scholarly journals Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors

Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 314 ◽  
Author(s):  
Cosmin Mihai Vesa ◽  
Loredana Popa ◽  
Amorin Remus Popa ◽  
Marius Rus ◽  
Andreea Atena Zaha ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Cardiovascular Complications ◽  
Current Data ◽  
Coronary Syndrome ◽  
Cardiovascular Morbidity And Mortality ◽  
Severe Atherosclerosis ◽  
Artery Disease ◽  
The Moment

Reducing cardiovascular risk (CVR) is the main focus of diabetes mellitus (DM) management nowadays. Complex pathogenic mechanisms that are the subject of this review lead to early and severe atherosclerosis in DM patients. Although it is not a cardiovascular disease equivalent at the moment of diagnosis, DM subjects are affected by numerous cardiovascular complications, such as acute coronary syndrome, stroke, or peripheral artery disease, as the disease duration increases. Therefore, early therapeutic intervention is mandatory and recent guidelines focus on intensive CVR factor management: hyperglycaemia, hypertension, and dyslipidaemia. Most important, the appearance of oral or injectable antidiabetic medication such as SGLT-2 inhibitors or GLP-1 agonists has proven that an antidiabetic drug not only reduces glycaemia, but also reduces CVR by complex mechanisms. A profound understanding of intimate mechanisms that generate atherosclerosis in DM and ways to inhibit or delay them are of the utmost importance in a society where cardiovascular morbidity and mortality are predominant.

scholarly journals Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohd Iqbal Dar ◽  
Jahangir Rashid Beig ◽  
Iqra Jan ◽  
Tariq Rashid Shah ◽  
Muzaffar Ali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Type 2 Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Syndrome ◽  
Cardiovascular Prognosis ◽  
Artery Disease

Abstract Background Acute coronary syndrome (ACS) indicates the serious clinical manifestation of coronary artery disease (CAD) and is closely associated with cardiovascular prognosis in patients with ACS. This study was aimed to study the prevalence of type 2 diabetes mellitus (T2DM) and the relation of HbA1c with the severity of CAD in patients presenting as non-diabetic ACS. Diabetic status of the patients was assessed with fasting blood sugar (FBS) and HbA1c levels, and coronary artery disease burden was assessed by coronary angiography. Results Out of 208 patients, 85.1% were males, and 14.9% were females; 73.56% cases were hypertensive. 80.77% of cases had STEMI, 17.79% had NSTEMI, and 1.44% had unstable angina. Out of 168 STEMI patients, 64.3% were thrombolysed, 21.42% presented late, 2.38% had contraindications to thrombolysis, and 11.9% underwent primary PCI. FBS in diabetic range was found in 44.23% of cases, impaired FBS in 36.54%, and 19.23% of patients had FBS in non-diabetic range. According to HbA1c, 41.8% were diabetic, 39.4% were pre-diabetic, and 18.8% were non-diabetic. A significant positive correlation was found between HbA1c and Gensini score and between HbA1c and the number of vessels involved. Conclusion This study emphasises the importance of evaluating the presence of diabetes in patients presenting as non-diabetic acute coronary syndrome in developing countries. Acute coronary syndrome may be considered as one of the presentations of diabetes mellitus.

scholarly journals Polycystic ovary syndrome and cardiovascular risk

2019 ◽  
Vol 24 (6) ◽  
pp. 654-665
Author(s):  
P. V. Popova ◽  
I. V. Gorelova ◽  
E. N. Grineva
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Cardiovascular Morbidity And Mortality

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. In addition to hyperandrogenism, impaired ovulation and fertility, PCOS is associated with an increased detection of cardiovascular risk factors such as obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension, and obstructive sleep apnea. The initial stages of the atherosclerotic process are also well documented in women with PCOS. However, data from prospective studies on the end points of cardiovascular morbidity and mortality are scarce and controversial. Perhaps this is due to the fact that PCOS is a heterogeneous group of endocrine, metabolic and reproductive disorders, and different authors consider various combinations of these disorders as the syndrome. Different phenotypes of PCOS may be associated with different cardiovascular risk. Women with a “complete” phenotype (a combination of all three PCOS diagnostic criteria) and with the predominant hyperandrogenism have higher risk. According to a number of studies, obesity affects more than half of women with PCOS and contributes the most to the increased risk of type 2 diabetes mellitus. Despite the weakness of the evidence regarding the association of PCOS with cardiovascular morbidity and mortality, most international organizations recommend active screening for cardiovascular risk factors in women with PCOS.

scholarly journals High cardiovascular risk of patients with type 2 diabetes is only partially attributed to angiographic burden of atherosclerosis

2020 ◽  
Vol 17 (5) ◽  
pp. 147916412095361
Author(s):  
Simone Battermann ◽  
Andrea Milzi ◽  
Rosalia Dettori ◽  
Kathrin Burgmaier ◽  
Nikolaus Marx ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Quantitative Coronary Angiography ◽  
High Cardiovascular Risk ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Angiographic Data ◽  
Artery Disease ◽  
Stable Cad

Background: Patients with type 2 diabetes (T2DM) are at high risk for cardiovascular events and present more severe coronary artery disease (CAD). The Gensini and COURAGE scores are established angiographic instruments to assess CAD severity, which may also predict future cardiovascular risk. However, it is unclear if these scores are able to depict the increased risk of patients with T2DM and stable CAD (T2DM-SAP). Methods: We performed quantitative coronary angiography and assessed the Gensini and COURAGE scores in 124 patients with T2DM-SAP. Angiographic data were compared to patients with stable angina without T2DM (Non-DM-SAP, n = 74), and to patients with acute coronary syndrome and T2DM (T2DM-ACS, n = 53). Results: T2DM-SAP patients had similar Gensini and COURAGE-scores compared to Non-DM-SAP-patients (Gensini: 14.44 ± 27.34 vs 11.49 ± 26.99, p = 0.465; COURAGE: 3.48 ± 4.49 vs 3.60 ± 4.72, p = 0.854). In contrast, T2DM-SAP patients had significantly lower Gensini (14.44 ± 27.34 vs 30.94 ± 48.74, p = 0.003) and lower COURAGE (3.48 ± 4.49 vs 5.30 ± 4.63, p = 0.016) scores compared to T2DM-ACS-patients. Conclusion: Both the Gensini and the COURAGE score fail to predict the high cardiovascular risk of patients with T2DM-SAP. Therefore, these scores should be used with caution in the assessment of future risk of patients with T2DM. However, among T2DM-ACS patients, both scores are increased, reflecting the high cardiovascular risk in this patient population.

scholarly journals Modern approaches to management of cardiovascular risk factors at patients with diabetes mellitus type 2

2018 ◽  
Vol 90 (8) ◽  
pp. 113-117
Author(s):  
A F Verbovoy ◽  
A V Pashentseva ◽  
N I Verbovaya ◽  
I V Madyanov ◽  
L A Sharonova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Diabetes Mellitus Type 2 ◽  
Independent Risk Factor ◽  
Cardiovascular Complications ◽  
The World ◽  
Patients With Diabetes ◽  
Dm Type 2

Diabetes mellitus (DM) type 2 is the serious progressing chronic disease representing independent risk factor of development of cardiovascular complications. The mortality from cardiovascular diseases at the persons suffering from DM type 2 continues to grow around the world, despite constant augmentation of expenses on treatment and prophylaxis. In this article factors of cardiovascular risk at DM are analyzed and possible ways of their correction are surveyed.

Prognostic value of uric acid in patients with Type 2 diabetes mellitus and coronary artery disease

2012 ◽  
Vol 124 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Gjin Ndrepepa ◽  
Siegmund Braun ◽  
Lamin King ◽  
Salvatore Cassese ◽  
Tomohisa Tada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
All Cause Mortality ◽  
Artery Disease

Studies investigating the prognostic role of UA (uric acid) in patients with Type 2 diabetes mellitus have given conflicting findings. We undertook the present study to assess the association between UA and outcome in patients with Type 2 diabetes mellitus and CAD (coronary artery disease). The study included 3705 patients with diabetes mellitus and angiography-proven CAD. UA was measured before coronary angiography. The primary outcome was 1-year all-cause mortality. The UA concentration [median (25th–75th quartiles)] was 6.44 mg/dl (5.40–7.70 mg/dl). There were 264 deaths (7.1%) during follow-up: 45 deaths in patients of the first UA quartile, 43 deaths in patients of the second UA quartile, 51 deaths in patients of the third UA quartile and 125 deaths in patients of the fourth UA quartile {Kaplan–Meier estimates of mortality, 5.1, 4.8, 5.6 and 14.0% respectively; unadjusted HR (hazard ratio), 2.81 [95% CI (confidence interval), 2.21–3.58]; P<0.001 for fourth quartile compared with first–third quartiles combined}. In the multivariable analysis, UA predicted all-cause mortality with an adjusted HR of 1.29 (95% CI, 1.12–1.48; P<0.001), for each S.D. increase in the logarithmic scale of UA level. The inclusion of UA in the multivariable model alongside known cardiovascular risk factors and other relevant variables increased the discriminatory power of the model regarding prediction of all-cause mortality [absolute and relative IDI (integrated discrimination improvement) 0.034 and 20.5% respectively; P<0.001]. In conclusion, in patients with Type 2 diabetes mellitus and confirmed CAD, elevated levels of UA predict mortality independently of known cardiovascular risk factors.

Antithrombotic therapy and revascularisation strategies in people with diabetes and coronary artery disease

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 92-105 ◽  
Author(s):  
Bianca Rocca ◽  
Andrea Rubboli ◽  
Francesco Zaccardi
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Antiplatelet Drug ◽  
Chronic Coronary Artery Disease ◽  
Patients With Diabetes ◽  
Artery Disease ◽  
Diabetes Patients

Background Diabetes mellitus, largely type 2, affects nearly 10% of the global adult population according to the World Health Organization. Diabetes is an independent risk factor for atherosclerotic cardiovascular diseases, including coronary artery disease. Diabetes patients experience a two to three-fold increased incidence of coronary artery disease, despite improved metabolic control and management of other cardiovascular risk factors. Discussion Platelet abnormalities and activation as well as reduced antiplatelet drug responsiveness characterise diabetes mellitus. Mechanisms linking diabetes to platelet and vascular abnormalities, atherogenesis and atherosclerotic cardiovascular disease are still only partially known, highlighting the unique complexity of the pro-atherogenic clinical scenario and its treatment. Consistently, a higher residual cardiovascular risk characterises patients with diabetes compared with those without, in spite of improved antiplatelet and antithrombotic treatment combinations. Randomised clinical trials aimed at optimising antiplatelet treatment specifically in patients with diabetes are lacking, both in acute and chronic coronary artery disease settings. Thus, patients with diabetes are treated with regimens validated in studies including only variable proportions of diabetes patients. Myocardial revascularisation appears to confer a comparable relative benefit between diabetes patients and patients without diabetes, and generally coronary artery bypass grafting has a better outcome in diabetes mellitus versus peripheral coronary intervention. New glucose-lowering drugs have been shown to reduce the incidence of major cardiovascular events in secondary prevention. Type 1 diabetes mellitus remains less explored than type 2 in this context. Conclusion Diabetes-tailored antithrombotic strategies in acute and chronic coronary artery disease remain an unmet clinical need, requiring ad-hoc trials and precision pharmacological strategies.

scholarly journals Cost-effectiveness of screening of coronary artery disease in patients with type 2 DIABetes at a very high cardiovascular risk (SCADIAB study) rational and design

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kamel Mohammedi ◽  
Nathalie Préaubert ◽  
Tanguy Cariou ◽  
Vincent Rigalleau ◽  
Ninon Foussard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Lower Limb ◽  
High Cardiovascular Risk ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Very High

Abstract Background Screening for coronary artery disease (CAD) remains broadly performed in patients with type 2 diabetes (T2DM), although the lack of evidence. We conduct a real-world evidence (RWE) study to assess the risk of major clinical outcomes and economic impact of routine CAD screening in T2DM individuals at a very high cardiovascular risk. Methods SCADIAB is a comparative nationwide cohort study using data from the French National Health Data System. The main inclusion criteria are: age ≥ 40 years, DT2 diagnosed for ≥ 7 years, with ≥ 2 additional cardiovascular risk factors plus a history of microvascular or macrovascular disease, except CAD. We estimated ≥ 90,000 eligible participants for our study. Data will be extracted from 01/01/2008 to 31/12/2019. Eligible participants will be identified during a first 7-year selection period (2008–2015). Each participant will be assigned either in experimental (CAD screening procedure during the selection period) or control group (no CAD screening) on 01/01/2015, and followed for 5 years. The primary endpoint is the incremental cost per life year saved over 5 years in CAD screening group versus no CAD screening. The main secondary endpoints are: total 5-year direct costs of each strategy; incidence of major cardiovascular (acute coronary syndrome, hospitalization for heart failure, coronary revascularization or all-cause death), cerebrovascular (hospitalization for transient ischemic attack, stroke, or carotid revascularization) and lower-limb events (peripheral artery disease, ischemic diabetic foot, lower-limb revascularization or amputation); and the budget impact for the French Insurance system to promote the cost-effective strategy. Analyses will be adjusted for a high-dimension propensity score taking into account known and unknown confounders. SCADIAB has been funded by the French Ministry of Health and the protocol has been approved by the French ethic authorities. Data management and analyses will start in the second half of 2021. Discussion SCADIAB is a large and contemporary RWE study that will assess the economic and clinical impacts of routine CAD screening in T2DM people at a very high cardiovascular risk. It will also evaluate the clinical practice regarding CAD screening and help to make future recommendations and optimize the use of health care resources. Trial registration ClinicalTrials.gov Identifier: NCT04534530 (https://clinicaltrials.gov/ct2/show/NCT04534530)

scholarly journals Angiographic Pattern of Coronary Artery Stenosis in Type 2 Diabetic Patients with Acute Coronary Syndrome

2020 ◽  
Vol 19 (2) ◽  
pp. 21-22
Author(s):  
Abu Tarek Iqbal ◽  
Abdul Jalil ◽  
M Jalal Uddin
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Coronary Syndrome ◽  
Institutional Review ◽  
Artery Disease ◽  
Type 2 Diabetic

Background: Many studies were conducted in home and abroad on the subject but there is none in Chattogram region of Bangladesh. To unveil the existing situation we have conducted the study which will help better case management. Materials and methods: Properly diagnosed 54 consecutive type 2 diabetic patients with Acute Coronary Syndrome were selected for study. The study was conducted in 2016 (One year) at a private cardiac center of Chattogram city. After adequate preparation angiography was performed with standard Judkin’s technique. Data were manually managed and statistically analyzed. Results were compared with other similar studies. Informed consent was taken from the patients and the hospital authority before conducting the study. A competent institutional review board approved the protocol. Results: Sex of the patients were male 85% and female 15%. Age range was 30-70 years. Peak age group was 50-60 years. It was 41%. Mean age was 56±6.8 years. Multiple Vessels Disease (MVD) was the highest 39%. Commonly affected vessel was Left Anterior Descending artery (LAD) 83%. Conclusion: Diabetes mellitus is a notorious risk factor for coronary artery disease. It causes coronary artery lesions earlier. It significantly causes acute coronary syndrome. So all measures should be taken to prevent and control diabetes mellitus. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 21-22

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