What does this research mean for the field?

In patients with type 2 diabetes mellitus, alterations in hemostatic, fibrinolytic, and rheologic parameters create a prothrombogenic state that is directly associated with more severe and distally located coronary atherosclerosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate whether hemostatic and rheologic risk factors influence the extent, severity, and anatomical distribution of coronary artery disease in patients with type 2 diabetes.

January 1, 2009Cardiovascular DiabetologyOpen Access

Relevance of hemostatic risk factors on coronary morphology in patients with diabetes mellitus type 2

View Full Paper

Ask AI

Bookmark

Why the study?

Do hemostatic and fibrinolytic risk factors correlate with the morphological extent and severity of coronary artery disease in patients with type 2 diabetes mellitus?

Key Points

To investigate whether hemostatic and rheologic risk factors influence the extent, severity, and anatomical distribution of coronary artery disease in patients with type 2 diabetes.
Evaluated 150 consecutive patients with angiographically confirmed coronary artery disease, including 29 patients with type 2 diabetes.
Measured lipid parameters, rheologic measures (plasma viscosity, red blood cell aggregation), and hemostatic markers (fibrinogen, t-PA, PAI, PAP, F1+2, TAT, vWF, PF4, GMP140).
Assessed coronary artery disease extent, severity, and distal stenosis distribution using American Heart Association angiographic criteria.
Patients with diabetes presented with significantly higher prothrombin fragment 1+2, red blood cell aggregation, and plasminogen activator inhibitor levels than non-diabetic patients.
Diabetic individuals showed significantly more severe coronary arteriosclerosis that extended farther into distal vessel segments.
A significant positive correlation linked blood glucose, platelet activation (vWF), and impaired fibrinolysis (PAI) to CAD severity and distal stenosis location (r = 0.6, p < 0.001).

Structured PICO

Do hemostatic and fibrinolytic risk factors correlate with the morphological extent and severity of coronary artery disease in patients with type 2 diabetes mellitus?

Population

150 consecutive patients aged 50-65 years with angiographically proven coronary artery disease (28 with DM type 2, 122 without). Exclusion criteria: unstable angina pectoris, acute myocardial infarction within the last six months, prior coronary interventions, acute or chronic infections, malignant diseases, and type 1 diabetes.

Comparator

Patients without diabetes mellitus type 2 (n=122)

Outcome

Extent and severity of coronary artery disease evaluated according to the criteria of the American Heart Association (total score, proximal score, distal score)surrogate

In patients with coronary artery disease, type 2 diabetes is associated with more severe and distally pronounced atherosclerosis, which correlates with prothrombotic alterations in hemostatic and fibrinolytic parameters.

Limitations

Oral glucose tolerance test (OGTT) was not part of the protocol, potentially underestimating the true rate of diabetes
Angiographic assessment could underestimate the true plaque burden compared to intravascular ultrasound (IVUS)

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Type 2 diabetes was associated with more severe distal coronary atherosclerosis; hypothesis-generating for hemostatic correlations and requires prospective validation before practice implications.

Cite This Study

Jax et al. (2009) studied this question.

synapsesocial.com/papers/6a1deeb48b32c80b54603607 https://doi.org/10.1186/1475-2840-8-24

Topics

Coronary artery disease

View Full Paper

Ask AI

Bookmark

Implication

Type 2 diabetes was associated with more severe distal coronary atherosclerosis; hypothesis-generating for hemostatic correlations and requires prospective validation before practice implications.

Relevance of hemostatic risk factors on coronary morphology in patients with diabetes mellitus type 2

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Relevance of hemostatic risk factors on coronary morphology in patients with diabetes mellitus type 2

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider