Association Between Albuminuria and Duration of Diabetes and Myocardial Dysfunction and Peripheral Arterial Disease Among Patients With Stable Coronary Artery Disease in the BARI 2D Study
OBJECTIVE To evaluate the effect of prior duration of diabetes, glycated hemoglobin level at study entry, and microalbuminuria or macroalbuminuria on the extent and severity of coronary artery disease (CAD) and peripheral arterial disease. PATIENTS AND METHODS We studied baseline characteristics of...
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| creator | Escobedo, Jorge, MD, MSc Rana, Jamal S., MD, PhD Lombardero, Manuel S., MS Albert, Stewart G., MD Davis, Andrew M., MD, MPH Kennedy, Frank P., MD Mooradian, Arshag D., MD Robertson, David G., MD Srinivas, V.S., MBBS Gebhart, Suzanne S.P., MD |
| description | OBJECTIVE To evaluate the effect of prior duration of diabetes, glycated hemoglobin level at study entry, and microalbuminuria or macroalbuminuria on the extent and severity of coronary artery disease (CAD) and peripheral arterial disease. PATIENTS AND METHODS We studied baseline characteristics of the 2368 participants of the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) study, a randomized clinical trial that evaluates treatment efficacy for patients with type 2 diabetes and angiographically documented stable CAD. Patients were enrolled from January 1, 2001, through March 31, 2005. Peripheral arterial disease was ascertained by an ankle-brachial index (ABI) of 0.9 or less, and extent of CAD was measured by presence of multivessel disease, a left ventricular ejection fraction (LVEF) of less than 50%, and myocardial jeopardy index. RESULTS Duration of diabetes of 20 or more years was associated with increased risk of ABI of 0.9 or less (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.04-2.26), intermittent claudication (OR, 1.61; 95% CI, 1.10-2.35), and LVEF of less than 50% (OR, 2.03; 95% CI, 1.37-3.02). Microalbuminuria was associated with intermittent claudication (OR, 1.53; 95% CI, 1.16-2.02) and ABI of 0.9 or less (OR, 1.31; 95% CI, 0.98-1.75), whereas macroalbuminuria was associated with abnormal ABI, claudication, and LVEF of less than 50%. There was a significant association between diabetes duration and extent of CAD as manifested by number of coronary lesions, but no other significant associations were observed between duration of disease, glycated hemoglobin levels, or albumin-to-creatinine ratio and other manifestations of CAD. CONCLUSION Duration of diabetes and microalbuminuria or macroalbuminuria are important predictors of severity of peripheral arterial disease and left ventricular dysfunction in a cohort of patients selected for the presence of CAD. |
| doi_str_mv | 10.4065/mcp.2009.0265 |
| format | Article |
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PATIENTS AND METHODS We studied baseline characteristics of the 2368 participants of the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) study, a randomized clinical trial that evaluates treatment efficacy for patients with type 2 diabetes and angiographically documented stable CAD. Patients were enrolled from January 1, 2001, through March 31, 2005. Peripheral arterial disease was ascertained by an ankle-brachial index (ABI) of 0.9 or less, and extent of CAD was measured by presence of multivessel disease, a left ventricular ejection fraction (LVEF) of less than 50%, and myocardial jeopardy index. RESULTS Duration of diabetes of 20 or more years was associated with increased risk of ABI of 0.9 or less (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.04-2.26), intermittent claudication (OR, 1.61; 95% CI, 1.10-2.35), and LVEF of less than 50% (OR, 2.03; 95% CI, 1.37-3.02). Microalbuminuria was associated with intermittent claudication (OR, 1.53; 95% CI, 1.16-2.02) and ABI of 0.9 or less (OR, 1.31; 95% CI, 0.98-1.75), whereas macroalbuminuria was associated with abnormal ABI, claudication, and LVEF of less than 50%. There was a significant association between diabetes duration and extent of CAD as manifested by number of coronary lesions, but no other significant associations were observed between duration of disease, glycated hemoglobin levels, or albumin-to-creatinine ratio and other manifestations of CAD. CONCLUSION Duration of diabetes and microalbuminuria or macroalbuminuria are important predictors of severity of peripheral arterial disease and left ventricular dysfunction in a cohort of patients selected for the presence of CAD.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.4065/mcp.2009.0265</identifier><identifier>PMID: 20042560</identifier><identifier>CODEN: MACPAJ</identifier><language>eng</language><publisher>Rochester, MN: Elsevier Inc</publisher><subject>Age Factors ; Albuminuria ; Albuminuria - complications ; Associated diseases and complications ; Biological and medical sciences ; Cardiomyopathies - complications ; Care and treatment ; Complications and side effects ; Coronary Artery Disease - etiology ; Coronary heart disease ; Development and progression ; Diabetes Mellitus, Type 2 - complications ; Diabetes. Impaired glucose tolerance ; Diagnosis ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; General aspects ; Glycated Hemoglobin A - analysis ; Humans ; Internal Medicine ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Nephrology. Urinary tract diseases ; Odds Ratio ; Original ; Peripheral vascular diseases ; Peripheral Vascular Diseases - complications ; Sex Factors ; Time Factors ; Type 2 diabetes ; Urinary system involvement in other diseases. Miscellaneous</subject><ispartof>Mayo Clinic proceedings, 2010, Vol.85 (1), p.41-46</ispartof><rights>Mayo Foundation for Medical Education and Research</rights><rights>2010 Mayo Foundation for Medical Education and Research</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Elsevier, Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Jan 2010</rights><rights>2010 Mayo Foundation for Medical Education and Research 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c616t-43fcacc16dfd875c175e6a1fbc7dd2f50bea950bc10708350613d238ab8f2c783</citedby><cites>FETCH-LOGICAL-c616t-43fcacc16dfd875c175e6a1fbc7dd2f50bea950bc10708350613d238ab8f2c783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800289/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/216875889?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,4025,27928,27929,27930,53796,53798,64390,64392,64394,72474</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22405284$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20042560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Escobedo, Jorge, MD, MSc</creatorcontrib><creatorcontrib>Rana, Jamal S., MD, PhD</creatorcontrib><creatorcontrib>Lombardero, Manuel S., MS</creatorcontrib><creatorcontrib>Albert, Stewart G., MD</creatorcontrib><creatorcontrib>Davis, Andrew M., MD, MPH</creatorcontrib><creatorcontrib>Kennedy, Frank P., MD</creatorcontrib><creatorcontrib>Mooradian, Arshag D., MD</creatorcontrib><creatorcontrib>Robertson, David G., MD</creatorcontrib><creatorcontrib>Srinivas, V.S., MBBS</creatorcontrib><creatorcontrib>Gebhart, Suzanne S.P., MD</creatorcontrib><creatorcontrib>for the BARI 2D Study Group</creatorcontrib><creatorcontrib>BARI 2D Study Group</creatorcontrib><title>Association Between Albuminuria and Duration of Diabetes and Myocardial Dysfunction and Peripheral Arterial Disease Among Patients With Stable Coronary Artery Disease in the BARI 2D Study</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>OBJECTIVE To evaluate the effect of prior duration of diabetes, glycated hemoglobin level at study entry, and microalbuminuria or macroalbuminuria on the extent and severity of coronary artery disease (CAD) and peripheral arterial disease. PATIENTS AND METHODS We studied baseline characteristics of the 2368 participants of the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) study, a randomized clinical trial that evaluates treatment efficacy for patients with type 2 diabetes and angiographically documented stable CAD. Patients were enrolled from January 1, 2001, through March 31, 2005. Peripheral arterial disease was ascertained by an ankle-brachial index (ABI) of 0.9 or less, and extent of CAD was measured by presence of multivessel disease, a left ventricular ejection fraction (LVEF) of less than 50%, and myocardial jeopardy index. RESULTS Duration of diabetes of 20 or more years was associated with increased risk of ABI of 0.9 or less (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.04-2.26), intermittent claudication (OR, 1.61; 95% CI, 1.10-2.35), and LVEF of less than 50% (OR, 2.03; 95% CI, 1.37-3.02). Microalbuminuria was associated with intermittent claudication (OR, 1.53; 95% CI, 1.16-2.02) and ABI of 0.9 or less (OR, 1.31; 95% CI, 0.98-1.75), whereas macroalbuminuria was associated with abnormal ABI, claudication, and LVEF of less than 50%. There was a significant association between diabetes duration and extent of CAD as manifested by number of coronary lesions, but no other significant associations were observed between duration of disease, glycated hemoglobin levels, or albumin-to-creatinine ratio and other manifestations of CAD. CONCLUSION Duration of diabetes and microalbuminuria or macroalbuminuria are important predictors of severity of peripheral arterial disease and left ventricular dysfunction in a cohort of patients selected for the presence of CAD.</description><subject>Age Factors</subject><subject>Albuminuria</subject><subject>Albuminuria - complications</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Cardiomyopathies - complications</subject><subject>Care and treatment</subject><subject>Complications and side effects</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary heart disease</subject><subject>Development and progression</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diagnosis</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>General aspects</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Peripheral vascular diseases</subject><subject>Peripheral Vascular Diseases - complications</subject><subject>Sex Factors</subject><subject>Time Factors</subject><subject>Type 2 diabetes</subject><subject>Urinary system involvement in other diseases. 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Impaired glucose tolerance</topic><topic>Diagnosis</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>General aspects</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Peripheral vascular diseases</topic><topic>Peripheral Vascular Diseases - complications</topic><topic>Sex Factors</topic><topic>Time Factors</topic><topic>Type 2 diabetes</topic><topic>Urinary system involvement in other diseases. 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PATIENTS AND METHODS We studied baseline characteristics of the 2368 participants of the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) study, a randomized clinical trial that evaluates treatment efficacy for patients with type 2 diabetes and angiographically documented stable CAD. Patients were enrolled from January 1, 2001, through March 31, 2005. Peripheral arterial disease was ascertained by an ankle-brachial index (ABI) of 0.9 or less, and extent of CAD was measured by presence of multivessel disease, a left ventricular ejection fraction (LVEF) of less than 50%, and myocardial jeopardy index. RESULTS Duration of diabetes of 20 or more years was associated with increased risk of ABI of 0.9 or less (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.04-2.26), intermittent claudication (OR, 1.61; 95% CI, 1.10-2.35), and LVEF of less than 50% (OR, 2.03; 95% CI, 1.37-3.02). Microalbuminuria was associated with intermittent claudication (OR, 1.53; 95% CI, 1.16-2.02) and ABI of 0.9 or less (OR, 1.31; 95% CI, 0.98-1.75), whereas macroalbuminuria was associated with abnormal ABI, claudication, and LVEF of less than 50%. There was a significant association between diabetes duration and extent of CAD as manifested by number of coronary lesions, but no other significant associations were observed between duration of disease, glycated hemoglobin levels, or albumin-to-creatinine ratio and other manifestations of CAD. CONCLUSION Duration of diabetes and microalbuminuria or macroalbuminuria are important predictors of severity of peripheral arterial disease and left ventricular dysfunction in a cohort of patients selected for the presence of CAD.</abstract><cop>Rochester, MN</cop><pub>Elsevier Inc</pub><pmid>20042560</pmid><doi>10.4065/mcp.2009.0265</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; ProQuest Central UK/Ireland; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Factors Albuminuria Albuminuria - complications Associated diseases and complications Biological and medical sciences Cardiomyopathies - complications Care and treatment Complications and side effects Coronary Artery Disease - etiology Coronary heart disease Development and progression Diabetes Mellitus, Type 2 - complications Diabetes. Impaired glucose tolerance Diagnosis Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female General aspects Glycated Hemoglobin A - analysis Humans Internal Medicine Kidneys Male Medical sciences Middle Aged Multivariate Analysis Nephrology. Urinary tract diseases Odds Ratio Original Peripheral vascular diseases Peripheral Vascular Diseases - complications Sex Factors Time Factors Type 2 diabetes Urinary system involvement in other diseases. Miscellaneous |
| title | Association Between Albuminuria and Duration of Diabetes and Myocardial Dysfunction and Peripheral Arterial Disease Among Patients With Stable Coronary Artery Disease in the BARI 2D Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-16T08%3A42%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20Between%20Albuminuria%20and%20Duration%20of%20Diabetes%20and%20Myocardial%20Dysfunction%20and%20Peripheral%20Arterial%20Disease%20Among%20Patients%20With%20Stable%20Coronary%20Artery%20Disease%20in%20the%20BARI%202D%20Study&rft.jtitle=Mayo%20Clinic%20proceedings&rft.au=Escobedo,%20Jorge,%20MD,%20MSc&rft.aucorp=for%20the%20BARI%202D%20Study%20Group&rft.date=2010&rft.volume=85&rft.issue=1&rft.spage=41&rft.epage=46&rft.pages=41-46&rft.issn=0025-6196&rft.eissn=1942-5546&rft.coden=MACPAJ&rft_id=info:doi/10.4065/mcp.2009.0265&rft_dat=%3Cgale_pubme%3EA216442332%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=216875889&rft_id=info:pmid/20042560&rft_galeid=A216442332&rft_els_id=1_s2_0_S0025619611603091&rfr_iscdi=true |