Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus

Abstract

Background We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM). Methods In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c). Results The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056–0.915, P = 0.037), Gensini score (β = − 0.470, P < 0.001) and SYNTAX score (β = − 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05). Conclusion Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.

Impact of type 2 diabetes mellitus on left ventricular deformation in non-ischemic dilated cardiomyopathy patients assessed by cardiac magnetic resonance imaging

“…Another study confirmed this change in myocardial relaxation by cardiac catheterization in patients with DM-complicated NIDCM [ 21 ]. A previous study demonstrated that poor glycemic control is closely related to severe endothelial dysfunction [ 32 ]. Furthermore, hyperglycemia-induced oxidative stress, autonomic deficiency, inflammation, abnormalities in calcium homeostasis, apoptosis, and interstitial fibrosis are also responsible for cardiac remodelling and dysfunction [ 2 , 3 , 33 ].…”

Assessment of the intracavernosal injection platelet‐rich plasma in addition to daily oral tadalafil intake in diabetic patients with erectile dysfunction non‐responding to on‐demand oral PDE5 inhibitors

“…In this study, it has been demonstrated that diabetes control was associated with the good response of PRP therapy having better results compared with diabetic ED cases with bad diabetic control mostly due to decreased endothelial dysfunction. Several researchers pointed out that good diabetic control has a constructive impact on ameliorating such endothelial dysfunction (Chen et al, 2021).…”

Impact of Infection on Glycemic Control in ‎Diabetic Patients; a Hospital-based Cohort ‎Study in Pakistan

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