The study cases were divided into two groups based on presence or absence of coronary artery disease. Group A included 50 cases of type 2 DM without manifested coronary artery disease and group B included 50 cases of type 2 DM with manifested coronary artery disease. PVI was obtained using automated cell counter.Results: MPV, PDW, P-LCR were significantly higher in diabetics as compared to controls subjects (P < 0.001 for all). However, no statistically significant difference was found between diabetics with and without manifested coronary artery disease.Conclusions: The study showed higher PVI in diabetic subjects when compared to control subjects, but no difference between patients with and without manifested coronary artery disease suggesting that various other factors might be associated with the pathogenesis of CAD in patients of DM.

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A study of prevalence of silent coronary artery disease in asymptomatic type II diabetes mellitus

10.17727/jmsr.2021/9-1 ◽

2021 ◽

Vol 9 (1) ◽

pp. 1-4

Author(s):

Moogaambiga S ◽

Kirubhakaran K ◽

Devi PL ◽

Santhosh P

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Diabetic Patients ◽

Treadmill Test ◽

Silent Coronary Artery Disease ◽

Artery Disease

Background: Cardiovascular disease is a major cause of morbidity and mortality in diabetics. However diabetic patients do not present with typical anginal symptoms or may be even asymptomatic and silent coronary artery disease (CAD) is prevalent in diabetics. Moreover silent CAD is not different from symptomatic CAD with respect to prognosis and adverse effects. Aim: The study was done to demonstrate the prevalence of silent myocardial ischemic changes in asymptomatic type 2 diabetes mellitus patients with normal resting ECG by doing a stress exercise test. Methodology: This descriptive study was done in 100 patients with type 2 diabetes more than 2 years who did not have any history of cardiovascular disease or symptoms. Detailed history was taken and investigations such as HbA1c, fasting and postprandial blood sugar, serum creatinine, urine examination were done. Resting ECG, Echocardiogram was found to be normal and they were subjected to a treadmill test. Results: Among the 100 participants 18 persons (18%) had positive ECG findings in treadmill test. A positive association was found between the duration of diabetes and prevalence of positive treadmill test. Conclusion: There is significant prevalence of silent CAD in diabetic patients and they tend to present with advanced disease at presentation and have poorer prognosis compared to non diabetic population. Hence it is necessary to screen early for silent CAD in diabetics to improve disease outcomes.

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Determination of Platelet Parameters with Impedance Automated Analyzers in Diabetic Patients with Coronary Artery Disease

Revista de Chimie ◽

10.37358/rc.19.4.7100 ◽

2019 ◽

Vol 70 (4) ◽

pp. 1242-1244

Author(s):

Maria-Cristina Apavaloaie (Vladeanu) ◽

Iris Bararu Bojan ◽

Oana Viola Badulescu ◽

Carmen Elena Plesoianu ◽

Daniela Jitaru ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Mean Platelet Volume ◽

Cardiovascular Complications ◽

Diabetic Patients ◽

Platelet Activity ◽

Platelet Volume ◽

Distribution Width ◽

The Mean ◽

Artery Disease

Atherosclerosis and platelet activity are two important chain factors linked together in the onset and the severity of coronary artery disease. Our study included 60 diabetic patients with ischemic heart disease, all having underwent coronary angiography. In this substudy from a larger epigenetical and genetical study, we phocused on the interrelationship between vessel disease and primary hemostasis. The haematological parameters included were platelet count (PLT), the platelet distribution width (PDW), the mean platelet volume (MPV) and the platelet larger cell ratio (P-LCR). ). The severity of the coronary disease was defined by the number of stenotic/occluded coronary arteries. We demonstrated a positive corelation with the duration of diabetes (p=0.032), as 34% of the patients with a long duration of the diabetes had a higher number of platelets. The mean platelet volume was slightly elevated in diabetic females over 65 years old, compared to younger diabetic men, though not statistically significant (p=0.101). Although the investigated parameters were mostly in the normal range, the fact that for some cathegories of patients they were orientated towards the upper limit, raises some questions for the next studies. Future adjustments of lot number and selection criteria for the following studies are needed. Using the MPV as a prediction test for cardiovascular complications is still a controversial subject, since the scientifical background contains both positive and negative studies on this matter.

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Association between Circulating Fibrinogen Level and Severity of Coronary Artery Disease in Type 2 Diabetic Patients with Chronic Stable Angina

Bangladesh Heart Journal ◽

10.3329/bhj.v35i2.52896 ◽

2021 ◽

Vol 35 (2) ◽

pp. 106-113

Author(s):

Md Sadaqul Islam Sikdar ◽

Md Mamunur Rashid ◽

Md Khalekuzzaman ◽

Iftekhar Alam ◽

Mst Nazmun Nahar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Stable Angina ◽

Chronic Stable Angina ◽

Diabetic Patients ◽

Gensini Score ◽

Artery Disease ◽

Vessel Score

Background: Prevalence of coronary artery disease (CAD) among Bangladeshi population is higher in urban than rural population. Among the conventional risk factors diabetes mellitus is a major concern for Bangladeshi population. Fibrinogen (Fg) in plasma is associated with severity of CAD in some populations with acute coronary syndrome. Objective: The aim of the study was to find out the correlation between circulating fibrinogen level and severity of coronary artery disease in patients with type 2 diabetes mellitus with chronic stable angina (CSA). Methods: The study was carried out in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka from October 2015 to March 2016.Total 132 patients with chronic stable angina (CSA) and type 2 diabetes mellitus who got admitted for coronary angiogram were included in the study and they were divided into 2 groups according to the on admission level of fibrinogen. Coronary angiogram (CAG) was performed in all patients. The severity of the CAD was assessed by angiographic vessel score and Gensini score. Results: Mean Gensini score was 27.0±22.3 vs 22.2±16.4 and mean vessel score 1.6±0.9 vs 1.2±1.0 in group I and group II respectively (p=0.03 and 0.04, respectively). There was positive correlation between Fg and CAD severity in term of vessel score (r=0.19) and Gensini score (r=0.15). Univariate and multivariate analysis revealed that dyslipidemia, smoking and elevated fibrinogen were the independently significant predictors of severe CAD in type 2 diabetic patients with CSA. Conclusion: Elevated plasma fibrinogen positively correlates with the severity of CAD in patients with diabetes mellitus having chronic stable angina. Bangladesh Heart Journal 2020; 35(2) : 106-113

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Stroke or coronary artery disease prediction from mean platelet volume in patients with type 2 diabetes mellitus

Platelets ◽

10.3109/09537104.2012.710858 ◽

2012 ◽

Vol 24 (5) ◽

pp. 401-406 ◽

Cited By ~ 32

Author(s):

Jung-Yeon Han ◽

Dong-Hyun Choi ◽

Seo-Won Choi ◽

Bo-Bae Kim ◽

Young-Jae Ki ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Mean Platelet Volume ◽

Disease Prediction ◽

Platelet Volume ◽

Artery Disease

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CHANGES IN PENTRAXIN-3 LEVEL AND ITS INTERACTION WITH METABOLIC INDICES IN PATIENTS WITH CORONARY ARTERY DISEASE AND TYPE 2 DIABETES MELLITUS

Wiadomości Lekarskie ◽

10.36740/wlek201902107 ◽

2019 ◽

Vol 72 (2) ◽

pp. 181-185 ◽

Cited By ~ 1

Author(s):

Pavlo G. Kravchun ◽

Olga I. Kadykova ◽

Dmitry G. Molotyagin

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Control Group ◽

Pentraxin 3 ◽

Type 2 Dm ◽

Artery Disease

Introduction: Recently great attention is paid to studying of coronary artery disease (CAD) pathogenesis against the background of the diabetes mellitus (DM). First of all, the question of an inflammatory component role in development of atherosclerosis in patients with DM 2 types is studied. One of new perspective markers of immune inflammation is pentraxin-3 (PTX-3). The aim of the study was to evaluate the nature of changes in the level of pentraxin-3 in patients with coronary artery disease, depending on the presence of type 2 diabetes mellitus and to investigate the nature of the relationship with metabolic parameters. Materials and methods: Comprehensive examination of 110 patients with CAD was conducted. Patients were divided into groups depending on presence of type 2 DM: to the first group (n = 75) entered patients with CAD and type 2 DM , the group of comparison was made by 35 patients with CAD without type 2 DM. 25 almost healthy persons entered into control group. Results: As a result of a research it is established the reliable increase in PTX-3 level in all patients with CAD in comparison with group of control for 65.40% . And in the conditions of the combined current of CAD and type 2 DM, PTX-3 level is for 80.14% higher, than in persons of control group. Also interrelation between PTX-3 and indicators of dcarbohydrate and lipidic exchanges were defines. According to the carried-out correlation analysis there was revealed existence of direct integral probable connections between PTX-3 level and levels of glucose (r = 0.41; p <0,05), insulin (r = 0.36; p <0,05), index of HOMA (r = 0.89; p <0,05), TG level (r = 0.74; p <0,05) and the return with the HDL (r = - 0.54; p <0,05). Conclusions: In patients with CAD with the accompanying type 2 DM it is established higher PTX-3 level, than in patients without type 2 DM and control group that demonstrates autoimune link activation. In the examined patients PTX-3 level increase was associated with violation of lipid and carbohydrate exchanges.

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Metabolic, inflammatory and imaging biomarkers in evaluation of coronary atherosclerosis severity in patients with coronary artery disease and diabetes mellitus type 2

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.09.201032 ◽

2021 ◽

Vol 93 (9) ◽

pp. 1030-1036

Author(s):

Olga A. Koshelskaya ◽

Olga A. Kharitonova ◽

Irina V. Kologrivova ◽

Tatiana E. Suslova ◽

Natalia Yu. Margolis ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Linear Regression ◽

Diabetes Mellitus Type 2 ◽

Diabetic Patients ◽

Group 2 ◽

Artery Disease

Aim. To study interconnections between epicardial adipose tissue thickness (EATt), parameters of glucose metabolism/insulin, C-reactive protein (hsCRP), serum adipokines and severity of coronary artery disease (CAD) depending on the presence of diabetes mellitus type 2 (DM 2); to determine significant markers of CAD severity in patients with DM 2. Materials and methods. The study involved 106 patients with CAD (m/f 64/42, 60.96.8 years), including patients with DM 2 (group 1, n=35) and non-diabetic patients (group 2, n=71). Severity of CAD was evaluated according to angiography data with calculation of Gensini Score (GS). EATt was assessed via echocardiography. Serum levels of glucose/insulin metabolism parameters, lipid fractions, hsCRP and adipokines were evaluated. Clinical parameters, including GS, did not differ between groups. Results. EAT thickness median was elevated in gr.1 (5.1 mm vs. 4.4 mm in group 2), while adiponectin levels were decreased (6.55 g/ml vs. 7.71 g/ml). Linear regression of body mass index and resistin levels on EATt was revealed in gr.1; in gr.2 EATt linearly increased with waist circumference increment when EATt6 mm. Linear regression of EATt on GS was revealed in gr.1 when EATt8 mm, while linear regression in the whole GS range was obtained for HDL-C and hsCRP levels. Conclusion. Study results demonstrate differences in mechanisms of deposition and functioning of epicardial and abdominal adipose tissue depending on the presence or absence of diabetic status. Patients with DM2 are characterized by the excessive EAT deposition and decrease of serum adiponectin levels compared to non-diabetic patients in the equal conditions. Independent markers of CAD severity in DM 2 are decreased HDL-C and increased hsCRP levels, but not EATt.

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Abstract #212 Association of Serum Insulin and Urinary Albumin with Occult Coronary Artery Disease in Patients with Type-2 Diabetes Mellitus

Endocrine Practice ◽

10.1016/s1530-891x(20)47058-2 ◽

2018 ◽

Vol 24 ◽

pp. 33-34

Author(s):

Sudhir Bhandari ◽

Senior ◽

Banshi Saboo ◽

Shashank Joshi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Serum Insulin ◽

Urinary Albumin ◽

Artery Disease

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Evaluation of aortic arch calcification in type 2 diabetic patients

VASA ◽

10.1024/0301-1526.34.2.113 ◽

2005 ◽

Vol 34 (2) ◽

pp. 113-117 ◽

Cited By ~ 4

Author(s):

Papanas ◽

Symeonidis ◽

Maltezos ◽

Giannakis ◽

Mavridis ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Aortic Arch ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Insulin Dependence ◽

Artery Disease ◽

Type 2 Diabetic ◽

Aortic Arch Calcification

Background: The purpose of this study is to evaluate the severity of aortic arch calcification among type 2 diabetic patients in association with diabetes duration, diabetic complications, coronary artery disease and presence of cardiovascular risk factors. Patients and methods: This study included 207 type 2 diabetic patients (101 men) with a mean age of 61.5 ± 8.1 years and a mean diabetes duration of 13.9 ± 6.4 years. Aortic arch calcification was assessed by means of posteroanterior chest X-rays. Severity of calcification was graded as follows: grade 0 (no visible calcification), grade 1 (small spots of calcification or single thin calcification of the aortic knob), grade 2 (one or more areas of thick calcification), grade 3 (circular calcification of the aortic knob). Results: Severity of calcification was grade 0 in 84 patients (40.58%), grade 1 in 64 patients (30.92%), grade 2 in 43 patients (20.77%) and grade 3 in 16 patients (7.73%). In simple regression analysis severity of aortic arch calcification was associated with age (p = 0.032), duration of diabetes (p = 0.026), insulin dependence (p = 0.042) and presence of coronary artery disease (p = 0.039), hypertension (p = 0.019), dyslipidaemia (p = 0.029), retinopathy (p = 0.012) and microalbuminuria (p = 0.01). In multiple regression analysis severity of aortic arch calcification was associated with age (p = 0.04), duration of diabetes (p = 0.032) and presence of hypertension (p = 0.024), dyslipidaemia (p = 0.031) and coronary artery disease (p = 0.04), while the association with retinopathy, microalbuminuria and insulin dependence was no longer significant. Conclusions: Severity of aortic arch calcification is associated with age, diabetes duration, diabetic complications (retinopathy, microalbuminuria), coronary artery disease, insulin dependence, and presence of hypertension and dyslipidaemia.

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