Vascular Events and Carotid Atherosclerosis: A 5-Year Prospective Cohort Study in Patients with Type 2 Diabetes and a Contemporary Cardiovascular Prevention Treatment

Abstract

Background and Aims. European recommendations on cardiovascular prevention suggest that carotid atherosclerosis assessment by duplex ultrasonography could help in some cases to better assess CV risk. We investigated whether the presence of carotid atherosclerosis determined by duplex ultrasonography is associated with cardiovascular events in patients with type 2 diabetes and could therefore help to reclassify cardiovascular risk. Methods. Among 624 consecutive patients with type 2 diabetes and carotid atherosclerosis assessment by duplex ultrasonography between January and December 2012, 583 (93%) were included and followed up prospectively. The primary endpoint was the occurrence of cardiovascular events. The rate of new cardiovascular events was compared between patients with (n=104) and those without (n=479) prior cardiovascular events. Results. A total of new 104 cardiovascular events occurred in 72 patients (12.5%) during a mean±SD follow-up period of 5.1±1.6 years. At baseline, for 202 patients (34.6%), carotid evaluation was normal; 381 (65.4%) had a carotid atherosclerosis lesion. The presence of carotid atherosclerosis at baseline was not significantly associated with an increased risk of new cardiovascular events in both groups. The rate of new cardiovascular events was more than twice as high in patients with prior cardiovascular event than those without. Conclusion. Systematic carotid atherosclerosis assessment by duplex ultrasonography in patients with type 2 diabetes and a contemporary cardiovascular prevention treatment does not offer additional information as to the risk of cardiovascular events. This trial is registered with ClinicalTrials.gov (ID: NCT02929355).

Prevalence and factors associated with carotid atherosclerosis in a Malagasy population with Type 2 diabetes mellitus: A cross‐sectional retrospective study

“…Male predominance in the present study was also found by other authors 17,19,20 . In a study conducted by Herinirina et al in a general Malagasy population, male gender was a determining factor in the increase in common carotid intima‐media thickness ( p value = .008) 24 .…”

“…This was superimposable on the findings of French studies in which 65.4% of a diabetic population presented with carotid atherosclerosis and the proportion of stenoses <50% and ≥50% were 64.6% and 4.1%, respectively. 17 , 19 However, in other Chinese and Korean studies found lower prevalence ranging from 30.8% to 45%. 20 , 21 , 22 In the study by Yang et al, 82.25% of patients had ≤49% stenosis.…”

“…Male predominance in the present study was also found by other authors. 17,19,20 In a study conducted by Herinirina et al in a general Malagasy population, male gender was a determining factor in the increase in common carotid intima-media thickness (p value = .008). 24 Also, according to a literature review conducted by Man, et al male subjects develop earlier, more inflamed and unstable atherosclerotic plaques.…”

Identification of key pathways and genes in carotid atherosclerosis through bioinformatics analysis of RNA-seq data

“…It is characterized by three pathological and anatomic stages, including the initial stage, progressive stage, and terminal stage [ 17 ]. CAS plaque rupture or erosion is a high-risk factor for cardiovascular disease and accounts for most deaths in CAS patients [ 18 , 19 ]. Transcriptomic sequencing (RNA-seq) is a highly useful tool for studying gene expression.…”

Sex Differences in Risk Factors Associated with Coronary Artery Disease: What Does Glycated Albumin Indicate?

“…Currently, the gold standard for monitoring blood glucose levels is blood HbA1c concentration and this has been proved to be an independent marker for cardiovascular disease risk [8]. However, HbA1c can be influenced by the presence of drugs, ethnicity, and other factors.…”