The Euro Heart Survey – Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease

Drechsler, K.; Fikenzer, Sven; Sechtem, Udo; Blank, Elisabeth; Breithardt, G.; Zeymer, Uwe; Niebauer, Josef

doi:10.1007/s00392-008-0643-z

Cited by 14 publications

(3 citation statements)

References 16 publications

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“…The OGTT identified IGT, a prognostic parameter,25 in a high percentage of patients and predominantly in the older group. In the Euro Heart Survey on diabetes and the heart,26 the rate of patients with unknown IGT who were referred to undergo elective or acute angiography was remarkable at 39%. This high prevalence of glucometabolic disorders is confirmed by other study groups 27.…”

Section: Discussionmentioning

confidence: 99%

Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients

Reibis¹,

Treszl²,

Wegscheider³

et al. 2012

VHRM

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BackgroundThere are few data available regarding the specificity and modifiability of major cardiovascular (CV) risk factors in patients with premature versus (vs) late-onset coronary artery disease (CAD). This study was designed to analyze and compare these risk factors.Patients and methodsData from 15,381 consecutive patients (mean age, 62.3 ± 11.7 years; female, 33.8%) hospitalized with CAD were collected from a large-scale registry (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management) and analyzed. The patients were divided into two groups, depending on age at inclusion: group 1 patients (n = 5725; mean age, 50.5 ± 7.2 years) were males aged < 55 years and females aged < 65 years; group 2 patients (n = 9656; mean age, 69.4 ± 7.4 years) were males aged > 55 years and females aged > 65 years and had a low-density lipoprotein cholesterol level of >100 mg/dL on admission to cardiac rehabilitation. Besides the conventional risk factors, lipoprotein(a) concentrations and glucose tolerance were measured facultatively. Univariate (chi-square test) and multivariate logistic regression models were used.ResultsCigarette smoking (group 1 at 31.5% vs group 2 at 9.4%; P < 0.001), family history of CAD (group 1 at 43.6% vs group 2 at 26.5%; P < 0.001), and dyslipidemia (group 1 at 92.7% vs group 2 at 91.8%; P < 0.001) were dominant risk factors in the younger group. Arterial hypertension (group 1 at 71.4% vs group 2 at 87.0%; P < 0.001) and diabetes (group 1 at 23.5% vs group 2 at 30.1%; P < 0.001) were dominant risk factors in the older group. Impaired glucose tolerance and diabetes were less frequent in the younger group (Ptrend = 0.038), and identical lipoprotein(a) concentration levels of >30 mg/dL were found in both groups (8.0%; P = 0.810). Modification of lipid profile and blood pressure was more effective in the younger group (low-density lipoprotein cholesterol < 100 mg/dL: group 1 at 66.3% vs group 2 at 61.1%; systolic blood pressure < 140 mmHg: group 1 at 91.7% vs group 2 at 83.0%; P < 0.001).ConclusionCV risk factors differ markedly between premature and non-premature CAD. Cardiac rehabilitation provides an opportunity to reinforce secondary prevention after acute coronary syndrome.

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Section: Discussionmentioning

confidence: 99%

Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients

Reibis¹,

Treszl²,

Wegscheider³

et al. 2012

VHRM

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“…Increased oxidative stress has been implicated in molecular pathomechanisms of DM and majority of chronic diseases developed secondary to diabetes [23–25]. Several studies demonstrated the excessive production of ROS to be the common feature of both diabetes types [10, 22, 26–28].…”

Section: Subcellular and Molecular Mechanisms In Dm-predisposition Tomentioning

confidence: 99%

Cancer predisposition in diabetics: risk factors considered for predictive diagnostics and targeted preventive measures

2010

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Diabetes mellitus (DM) is a lifelong progressive disease with high morbidity and mortality worldwide. Whereas cardiovascular complications are well-known for DM, increasing evidence indicates that diabetics are predisposed to cancer. Understanding of molecular pathomechanisms of cancer in DM is of great importance. Dysregulation of glucose/insulin homeostasis leads to increased production of Reactive Oxygen/Nitrogen Species (ROS/RNS) and consequent damage to chromosomal/mitochondrial DNA, a frequent finding in DM. Long-term accumulation of modified/damaged DNA is well-acknowledged as triggering cancer. DNA-repair is a highly energy consuming process provoking increased mitochondrial activity. Particularly dangerous is a provoked activity of damaged mitochondria leading to a “vicious circle” lowering energy supply and potentiating ROS/RNS production. Mitochondrial dysfunction may be implicated in pathomechanisms of diabetes-related cancer. High risk for infectious disorders and induced viral proto-oncogenic activity may further contribute to cancer provocation. Much attention should be focused on preventive measures in diabetic healthcare, in order to restrict severe diabetes-related complications.

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“…The Euro Heart Survey (Germany) found that more than one third of the patients with CAD who underwent an OGTT had an impaired glucose tolerance [14]. Prospective studies have shown that hyperglycemia itself is clearly involved in predicting CAD [15].…”

Section: Discussionmentioning

confidence: 99%

Impact of Acarbose on the Serum YKL-40 Concentrations of Coronary Heart Disease Patients with Impaired Glucose Tolerance

Ni¹

2017

J Clin Exp Cardiolog

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The Euro Heart Survey – Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease

Cited by 14 publications

References 16 publications

Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients

Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients

Cancer predisposition in diabetics: risk factors considered for predictive diagnostics and targeted preventive measures

Impact of Acarbose on the Serum YKL-40 Concentrations of Coronary Heart Disease Patients with Impaired Glucose Tolerance

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