Association Between Blood Glucose Variability and the Characteristics of Vulnerable Plaque in Elderly Non-ST Segment Elevation Acute Coronary Syndrome Patients

Zhang, Tao; Gong, Sitang; Mi, Shuhua; Yang, Hongxia; Wei, Xin; Dai, Wenlong; Liu, Jinghua

doi:10.1536/ihj.18-503

Cited by 17 publications

(12 citation statements)

References 21 publications

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“…Ceriello et al showed that targeting postprandial hyperglycemia has the potential to reduce oxidative stress [21]. We have recently reported that glycemic variability, a component of which is PPG excursions, was significantly correlated with oxidative stress measured as urinary 8-iso-PGF 2α in patients with ACS [22]. The present study showed that serum 1,5-AG level, but not HbA 1c ,…”

Section: Discussionsupporting

confidence: 50%

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome

Su¹,

Gao²,

Yao³

et al. 2020

Preprint

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Background Postprandial hyperglycemia was reported to play a key role in established risk factors of coronary artery diseases (CAD) and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of short-term postprandial glucose (PPG) excursions. Low serum 1,5-AG levels have been associated with occurrence of CAD; however, the relationship between 1,5-AG levels and coronary plaque rupture has not been fully elucidated. The aim of this study was to evaluate 1,5-AG as a predictor of coronary plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).Methods A total of 132 diabetic patients with NSTE-ACS were included in this study. All patients underwent intravascular ultrasound examination, which revealed 38 patients with plaque rupture and 94 patients without plaque rupture in the culprit lesion. Fasting blood glucose (FBS), hemoglobin A1c (HbA1c) and 1,5-AG levels were measured before coronary angiography. Fasting urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) level was measured and corrected by creatinine clearance. Results Patients with ruptured plaque had significantly lower serum 1,5-AG levels and a tendency of higher HbA1c levels than patients without ruptured plaque in our study population. In multivariate analysis, low 1,5-AG levels were an independent predictor of plaque rupture (odds ratio 3.3; p = 0.006) in diabetic patients with NSTE-ACS, but HbA1c was not. The area under the receiver-operating characteristic curve for 1,5-AG (0.678, p = 0.001) to predict plaque rupture was superior to that for HbA1c (0.618, p = 0.034). Levels of 1,5-AG were significantly correlated with urinary 8-iso-PGF2α levels (r=-0.224, p = 0.010).Conclusions Serum 1,5-AG may identify high risk for coronary plaque rupture in diabetic patients with NSTE-ACS, which suggests PPG excursions are related to the pathogenesis of plaque rupture in diabetes.

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Section: Discussionsupporting

confidence: 50%

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome

Su¹,

Gao²,

Yao³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ceriello et al showed that targeting postprandial hyperglycemia has the potential to reduce oxidative stress [26]. We have recently reported that glycemic variability, a component of which is PPG excursions, was significantly correlated with oxidative stress measured as urinary 8-iso-PGF 2α in patients with ACS [27]. Urinary 8-iso-PGF 2α have been proved to be the most reliable marker to assess lipid peroxidation, which is a key mechanism for the development of atherosclerotic plaques in humans.…”

Section: Mechanism For Ppg Excursions Affecting Plaque Rupturementioning

confidence: 95%

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with acute coronary syndrome

Gong

Gao

Shi

et al. 2020

Cardiovasc Diabetol

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Background: Postprandial hyperglycemia was reported to play a key role in established risk factors of coronary artery diseases (CAD) and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of short-term postprandial glucose (PPG) excursions. Low serum 1,5-AG levels have been associated with occurrence of CAD. However, the relationship between 1,5-AG levels and coronary plaque rupture has not been fully elucidated. The aim of this study was to evaluate 1,5-AG as a predictor of coronary plaque rupture in diabetic patients with acute coronary syndrome (ACS).Methods: A total of 144 diabetic patients with ACS were included in this study. All patients underwent intravascular ultrasound examination, which revealed 49 patients with plaque rupture and 95 patients without plaque rupture in the culprit lesion. Fasting blood glucose (FBG), hemoglobin A 1c (HbA 1c ) and 1,5-AG levels were measured before coronary angiography. Fasting urinary 8-iso-prostaglandin F 2α (8-iso-PGF 2α ) level was measured and corrected by creatinine clearance.Results: Patients with ruptured plaque had significantly lower serum 1,5-AG levels, longer duration of diabetes, higher HbA 1c and FBG levels than patients without ruptured plaque in our study population. In multivariate analysis, low 1,5-AG levels were an independent predictor of plaque rupture (odds ratio 3.421; P = 0.005) in diabetic patients with ACS. The area under the receiver-operating characteristic curve for 1,5-AG (0.658, P = 0.002) to predict plaque rupture was superior to that for HbA 1c (0.587, P = 0.087). Levels of 1,5-AG were significantly correlated with urinary 8-iso-prostaglandin F 2α levels (r = − 0.234, P = 0.005).Conclusions: Serum 1,5-AG may identify high risk for coronary plaque rupture in diabetic patients with ACS, which suggests PPG excursions are related to the pathogenesis of plaque rupture in diabetes.

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“…Short-term GV is also associated with increased mortality after cardiac procedure such as transcatheter aortic valve implantation [ 12 ]. Long-term GV was found to be associated with greater progression of coronary artery calcification in young adults [ 13 ]. High GV also causes left ventricular diastolic dysfunction and increased the risk of heart failure [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Higher long-term visit-to-visit glycemic variability predicts new-onset atrial fibrillation in patients with diabetes mellitus

Hsu

Yang

Chuang

et al. 2021

Cardiovasc Diabetol

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Background Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Glycemic variability (GV) is associated with risk of micro- and macrovascular diseases. However, whether the GV can increase the risk of AF remains unknown. Methods The cohort study used a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, a total of 27,246 adult patients with T2DM were enrolled for analysis. Each individual was assessed to determine the coefficients of variability of fasting glucose (FGCV) and HbA1c variability score (HVS). The GV parameters were categorized into quartiles. Multivariate Cox regression models were employed to estimate the relationship between the GV parameters and the risk of AF, transient ischemic accident (TIA)/ischemic stroke and mortality in patients with T2DM. Results The incidence rates of AF and TIA/ischemic stroke were 21.31 and 13.71 per 1000 person-year respectively. The medium follow-up period was 70.7 months. In Cox regression model with full adjustment, the highest quartile of FGCV was not associated with increased risk of AF [Hazard ratio (HR): 1.12, 95% confidence interval (CI) 0.96–1.29, p = 0.148] or TIA/ischemic stroke (HR: 1.04, 95% CI 0.83–1.31, p = 0.736), but was associated with increased risk of total mortality (HR: 1.33, 95% CI 1.12–1.58, p < 0.001) and non-cardiac mortality (HR: 1.41, 95% CI 1.15–1.71, p < 0.001). The highest HVS was significantly associated with increased risk of AF (HR: 1.29, 95% CI 1.12–1.50, p < 0.001), total mortality (HR: 2.43, 95% CI 2.03–2.90, p < 0.001), cardiac mortality (HR: 1.50, 95% CI 1.06–2.14, p = 0.024) and non-cardiac mortality (HR: 2.80, 95% CI 2.28–3.44, p < 0.001) but was not associated with TIA/ischemic stroke (HR: 0.98, 95% CI 0.78–1.23, p = 0.846). The Kaplan–Meier analysis showed significantly higher risk of AF, cardiac and non-cardiac mortality according to the magnitude of GV (log-rank test, p < 0.001). Conclusions Our data demonstrate that high GV is independently associated with the development of new-onset AF in patients with T2DM. The benefit of maintaining stable glycemic levels to improve clinical outcomes warrants further studies.

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Association Between Blood Glucose Variability and the Characteristics of Vulnerable Plaque in Elderly Non-ST Segment Elevation Acute Coronary Syndrome Patients

Cited by 17 publications

References 21 publications

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with non-ST segment elevation acute coronary syndrome

Effect of 1,5-anhydroglucitol levels on culprit plaque rupture in diabetic patients with acute coronary syndrome

Higher long-term visit-to-visit glycemic variability predicts new-onset atrial fibrillation in patients with diabetes mellitus

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