Limits...
Severely impaired microvascular reactivity in diabetic patients with an acute coronary syndrome.

Östlund Papadogeorgos N, Jörneskog G, Bengtsson M, Kahan T, Kalani M - Cardiovasc Diabetol (2016)

Bottom Line: Microvascular function is impaired in patients with stable coronary artery disease.Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls.Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)).

View Article: PubMed Central - PubMed

Affiliation: Dept of Cardiology, Danderyd University Hospital Corp, 182 88, Stockholm, Sweden. nikolaos.ostlund-papadogeorgos@ds.se.

ABSTRACT

Background: Microvascular function is impaired in patients with stable coronary artery disease. The aim was to study microvascular function in patients with diabetes and acute coronary syndrome (ACS).

Methods: Microvascular function was evaluated in 83 patients by laser Doppler fluxmetry (LDF) [PU; perfusion unit, median (interquartile range)] measuring resting LDF and peak LDF following a six min heating of the skin to 44 °C at the foot, respectively. All patients with ACS and without previously known diabetes underwent oral glucose tolerance test. Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls.

Results: Peak LDF was significantly (P = 0.03) lower in patients with ACS and diabetes (n = 22; 72 (52)) and diabetes without coronary artery disease (n = 39; 69 (51)) as compared to patients with ACS without diabetes (n = 46; 97 (60)), and patients without ACS (n = 15; 140 (121)), respectively. Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)).

Conclusion: Microvascular reactivity is severely impaired in patients with diabetes and ACS. Diabetes has a major influence on microvascular function in patients with coronary artery disease.

No MeSH data available.


Related in: MedlinePlus

Resting laser Doppler fluxmetry (a) and post reactive hyperaemia (peak LDF) (b) in patients with ACS and diabetes (ACS+/DM+; n = 22), ACS without diabetes (ACS+/DM−; n = 46), no ACS and no diabetes (ACS−/DM−; n = 15), and diabetes without coronary artery disease (ACS−/DM+; n = 39). Data are depicted as median and quartiles. PU perfusion unit
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4837627&req=5

Fig1: Resting laser Doppler fluxmetry (a) and post reactive hyperaemia (peak LDF) (b) in patients with ACS and diabetes (ACS+/DM+; n = 22), ACS without diabetes (ACS+/DM−; n = 46), no ACS and no diabetes (ACS−/DM−; n = 15), and diabetes without coronary artery disease (ACS−/DM+; n = 39). Data are depicted as median and quartiles. PU perfusion unit

Mentions: The results of the investigations of skin microvascular reactivity are presented in Fig. 1. There were no significant differences in resting LDF between the groups (Fig. 1a). Significantly lower peak LDF was measured in patients with ACS and diabetes and patients with diabetes free from CAD, respectively, compared to patients with ACS without diabetes and patients without ACS (Fig. 1b). The highest peak LDF was found in the patients without ACS and no diabetes (Fig. 1b). In the ten patients with ACS and IGT, peak LDF was 101 (75) PU, as compared to 72 (52) PU in 22 patients with diabetes (P = 0.07). There were no differences in skin temperature between the groups (data not shown). A weak negative correlation (r = −0.22; P = 0.05) was found between body mass index and peak LDF. Age, blood lipids, fasting plasma glucose, HbA1c, brachial or ankle systolic blood pressure did not relate to peak LDF.Fig. 1


Severely impaired microvascular reactivity in diabetic patients with an acute coronary syndrome.

Östlund Papadogeorgos N, Jörneskog G, Bengtsson M, Kahan T, Kalani M - Cardiovasc Diabetol (2016)

Resting laser Doppler fluxmetry (a) and post reactive hyperaemia (peak LDF) (b) in patients with ACS and diabetes (ACS+/DM+; n = 22), ACS without diabetes (ACS+/DM−; n = 46), no ACS and no diabetes (ACS−/DM−; n = 15), and diabetes without coronary artery disease (ACS−/DM+; n = 39). Data are depicted as median and quartiles. PU perfusion unit
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837627&req=5

Fig1: Resting laser Doppler fluxmetry (a) and post reactive hyperaemia (peak LDF) (b) in patients with ACS and diabetes (ACS+/DM+; n = 22), ACS without diabetes (ACS+/DM−; n = 46), no ACS and no diabetes (ACS−/DM−; n = 15), and diabetes without coronary artery disease (ACS−/DM+; n = 39). Data are depicted as median and quartiles. PU perfusion unit
Mentions: The results of the investigations of skin microvascular reactivity are presented in Fig. 1. There were no significant differences in resting LDF between the groups (Fig. 1a). Significantly lower peak LDF was measured in patients with ACS and diabetes and patients with diabetes free from CAD, respectively, compared to patients with ACS without diabetes and patients without ACS (Fig. 1b). The highest peak LDF was found in the patients without ACS and no diabetes (Fig. 1b). In the ten patients with ACS and IGT, peak LDF was 101 (75) PU, as compared to 72 (52) PU in 22 patients with diabetes (P = 0.07). There were no differences in skin temperature between the groups (data not shown). A weak negative correlation (r = −0.22; P = 0.05) was found between body mass index and peak LDF. Age, blood lipids, fasting plasma glucose, HbA1c, brachial or ankle systolic blood pressure did not relate to peak LDF.Fig. 1

Bottom Line: Microvascular function is impaired in patients with stable coronary artery disease.Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls.Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)).

View Article: PubMed Central - PubMed

Affiliation: Dept of Cardiology, Danderyd University Hospital Corp, 182 88, Stockholm, Sweden. nikolaos.ostlund-papadogeorgos@ds.se.

ABSTRACT

Background: Microvascular function is impaired in patients with stable coronary artery disease. The aim was to study microvascular function in patients with diabetes and acute coronary syndrome (ACS).

Methods: Microvascular function was evaluated in 83 patients by laser Doppler fluxmetry (LDF) [PU; perfusion unit, median (interquartile range)] measuring resting LDF and peak LDF following a six min heating of the skin to 44 °C at the foot, respectively. All patients with ACS and without previously known diabetes underwent oral glucose tolerance test. Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls.

Results: Peak LDF was significantly (P = 0.03) lower in patients with ACS and diabetes (n = 22; 72 (52)) and diabetes without coronary artery disease (n = 39; 69 (51)) as compared to patients with ACS without diabetes (n = 46; 97 (60)), and patients without ACS (n = 15; 140 (121)), respectively. Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)).

Conclusion: Microvascular reactivity is severely impaired in patients with diabetes and ACS. Diabetes has a major influence on microvascular function in patients with coronary artery disease.

No MeSH data available.


Related in: MedlinePlus