scholarly journals Prognostic Assessment of Diabetics Using Myocardial Perfusion Imaging: Diabetes Mellitus is Still a Coronary Artery Disease Equivalent

2017 ◽  
Vol 11 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Andrea De Lorenzo ◽  
Victor F. Souza ◽  
Leticia Glerian ◽  
Ronaldo SL Lima
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Diabetic Patients ◽  
Death Rates ◽  
Prognostic Assessment ◽  
Increased Risk ◽  
Risk Condition ◽  
Artery Disease

Background:Even though diabetes mellitus (DM) has been considered a “Coronary Artery Disease (CAD) equivalent”, that is still controversial, especially in a contemporary population subject to optimized treatment.Objective:We aimed to assess the cardiovascular risk of diabetics by myocardial perfusion scintigraphy (MPS).Methods:Consecutive patients who underwent MPS from 2008 to 2012 were studied. Perfusion scores were calculated, and abnormal MPS was defined as a summed stress score >3. Patients were followed for 3±1 years for all-cause death, which was compared between patients with DM (without known CAD) and patients with known CAD but without DM.Results:Among 3409 patients, 471 (13.8%) were diabetics without known CAD (DM group) and 638 (18.7%) had CAD without diabetes (CAD group). Annualized death rates were not significantly different between DM or CAD patients (0.9vs1.5%, p=0.09). With normal MPS, death rates were 0.7% for DM and 0.6% for CAD (p=0.8). With abnormal MPS, death rates increased similarly in the DM and CAD groups.Conclusions:In diabetic patients without known CAD, the rate of death was not significantly different from patients with prior CAD and without DM. Abnormal MPS increased risk similarly in diabetic patients and in those with CAD. These findings suggest that DM may still be considered a high-risk condition, comparable to known CAD, and effectively stratified by MPS.

Comparison of Extent and Severity of Coronary Artery Disease in Patients with and without Diabetes Mellitus Presenting with Non ST-Segment Elevation Myocardial Infarction

2020 ◽  
Vol 17 (2) ◽  
pp. 7-11
Author(s):  
Birat Krishna Timalsena ◽  
Rabi Malla ◽  
Arun Maskey ◽  
Sujeeb Rajbhandari ◽  
Aryan Parajuli ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Increased Risk ◽  
Artery Disease

Background and Aims: Diabetic patients are at increased risk of developing coronary artery disease. This study was conducted with the aim to compare the extent and severity of coronary artery disease in patients with and without diabetes presenting with non ST segment elevation myocardial infarction (NSTEMI). Methods: This was a single center, hospital based, cross sectional, observational comparative study in which total 172 patients presenting with NSTEMI were divided into two groups of 86 patients each based on presence or absence of diabetes mellitus. Demographic, laboratory and angiographic data were analysed and compared between two groups. Results: Among 86 patients enrolled in each group demographic characteristics and risk profile were not significantly different except for smoking status. Significant number of non-diabetics were current smoker (26.7% vs. 9.3%; p < 0.01). Hypertension was the most common risk factor in both groups. Non-diabetic patients had significantly high single vessel disease when compared to diabetics (11.6% vs 24.4%; p=0.03) while multivessel disease was significantly higher among diabetics (80.2% vs 59.3%; p<0.01). Diabetics had severe coronary artery disease with significantly high Gensini score (71.18±39.03 vs 59.84±33.68; p=0.04). There was no difference in terms of type of vessel affected. Conclusions: Diabetic patients presenting with NSTEMI are likely to have more severe and extensive coronary artery disease compared to non-diabetic patients.

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

2020 ◽  
Author(s):  
Ayesh Khatoon ◽  
Shakti Kumar Yadav ◽  
Sompal Singh ◽  
Harsh Vardhan Singh ◽  
Namrata Sarin
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Platelet Volume ◽  
Distribution Width ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Artery Disease

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.

scholarly journals IMMUNOLOGICAL STUDY OF CORONARY ARTERY DISEASE ASSOCIATED WITH DIABETES MELLITUS TYPE II IN IRAQI PATIENTS

2018 ◽  
Vol 11 (12) ◽  
pp. 269
Author(s):  
Mundher Jabbar Al-okhedi ◽  
Mohammed Qais Al-ani ◽  
Marrib N Rasheed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Levels ◽  
Control Group ◽  
Immunological Study ◽  
Increased Risk ◽  
Artery Disease

Objective: The objective of this study was to investigate the association between proinflammatory cytokines in special, the interleukin-6 (IL-6), and insulin-like growth factor (IGF-1) levels in coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM).Methods: This study was conducted from November 2017 to March 2018 in Anbar, Iraq. We studied a total of 90 individuals (46 men and 44 women) aged between 20 and 87 years. The samples were divided into four groups: CAD patients (n=23), T2DM patients (n=23), coronary artery disease and type 2 diabetes together in the same patient (n=23), and control group (n=21). The concentrations of IL-6 and IGF-1 were determined using a commercially available enzyme-linked immune sorbent assay.Results: The results of the present study showed that there were elevated serum levels of IL-6 and low levels of IGF-1 in all the tested groups, compared with the control. The difference was statistically significant at p<0.05. The results showed a positively correlated between IL-6 and IGF-1 in the CAD group and T2DM group, while it was a negative correlation between serum levels of IL-6 and IGF-1 in the T2DM+CAD group.Conclusion: Elevated levels serum of IL-6 predicts the development of CAD and T2DM. These data support a possible role for inflammation in diabetogenesis and complication of the cardiovascular disease. There is an inverse relationship between the levels serum of IGF-1 and increased risk of CAD and development of T2DM.

scholarly journals Comparative Study between Diabetic and non- Diabetic Patients Regarding Prevalence of Coronary Artery Disease and Plaque Composition by Multi-detector CT Coronary Angiography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Morsy ◽  
L A Habib ◽  
E H Abdeldayem ◽  
A I Sayed
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Artery Disease ◽  
Msct Angiography

Abstract Diabetes is known to be a major cardiovascular risk factor associated with significantly increased morbidity and mortality and particularly increased risk of major cardiac events especially myocardial infarction as a manifestation of highly incident coronary artery disease (CAD).This can lead to decreased life expectation and life quality. Major cause for myocardial infarction is plaque rupture. Prevalence of obstructive and non-obstructive plaques is increased in diabetic patients. Background and Objectives The prevalence of coronary heart disease in diabetic patients compared to non- diabetics and evaluating the composition of the plaque in diseased individuals in both groups by usage of multislice computed tomography (MSCT) angiography . Subjects and Methods A total of 80 consecutive MSCT angiography examinations were performed between August 2017 and June 2018. Of these, the patients were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing. Results Eighty (40 in the diabetic group and 40 in the non-diabetic group) patients underwent MSCT angiography with DM prevalence of 0.212 (95% Cl for AOR 0.056 -1.896). Among them, 20 patients (50 %) in the diabetic group and 14 patients (35 %) in the non-diabetic group had +ve coronary heart disease, 33.3 % had significant and moderately significant coronary narrowing on diabetic group and 31.3 % in non-diabetic group on MSCT angiography. Diabetic patients had more soft plaque compared with non-diabetic patients. Conclusion DM is not an independent factor for the disease occurrence in coronary artery disease but is a dependent factor in the association of other risk factors such as smoking ,hypertension and dyslipidemia.

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

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.

scholarly journals The Relationship Between Adiponectin Serum Level and Coronary Artery Disease in Type 2 Diabetic Patients

2021 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Saeed Choobkar ◽  
Ramin Khameneh Bagheri ◽  
Mina AkbariRad ◽  
Abdollah Firoozi
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Level ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Artery Disease

Adiponectin is an adipocytokine that has a higher serum level in healthy people. In type 2 diabetes, insulin resistance, hypertension, MI, and dyslipidemia, the serum level of adiponectin is lower than 4 µg/mL. Adiponectin is proved to have a protective role against atherosclerotic changes where its low serum levels in type 2 diabetes can lead to the progression of atherosclerotic lesions. In this study, we aimed to survey the possible effects of adiponectin in the development of coronary artery disease in type 2 diabetics. Thirty diabetic cases with coronary artery disease, 30 diabetic cases without known coronary artery disease, and a group of 30 healthy volunteers, all of them were between 18-65-year-old, were entered ourstudy. We gathered demographic data by performing a physical examination followed by filling a checklist and a set of laboratory tests. All the groups were sex and age-matched (P=0.284 and P=0.163 respectively). CAD group had the lowest HBA1C (P<0.001). Both LDL and HDL were also lower in the CAD group (P<0.001). Adiponectin was also lower in the CAD group when compared to other groups (P<0.008) or when compared with only normal diabetics (P<0.002). We found a correlation between adiponectin and HDL (r=0.348, P=0.008), suggesting each unit of reduction in serum level of adiponectin could increase the chance of coronary artery disease by 38% in diabetics. In this study, we showed that the lower serum level of adiponectin is correlated with an increased risk of coronary artery disease in type 2 diabetics.

COMPARISON OF METABOLIC PROFILE OF OBESE NON-DIABETIC PATIENTS WITH CORONARY ARTERY DISEASE DEPENDING ON ATORVASTATIN DOSE

2019 ◽  
Vol 72 (5) ◽  
pp. 846-850
Author(s):  
Tetiana Maksymets ◽  
Maria Sorochka ◽  
Olha Bondarenko ◽  
Natalia Karpyshyn ◽  
Olesia Bochar ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Metabolic Profile ◽  
Fasting Glucose ◽  
Overweight And Obesity ◽  
Diabetic Patients ◽  
Anthropometric Parameters ◽  
Increased Risk ◽  
Artery Disease

Introduction: Cardiovascular diseases (CVD) are one of the most important medical-biological and social problems in Ukraine and in the world because coronary artery disease (CAD) is a major cause of death and disability. Overweight and obesity are risk factor of CVD and type 2 diabetes mellitus (T2DM). Although statins have been shown to be beneficial in secondary prevention of CVD in a number of trials, current reports of increased risk of T2DM with statin use raise concerns. The aim: To compare the metabolic profile and therapeutic targets of non-diabetic obese patients with CAD depending on the dose of atorvastatin. Materials and methods: The study included 107 patients (82 men and 25 women) with CAD and abdominal obesity. Patients were divided into two groups: those taking 20 mg and 40 mg of atorvastatin daily correspondingly. Glucose, insulin, HbA1c, HOMA-IR, lipids, hs-CRP and anthropometric parameters were measured for each subject. Results: For patients with CAD and obesity, who had taken atorvastatin in a 40-mg dose, we observed a significant increase in insulin resistance and impaired fasting glucose. Also we found a reliable correlation between the carbohydrate and lipid spectrum. These parameters reflect the mechanism of the formation of metabolic disorders as a result of intensive statin therapy. Сonclusions: Despite of the beneficial reductions in LDL and total cholesterol, atorvastatin treatment on a dose 40 mg resulted in significant increase of fasting glucose, insulin levels and insulin resistance pertaining to those patients.

Abstract 6094: Alterations in Blood Flow Reserve Secondary to Decompensated Diabetes Mellitus - Preliminary Results Obtained by Myocardial Contrast Echocardiography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Natanael V Moraes ◽  
Carolina P Oliveira ◽  
Jeane Tsutsui ◽  
Antônio C Lerário ◽  
Wilson Mathias
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Contrast Echocardiography ◽  
Blood Glucose Control ◽  
Diabetic Patients ◽  
Flow Reserve ◽  
Artery Disease

Diabetes mellitus (DM) is one of the most important health problems in developed countries. Poor blood glucose control is known to be associated with clinical symptoms and increased risk for cardiovascular complications. Myocardial contrast echocardiography (MCE) has been demonstrated to be valuable for assessing myocardial blood flow reserve (MBFR) in patients with obstructive coronary artery disease and in those with microcirculatory alterations. We hypothesized that DM would result in impairment of MBFR, as measured by MCE, even in patients without obstructive coronary artery disease. Methods: We studied 30 patients with DM (mean age 55 years, 13 men) and 10 control subjects (mean age 53 years, 5 men) with normal global and regional systolic function. MBFR was determined by quantitative contrast echocardiography during dipyridamol (0.84 mg/Kg) stress using intravenous commercialy available microbubbles contrast (Definity, Bristol-Myers Squibb). Diabetic patients were studied in a decompensated state, with mean glycosylated hemoglobin of 9.0% (ranging from 8.5% to 13.0%). Quantification of peak myocardial intensity (A), microbubble velocity (Beta) and MBFR (peak dipyridamol/baseline AxBeta) were measured off line using Q-Lab software (Philips Medical Imaging). All patients underwent computed tomography coronary angiography (64 slices) which demonstrated no obstructive coronary artery disease. Results: Values of A (dB), Beta (1/s), and AxBeta (dB/s) both at baseline and during dipyridamol stress are described in Table . MBFR was significantly lower in patients with decompensated DM than in control subjects (1.58 versus 2.87; p<0.001). Conclusion: These preliminary results suggest that diabetic patients with poor blood glucose control and no obstructive coronary artery disease have impaired MBFR. MCE may be a useful noninvasive technique for evaluating changes in MBFR in this group of patients.

scholarly journals Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging

2021 ◽  
Author(s):  
Roberta Assante ◽  
Ciro Gabriele Mainolfi ◽  
Emilia Zampella ◽  
Valeria Gaudieri ◽  
Carmela Nappi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Suspected Coronary Artery Disease ◽  
Diabetic Patients ◽  
Event Free Survival ◽  
Free Survival ◽  
Patients With Diabetes ◽  
Artery Disease

Abstract Background We assessed the prognostic value of structural abnormalities and coronary vasodilator function in diabetic patients referred to a PET/CT for suspected coronary artery disease (CAD). Methods We studied 451 diabetics and 451 nondiabetics without overt CAD and normal myocardial perfusion. Myocardial blood flow (MBF) was computed from the dynamic rest and stress imaging. Myocardial flow reserve (MFR) was defined as ratio of hyperemic to baseline MBF and was considered reduced when < 2. Results During a mean follow-up of 44 months 33 events occurred. Annualized event rate (AER) was higher in diabetic than nondiabetic patients (1.4% vs 0.3%, P < .001). Diabetic patients with reduced MFR had higher AER compared to those with preserved MFR (3.3% vs 0.4%, P  < .001). At Cox analysis, age, BMI and reduced MFR were independent predictors of events in diabetic patients. Patients with diabetes and reduced MFR had lower event-free survival compared to nondiabetic patients and MFR < 2 (P < .001). Event-free survival was similar in patients with diabetes and normal MFR and those without diabetes and reduced MFR. Conclusions Diabetic patients with reduced MFR had higher AER and lower event-free survival compared to those with preserved MFR and to nondiabetic patients.

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