Post-Challenge Hyperglycemia in Older Adults Is Associated with Increased Cardiovascular Risk Profile

Crandall, Jill P.; Shamoon, Harry; Cohen, Hillel W.; Reid, Migdalia; Gajavelli, Srikanth; Trandafirescu, Georgeta G.; Tabatabaie, Vafa; Barzilai, Nir

doi:10.1210/jc.2008-1829

Cited by 31 publications

(22 citation statements)

References 37 publications

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“…Variability between serial measurements was assessed in 6 normal volunteers by performing peripheral endothelial function assessment with Endo-PAT 2000 on 2 consecutive days in the morning, after 12-h fasting state. Average coefficient of variation between 2 consecutive measurements was 15 ± 9%, in line with previous reports [15]. Taking into account Endo-PAT test variability, the study was designed to have 80% power based on a difference of 3.0% points of Endoscore change after 600 mg clopidogrel as previously observed [7], with a minimum sample size of 10 patients per group (group with LPR vs. group with HPR).…”

Section: Assessment Of Platelet Responsementioning

confidence: 55%

Relationship between peripheral arterial reactive hyperemia and residual platelet reactivity after 600 mg clopidogrel

Hamilos

Müller

Ntalianis

et al. 2011

J Thromb Thrombolysis

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Clopidogrel reduces long-term ischemic events in patients with acute coronary syndrome or stable angina (SA) undergoing percutaneous coronary intervention (PCI). Endothelial function improvement has been proposed, among other factors, for this beneficial effect of clopidogrel, but whether this might be associated to its anti-platelet action remains unclear. We tested the hypothesis that clopidogrel improvement of peripheral vascular endothelial function might be associated with inhibition of platelet aggregation. Endothelial function was evaluated before and at least 12 h after 600 mg clopidogrel in 43 SA pts undergoing elective PCI by: (a) reactive hyperemia peripheral arterial tonometry (measuring the Endoscore); (b) circulating endothelial microparticles (EMPs). Response to clopidogrel was measured with point-of-care VerifyNow P2Y12 assay and expressed as platelet reaction unit (PRU) and percent platelet inhibition (%PI). High platelet reactivity after clopidogrel was defined as PRU ≥ 240. Endothelial function improved after clopidogrel in 20 pts. Changes in Endoscore (Δ Endoscore) were significantly correlated with both PRU (r = -0.61, P < 0.001) and %PI (r = 0.57, P < 0.001). Endoscore significantly increased after clopidogrel in pts with PRU < 240 (0.38 ± 0.26 to 0.57 ± 0.33, P < 0.001), but did not in pts with PRU ≥ 240 (0.53 ± 0.31 to 0.40 ± 0.37, P = 0.12). EMPs were also significantly reduced in pts with PRU < 240 (222 [140-593] to 142 [83-371]/μl, P = 0.001), while no changes were observed in pts with PRU ≥ 240 (256 [178-531] to 388 [238-499]/μl, P = 0.55). In patients with stable coronary artery disease, a single 600 mg clopidogrel loading dose improves vascular endothelial function. This improvement is associated with optimal platelet inhibition and it is not observed in patients with post-clopidogrel high platelet reactivity.

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Section: Assessment Of Platelet Responsementioning

confidence: 55%

Relationship between peripheral arterial reactive hyperemia and residual platelet reactivity after 600 mg clopidogrel

Hamilos

Müller

Ntalianis

et al. 2011

J Thromb Thrombolysis

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“…Reactive hyperaemia index falls after a glucose load in patients with insulin resistance and post‐glucose load hyperglycaemia, but not in patients with normal glucose tolerance . However, despite reduced insulin sensitivity and consequent postprandial hyperglycaemia, there was no change in the postprandial reduction in reactive hyperaemia index after acute prednisolone.…”

Section: Discussionmentioning

confidence: 92%

“…In patients with type 2 diabetes mellitus or impaired glucose tolerance, when insulin resistance results in postprandial hyperglycaemia it is more strongly associated with cardiovascular events, and arterial stiffness, than when insulin resistance causes fasting hyperglycaemia. Furthermore, vascular dysfunction in these patients may only manifest during the postprandial period …”

Section: Introductionmentioning

confidence: 99%

Effect of acute and chronic glucocorticoid therapy on insulin sensitivity and postprandial vascular function

Radhakutty

Mangelsdorf

Drake

et al. 2015

Clinical Endocrinology

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“…Polycystic ovarian syndrome, preeclampsia, obstructive sleep apnea, acute malaria infection, depression, mental stress, and postprandial hyperglycemia have all been associated with decreased PAT hyperemic response (Itzhaki et al 2005, Lowenstein et al 2007, Tomfohr et al 2008, Yeo et al 2007, Yinon et al 2006, Martin et al 2008, Crandall et al 2009). These studies provide evidence that systemic states associated with cardiovascular risk impair microvessel vasodilator function in the fingertip reflected in lower PAT hyperemic responses.…”

Section: Clinical Studies Measuring Endothelial Function With Digitalmentioning

confidence: 99%

Assessment of Endothelial Function Using Digital Pulse Amplitude Tonometry

Hamburg

Benjamin

2009

Trends in Cardiovascular Medicine

159

144

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The importance of endothelial dysfunction in the development and clinical expression of cardiovascular disease is well recognized. Impaired endothelial function has been associated with an increased risk of cardiovascular events. Endothelial function may be evaluated in humans by assessing vasodilation in response to stimuli known to induce the release of nitric oxide. A novel pulse amplitude tonometry device noninvasively measures vasodilator function in the microcirculation of the finger. This article reviews the recent studies that support the utility of digital pulse amplitude tonometry as a relevant test of peripheral endothelial function.

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Post-Challenge Hyperglycemia in Older Adults Is Associated with Increased Cardiovascular Risk Profile

Abstract: Older adults with PCH experience significant fasting and postprandial metabolic dysregulation, which is accompanied by a proatherosclerotic and prothrombotic vascular profile.

Cited by 31 publications

References 37 publications

Relationship between peripheral arterial reactive hyperemia and residual platelet reactivity after 600 mg clopidogrel

Relationship between peripheral arterial reactive hyperemia and residual platelet reactivity after 600 mg clopidogrel

Effect of acute and chronic glucocorticoid therapy on insulin sensitivity and postprandial vascular function

Assessment of Endothelial Function Using Digital Pulse Amplitude Tonometry

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