Non-ST-elevation myocardial infarction outcomes in patients with type 2 diabetes with non-obstructive coronary artery stenosis: Effects of incretin treatment

2017 ◽  
Vol 20 (3) ◽  
pp. 723-729 ◽  
Author(s):  
Raffaele Marfella ◽  
Celestino Sardu ◽  
Paolo Calabrò ◽  
Mario Siniscalchi ◽  
Fabio Minicucci ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals Are there sex differences in the effect of type 2 diabetes in the incidence and outcomes of myocardial infarction? A matched-pair analysis using hospital discharge data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ana Lopez-de-Andres ◽  
Rodrigo Jimenez-Garcia ◽  
Valentin Hernández-Barrera ◽  
Jose M. de Miguel-Yanes ◽  
Romana Albaladejo-Vicente ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Sex Differences ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Hospital Discharge ◽  
St Elevation Myocardial Infarction ◽  
Men And Women ◽  
St Elevation

Abstract Background To analyze incidence, use of therapeutic procedures, and in-hospital outcomes in patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to the presence of type 2 diabetes (T2DM) in Spain (2016–2018) and to investigate sex differences. Methods Using the Spanish National Hospital Discharge Database, we estimated the incidence of myocardial infarctions (MI) in men and women with and without T2DM aged ≥ 40 years. We analyzed comorbidity, procedures, and outcomes. We matched each man and woman with T2DM with a non-T2DM man and woman of identical age, MI code, and year of hospitalization. Propensity score matching was used to compare men and women with T2DM. Results MI was coded in 109,759 men and 44,589 women (30.47% with T2DM). The adjusted incidence of STEMI (IRR 2.32; 95% CI 2.28–2.36) and NSTEMI (IRR 2.91; 95% CI 2.88–2.94) was higher in T2DM than non-T2DM patients, with higher IRRs for NSTEMI in both sexes. The incidence of STEMI and NSTEMI was higher in men with T2DM than in women with T2DM. After matching, percutaneous coronary intervention (PCI) was less frequent among T2DM men than non-T2DM men who had STEMI and NSTEMI. Women with T2DM and STEMI less frequently had a code for PCI that matched that of non-T2DM women. In-hospital mortality (IHM) was higher among T2DM women with STEMI and NSTEMI than in matched non-T2DM women. In men, IHM was higher only for NSTEMI. Propensity score matching showed higher use of PCI and coronary artery bypass graft and lower IHM among men with T2DM than women with T2DM for both STEMI and NSTEMI. Conclusions T2DM is associated with a higher incidence of STEMI and NSTEMI in both sexes. Men with T2DM had higher incidence rates of STEMI and NSTEMI than women with T2DM. Having T2DM increased the risk of IHM after STEMI and NSTEMI among women and among men only for NSTEMI. PCI appears to be less frequently used in T2DM patients After STEMI and NSTEMI, women with T2DM less frequently undergo revascularization procedures and have a higher mortality risk than T2DM men.

scholarly journals Circulating Malondialdehyde-Modified LDL-Related Variables and Coronary Artery Stenosis in Asymptomatic Patients with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Kazuya Fujihara ◽  
Hiroaki Suzuki ◽  
Akira Sato ◽  
Satoru Kodama ◽  
Yoriko Heianza ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Characteristic Curve ◽  
Artery Stenosis ◽  
Related Variable ◽  
Modified Ldl ◽  
Luminal Narrowing ◽  
Asymptomatic Patients

Aims. To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM).Methods. Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of ≥50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis.Results. Seventeen patients had CAS. Each MDA-LDL-related variable was an independent predictor of CAS (P=0.039for MDALDL,P=0.013for MDA-LDL/LDL-C,P=0.047for MDA-LDL/HDL-C, andP=0.013for (MDA-LDL/LDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDL/LDL-C)/HDL-C were 0.675 (95% CI 0.496–0.854), 0.765 (0.602–0.927), 0.752 (0.592–0.913), and 0.799 (0.643–0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between MDA-LDL/LDL-C, MDA-LDL/HDL-C, or (MDALDL/LDL-C)/HDL-C and CAS (P=0.003for MDA-LDL/LDL-C,P=0.042for MDA-LDL/HDL-C, andP=0.001for (MDA-LDL/LDL-C)/HDL-C).Conclusions. Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MDA-LDL/LDL-C)/HDL-C are useful for predicting CAS.

scholarly journals IMPACT OF TYPE 2 DIABETES IN NON ST-ELEVATION MYOCARDIAL INFARCTION (NSTEMI).

2018 ◽  
Vol 6 (12) ◽  
pp. 1029-1033
Author(s):  
Sanoussi Hamza ◽  
◽  
Hasni MohammedAli ◽  
Kourireche Najla ◽  
Lakhal Zouhair ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals The C Allele of the Reactive Oxygen Species Modulator 1 (ROMO1) Polymorphism Rs6060566 is a Biomarker Predicting Coronary Artery Stenosis in Slovenian Subjects With Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Miha Tibaut ◽  
Sara Mankoč Ramuš ◽  
Daniel Petrovic
Keyword(s):  
Reactive Oxygen Species ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Stenosis ◽  
Reactive Oxygen ◽  
Artery Stenosis ◽  
Oxygen Species ◽  
Increased Risk

Abstract Background: We aimed to examine the role of the rs6060566 polymorphism of the reactive oxygen species modulator 1 (ROMO1) gene in the development of myocardial infarction (MI) in Caucasians with type 2 diabetes (T2DM).Methods: A total of 1072 subjects with T2DM were enrolled in this cross-sectional case-control study: 335 subjects with MI and 737 subjects without clinical signs of coronary artery disease (CAD). The genetic analysis of the rs6060566 polymorphism was performed in all subjects. To assess the degree of coronary artery obstruction, a subpopulation of 128 subjects with T2DM underwent coronary computed tomography angiography. Next, endarterectomy samples were obtained during myocardial revascularization from diffusely diseased coronary arteries in 40 cases, which were analysed for ROMO1 expression according to their genotype.Results: There were no statistically significant associations between different genotypes or alleles of the rs6060566 polymorphism and MI in subjects with T2DM. The carriers of the C allele of the ROMO1 rs6060566 had a threefold increased likelihood of having 50%-75% coronary artery stenosis (Adjusted OR= 3.27, 95% CI 1.16 – 9.20). Subjects with two affected coronary arteries had a 3.72 fold higher prevalence of MI (OR= 3.72, 95% CI 1.27 – 10.84). With CAD in LMCA or LAD, MI prevalence was about 3.5-fold higher (p=0.07 for LMCA and p=0.01 for LAD). Furthermore, the carriers of the rs6060566 C allele showed higher number of positive cells for ROMO1 expression in endarterectomy samples of coronary arteries.Conclusions: According to our study, the rs6060566 polymorphism of the ROMO1 gene is not a risk factor for MI in Caucasians with T2DM. However, we found that subjects carrying the C allele were at a 3.27-fold increased risk of developing severe CAD compared with those who had non-obstructive CAD. Moreover, C allele carriers showed a statistically higher number of cells positive for ROMO1 compared with T allele carriers in coronary endarterectomy samples.

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