Signs of subclinical atherosclerosis in asymptomatic patients at increased risk of type 2 diabetes mellitus

Kiss, Loretta; Bagyura, Zsolt; Vadas, Réka; Polgár, Lívia; Lux, Árpád; Edes, E.; Szenczi, Orsolya; Soós, Pál; Szelid, Zsolt; Becker, Dávid; Jermendy, György; Merkely, Béla

doi:10.1016/j.jdiacomp.2017.05.007

Cited by 12 publications

(11 citation statements)

References 45 publications

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“…Since myocardial ischemia is occasionally absent from the typical symptoms in patients with DM, severe multivessel CAD can manifest as silent myocardial ischemia or unrecognized myocardial infarction before treatment is begun. 10 With one-quarter of initial myocardial infarctions being unrecognized particularly in diabetic and prediabetic patients, 44 recognition is critical to minimize further CV risk. Although the ADA has recommended screening for DM and prediabetes in high-risk patients, 24 the previous studies have shown suboptimal screening rates in populations who meet ADA guidelines criteria.…”

Section: Discussionmentioning

confidence: 99%

“…5 Since epidemiological evidence suggests that this morbidity–mortality relationship begins early in the progression from normal glucose tolerance to overt DM, 6,7 “prediabetes” may be associated with an increased risk of coronary artery disease (CAD). 8 –11 Moreover, some speculated that myocardial infarction could be a prediabetes risk equivalent. 12 However, both prediabetes and DM are often not diagnosed until complications appear, and one-third of those with DM may be undiagnosed, 13 particularly among high-risk patients with ACS.…”

Section: Introductionmentioning

confidence: 99%

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Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Açar¹,

Özeke²,

Karakurt³

et al. 2018

Angiology

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Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Açar¹,

Özeke²,

Karakurt³

et al. 2018

Angiology

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“…Atherosclerosis is believed to be one of the fundamental pathological manifestations of diabetic vascular complications 1. Evidence from previous clinical trials indicated the role of hyperglycemia in the pathogenesis of diabetic vascular complications 2.…”

Section: Introductionmentioning

confidence: 99%

“…A therosclerosis is believed to be one of the fundamental pathological manifestations of diabetic vascular complications. 1 Evidence from previous clinical trials indicated the role of hyperglycemia in the pathogenesis of diabetic vascular complications. 2 Under circumstances of sustained hyperglycemia, glucose participates in nonenzymatic glycation reactions with lipids, nucleic acids, and amino groups of proteins, generating Schiff bases and Amadori products.…”

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confidence: 99%

Matrine‐Type Alkaloids Inhibit Advanced Glycation End Products Induced Reactive Oxygen Species‐Mediated Apoptosis of Aortic Endothelial Cells In Vivo and In Vitro by Targeting MKK3 and p38MAPK Signaling

Liu

Zhang

et al. 2017

JAHA

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BackgroundThe matrine‐type alkaloids are bioactive components extracted from Sophora flavescens, which is used in treatment of diabetes mellitus in traditional Chinese medicine. Advanced glycation end products mediate diabetic vascular complications. This study was aimed to investigate the protective effects and molecular mechanisms of matrine‐type alkaloids on advanced glycation end products–induced reactive oxygen species–mediated endothelial apoptosis.Methods and ResultsRats aorta and cultured rat aortic endothelial cells were exposed to advanced glycation end products. Matrine‐type alkaloids, p38 mitogen‐activated protein kinase (MAPK) inhibitor, and small interference RNAs against p38 MAPK kinases MAPK kinase kinase (MKK)3 and MKK6 were administrated. Intracellular reactive oxygen species production, cell apoptosis, phosphorylation of MKKs/p38 MAPK, and expression levels of heme oxygenase/NADPH quinone oxidoreductase were assessed. The nuclear factor erythroid 2‐related factor 2 nuclear translocation and the binding activity of nuclear factor erythroid 2‐related factor 2 with antioxidant response element were also evaluated. Matrine‐type alkaloids suppressed intracellular reactive oxygen species production and inhibited endothelial cell apoptosis in vivo and in vitro by recovering phosphorylation of MKK3/6 and p38 MAPK, nuclear factor erythroid 2‐related factor 2 nuclear translocation, and antioxidant response element binding activity, as well as the expression levels of heme oxygenase/NADPH quinone oxidoreductase. p38 MAPK inhibitor treatment impaired the effects of matrine‐type alkaloids in vivo and in vitro. MKK3/6 silencing impaired the effects of matrine‐type alkaloids in vitro.ConclusionsMatrine‐type alkaloids exert endothelial protective effects against advanced glycation end products induced reactive oxygen species–mediated apoptosis by targeting MKK3/6 and enhancing their phosphorylation.

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“…The initiation and progression of atherosclerosis are complicated, involving endothelial dysfunction, inflammation, oxidative stress and thrombus formation 2–4 . Risk factors such as hypercholesterolemia and diabetes enhance endothelial cell injury and inflammation and reinforce atherosclerosis progression in mice 5–7 and humans 8,9 . Despite the implementation of various regimens having had beneficial effects in CHD patients, a large number of patients still progress to repeated stenting for revascularisation and recurrent myocardial infarction 2 .…”

Section: Introductionmentioning

confidence: 99%

Circulating Hematopoietic Stem/Progenitor Cells are Associated with Coronary Stenoses in Patients with Coronary Heart Disease

Zhu

Zhang

et al. 2019

Sci Rep

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Inflammatory cells in atherosclerotic plaque exclusively originate from hematopoietic stem/progenitor cells (HSPCs). In this study, we investigated whether circulating HSPCs frequency related to coronary stenosis in patients with coronary heart disease (CHD). Coronary angiography was performed in 468 participants who were recruited at Cardiology Centre in LuHe Hospital from March 2016 to May 2017. Among these subjects, 344 underwent echocardiography. Mononuclear cells isolated from peripheral blood were stained with an antibody cocktail containing anti-human CD34, anti-human lineage, anti-human CD38, and anti-human CD45RA. Lineage−CD38−CD45RAdimCD34+HSPCs were quantified by flow cytometry. CHD was defined as coronary stenosis ≥50% and the extent of CHD was further categorised by coronary stenosis ≥70%. A p < 0.0031 was regarded statistically significant by the Bonferroni correction. Circulating HSPCs frequency was 1.8-fold higher in CHD patients than non-CHD participants (p = 0.047). Multivariate-adjusted logistic analysis demonstrated that HSPCs was the only marker that was associated with the odds ratio of having mild vs. severe coronary stenosis (2.08 (95% CI, 1.35–3.21), p = 0.0009). Left ventricular ejection fraction was inversely correlated with HSPCs frequency and CRP in CHD patients (p < 0.05 for both). In conclusion, HSPCs frequency in circulation is intimately related to coronary stenoses in CHD patients.

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Signs of subclinical atherosclerosis in asymptomatic patients at increased risk of type 2 diabetes mellitus

Cited by 12 publications

References 45 publications

Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Matrine‐Type Alkaloids Inhibit Advanced Glycation End Products Induced Reactive Oxygen Species‐Mediated Apoptosis of Aortic Endothelial Cells In Vivo and In Vitro by Targeting MKK3 and p38MAPK Signaling

Circulating Hematopoietic Stem/Progenitor Cells are Associated with Coronary Stenoses in Patients with Coronary Heart Disease

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