Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Acute coronary syndrome in diabetes mellitus

Authors: M.A. Alekseeva, E.U. Asymbekova

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-3-162-168

UDC: 616.132.2-008.6:616.379-008.64

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (3): 162-168

Quote as: Alekseeva M.A., Asymbekova E.U. Acute coronary syndrome in diabetes mellitus. Clinical Physiology of Circulation. 2018; 15 (3): 162–8 (in Russ.). DOI: 10.24022/1814-6910-2018-15-3-162-168

Received / Accepted:  19.03.2018/10.04.2018

Full text:  

Abstract

The article presents a literary review of epidemiology and the current state of the problem of acute coronary syndrome (ACS) in patients with type 2 diabetes mellitus. In diabetes mellitus, the risk of ischemic heart disease increases by 4 times and causes three-quarters of diabetes-related deaths. The presence of acute coronary syndrome of diabetes mellitus type 2 significantly complicates the course of ACS and worsens the patient's prognosis. The increased risk of mortality observed in patients with diabetes in ACS persists for several years. Adverse forecast in this category of patients is associated with recurrence of myocardial ischemia, left ventricular dysfunction, development of severe heart failure, electrical instability of the myocardium, repeated myocardial infarctions and strokes. Numerous factors of diabetes mellitus contribute to the formation of such a negative prognosis (diffuse lesion of the coronary bed, reduced vasodilatation reserve, decreased fibrinolytic activity of the blood, increased platelet aggregation, autonomic dysfunction, signs of diabetic cardiomyopathy).

References

  1. Абсейтова С.Р. Острый коронарный синдром. Современные аспекты диагностики и лечения: учебное пособие. Алматы; 2014. [Abseytova S.R. Acute coronary syndrome. Modern aspects of diagnosis and treatment: tutorial. Almaty; 2014 (in Russ.).]
  2. Дубикайтис Т.А. Острый коронарный синдром. Russian Family Doctor. 2017; 21 (1): 5–14. [Dubikajtis T.A. Acute coronary syndrome. Russian Family Doctor. 2017; 21 (1) 5: 14 (in Russ.).]
  3. Дорохова О.В. Прогностическое значение факто- ров риска неблагоприятных коронарных событий у больных с острым коронарным синдромом без подъема ST: Дис. … канд. мед. наук. М.; 2015. [Dorokhova O.V. Prognostic significance of risk factors for adverse coronary events in patients with acute coronary syndrome without ST segment elevation: Cand. Med. Sc. Diss. Moscow; 2015 (in Russ.).]
  4. Yeh R.W., Sidney S., Chandra M., Sorel M., Selby J.V., Go A.S. Population trends in the incidence and outcomes of acute myocardial infarction. N. Engl. J. Med. 2010; 362: 2155–65. DOI: 10.1056/nejmoa0908610
  5. Terkelsen C.J., Lassen J.F., Norgaard B.L., Gerdes J.C., Jensen T., Gоtzsche L.B.-H. et al. Mortality rates in patients with ST-elevation vs. non-ST-elevation acute myocardial infarction: observations from an unselected cohort. Eur. Heart J. 2005; 26 (1): 18–26. DOI: 10.1093/eurheartj/ehi002
  6. Hamm Ch.W., Bassand J.P., Agewall S., Bax J., Boersma E., Bueno H. et al. Рекомендации по лечению ос- трого коронарного синдрома без стойкого подъема сегмента ST. Рациональная фармакотерапия в кар- диологии. 2012; 8 (Прил. 2): 3–61. [Hamm Ch.W., Bassand J.P., Agewall S., Bax J., Boersma E., Bueno H. et al. Recommendations for the treatment of acute coronary syndrome without persistent elevation of the ST segment. Ratsional'naya Farmakoterapiya v Kardiologii (Rational Pharmacotherapy in Cardiology). 2012; 8 (Suppl. 2): 3–61 (in Russ.).]
  7. Сунцов Ю.И., Болотская Л.Л., Маслова О.В., Казаков И.В. Эпидемиология сахарного диабета и прогноз его распространенности в Российской Федерации. Сахарный диабет. 2011; 1: 5–18. [Suntsov Yu.I., Bolotskaya L.L., Maslova O.V., Kazakov I.V. Epidemiology of diabtes mellitus and the prognosis of its prevalence in the Russian Federation. Sakharnyy Diabet (Diabetes Mellitus). 2011; 1: 5–18 (in Russ.).]
  8. Geiss L.S., Pan L., Cadwell B., Gregg E.W., Benjamin S.M., Engelgau M.M. et al. Changes in incidence of diabetes in U.S. adults (1997–2003). Am. J. Prev. Med. 2006; 30 (5): 371–7. DOI: 10.1016/j.amepre.2005.12.009
  9. Alzuhairi K.S., Sogaard P., Ravkilde J., Azimi A., Mæng M., Jensen L.O. Long-term prognosis of patients with non-ST-segment elevation myocardial infarction according to coronary arteries atherosclerosis extent on coronary angiography: a historical cohort study. BMC Cardiovasc. Disord. 2017; 17 (1): 279. DOI: 10.1186/s12872-017-0710-3
  10. International Diabetes Federation. IDF Atlas, 6th ed. Brussels, Belgium: International Diabetes Federation 2013. Available at: http://www.idf.org/diabetsatlas (accessed 10 March 2018).
  11. Безденежных Н.А. Прогнозирование исходов коронарного шунтирования у пациентов с ишемической болезнью сердца и сахарным диабетом 2 типа: Дис. … канд. мед. наук. Кемерово; 2015. [Bezdenezhnykh N.A. Predicting outcomes of coronary bypass in patients with coronary artery disease and type 2 diabetes mellitus: Cand. Med. Sc. Diss. Kemerovo; 2015 (in Russ.).]
  12. Inohara T., Kohsaka S., Goto M., Furukawa Y., Fukushima M., Sakataet R. et al. Hypothesis of long-term outcome after coronary revascularization in Japanese patients compared to multiethnic groups in the US. PLoS ONE. 2017; 10 (5). DOI: 10.1371/journal.pone.0128252
  13. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur. Heart J. 2013; 34 (39): 3035–87.
  14. Pani L.N., Korenda L., Meigs J.B., Driver C., Chamany S., Fox C.S. et al. Effect of aging on A1C levels in individuals without diabetes: evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001–2004. Diabetes Care. 2008; 31: 1991–6. DOI: 10.2337/dc08-0577
  15. Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016; 19 (2): 104–12. DOI: 10.1434/DM2004116-17 [Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Sakharnyy Diabet (Diabetus Mellitus). 2016; 19 (2): 104–12 (in Russ.). DOI: 10.1434/DM2004116-17]
  16. Голухова Е.З., Кузнецова Е.В. Реваскуляризация миокарда у больных ИБС в сочетании с сахарным диабетом 2 типа: обзор современных технологий. Сахарный диабет. 2016; 19 (5): 406–13. DOI: 10.14341/DM8031 [Golukhova E.Z., Kuznetsova E.V. Myocardial revascularization in patients with IHD in combination with type 2 diabetes mellitus: an overview of modern techniques. Sakharnyy Diabet (Diabetus Mellitus). 2016; 19 (5): 406–13 (in Russ.). DOI: 10.14341/DM8031]
  17. Luscher T.F., Creager M.A., Beckman J.A., Cosentino F. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part II. Circulation. 2003; 108 (13): 1655–61. DOI: 10.1161/01.CIR.0000089189.70578.E2
  18. Grabowski M., Filipiak K.J., Opolski G., Główczyńska R., Gawałko M., Balsam P. et al. Risk factors for adverse outcomes of acute coronary syndrome patients – single center experience in long term follow-up of treated patients. Kardiol. Pol. 2018; 76 (5): 881–8. DOI: 10.5603/KP.a2018.0031
  19. Karlson B.W., Herlitz J., Hjalmarson A. Prognosis of acute myocardial infarction in diabetic and nondiabetic patients. Diabet Med. 1993; 10 (5): 449–54. DOI: 10.1111/j.1464-5491.1993.tb00097.x
  20. Abbud Z.A., Shindler D.M., Wilson A.C., Kostis J.B. Effect of diabetes mellitus on short and long-term mortality rates of patients with acute myocardial infarction: a statewide study. Myocardial infarction Data Acquisition System Study Group. Am. Heart J. 1995; 130: 51–8. DOI: 10.1016/0002-8703(95)90235-x
  21. Smith J.W., Marcus F.I., Serokman R. Prognosis of patients with diabetes mellitus after acute myocardial infarction. Am. J. Cardiol. 1984; 54: 718–21. DOI: 10.1016/s0002-9149(84)80196-4
  22. Savage M.P., Krolewski A.S., Kenien G.G., Lebeis M.P., Christlieb A.R., Lewis S.M. et al. Acute myocardial infarction in diabetes mellitus and significance of congestive heart failure as a prognostic factor. Am. J. Cardiol. 1988; 62: 665–9. DOI: 10.1016/0002-9149(88)91199-x
  23. Bartnik M., Ryden L., Ferrari R. Euro Heart Surveiу Investigаstors. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart. Eur. Heart J. 2004; 25: 1880–90. DOI: 10.1016/j.ehj.2004.07.027
  24. Dziedzic E.A., Gąsior J.S., Pawłowski M., Dąbrowski M. Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes. Diabetes Res. 2017. DOI: 10.1155/2017/3929075
  25. Kim J.A. Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation. 2006; 113: 1888–904. DOI: 10.1161/circulationaha.105.563213
  26. Romeo G.R. Metabolic syndrome, insulin resistance and roles of inflammation: mechanisms and therapeutic targets. Arterioscler. Thromb. Vasc. Biol. 2012; 32: 1771–6. DOI: 10.1161/atvbaha.111.241869
  27. Cannon C.P. Mixed dyslipidemia, metabolic syndrome, diabetes mellitus and cardiovascular disease: clinical implications. Cardiol. 2008; 102: 5–9. DOI: 10.1016/j.amjcard.2008.09.067
  28. Vlachopoulos C., Aznaouridis K., Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Am. Coll. Cardiol. 2010; 55: 1318–27. DOI: 10.1016/j.jacc.2009.10.061
  29. Канорский С.Г., Мамедов М.Н. Конгресс Европейского общества кардиологов (Амстердам, 2013): новые рекомендации и важнейшие клинические исследования. Кардиология. 2014; 54 (5): 62–7. DOI: 10.18565/cardio.2014.5.62-67 [Kanorskiy S.G., Mamedov M.N. Congress of European Society of Cardiology (Amsterdam, 2013): New recommendations and clinical studies. Kardiologiya (Cardiology). 2014; 54 (5): 62–7 (in Russ.). DOI: 10.18565/cardio.2014.5.62-67]
  30. Давид Л.А., Гросу А.А. Нарушение толерантности к глюкозе и долгосрочный прогноз у больных острым инфарктом миокарда. Кардиология. 2013; 53 (9): 15–20. [David L.A., Grosu A.A. Abnormal glucose tolerance and long-term prognosis in patients with acute myocardial infarction. Kardiologiya (Cardiology). 2013; 53 (9): 15–20 (in Russ.).]
  31. Meisinger C., Heier M., von Scheidt W., Kirchberger I., Hörmann A., Kuch B. Gender-Specific short and longterm mortality in diabetic versus nondiabetic patients with incident acute myocardial infarction in the reperfusion era (the MONICA/KORA Myocardial Infarction Registry). Cardiol. 2010; 106: 1680–4. DOI: 10.1016/j.amjcard.2010.08.009
  32. Basu A., Sukumar N., Ryder R.E. Young Asian men with diabetes have the highest risk for acute coronary events: retrospective cohort analyses. JRSM Open. 2018; 9 (1): 205–11. DOI: 10.1177/2054270417732699
  33. O'Donoghue M.L., Vaidya R., Afsal R., Alfredsson J., Boden W.E., Braunwald E. et al. An invasive or conservative strategy in patients with diabetes mellitus and non-ST-segment elevation acute coronary syndromes: a collaborative meta-analysis of randomized trials. Am. Coll. Cardiol. 2012; 60 (2): 106–11. DOI: 10.1016/j.jacc.2012.02.059
  34. Higny J., Guédès A., Jamart J., Hanet C., Gabriel L., Dangoisse V. et al. Early prognosis and predictor analysis for positive coronary angiography after out-of-hospital cardiac arrest (OHCA). Acta Cardiol. 2018; 16: 1–8. DOI: 10.1080/00015385.2017.1415403
  35. International Diabetes Federation. Global Guideline For Type 2 Diabetes. International Diabetes Federation. 2012. Available at: http://www.idf.org
  36. Standards of Medical Care in Diabetesd 2016: Summary of Revisions. Diabetes Care. 2016; 39 (1): 4–5. DOI: 10.2337/dc16-s003
  37. Wang C.L., Hess C.N., Hiatt W.R., Goldfine A.B. Clinical update: cardiovascular disease in diabetes mellitus: atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus – mechanisms, management, and clinical considerations. Circulation. 2016; 133: 2459–502. DOI: 10.1161/circulationaha.116.022194
  38. De la Hera J.M., Delgado E., Hernández E., Garcia- Ruiz J.M., Vegas J.M., Avanzas P. et al. Prevalence and outcome of newly detected diabetes in patients who undergo percutaneous coronary intervention. Eur. Heart J. 2009; 30 (21): 2614–21. DOI: 10.1093/eurheartj/ehp278
  39. Petursson P., Herlitz J., Lindqvist J., Sjöland H., Gudbjörnsdottir S. Prevalence and severity of abnormal glucose regulation and its relation to long-term prognosis after coronary artery bypass grafting. Coron. Artery Dis. 2013; 24 (7): 577–82. DOI: 10.1097/mca.0b013e3283645c94
  40. Glas C.K., Witztum J.l. Atherosclerosis, the road ahead. Cell. 2001; 104: 503–16. DOI: 10.1016/s0092-8674(01)00238-0
  41. Беленькова Ю.А., Каретникова В.Н., Дяченко А.О., Груздева О.В., Благовещенская О.П., Молодцова Т.С., Барбараш О.Л. Роль воспаления в развитии неблагоприятного прогноза у больных инфарктом миокарда с подъемом сегмента ST, подвергшихся чрескожному коронарному вмешательству, на фоне нарушенной толерантности к глюкозе и сахарного диабета. Российский кардиологический журнал. 2014; 19 (8): 84–91. DOI: 10.15829/1560-4071-2014-8-84-91 [Belen'kova Yu.A., Karetnikova V.N., Dyachenko A.O., Gruzdeva O.V., Blagoveshchenskaya O.P., Molodtsova T.S., Barbarash O.L. The role of inflammation for the worse outcomes in patients with ST elevation myocardial infarction underwent transcutaneous coronary intervention, comorbid with impaired glucose tolerance. Rossiyskiy Kardiologicheskiy Zhurnal (Russian Journal of Cardiology). 2014; 19 (8): 84–91 (in Russ.). DOI: 10.15829/1560-4071-2014-8-84-91]
  42. Giraldez R.R., Clare R.M., Lopes R.D., Dalby A.J., Prabhakaran D., Brogan G.X. et al. Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-STsegment elevation acute coronary syndrome. Am. Heart J. 2013; 165 (6): 918–25. DOI: 10.1016/j.ahj.2013.01.005
  43. Savonitto S., Morici N., Nozza A., Cosentino F., Perrone Filardi P., Murena E. et al. Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes. Diab. Vasc. Dis. Res. 2018; 15 (1): 14–23. DOI: 10.1177/1479164117735493
  44. Безденежных Н.А., Сумин А.Н., Барбараш О.Л. Пациент с сахарным диабетом и реваскуляризация миокарда с позиций доказательной медицины: взгляд кардиолога. Часть 1. Российский кардиологический журнал. 2017; 22 (4): 105–13. DOI: 10.15829/1560-4071-2017-4-105-113 [Bezdenezhnykh N.A., Sumin A.N., Barbarash O.L. Diabetes patient and myocardial revascularization from the evidence guided perspective: cardiologist opinion. Part 1. Rossiyskiy Kardiologicheskiy Zhurnal (Russian Journal of Cardiology). 2017; 22 (4): 105–13 (in Russ.). DOI: 10.15829/1560-4071-2017-4-105-113]

About Authors

  • Alekseeva Mariya Andreevna, Postgraduate; orcid.org/0000-0002-3736-2991
  • Asymbekova El’mira Umetovna, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0002-5422-2069

 If you found mistakes, select text and press Alt+A