Impact of free fatty acids on prognosis in coronary artery disease patients under different glucose metabolism status

Jin, Jing‐Lu; Cao, Ye‐Xuan; Liu, Huihui; Zhang, Huiwen; Guo, Yuan‐Lin; Wu, Na‐Qiong; Zhu, Cheng‐Gang; Xu, Rui‐Xia; Gao, Ying; Sun, Jing; Dong, Qian; Li, Jianjun

doi:10.1186/s12933-019-0936-8

Cited by 22 publications

(12 citation statements)

References 31 publications

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“…Up to now, previous studies including ours have demonstrated a series of risk factors for predicting cardiovascular outcomes in subjects with pre-DM or DM. Besides traditional cardiovascular risk factors [ 19 , 28 ], numerous novel parameters, including lipoprotein(a) [ 29 ], fibrinogen [ 30 ], free fatty acids [ 31 ], cystatin C [ 32 , 33 ] and so on, have emerged as significant cardiovascular risk factors in subjects with dysglycemia. However, given the growing prevalence and the added cardiovascular burden of pre-DM and DM, new avenues for exploration of more valuable prognostic biomarkers in these conditions is of increasing interest in cardiovascular field.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study

Liu

Cao

Jin

et al. 2021

Cardiovasc Diabetol

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Background The prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with coronary artery disease (CAD) with different glucose status has not been established. This study sought to evaluate the significance of NT-proBNP in predicting major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome (CCS) and normal left-ventricular systolic function (LVSF) according to different glucose status, especially in those with abnormal glucose metabolism. Methods A total of 8062 patients with CCS and normal LVSF were consecutively enrolled in this prospective study. Baseline plasma NT-proBNP levels were measured. The follow-up data of all patients were collected. Kaplan-Meier and Cox regression analyses were used to assess the risk of MACEs according to NT-proBNP tertiles stratified by glucose status. Results Over an average follow-up of 59.13 ± 18.23 months, 569 patients (7.1 %) suffered from MACEs, including cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Kaplan-Meier analysis showed that high NT-proBNP levels had a significant association with MACEs in subjects with prediabetes mellitus (pre-DM) or DM, but not in patients with normoglycemia. Multivariate Cox regression analysis revealed that NT-proBNP remained an independent predictor of MACEs in patients with pre-DM [hazard ratio (HR): 2.56, 95% confidence interval (CI): 1.34–4.91] or DM (HR: 2.34, 95% CI: 1.32–4.16). Moreover, adding NT-proBNP to the original Cox model including traditional risk factors significantly increased the C-statistic by 0.035 in pre-DM and DM, respectively. Conclusions The present study indicated that NT-proBNP could well predict worse outcomes in dysglycemic patients with CCS and normal LVSF, suggesting that NT-proBNP may help with risk stratification in this population.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study

Liu

Cao

Jin

et al. 2021

Cardiovasc Diabetol

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“…Patients with CAD but without apparent glucose abnormalities were recommended to evaluate their glycemic state [36]. Prediabetes was associated with a worse prognosis in individuals with stable CAD only when combined with other cardiometabolic disorders [37][38][39]. Several previous studies demonstrated that the measurement of Fib provided incremental value to risk assessment in CAD patients with DM.…”

Section: Fib and Cardiovascular Outcomes In Patients With Coronary Armentioning

confidence: 99%

Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease

Liu

Shi

et al. 2020

Cardiovasc Diabetol

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Background: The present cohort study aims to examine the relationship between fibrinogen (Fib) levels and glucose metabolism [fasting blood glucose (FBG) and hemoglobin A1c (HbA1c)] and investigate the impact of high Fib on cardiovascular outcomes in patients with stable CAD and pre-diabetes mellitus (pre-DM) or diabetes mellitus (DM). Methods:This study included 5237 patients from March 2011 to December 2015. Patients were distributed into three groups according to Fib levels (low Fib, median Fib, high Fib) and further categorized by glucose metabolism status [normal glucose regulation (NGR), Pre-DM, DM]. All patients were followed up for the occurrences of major adverse cardiovascular events (MACEs), including cardiovascular mortality, nonfatal MI, stroke, and unplanned coronary revascularization.Results: Linear regression analyses showed that FBG and HbA1c levels were positively associated with Fib in overall CAD participants, either with or without DM (all P < 0.001). During an average of 18,820 patient-years of follow-up, 476 MACEs occurred. High Fib was independently associated with MACEs after adjusting for confounding factors [Hazard Ratio (HR): 1.57, 95% confidence interval (CI) 1.26-1.97, P < 0.001]. Furthermore, DM but not pre-DM was a significant predictor of MACEs (P < 0.001 and P > 0.05, respectively). When patients were stratified by both glucose metabolism status and Fib levels, high Fib was associated with a higher risk of MACEs in pre-DM (HR 1.66, 95% CI 1.02-2.71, P < 0.05). Medium and high Fib levels were associated with an even higher risk of MACEs in DM (HR 1.86, 95% CI 1.14-3.05 and HR 2.28, 95% CI 1.42-3.66, all P < 0.05). After adding the combination of Fib and glucose status to the Cox model, the C-statistic was increased by 0.015 (0.001-0.026). Conclusions:The present study suggested that Fib levels were associated with FBG and HbA1c in stable CAD patients. Moreover, elevated Fib was independently associated with MACEs in CAD patients, especially among those with pre-DM and DM, suggesting that Fib may provide incremental value in the cardiovascular risk stratification of pre-DM and DM patients.

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“…Type 2 diabetes mellitus (T2DM) occurs mainly in the adults who are obese and is a common metabolic disease characterized by hyperglycemia and insulin resistance [ 6 ]. T2DM is associated with dyslipidemia alone or with metabolic syndrome, thereby increasing the risk of cardiovascular disease [ 7 , 8 ]. Diabetic dyslipidemia is typically characterized by increased levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) and decreased levels of high-density lipoprotein cholesterol (HDL-C) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Elevated Serum Small Dense Low-Density Lipoprotein Cholesterol May Increase the Risk and Severity of Coronary Heart Disease and Predict Cardiovascular Events in Patients with Type 2 Diabetes Mellitus

Huang

Bao

et al. 2021

Disease Markers

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Background. Coronary heart disease (CHD) is a common and severe complication in type 2 diabetes mellitus (T2DM) patients. Increased amount of circulatory small dense low-density lipoprotein cholesterol (sdLDL-C) particles is known to be a sign of dyslipidemia and can result in atherosclerosis. However, the association between serum sdLDL-C levels and CHD in T2DM patients remains unclear. Methods. A total of 3684 T2DM patients who received selective coronary angiography (CAG) were selected. For analyzing the association between sdLDL-C and CHD severity in T2DM, the patients with CHD were further divided into four subgroups according to the quartiles of sdLDL-C. A multivariate logistic regression was used for analyzing the risks and severity of CHD. A total of 3427 patients with continuous stable CHD were recruited and followed up for 5 years. Results. Serum sdLDL-C levels in the CHD group were significantly increased compared with those in the non-CHD group [0.80 (0.49) mmol/L vs. 0.70 (0.30) mmol/L, p < 0.001 ]. The results from CHD subgroup analysis indicated that the sdLDL-C levels in patients with multiple-vessel disease and high Gensini score (GS) were significantly increased. By adjusting the confounding factors and analyzing with multiple logistic regression, we found that sdLDL-C independently correlated with the presence and severity of CHD (CHD: OR = 2.257 ; multiple-vessel disease: OR = 3.288 ; high GS: OR = 2.554 ). A total of 484 major cardiovascular events (MACEs) were documented. After Kaplan-Meier analysis and chi-squared analysis, the incidence of MACEs in the high sdLDL-C group was higher than that in the low sdLDL-C group (16.04% vs. 12.25%, p = 0.002 ). Conclusion. In T2DM patients, elevated serum sdLDL-C may increase the severity of CHD and predict cardiovascular events in the future. Therefore, serum sdLDL-C may be a potential biomarker for the surveillance of CHD in T2DM patients.

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Impact of free fatty acids on prognosis in coronary artery disease patients under different glucose metabolism status

Cited by 22 publications

References 31 publications

Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study

Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study

Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease

Elevated Serum Small Dense Low-Density Lipoprotein Cholesterol May Increase the Risk and Severity of Coronary Heart Disease and Predict Cardiovascular Events in Patients with Type 2 Diabetes Mellitus

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