Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

Guaricci, Andrea Igoren; Santis, Delia De; Carbone, Mariangela; Muscogiuri, Giuseppe; Guglielmo, Marco; Baggiano, Andrea; Serviddio, Gaetano

doi:10.1155/2018/8927281

Cited by 9 publications

(10 citation statements)

References 113 publications

(91 reference statements)

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“…Most patients with type 2 diabetes who had atherosclerotic cardiovascular disease were diagnosed with ischemic heart disease (86.2%); much smaller percentages presented other clinical manifestation of atherosclerotic cardiovascular disease. This is probably due to the predilection of atherosclerosis in the coronary arteries in patients with diabetes [35].…”

Section: Discussionmentioning

confidence: 99%

Pulse Pressure Is More Relevant Than Systolic and Diastolic Blood Pressure in Patients With Type 2 Diabetes and Cardiovascular Disease

Buda

Ciobanu

Román

2018

Medicine and Pharmacy Reports

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Background and aimsThe parameters evaluated during 24-hour ambulatory blood pressure monitoring were reported to be predictors of cardiovascular events. We aimed to investigate mean blood pressure, blood pressure variability and pulse pressure during 24-hour ambulatory blood pressure monitoring in type 2 diabetes patients and to establish their relationship with the presence of atherosclerotic cardiovascular disease (CVD).MethodsThe observational study included type 2 diabetes patients randomly selected and distributed in 2 study groups depending on the presence of atherosclerotic cardiovascular disease: CVD(−), n=90, and CVD(+), n=87. Daytime, nighttime and 24-hour systolic and diastolic blood pressure were monitored and mean blood pressure, blood pressure variability and pulse pressure were calculated.ResultsThe study groups were comparable as age, gender ratio, smoking status, body mass index and abdominal circumference. Diabetes and hypertension duration were significantly higher in the CVD(+) group. Mean systolic and diastolic blood pressure, blood variability, dipper prevalence did not differ between study groups. Pulse pressure was significantly higher in the CVD(+) group compared to CVD(−) group (daytime pulse pressure 56.2±13.1 vs. 50.6±11.3 mmHg, p=0.003; nighttime pulse pressure 56.5±14.2 vs. 50.7±12.4 mmHg, p=0.005; 24-hour pulse pressure 54.7±13.6 vs. 49.0±12.0 mmHg, p=0.003).ConclusionsAmbulatory pulse pressure was significantly higher in patients with type 2 diabetes and atherosclerotic cardiovascular disease compared to those without cardiovascular disease, although mean systolic and diastolic blood pressure and blood pressure variability were similar.

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Section: Discussionmentioning

confidence: 99%

Pulse Pressure Is More Relevant Than Systolic and Diastolic Blood Pressure in Patients With Type 2 Diabetes and Cardiovascular Disease

Buda

Ciobanu

Román

2018

Medicine and Pharmacy Reports

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“…There are well-reviewed studies on subclinical CAD assessments by CCTA in asymptomatic patients with T2DM [42,43], which can serve as a reference for further information.…”

Section: Coronary Computed Tomography Angiographymentioning

confidence: 99%

Recent Updates on Vascular Complications in Patients with Type 2 Diabetes Mellitus

Jung

Mok

2020

Endocrinol Metab

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It is well known that patients with type 2 diabetes mellitus (T2DM) are at an increased risk of morbidity and mortality from atherosclerotic cardiovascular (CV) complications. Previously, the concept that diabetes mellitus (DM) is a "coronary artery disease (CAD) risk equivalent" was widely accepted, implying that all DM patients should receive intensive management. However, considerable evidence exist for wide heterogeneity in the risk of CV events among T2DM patients and the concept of a "CAD risk equivalent" has changed. Recent guidelines recommend further CV risk stratification in T2DM patients, with treatment tailored to the risk level. Although imaging modalities for atherosclerotic cardiovascular disease (ASCVD) have been used to improve risk prediction, there is currently no evidence that imaging-oriented therapy improves clinical outcomes. Therefore, controversy remains whether we should screen for CVD in asymptomatic T2DM. The coexistence of T2DM and heart failure (HF) is common. Based on recent CV outcome trials, sodium glucose cotransporter-2 inhibitors and glucagon like peptide-1 receptor agonists are recommended who have established ASCVD, indicators of high risk, or HF because of their demonstrated benefits for CVD. These circumstances have led to an increasing emphasis on ASCVD and HF in T2DM patients. In this review, we examine the literature published within the last 5 years on the risk assessment of CVD in asymptomatic T2DM patients. In particular, we review recent guidelines regarding screening for CVD and research focusing on the role of coronary artery calcium, coronary computed tomography angiography, and carotid intima-media thickness in asymptomatic T2DM patients.

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“…Consequently, the controversy over the role in CVD of the synthesis and absorption markers of cholesterol remains. This controversy is even more provocative due to the well-established relationship of diabetes mellitus (DM) with atherosclerotic CVD [13,14]. In this regard, various publications show controversial results on plasma non-cholesterol sterols as markers of cholesterol metabolism in DM.…”

Section: Introductionmentioning

confidence: 99%

The coronary artery calcium score is linked to plasma cholesterol synthesis and absorption markers: Brazilian Longitudinal Study of Adult Health

et al. 2020

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Abstract It is controversial whether atherosclerosis is linked to increased intestinal cholesterol absorption or synthesis in humans. The aim of the present study was to relate atherosclerosis to the measurements of plasma markers of cholesterol synthesis (desmosterol, lathosterol) and absorption (campesterol, sitosterol). In healthy male (n=344), non-obese, non-diabetics, belonging to the city of São Paulo branch of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we measured in plasma these non-cholesterol sterol markers, together with their anthropometric, dietary parameters, traditional atherosclerotic risk factors, and blood chemistry, coronary arterial calcium score (CAC), and ultrasonographically measured common carotid artery intima-media thickness (CCA-IMT). Cases with CAC>zero had the following parameters higher than cases with CAC = zero: age, waist circumference (WC), plasma total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), and non-high density lipoprotein-cholesterol (non HDL-C). Plasma desmosterol and campesterol, duly corrected for TC, age, body mass index (BMI), waist circumference (WC), hypertension, smoking, and the homeostasis model assessment-insulin resistance (HOMA-IR) correlated with CAC, but not with CCA-IMT. The latter related to increased age, BMI, waist circumference (WC), and systolic blood pressure (SBP). Plasma HDL-C concentrations did not define CAC or CCA-IMT degrees, although in relation to the lower tertile of HDL-C in plasma the higher tertile of HDL-C had lower HOMA-IR and concentration of a cholesterol synthesis marker (desmosterol). Present work indicated that increased cholesterol synthesis and absorption represent primary causes of CAD, but not of the common carotid artery atherosclerosis.

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Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives

Cited by 9 publications

References 113 publications

Pulse Pressure Is More Relevant Than Systolic and Diastolic Blood Pressure in Patients With Type 2 Diabetes and Cardiovascular Disease

Pulse Pressure Is More Relevant Than Systolic and Diastolic Blood Pressure in Patients With Type 2 Diabetes and Cardiovascular Disease

Recent Updates on Vascular Complications in Patients with Type 2 Diabetes Mellitus

The coronary artery calcium score is linked to plasma cholesterol synthesis and absorption markers: Brazilian Longitudinal Study of Adult Health

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