Inflammation and coronary angiography in asymptomatic type 2 diabetic subjects

• Published in: Scandinavian journal of clinical and laboratory investigation 2007, Vol.67 (3), p.306-316
• Main Authors: Johansen, O. E., Birkeland, K. I., Orvik, E., Flesland, Ø., Wergeland, R., Ueland, T., Smith, C., Endresen, K., Aukrust, P., Gullestad, L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Comorbidity; Coronary Angiography; coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - physiopathology; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - epidemiology; Diabetes Complications - diagnostic imaging; Diabetes Complications - epidemiology; Diabetes Complications - physiopathology; Diabetes Mellitus, Type 2 - epidemiology; Exercise Test; Female; Humans; inflammation; Inflammation - blood; Inflammation - epidemiology; Interleukin-6 - blood; Male; metabolic syndrome; Middle Aged; Norway - epidemiology; Prevalence; prevention; Risk Factors; Sex Distribution; type 2 diabetes mellitus
• ISSN: 0036-5513; 1502-7686
• DOI: 10.1080/00365510601045088

Objective. Coronary artery disease (CAD) is prevalent in patients with type 2 diabetes mellitus (T2DM) and because it is often asymptomatic and extensive in comparison with CAD in subjects without diabetes, it represents a diagnostic challenge. The objective of the study was to investigate the prevalence of CAD in asymptomatic T2DM patients utilizing angiography and to investigate its association with cardiovascular (CV) risk factors, the metabolic syndrome and markers of inflammation. Material and methods. Eighty-two patients with T2DM without symptoms of CAD, and with 1 CV risk factor (hypertension, dyslipidaemia, premature familial CAD, smoking or microalbuminuria) underwent a diagnostic stress test and coronary angiography irrespective of stress test results. Stenosis detected in the main coronary arteries 50% of lumen diameter was categorized as one-, two- or three-vessel disease. Inflammatory markers were analysed in fasting samples. Results. Fifteen men and two women had significant CAD (21%) (1-vessel disease, n = 10; 2- or 3-vessel disease, n = 7). Patients with 2- or 3-vessel disease were significantly older and had a longer duration of diabetes, but the prevalence of other traditional CV risk factors or the metabolic syndrome was similar among those with 1-vessel and those with 2- or 3-vessel disease. Sensitivity for CAD of the stress test was low (0.35). The mean level of the pro-inflammatory marker interleukin-6 was elevated in patients with 2- to 3-vessel CAD as compared to patients with no or 1-vessel CAD (p