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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Type 2 diabetes mellitus and myocardial ischemic preconditioning in symptomatic coronary artery disease patients

Authors: Paulo Cury Rezende, Rosa Maria Rahmi, Augusto Hiroshi Uchida, Leandro Menezes Alves da Costa, Thiago Luis Scudeler, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Carlos Alexandre Wainrober Segre, Priscyla Girardi, Myrthes Takiuti, Marcela Francisca Silva, Whady Hueb, Jose Antonio Franchini Ramires, Roberto Kalil Filho

Published in: Cardiovascular Diabetology | Issue 1/2015

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Abstract

Background

The influence of diabetes mellitus on myocardial ischemic preconditioning is not clearly defined. Experimental studies are conflicting and human studies are scarce and inconclusive.

Objectives

Identify whether diabetes mellitus intervenes on ischemic preconditioning in symptomatic coronary artery disease patients.

Methods

Symptomatic multivessel coronary artery disease patients with preserved systolic ventricular function and a positive exercise test underwent two sequential exercise tests to demonstrate ischemic preconditioning. Ischemic parameters were compared among patients with and without type 2 diabetes mellitus. Ischemic preconditioning was considered present when the time to 1.0 mm ST deviation and rate pressure-product were greater in the second of 2 exercise tests. Sequential exercise tests were analyzed by 2 independent cardiologists.

Results

Of the 2,140 consecutive coronary artery disease patients screened, 361 met inclusion criteria, and 174 patients (64.2 ± 7.6 years) completed the study protocol. Of these, 86 had the diagnosis of type 2 diabetes. Among diabetic patients, 62 (72 %) manifested an improvement in ischemic parameters consistent with ischemic preconditioning, whereas among nondiabetic patients, 60 (68 %) manifested ischemic preconditioning (p = 0.62). The analysis of patients who demonstrated ischemic preconditioning showed similar improvement in the time to 1.0 mm ST deviation between diabetic and nondiabetic groups (79.4 ± 47.6 vs 65.5 ± 36.4 s, respectively, p = 0.12). Regarding rate pressure-product, the improvement was greater in diabetic compared to nondiabetic patients (3011 ± 2430 vs 2081 ± 2139 bpm x mmHg, respectively, p = 0.01).

Conclusions

In this study, diabetes mellitus was not associated with impairment in ischemic preconditioning in symptomatic coronary artery disease patients. Furthermore, diabetic patients experienced an improvement in this significant mechanism of myocardial protection.
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Metadata
Title
Type 2 diabetes mellitus and myocardial ischemic preconditioning in symptomatic coronary artery disease patients
Authors
Paulo Cury Rezende
Rosa Maria Rahmi
Augusto Hiroshi Uchida
Leandro Menezes Alves da Costa
Thiago Luis Scudeler
Cibele Larrosa Garzillo
Eduardo Gomes Lima
Carlos Alexandre Wainrober Segre
Priscyla Girardi
Myrthes Takiuti
Marcela Francisca Silva
Whady Hueb
Jose Antonio Franchini Ramires
Roberto Kalil Filho
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0228-x

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