Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease
•Direct relation of glucose variability to coronary endothelial function is unclear.•This study showed that coronary endothelial function was correlated with mean amplitude of glycemic excursion (MAGE).•Peripheral endothelial function was not significantly associated with MAGE.•Greater glucose varia...
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| Veröffentlicht in: | Journal of cardiology 2022-01, Vol.79 (1), p.65-70 |
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| creator | Tateishi, Kazuya Saito, Yuichi Kitahara, Hideki Kobayashi, Yoshio |
| description | •Direct relation of glucose variability to coronary endothelial function is unclear.•This study showed that coronary endothelial function was correlated with mean amplitude of glycemic excursion (MAGE).•Peripheral endothelial function was not significantly associated with MAGE.•Greater glucose variability may have an impact on coronary endothelial dysfunction.
Background: Previous studies have reported that glucose variability leads to endothelial dysfunction and progression of coronary atherosclerosis. However, few studies have directly evaluated the relation between glucose variability and coronary endothelial function in patients with coronary artery disease (CAD).
Methods: A total of 38 patients with chronic CAD and a history of coronary drug-eluting stent implantation were enroled. Coronary endothelial function was evaluated by measuring the coronary vasoreactivity using quantitative coronary angiography in the segment distal to implanted stent in response to intracoronary acetylcholine (ACh) infusion (10−7 mol/l). Peripheral endothelial function was also assessed with reactive hyperemia index (RHI). The mean amplitude of glycemic excursion (MAGE) was calculated as a primary metric of glucose variability using a flash glucose monitoring system.
Results: Of 38 patients, 17 (45%) had diabetes mellitus. The mean levels of glycated hemoglobin, MAGE, and RHI were 6.3 ± 0.8%, 71.4 ± 29.8 mg/dl, and 1.85 ± 0.63. In the distal segment to coronary stent, lumen diameter was constricted by 0.6 ± 7.3% in response to intracoronary ACh infusion compared to that at baseline. While peripheral endothelial function assessed with RHI was not significantly associated with MAGE (r = −0.16, p = 0.35), coronary endothelial function was correlated with MAGE (r = −0.38, p = 0.02).
Conclusion: Greater glucose variability was significantly associated with coronary rather than peripheral endothelial dysfunction in patients with CAD, suggesting an impact of glucose variability on coronary atherosclerosis.
[Display omitted] |
| doi_str_mv | 10.1016/j.jjcc.2021.08.009 |
| format | Article |
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Background: Previous studies have reported that glucose variability leads to endothelial dysfunction and progression of coronary atherosclerosis. However, few studies have directly evaluated the relation between glucose variability and coronary endothelial function in patients with coronary artery disease (CAD).
Methods: A total of 38 patients with chronic CAD and a history of coronary drug-eluting stent implantation were enroled. Coronary endothelial function was evaluated by measuring the coronary vasoreactivity using quantitative coronary angiography in the segment distal to implanted stent in response to intracoronary acetylcholine (ACh) infusion (10−7 mol/l). Peripheral endothelial function was also assessed with reactive hyperemia index (RHI). The mean amplitude of glycemic excursion (MAGE) was calculated as a primary metric of glucose variability using a flash glucose monitoring system.
Results: Of 38 patients, 17 (45%) had diabetes mellitus. The mean levels of glycated hemoglobin, MAGE, and RHI were 6.3 ± 0.8%, 71.4 ± 29.8 mg/dl, and 1.85 ± 0.63. In the distal segment to coronary stent, lumen diameter was constricted by 0.6 ± 7.3% in response to intracoronary ACh infusion compared to that at baseline. While peripheral endothelial function assessed with RHI was not significantly associated with MAGE (r = −0.16, p = 0.35), coronary endothelial function was correlated with MAGE (r = −0.38, p = 0.02).
Conclusion: Greater glucose variability was significantly associated with coronary rather than peripheral endothelial dysfunction in patients with CAD, suggesting an impact of glucose variability on coronary atherosclerosis.
[Display omitted]</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2021.08.009</identifier><identifier>PMID: 34456069</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acetylcholine ; Blood Glucose ; Blood Glucose Self-Monitoring ; Coronary Angiography ; Coronary Artery Disease ; Drug-Eluting Stents ; Endothelial function ; Endothelium, Vascular ; Glucose variability ; Humans</subject><ispartof>Journal of cardiology, 2022-01, Vol.79 (1), p.65-70</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-42c63e692fca20b4b2691f2f993d6e27ed68ae85838f5e60bfed83626444d1713</citedby><cites>FETCH-LOGICAL-c380t-42c63e692fca20b4b2691f2f993d6e27ed68ae85838f5e60bfed83626444d1713</cites><orcidid>0000-0002-2888-6160 ; 0000-0002-7655-7628</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0914508721002057$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34456069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tateishi, Kazuya</creatorcontrib><creatorcontrib>Saito, Yuichi</creatorcontrib><creatorcontrib>Kitahara, Hideki</creatorcontrib><creatorcontrib>Kobayashi, Yoshio</creatorcontrib><title>Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>•Direct relation of glucose variability to coronary endothelial function is unclear.•This study showed that coronary endothelial function was correlated with mean amplitude of glycemic excursion (MAGE).•Peripheral endothelial function was not significantly associated with MAGE.•Greater glucose variability may have an impact on coronary endothelial dysfunction.
Background: Previous studies have reported that glucose variability leads to endothelial dysfunction and progression of coronary atherosclerosis. However, few studies have directly evaluated the relation between glucose variability and coronary endothelial function in patients with coronary artery disease (CAD).
Methods: A total of 38 patients with chronic CAD and a history of coronary drug-eluting stent implantation were enroled. Coronary endothelial function was evaluated by measuring the coronary vasoreactivity using quantitative coronary angiography in the segment distal to implanted stent in response to intracoronary acetylcholine (ACh) infusion (10−7 mol/l). Peripheral endothelial function was also assessed with reactive hyperemia index (RHI). The mean amplitude of glycemic excursion (MAGE) was calculated as a primary metric of glucose variability using a flash glucose monitoring system.
Results: Of 38 patients, 17 (45%) had diabetes mellitus. The mean levels of glycated hemoglobin, MAGE, and RHI were 6.3 ± 0.8%, 71.4 ± 29.8 mg/dl, and 1.85 ± 0.63. In the distal segment to coronary stent, lumen diameter was constricted by 0.6 ± 7.3% in response to intracoronary ACh infusion compared to that at baseline. While peripheral endothelial function assessed with RHI was not significantly associated with MAGE (r = −0.16, p = 0.35), coronary endothelial function was correlated with MAGE (r = −0.38, p = 0.02).
Conclusion: Greater glucose variability was significantly associated with coronary rather than peripheral endothelial dysfunction in patients with CAD, suggesting an impact of glucose variability on coronary atherosclerosis.
[Display omitted]</description><subject>Acetylcholine</subject><subject>Blood Glucose</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease</subject><subject>Drug-Eluting Stents</subject><subject>Endothelial function</subject><subject>Endothelium, Vascular</subject><subject>Glucose variability</subject><subject>Humans</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFO3DAQhq0KVBbaF-gB-cglqe04jiP1ghAFJKReytly7HHXURIH2wvaPn29Wqh66mnm8P2_Zj6EvlBSU0LF17EeR2NqRhitiawJ6T-gDZWdqHjXyBO0IT3lVUtkd4bOUxoJEaSX4iM6azhvBRH9Bv1-mFdtMg4O_5r2BmZv8IuOXg9-8nmPw4JNiGHRcY_1YvEK0a9biHrCsNiQtzD5stt9crvFZF94v-BVZw9LTvjV5-0_BTFDGdYn0Ak-oVOnpwSf3-YFevp--_Pmvnr8cfdwc_1YmUaSXHFmRAOiZ85oRgY-MNFTx1zfN1YA68AKqUG2spGuBUEGB1Y2ggnOuaUdbS7Q1bF3jeF5Bymr2ScD06QXCLukWCsKLVjHC8qOqIkhpQhOrdHP5XRFiTo4V6M6OFcH54pIVZyX0OVb_26Ywf6NvEsuwLcjAOXLFw9RJVP0GLA-gsnKBv-__j_kRpVW</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Tateishi, Kazuya</creator><creator>Saito, Yuichi</creator><creator>Kitahara, Hideki</creator><creator>Kobayashi, Yoshio</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2888-6160</orcidid><orcidid>https://orcid.org/0000-0002-7655-7628</orcidid></search><sort><creationdate>20220101</creationdate><title>Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease</title><author>Tateishi, Kazuya ; Saito, Yuichi ; Kitahara, Hideki ; Kobayashi, Yoshio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-42c63e692fca20b4b2691f2f993d6e27ed68ae85838f5e60bfed83626444d1713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acetylcholine</topic><topic>Blood Glucose</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease</topic><topic>Drug-Eluting Stents</topic><topic>Endothelial function</topic><topic>Endothelium, Vascular</topic><topic>Glucose variability</topic><topic>Humans</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tateishi, Kazuya</creatorcontrib><creatorcontrib>Saito, Yuichi</creatorcontrib><creatorcontrib>Kitahara, Hideki</creatorcontrib><creatorcontrib>Kobayashi, Yoshio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tateishi, Kazuya</au><au>Saito, Yuichi</au><au>Kitahara, Hideki</au><au>Kobayashi, Yoshio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>79</volume><issue>1</issue><spage>65</spage><epage>70</epage><pages>65-70</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>•Direct relation of glucose variability to coronary endothelial function is unclear.•This study showed that coronary endothelial function was correlated with mean amplitude of glycemic excursion (MAGE).•Peripheral endothelial function was not significantly associated with MAGE.•Greater glucose variability may have an impact on coronary endothelial dysfunction.
Background: Previous studies have reported that glucose variability leads to endothelial dysfunction and progression of coronary atherosclerosis. However, few studies have directly evaluated the relation between glucose variability and coronary endothelial function in patients with coronary artery disease (CAD).
Methods: A total of 38 patients with chronic CAD and a history of coronary drug-eluting stent implantation were enroled. Coronary endothelial function was evaluated by measuring the coronary vasoreactivity using quantitative coronary angiography in the segment distal to implanted stent in response to intracoronary acetylcholine (ACh) infusion (10−7 mol/l). Peripheral endothelial function was also assessed with reactive hyperemia index (RHI). The mean amplitude of glycemic excursion (MAGE) was calculated as a primary metric of glucose variability using a flash glucose monitoring system.
Results: Of 38 patients, 17 (45%) had diabetes mellitus. The mean levels of glycated hemoglobin, MAGE, and RHI were 6.3 ± 0.8%, 71.4 ± 29.8 mg/dl, and 1.85 ± 0.63. In the distal segment to coronary stent, lumen diameter was constricted by 0.6 ± 7.3% in response to intracoronary ACh infusion compared to that at baseline. While peripheral endothelial function assessed with RHI was not significantly associated with MAGE (r = −0.16, p = 0.35), coronary endothelial function was correlated with MAGE (r = −0.38, p = 0.02).
Conclusion: Greater glucose variability was significantly associated with coronary rather than peripheral endothelial dysfunction in patients with CAD, suggesting an impact of glucose variability on coronary atherosclerosis.
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| subjects | Acetylcholine Blood Glucose Blood Glucose Self-Monitoring Coronary Angiography Coronary Artery Disease Drug-Eluting Stents Endothelial function Endothelium, Vascular Glucose variability Humans |
| title | Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease |
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