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Myocardial injury in diabetic patients with multivessel coronary artery disease after revascularization interventions
| Content Provider | Semantic Scholar |
|---|---|
| Author | Rezende, Paulo Cury Hueb, Whady Rahmi, Rosa Maria Scudeler, Thiago Luis Azevedo, Diogo Freitas Cardoso De Garzillo, Cibele Larrosa Segre, Carlos Alexandre Wainrober Ramires, José Antonio F. Filho, Roberto Kalil |
| Copyright Year | 2017 |
| Abstract | AbstractBackgroundDiabetic patients may be more susceptible to myocardial injury after coronary interventions. Thus, the aim of this study was to assess the release of cardiac biomarkers, CK-MB and troponin, and the findings of new late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in patients with type 2 diabetes mellitus after elective revascularization procedures for multivessel coronary artery disease (CAD).MethodsPatients with multivessel CAD and preserved systolic ventricular function underwent either elective percutaneous coronary intervention (PCI), off-pump or on-pump bypass surgery (CABG). Troponin and CK-MB were systematically collected at baseline, 6, 12, 24, 36, 48 and 72 h after the procedures. CMR with LGE was performed before and after the interventions. Patients were stratified according to diabetes status at study entry. Biomarkers and CMR results were compared between diabetic and nondiabetics patients. Analyses of correlation were also performed among glycemic and glycated hemoglobin (A1c) levels and troponin and CK-MB peak levels. Patients were also stratified into tertiles of fasting glycemia and A1c levels and were compared in terms of periprocedural myocardial infarction (PMI) on CMR.ResultsNinety (44.5%) of the 202 patients had diabetes mellitus at study entry. After interventions, median peak troponin was 2.18 (0.47, 5.14) and 2.24 (0.69, 5.42) ng/mL (P = 0.81), and median peak CK-MB was 14.1 (6.8, 31.7) and 14.0 (4.2, 29.8) ng/mL (P = 0.43), in diabetic and nondiabetic patients, respectively. The release of troponin and CK-MB over time was statistically similar in both groups and in the three treatments, besides PCI. New LGE on CMR indicated that new myocardial fibrosis was present in 18.9 and 17.3% (P = 0.91), and myocardial edema in 15.5 and 22.9% (P = 0.39) in diabetic and nondiabetic patients, respectively. The incidence of PMI in the glycemia tertiles was 17.9% versus 19.3% versus 18.7% (P = 0.98), and in the A1c tertiles was 19.1% versus 13.3% versus 22.2% (P = 0.88).ConclusionsIn this study, diabetes mellitus did not add risk of myocardial injury after revascularization interventions in patients with multivessel coronary artery disease. Trial Registration Name of Registry: Evaluation of cardiac biomarker elevation after percutaneous coronary intervention or coronary artery bypass graft; URL: http://www.controlled-trials.com.ISRCTN09454308 |
| Starting Page | 172 |
| Ending Page | 182 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://dmsjournal.biomedcentral.com/track/pdf/10.1186/s13098-017-0292-3?site=dmsjournal.biomedcentral.com |
| PubMed reference number | 5697213 |
| Alternate Webpage(s) | https://doi.org/10.1186/s13098-017-0292-3 |
| DOI | 10.1186/s13098-017-0292-3 |
| Journal | Diabetology & Metabolic Syndrome |
| Volume Number | 9 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angioedema Arteriopathic disease Biologic Preservation Biological Markers Biotinidase Deficiency Blood Glucose Cardiomyopathies Coronary Artery Bypass Surgery Coronary Artery Disease Creatine Kinase MB Isoenzyme Diabetes Mellitus Diabetes Mellitus, Non-Insulin-Dependent Edema Fibrosis Gadolinium Myocardial Infarction Myocardial Ischemia Myocardium Patients Percutaneous Coronary Intervention Uniform Resource Locator Ventricular Function revascularization |
| Content Type | Text |
| Resource Type | Article |
