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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2021

Open Access 01-12-2021 | Arterial Occlusive Disease | Original investigation

Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus

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

Published in: Cardiovascular Diabetology | Issue 1/2021

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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.
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Metadata
Title
Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus
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
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2021
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-021-01257-y

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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