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Rallidis LS, Papathanasiou KA, Tsamoulis D, Bouratzis V, Leventis I, Kalantzis C, Malkots B, Kalogeras P, Tasoulas D, Delakis I, Lykoudis A, Daios S, Potoupni V, Zervakis S, Theofilatos A, Kotrotsios G, Kostakou PM, Kostopoulos K, Gounopoulos P, Mplani V, Zacharis E, Barmpatzas N, Kotsakis A, Papadopoulos C, Trikas A, Ziakas A, Skoularigis I, Naka KK, Tziakas D, Panagiotakos D, Vlachopoulos C. Newly detected diabetes mellitus patients with acute coronary syndrome have an adverse cardiometabolic profile similar to patients with prior diabetes and a more extensive ischemic myocardial insult. Diabetes Res Clin Pract 2024; 211:111664. [PMID: 38604446 DOI: 10.1016/j.diabres.2024.111664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/12/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
AIMS The impact of newly detected diabetes mellitus (NDDM) on metabolic parameters and extent of myocardial necrosis in patients with acute coronary syndrome (ACS) is not fully explored. We examined the impact of NDDM on cardiometabolic characteristics and myocardial necrosis in ACS patients. METHODS CALLINICUS-Hellas Registry is an ongoing prospective multicenter observational study evaluating the adherence to lipid-lowering therapy (LLT) among ACS patients in Greece. Three groups were created: a) patients with NDDM (abnormal fasting glucose, HbA1c ≥ 6.5 % and no previous history of DM), b) patients without known DM and HbA1c < 6.5 % (non-DM) and c) patients with prior DM. RESULTS The prevalence of NDDM among 1084 patients was 6.9 %. NDDM patients had lower HDL-C [38 (32-45) vs 42 (36-50) mg/dL] and higher triglycerides levels [144 (104-231) vs 115 (87-152) mg/dL] compared to non-DM patients (p < 0.05). NDDM patients featured both higher body mass index [29.5 (26.4-34.3) vs 27.1 (24.9-29.9) kg/m2] and waist circumference [107 (100-114) vs 98 (91-106) cm] compared to non-DM patients (p < 0.05). In addition, NDDM patients had more extensive myocardial necrosis than patients with prior DM. CONCLUSIONS ACS patients with NDDM have an adverse cardiometabolic profile similar to patients with prior DM and have more extensive myocardial insult.
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Affiliation(s)
- Loukianos S Rallidis
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
| | - Konstantinos A Papathanasiou
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece.
| | | | - Vasileios Bouratzis
- Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece
| | - Ioannis Leventis
- Department of Cardiology, University General Hospital of Larissa, Larissa, Greece
| | - Charalampos Kalantzis
- 1st Department of Cardiology, Medical School, National and Kapodistrian, University of Athens, Hippokration Hospital, Athens, Greece
| | - Belkis Malkots
- Cardiology Department, Medical School, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - Petros Kalogeras
- Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece
| | - Dimitrios Tasoulas
- 2nd Department of Cardiology, General Hospital of Nikea, Piraeus, Greece
| | - Iosif Delakis
- 1st Department of Cardiology, General Hospital of Nikea, Piraeus, Greece
| | - Anastasios Lykoudis
- 2nd Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece
| | - Stylianos Daios
- 1st Department of Cardiology, University General Hospital of Thessaloniki, AHEPA, Thessaloniki, Greece
| | - Victoria Potoupni
- 3rd Cardiology Department, Hippokration University Hospital, Aristotle University, Thessaloniki, Greece
| | - Stelios Zervakis
- Cardiology Department, Heraklion University Hospital, Crete, Greece
| | | | - Georgios Kotrotsios
- 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
| | - Peggy M Kostakou
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | | | - Pantelis Gounopoulos
- 2nd Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece
| | - Virginia Mplani
- Department of Cardiology, Patras University Hospital, Patras, Greece
| | | | | | | | | | | | - Antonios Ziakas
- 1st Department of Cardiology, University General Hospital of Thessaloniki, AHEPA, Thessaloniki, Greece
| | - Ioannis Skoularigis
- Department of Cardiology, University General Hospital of Larissa, Larissa, Greece
| | - Katerina K Naka
- Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece
| | - Dimitrios Tziakas
- Cardiology Department, Medical School, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | | | - Charalambos Vlachopoulos
- 1st Department of Cardiology, Medical School, National and Kapodistrian, University of Athens, Hippokration Hospital, Athens, Greece
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Meir J, Huang L, Mahmood S, Whiteson H, Cohen S, Aronow WS. The vascular complications of diabetes: a review of their management, pathogenesis, and prevention. Expert Rev Endocrinol Metab 2024; 19:11-20. [PMID: 37947481 DOI: 10.1080/17446651.2023.2279533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION This review highlights the pathogenesis of both microvascular and macrovascular complications of diabetes and how these mechanisms influence both the management and preventative strategies of these complications. The cumulative data shown in this review suggest hyperglycemic and blood pressure control remain central to this intricate process. AREAS COVERED We reviewed the literature including retrospective, prospective trials as well as meta-analysis, and post hoc analysis of randomized trials on microvascular andmacrovascular complications. EXPERT OPINION Further research is needed to explore the ideal intervention targets and preventative strategies needed to prevent macrovascular complications. Furthermore, as the data for trials looking at microvascular complications lengthen more long-term data will further elucidate the role that the duration of diabetes has on these complications. Additionally, trials looking to maximize hyperglycemic control with multiple agents in diabetes, such as metformin, SGL2isand GLP-1 receptor agonists are currently in process, which will have implications for rates of microvascular as well as macrovascular complications.
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Affiliation(s)
- Juliet Meir
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Lillian Huang
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Sumaita Mahmood
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Harris Whiteson
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Scott Cohen
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Wilbert S Aronow
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
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