Silent coronary heart disease in patients with type 2 diabetes: application of a screening approach in a follow-up study

Kreutzenberg, Saula Vigili de; Solini, Anna; Vitolo, Edoardo; Boi, A.; Bacci, Simonetta; Cocozza, Sara; Nappo, R N Lynn; Rivellese, Angela Albarosa; Avogaro, Angelo; Baroni, Marco Giorgio

doi:10.1016/j.jdiacomp.2017.03.014

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…DM is an independent risk factor for patients with coronary heart disease. In patients with coronary heart disease combined with T2DM, the persistent chronic hyperglycemia in the body damages the blood vessel wall and endothelial cells, and the action of a variety of inflammatory cytokines leads to the formation of atherosclerotic plaques, thus resulting in or accelerating the occurrence and development of coronary heart disease and other atherosclerotic lesions ( 13 , 14 ). A number of studies in China and elsewhere indicated that there are correlations of serum PTX3, HbAlc and ApoA1/ApoB with the change in the condition of coronary heart disease or DM in patients and their prognoses ( 10 – 12 ).…”

Section: Discussionmentioning

confidence: 99%

Expression and influence of pentraxin-3, HbAlc and ApoA1/ApoB in serum of patients with acute myocardial infarction combined with diabetes mellitus type 2

Zhu

Wang

et al. 2018

Exp Ther Med

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The present study investigated the clinical significance of changes in levels of hypersensitive plasma pentraxin-3 (PTX3), hemoglobin A1c (HbAlc) and apolipoprotein A-I (ApoA1)/apolipoprotein B (ApoB) on patients with acute myocardial infarction (AMI) and diabetes mellitus type 2 (T2DM). After admission, 100 patients diagnosed with AMI combined with T2DM were selected as Group A. According to the level of fasting blood glucose (FBG), they were then subdivided into Group A1 (n=44) with FBG ≥13.0 mmol/l and Group A2 (n=56) with FBG <13.0 mmol/l. A total of 100 hospitalized patients with AMI in People's Hospital of Dongying (Dongying, China) were collected as Group B, and 100 healthy people receiving physical examination in the Physical Examination Center of People's Hospital of Dongying were selected as Group C. Serum PTX3, HbAlc and ApoA1/ApoB of all the study participants were tested, and diseased coronary artery vessels were divided into single-, double- and triple-vessel lesions according to their numbers. Logistic regression analysis was performed for the number of diseased coronary artery vessels and each index. The level of PTX3 in Group A1 was higher than that in Group A2; the level of ApoA1/ApoB in the former was lower than that in the latter (P<0.05); and the level of HbAlc in the former was significantly higher than that in the latter (P<0.01); the levels of PTX3 and HbA1c in Group A2 were higher than those in Group B, while the level of ApoA1/ApoB in the former was lower than that in the latter (P<0.05). Logistic regression analysis showed that the number of diseased coronary artery vessels was positively correlated with PTX3 and HbA1c, but negatively correlated with ApoA1/ApoB. PTX3, HbAlc and ApoA1/apoB have a certain clinical significance in assessing the severity of AMI combined with T2DM.

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Section: Discussionmentioning

confidence: 99%

Expression and influence of pentraxin-3, HbAlc and ApoA1/ApoB in serum of patients with acute myocardial infarction combined with diabetes mellitus type 2

Zhu

Wang

et al. 2018

Exp Ther Med

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“…An abnormal ECG was defined to be a strong, independent predictor of silent CAD (OR 8.9; CI 1.27-62.5; p=0.028) in T2DM (Vigili de Kreutzenberg et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of silent myocardial ischemia in working-age patients with type 2 diabetes mellitus

Kisko¹,

Vereb²,

Dobransky³

et al. 2017

Zdravje Delovno Aktivne Populacije / Health of the Working-Age Population

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Introduction: Data confirm a relatively high prevalence of silent myocardial ischemia (SMI) in elderly patients with type 2 diabetes mellitus (T2DM), while no data are available regarding working-age subjects (≤60 years). Methods: Medical records of 192 patients with T2DM aged ≤60 years (110 male patients; 57.3%), who had undergone myocardial perfusion imaging (MPI) between 2010 and 2014 followed by coronary angiography in case of abnormal result, were retrospectively analysed. Results: MPI was positive in 35 patients (18.2%); of those 31 (88.6%) had angiographically confirmed coronary stenosis. The positive predictive value of the MPI for predicting angiographic coronary stenosis in this age subgroup was 88.9%. Univariate analysis revealed post-stress LVEF drop ≥5% (p<0.03) and NT-proBNP levels detected in stress (p<0.05) to be associated with greater risk of ischemia in workingage T2DM patients. In multivariate analysis, LVEF drop ≥5% (p< 0.03) remained an independent predictor of SMI. Conclusion: Prevalence of SMI in diabetic working-age patients was similar to that observed in studies of subjects over 65 years-old. Poststress LVEF drop ≥5% and NT-proBNP levels can contribute to more precise identification of SMI. Our data suggest that "aggressive" management strategy should be implemented to reduce the risk of cardiac events in T2DM patients of working-age.

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“…Pathological Q waves were independently associated with a high-risk scan in the American study by Rajagopalan et al [39]. In a more recent, small, Italian study, an abnormal ECG was the strongest, independent predictor of silent CAD in 102 asymptomatic T2DM individuals (OR 8.9, CI 1.27-62.5; P = 0.028) [92].…”

Section: Factors Associated With Silent Coronary Artery Disease In Tymentioning

confidence: 93%

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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Silent coronary heart disease in patients with type 2 diabetes: application of a screening approach in a follow-up study

Abstract: An abnormal ECG was a strong, independent predictor of silent CHD (OR 8.9; CI 1.27-62.5; p=0.028) in DM2. Therefore, a functional stress testing should be considered in DM2 patients with ECG abnormalities.

Cited by 7 publications

References 29 publications

Expression and influence of pentraxin-3, HbAlc and ApoA1/ApoB in serum of patients with acute myocardial infarction combined with diabetes mellitus type 2

Expression and influence of pentraxin-3, HbAlc and ApoA1/ApoB in serum of patients with acute myocardial infarction combined with diabetes mellitus type 2

Prevalence of silent myocardial ischemia in working-age patients with type 2 diabetes mellitus

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

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