<p>Vascular Age as a Cardiovascular Risk Marker in Asymptomatic Patients with Type 2 Diabetes</p>

Abstract

Aim: There is a wide variety of cardiovascular outcomes in patients with type 2 diabetes (T2DM), even in asymptomatic individuals. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and can be considered as a predictor of cardiovascular risk (CVR). The aim of this study was to evaluate the relationship between CIMT-determined vascular age (VA), CVR scores, and thyroid function in asymptomatic patients with T2DM. Patients and Methods: Clinical laboratory and CIMT parameters were measured in 154 asymptomatic patients with T2DM. The Framingham risk score (FRS) was performed with chronological age (CA) and with VA. A multinomial logistic regression model was used to analyze variables related to CVR reclassification. Results: The use of CIMT-determined VA led to the reclassification of 54 (35.52%) out of 152 asymptomatic T2DM patients, being 20 (37.03%) to a lower categorical risk and 34 (62.96%) to a higher categorical risk according to FRS. The variables that were associated to reclassification to a higher categorical risk were positive family history (FH) of premature coronary artery disease (p=0.046), FH of thyroid disease (p=0.010), use of statins (p=0.027), and free T4 levels (p=0.009). Conclusion: VA determined from CIMT allowed the reclassification of the CVR in asymptomatic T2DM patients. FH of premature CAD, FH of known thyroid disease, use of statins, and free T4 levels were associated to a reclassification into a higher risk category. The use of doppler to perform CIMT measure is currently more accessible, especially in a low-middle income country like Brazil. However, further prospective studies must be performed to establish the predictive values of CIMT on atherosclerosis and how thyroid function acts like cardiovascular risk marker on CVR scores.

Pragmatic clinic-based investigation of echocardiogram parameters in asymptomatic patients with type 2 diabetes in routine clinical practice and its association with suggestive coronary artery disease: A pilot study

“…The Institutional Research Ethics Committee approved the study protocol (number CAAE:31940114.8.0000.5259). The inclusion and exclusion criteria, clinical variables, comorbidities, renal function, diabetic retinopathy, Framingham risk score (FRS) and determination of carotid intima media thickness were all previously described 12 .…”

Relationship between vascular age and atherosclerosis-related cardiovascular diseases

“…Индекс массы тела (ИМТ) определялся как вес в кг и рост в сантиметрах: ИМТ = вес/рост 2 , кг/м 2 . Уровень ИМТ считали нормальным или здоровым весом, когда он составлял 18,5-24,9 кг/м 2 , недостаточным весом, когда он был ниже 18,5 кг/м 2 , избы-Определение сосудистого возраста (СВ) рассматривается как один из маркеров определения риска осложнений сердечно-сосудистых заболеваний (ССЗ), связанных с атеросклерозом [1]. Эксперты его еще именуют как "окно" к коронарным артериям.…”