Diabetes Mellitus and Acute Coronary Syndrome: Lessons From Randomized Clinical Trials

Sethi, Sanjum S.; Akl, E.M.; Farkouh, Michael E.

doi:10.1007/s11892-012-0272-9

Cited by 38 publications

(38 citation statements)

References 90 publications

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“…Finding accurate indicators which can be used to determine the prognosis of these patients emerges as a target of interest. In our study, we analyzed the general conditions and comorbidities in DM and non-DM patients, and the ratio of DM in the observed Chinese ACS octogenarians was over one third, which was higher than the prior reports by about 20-30% [33,34]. The Cys C level was significantly different, while severity of coronary artery (Genesis score), GRACE risk score as well as general renal function indicators were not significantly different between DM and non-DM patients.…”

Section: Discussionmentioning

confidence: 76%

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Xue

Guo

et al. 2013

Cardiovasc Diabetol

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ObjectiveCystatin C (Cys C) is a marker of renal dysfunction. Prior studies have shown that blood Cys C is related to the prognosis of coronary heart disease. The aim of the present study was to evaluate the long-term prognostic impact of Cys C on acute coronary syndrome (ACS) octogenarians with diabetes mellitus (DM).MethodsWe enrolled 660 consecutive ACS octogenarians who underwent coronary angiography and were classified into two groups based on diabetes. The baseline characters and Cys C level were measured on admission. Survival curve was calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify predictors of mortality and of major adverse cardiac events (MACE) rate.ResultsThere were 223 and 398 patients in groups DM and non-DM who fulfilled the follow-up. The average follow-up period was 28 (IQR 16–38) months. Diastolic blood pressure (DBP) was lower, ratios of hypertension and chronic renal failure (CRF), fasting blood glucose, HbA1c and Cys C levels were higher in DM group than those in non-DM group (P<0.01). The cumulative survival of DM group was significantly lower than that of non-DM group in the long term (P = 0.018). All cause mortality and MACE of DM group were higher than those of non-DM group (P<0.05). The plasma Cys C concentration (OR = 3.32, 95% CI = 1.18-10.92, P = 0.023) was the uniqueness independent predictor for long-term all cause mortality. The plasma Cys C concentration (OR = 2.47, 95% CI = 1.07-7.86, P = 0.029) and Genesis score (OR = 1.01, 95% CI = 1.00-1.03, P = 0.043) were independent predictors for MACE in DM group. ROC curve analysis showed that the predictive cut-off value of Cys C for mortality of DM group was 1.605 (0.718, 0.704).ConclusionsCys C is an independent predictor for long-term mortality and MACE of ACS octogenarians with DM.

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Section: Discussionmentioning

confidence: 76%

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Xue

Guo

et al. 2013

Cardiovasc Diabetol

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“…DM is a major independent risk factor for acute coronary syndrome (ACS). Diabetic patients with ACS suffer from higher mortality compared to their nondiabetic peers [27]. The presence of type 2 DM extends the risks associated with ACS, increasing the risk of recurrent cardiovascular events (CVEs) and doubling the risk of death.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Acute Coronary Syndrome in Northern Saudi Arabia

2017

JCCR

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Objective: The aim of this study was to find out the common risk factors associated with Acute Coronary Syndrome (ACS) in Northern Kingdom of Saudi Arabia (KSA).Methodology: One hundred and fifty six patients with ACS were investigated in intensive care unit (ICU), at cardiac center in King Khalid Hospital, in northern KSA, city of Hail.Results: Risk factors for ACS including; Hypertension, Ischemic Heart Disease (IHD), Smoking, Diabetes Miletus (DM), and Dyslipidemia were found in 68.6%, 34.6%, 20.5%, 59% and 83.3% of the patients, respectively. Conclusion:The most common risk factors for ACS in northern KSA (Hail region) were dyslipidemia and hypertension. These favored the urgent need for intervention and control, which lower the burden of ACS.

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“…Therefore, atherosclerotic cardiovascular disease has become the most serious complication of diabetes 1,2. Patients with diabetes are at a high risk for developing acute coronary syndrome (ACS) 3. Diabetic patients with ACS suffer from increased mortality due to rupture of vulnerable atherosclerotic plaques compared with their non-diabetic peers 4,5.…”

Section: Introductionmentioning

confidence: 99%

Overexpression of STAMP2 suppresses atherosclerosis and stabilizes plaques in diabetic mice

Wang

Han

Wang

et al. 2014

J Cellular Molecular Medi

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Our research aims to evaluate the function of the STAMP2 gene, an important trigger in insulin resistance (IR), and explore its role in macrophage apoptosis in diabetic atherosclerotic vulnerable plaques. The characteristics of diabetic mice were measured by serial metabolite and pathology tests. The level of STAMP2 was measured by RT-PCR and Western blot. The plaque area, lipid and collagen content of brachiocephalic artery plaques were measured by histopathological analyses, and the macrophage apoptosis was measured by TUNEL. Correlation of STAMP2/Akt signaling pathway and macrophage apoptosis was validated by Ad-STAMP2 transfection and STAMP2 siRNA inhibition. The diabetic mice showed typical features of IR, hyperglycaemia. Overexpression of STAMP2 ameliorated IR and decreased serum glucose level. In brachiocephalic lesions, lipid content, macrophage quantity and the vulnerability index were significantly decreased by overexpression of STAMP2. Moreover, the numbers of apoptotic cells and macrophages in lesions were both significantly decreased. In vitro, both mRNA and protein expressions of STAMP2 were increased under high glucose treatment. P-Akt was highly expressed and caspase-3 was decreased after overexpression of STAMP2. However, expression of p-Akt protein was decreased and caspase-3 was increased when STAMP2 was inhibited by siRNA. STAMP2 overexpression could exert a protective effect on diabetic atherosclerosis by reducing IR and diminishing macrophage apoptosis.

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Diabetes Mellitus and Acute Coronary Syndrome: Lessons From Randomized Clinical Trials

Cited by 38 publications

References 90 publications

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Long-term prognostic impact of cystatin c on acute coronary syndrome octogenarians with diabetes mellitus

Risk Factors Associated with Acute Coronary Syndrome in Northern Saudi Arabia

Overexpression of STAMP2 suppresses atherosclerosis and stabilizes plaques in diabetic mice

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