Evolution of silent myocardial ischaemia prevalence and cardiovascular disease risk factor management in Type 2 diabetes over a 10‐year period: an observational study

Sultan, Ariane; Perriard, François; Macioce, Valérie; Mariano‐Goulart, Denis; Boegner, C.; Daurès, Jean Pierre; Avignon, A.

doi:10.1111/dme.13364

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…Furthermore, the number of additional cardiovascular risk factors and the presence of diabetic complications, especially nephropathy and cardiac autonomic neuropathy play a role [3,4]. The prevalence of silent ischemia which was 20-30% in the 1990's [4] has dropped in the last decade [5]. Some recent studies showed that coronary computed tomography angiography (CCTA) may detect coronary artery stenoses in a large proportion of asymptomatic patients with diabetes [6,7].…”

mentioning

confidence: 99%

Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

Thai¹,

Tien

Minh

et al. 2020

Cardiovasc Diabetol

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Background Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed. Results The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p < 0.05 to < 0.0001). TyG index correlated with logHOMA-IR (p < 0.0001). CS ≥ 50% were present in 60 participants and 32 had coronary artery stenosis ≥ 70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥ 70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p = 0.04 and < 0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy. Conclusion More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.

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mentioning

confidence: 99%

Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

Thai¹,

Tien

Minh

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…Peripheral vascular disease has been shown to be independently associated with silent CAD in several studies [11,39,45,108,110,111]. Rajagopalan et al [39] concluded that ECG Q waves, and peripheral artery disease (OR 2.134, CI 1.150-3.961; P = 0.016) were the 2 most important variables associated with high risk findings on stress SPECT, in their analysis.…”

Section: Factors Associated With Silent Coronary Artery Disease In Tymentioning

confidence: 99%

“…It is also clinically relevant to underline that myocardial ischemia can resolve, as demonstrated in the DIAD study, after patients underwent intensive CV risk factor control; in follow-up of the DIAD study, resolution of ischemia was found in 79% of 71 T2DM patients who initially had abnormal studies, after 3 years of optimal medical treatment [44]. Moreover, the prevalence of silent CAD seems to reduce over time: a French cohort of 770 T2DM, prospectively followed-up for a 10-year period, showed a progressive and steady reduction of SMI from 22.6% in 1999-2002, to 13.7% in 2003-2005 and to 5.9% in 2006-2009 (P < 0.0001) [45].…”

Section: The Clinical Relevance Of Silent Coronary Artery Disease In mentioning

confidence: 99%

Silent coronary artery disease in type 2 diabetes: a narrative review on epidemiology, risk factors, and clinical studies

Kreutzenberg

2021

Exploration of Medicine

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Silent coronary artery disease (CAD) is one of the manifestations of heart disease that particularly affects subjects with type 2 diabetes mellitus (T2DM). From a clinical point of view, silent CAD represents a constant challenge for the diabetologist, who has to decide whether a patient could or could not be screened for this disease. In the present narrative review, several aspects of silent CAD are considered: the epidemiology of the disease, the associated risk factors, and main studies conducted, in the last 20 years, especially aimed to demonstrate the usefulness of the screening of silent CAD, to improve cardiovascular outcomes in type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

Triglyceride Glucose Index for the Detection of Asymptomatic Coronary Artery Stenosis in Patients With Type 2 Diabetes

Thai

Tien

Minh³

et al. 2020

Preprint

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Background: Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods: This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed.Results: The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p<0.05 to <0.0001). TyG index correlated with logHOMA-IR (p<0.0001). CS ≥50% were present in 60 participants and 32 had coronary artery stenosis ≥70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p=0.04 and <0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy.Conclusion: More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.

show abstract

Evolution of silent myocardial ischaemia prevalence and cardiovascular disease risk factor management in Type 2 diabetes over a 10‐year period: an observational study

Cited by 11 publications

References 28 publications

Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes

Silent coronary artery disease in type 2 diabetes: a narrative review on epidemiology, risk factors, and clinical studies

Triglyceride Glucose Index for the Detection of Asymptomatic Coronary Artery Stenosis in Patients With Type 2 Diabetes

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