The report of male gender and retinopathy status improves the current consensus guidelines for the screening of myocardial ischemia in asymptomatic type 2 diabetic patients

Cosson, E.; Nguyen, Minh Tuan; Chanu, B.; Balta, Şevket; Takbou, K.; Valensi, P.

doi:10.1016/j.numecd.2012.01.009

Cited by 12 publications

(14 citation statements)

References 28 publications

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“…There have been some guidelines produced by the American Diabetes Association (ADA), the ALFEDIAM-SFC (French-speaking Societies for diabetes & cardiology) and CRI (Cardiac Radionuclide Imaging) for the screening of silent myocardial ischemia in asymptomatic patients with a normal resting electrocardiogram in type 2 diabetes ( 1 18 19 ). In addition, Cosson et al ( 20 ) have shown that the diagnostic value of these guidelines is improved by taking account of a male gender and the retinopathy status. However, the guidelines for the evaluation of CHD risk in diabetes have not been clearly defined yet.…”

Section: Discussionmentioning

confidence: 99%

The Degree of Diabetic Retinopathy in Patients with Type 2 Diabetes Correlates with the Presence and Severity of Coronary Heart Disease

Um¹,

Lee

Kang

et al. 2016

J Korean Med Sci

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Both diabetic retinopathy (DR) and coronary heart disease (CHD) are clinically significant in diabetic patients. We investigated the correlation between the severity of DR and the presence and severity of CHD among type 2 diabetic patients. A total of 175 patients who were examined at the DR clinic and underwent dual-source computed tomography (DSCT) angiography within 6 months were included. The degree of DR was graded as no DR, nonproliferative DR (NPDR), and proliferative DR (PDR). The severity of CHD and the numbers of significant stenotic coronary artery on DSCT angiography according to DR grade were assessed. The mean Agatston Calcium Score (ACS) in patients with PDR was significantly higher than other groups (P < 0.001). The overall odds of an ACS increase were about 4.7-fold higher in PDR group than in no DR group (P < 0.001). In PDR group, in comparison with in no DR, the odds of having 1 or 2 arterial involvement were 3-fold higher (P = 0.044), and those of having 3 were 17-fold higher (P = 0.011). The c-index, one of the predictability values in regression analysis model, was not significantly increased when PDR was added to classical CHD risk factors (0.671 to 0.706, P = 0.111). Conclusively, patients with PDR develop a greater likelihood of not only having CHD, but being more severe nature. PDR has no additional effect to classical CHD risk factors for predicting CHD.

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Section: Discussionmentioning

confidence: 99%

The Degree of Diabetic Retinopathy in Patients with Type 2 Diabetes Correlates with the Presence and Severity of Coronary Heart Disease

Um¹,

Lee

Kang

et al. 2016

J Korean Med Sci

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“…An eight-year cohort study in Japan found that patients who developed signs of mild DR were already at higher risk of coronary heart disease or stroke [ 9 ]. Factoring presence of DR in the assessment of patients with diabetes also improved risk assessment of silent myocardial infarcts [ 199 ]. Presence of DR was also associated with mortality from cardiovascular disease, especially if there is concomitant nephropathy [ 200 ].…”

Section: Reviewmentioning

confidence: 99%

Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss

2015

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Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.

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“…These patients had no cardiac symptoms, no history of coronary artery disease, a normal 12-lead resting ECG, and at least one of the following additional cardiovascular risk factors: dyslipidemia (total cholesterol >6.5 mmol/L or LDL cholesterol >4.1 mmol/L or both, HDL cholesterol <0.9 mmol/L, triglycerides >2.3 mmol/L or lipid-lowering medication or both); hypertension (systolic and diastolic blood pressure ≥140/90 mmHg or antihypertensive therapy); smoking; nephropathy; family history of premature coronary artery disease; and peripheral or carotid occlusive arterial disease. As previously reported (12–15), each patient underwent a 201 Tl myocardial scintigraphy after an ECG stress test or a pharmacological stress test (dipyridamole injection) or both. An ECG stress test was performed in the patients who could exercise on a bicycle ergometer and were expected to have an interpretable exercise ECG.…”

Section: Methodsmentioning

confidence: 95%

Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes

et al. 2013

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OBJECTIVEWe investigated whether glycation gap (G-Gap), an index of intracellular glycation of proteins, was associated with diabetes complications.RESEARCH DESIGN AND METHODSWe measured concomitantly HbA1c and fructosamine in 925 patients with type 2 diabetes to calculate the G-Gap, defined as the difference between measured HbA1c, and fructosamine-based predicted HbA1c. Patients were explored for retinopathy, nephropathy, peripheral neuropathy, cardiac autonomic neuropathy (n = 512), and silent myocardial ischemia (n = 506).RESULTSMacroproteinuria was the only complication that was associated with G-Gap (prevalence in the first, second, and third tertile of G-Gap: 2.9, 6.2, and 11.0%, respectively; P < 0.001). The G-Gap was higher in patients with macroproteinuria than in those without (1.06 ± 1.62 vs. 0.03 ± 1.30%; P < 0.0001). Because HbA1c was associated with both G-Gap (HbA1c 7.0 ± 1.4, 7.9 ± 1.4, and 10.1 ± 1.8% in the first, second, and third G-Gap tertile, respectively; P < 0.0001) and macroproteinuria (HbA1c 8.8 ± 2.2% if macroproteinuria, 8.3 ± 2.0% if none; P < 0.05), and because it could have been a confounder, we matched 54 patients with macroproteinuria and 200 patients without for HbA1c. Because macroproteinuria was associated with lower serum albumin and fructosamine levels, which might account for higher G-Gap, we calculated in this subpopulation albumin-indexed fructosamine and G-Gap; macroproteinuria was independently associated with male sex (odds ratio [OR] 3.2 [95% CI 1.5–6.7]; P < 0.01), hypertension (2.9 [1.1–7.5]; P < 0.05), and the third tertile of albumin-indexed G-Gap (2.3 [1.1–4.4]; P < 0.05) in multivariate analysis.CONCLUSIONSIn type 2 diabetic patients, G-Gap was associated with macroproteinuria, independently of HbA1c, albumin levels, and confounding factors, suggesting a specific role of intracellular glycation susceptibility on kidney glomerular changes.

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The report of male gender and retinopathy status improves the current consensus guidelines for the screening of myocardial ischemia in asymptomatic type 2 diabetic patients

Cited by 12 publications

References 28 publications

The Degree of Diabetic Retinopathy in Patients with Type 2 Diabetes Correlates with the Presence and Severity of Coronary Heart Disease

The Degree of Diabetic Retinopathy in Patients with Type 2 Diabetes Correlates with the Presence and Severity of Coronary Heart Disease

Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss

Glycation Gap Is Associated With Macroproteinuria but Not With Other Complications in Patients With Type 2 Diabetes

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