Are complex coronary lesions more frequent in patients with diabetes mellitus?

Barış, Nezihi; Akdeniz, Bahri; Uyar, Samet; Özel, Erdem; Kırımlı, Önder; Badak, Özer; Aslan, Özgür; Güneri, Sema

doi:10.1016/s0828-282x(06)70312-9

Cited by 19 publications

(11 citation statements)

References 13 publications

(12 reference statements)

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“…11,12 Diabetic patients have a higher risk of complications and a worse prognosis than nondiabetic subjects during coronary interventions. 13 The higher prevalence of multivessel and complex Type C lesions noted in the present study could be a factor contributing to this less favorable outcome. The more severe and extensive coronary artery lesions, and poorer collateral circulation in diabetic patients reported in another study 14 may have contributed to the less favorable clinical outcomes of this patient population.…”

Section: Discussionmentioning

confidence: 51%

Relationship between type 2 diabetes mellitus and coronary artery lesion characteristics: a single center study

2014

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Section: Discussionmentioning

confidence: 51%

Relationship between type 2 diabetes mellitus and coronary artery lesion characteristics: a single center study

2014

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“…Moreover, diabetic patients are known to have increased severity of atherosclerosis as well as higher rates for multivessel disease and more complex lesions such Comparison between intermediate SYNTAX score tertile and high SYNTAX score tertile; CVD -cerebrovascular disease; PAD -peripheral artery disease; WBC -white blood cell; LDL-C -low-density lipoprotein-cholesterol; HDL-C -high--density lipoprotein-cholesterol as long lesions, bifurcation lesions, and diffuse small vessel disease [16,17]. Furthermore, several studies have demonstrated that HT, smoking, and dyslipidaemia are associated with the complexity of atherosclerosis [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

et al. 2016

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A b s t r a c tBackground: CHADS 2 and CHA 2 DS 2 -VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA 2 DS 2 -VASc-HSF score promote atherosclerosis and are associated with severity of CAD. Aim:To investigate the association of the CHA 2 DS 2 -VASc-HSF score with the severity of CAD as assessed by SYNTAX score (SxS) in patients with ST segment elevation myocardial infarction (STEMI).Methods: A total of 454 consecutive patients with STEMI (males 79%, mean age 57.3 ± 12.9 years), who underwent primary percutaneous coronary intervention were included in our study. The patients were divided into three groups according to the SxS tertiles: low SxS group (SxS < 14; 151 patients), intermediate SxS group (SxS 14-20; 152 patients), and high SxS group (SxS ≥ 21; 151 patients). Results:The CHADS 2 , CHA 2 DS 2 -VASc, and CHA 2 DS 2 VASc-HSF scores were found to be significantly different among the SxS groups (p < 0.001, p < 0.001, and p < 0.001). After multivariate analysis, the CHA 2 DS 2 -VASc-HSF score was associated with high SxS (odds ratio [OR] 1.258, 95% confidence interval [CI] 1.026-1.544; p = 0.028) together with age (OR 1.032, 95% CI 1.013-1.050; p = 0.001) and ejection fraction (OR 0.927, 95% CI 0.901-0.955; p < 0.001). Conclusions:A newly diagnosed CHA 2 DS 2 -VASc-HSF score predicts the severity of atherosclerosis in patients with STEMI.

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“…In diabetic patients, even without preclinical or clinical atherosclerosis, endothelial function is already disturbed 19). Also, the prevalence of complex coronary lesions, such as bifurcation lesions, is more than two fold higher in diabetic patients 20). In addition, despite intervention with stents, diabetic patients have a greater than three times higher risk of stent thrombosis and major adverse cardiac events 21).…”

Section: Discussionmentioning

confidence: 99%

Krüppel-Like Factor 2 Suppression by High Glucose as a Possible Mechanism of Diabetic Vasculopathy

Lee

Youn

et al. 2012

Korean Circ J

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Background and ObjectivesEndothelial dysfunction is widely observed in diabetes mellitus, resulting in diabetic vascular complications. Krüppel-like factor 2 (KLF2) is implicated as being a key molecule that maintains endothelial function. We evaluated the expression of KLF2 in endothelial cells cultured in high glucose and investigated its functional implication in a diabetic animal model.Subjects and MethodsHuman umbilical vein endothelial cells (HUVECs) were cultured in physiologically high glucose (35 mM) condition. The Otsuka Long Evans Tokushima Fatty (OLETF) strain of rat was used as an excellent model of obese type II diabetes, and their lean littermates are Long Evans Tokushima Otsuka (LETO) rats.ResultsIn HUVECs cultured in physiologically high glucose condition, FOXO1 was activated whereas KLF2 and endothelial nitric oxide synthase (eNOS) expression was near completely abolished, which was completely reversed by FOXO1 small interfering ribonucleic acid. In the vessels harvested from the OLETF rats, the animal model of type II diabetes, KLF2 and eNOS expression were found depleted. When vascular remodeling was induced in the left common carotid artery by reduction of blood flow with partial ligation of the distal branches, greater neointimal hypertrophy was observed in OLETF rats compared with the control LETO rats.ConclusionKLF2 suppression in endothelial cells by high glucose is a possible mechanism of diabetic endothelial dysfunction. The strategy of replenishing KLF2 may be effective for preventing diabetic vascular dysfunction.

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Are complex coronary lesions more frequent in patients with diabetes mellitus?

Cited by 19 publications

References 13 publications

Relationship between type 2 diabetes mellitus and coronary artery lesion characteristics: a single center study

Relationship between type 2 diabetes mellitus and coronary artery lesion characteristics: a single center study

Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

Krüppel-Like Factor 2 Suppression by High Glucose as a Possible Mechanism of Diabetic Vasculopathy

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