Impact of Glycemic Control on the Association of Endothelial Dysfunction and Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Overview

Journal Cardiovasc Diabetol

Publisher Biomed Central

Specialties Cardiology & Vascular Diseases
Endocrinology

Date 2021 Mar 14

PMID 33714276

Citations 20

Authors

Shuai Chen

Ying Shen

Yong-Hua Liu

Yang Dai

Zhi-Ming Wu

Xiao-Qun Wang

Chen-Die Yang

Le-Ying Li

Jing-Meng Liu

Li-Ping Zhang

Wei-Feng Shen

Ri Ji

Lin Lu

Feng-Hua Ding

Affiliations

Soon will be listed here.

Abstract

Background: We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM).

Methods: In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c).

Results: The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056-0.915, P = 0.037), Gensini score (β = - 0.470, P < 0.001) and SYNTAX score (β = - 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05).

Conclusion: Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.

Citing Articles

[Explorative Exmination of Coronary Microcirculatory Ischemia in Type 2 Diabetes Mellitus Patients With One-Stop Cardiac Computed Tomography].

Xiong Y, Zhu W, Ling R, Ma J, Li Y Sichuan Da Xue Xue Bao Yi Xue Ban. 2025; 55(6):1371-1377.

PMID: 39990842 PMC: 11839373. DOI: 10.12182/20241160105.

Major adverse cardiovascular events' reduction and their association with glucose-lowering medications and glycemic control among patients with type 2 diabetes: A retrospective cohort study using electronic health records.

Hsu H, Kocis P, Pichardo-Lowden A, Hwang W J Diabetes. 2024; 16(10):e13604.

PMID: 39431844 PMC: 11492400. DOI: 10.1111/1753-0407.13604.

Time to first optimal glycemic control and its predictors among adult type 2 diabetes patients in Amhara Regional State comprehensive specialized hospitals, Northwest Ethiopia.

Chalie S, Ewunetie A, Assemie M, Liknaw A, Molla F, Telayneh A BMC Endocr Disord. 2024; 24(1):169.

PMID: 39215294 PMC: 11363452. DOI: 10.1186/s12902-024-01695-1.

Impact of Glycemic Control on Coronary Inflammation Evaluated by Computed Tomography Pericoronary Fat Attenuation Index in Patients with Acute Coronary Syndrome.

Jiang J, Yin Y, Li Y, Xu B, Zou Z, Ding S Rev Cardiovasc Med. 2024; 24(7):203.

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Prognostic value of geriatric nutritional risk index in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

Kuang M, Qiu J, Yang R, Wang C, Huang X, Xie G BMC Cardiovasc Disord. 2024; 24(1):264.

PMID: 38773437 PMC: 11106886. DOI: 10.1186/s12872-024-03940-w.

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