Endothelial dysfunction in patients with type 2 diabetes post acute coronary syndrome

Abstract

This single visit study examined whether endothelial function, in addition to cardiovascular (CV) risk factors and plasma microparticle content, was normalised in 15 patients with type 2 diabetes + acute coronary syndrome (ACS) (6 weeks-6 months post cardiac event) undergoing standard clinical care compared to 16 sex-and age-matched healthy controls. Results: While total and low-density lipoprotein (LDL) cholesterol levels were well controlled in the patients with type 2 diabetes + ACS, residual CV risk profiles such as increased body mass index (BMI), systolic blood pressure, glucose levels and triglycerides and lower high-density lipoprotein (HDL) levels were still apparent. Endothelium-dependent responses to acetylcholine (ACh) were significantly lower in type 2 diabetes + ACS patients compared to controls. Correspondingly, the reactive hyperaemic index (RHI) was lower in the patient cohort. Endothelial microparticle (EMP) levels (CD31 + , CD41 − ) were 40% lower in the patient cohort. Simultaneous analysis of platelet microparticle (PMP) levels (CD41 + ) showed no difference between cohorts. Conclusions: Patients with type 2 diabetes suffering from recent ACS exhibit residual CV risk factors despite being on standard clinical care. In addition, these patients continue to present with endothelial dysfunction despite having lower levels of EMPs.

Measures of atherosclerotic burden are associated with clinically manifest cardiovascular disease in type 2 diabetes: a European cross‐sectional study

“…Evidence from experimental studies has suggested that oxidative stress leading to endothelial dysfunction could be one important factor in the aetiology of diabetic vascular complications . Endothelial dysfunction as assessed by a low RHI has also been associated with the presence of coronary artery disease and risk of cardiovascular events both in patients with and without diabetes . However, in spite of clear evidence of the presence of impaired endothelial function in T2D subjects, as assessed by the RHI, we found no correlation with surrogate markers of atherosclerosis such as carotid IMT and ABPI.…”

Cell-Derived Microparticles in Patients with Type 2 Diabetes Mellitus: a Systematic Review and Meta-Analysis

“…Only three studies [24,28,31] provided information about the blinding method of measurement. Ten studies described the matching information [12,15,20,24,26,28,[31][32][33]40], and the matching strategies were various. The details of quality assessment of each included study were shown in the supplementary material- Table S3.…”

Microparticles as Potential Biomarkers of Cardiovascular Disease

“…Lumsden et al 41 have assessed patients with type 2 diabetes mellitus after acute coronary syndrome (six months prior to event), who had reduced levels of EMP and no PMP changes. Those authors have suggested that those unexpected findings, which disagree with most studies in the literature, can result from concomitant medications used by patients 42 - 44 .…”