Arterial stiffness predicts risk for long-term recurrence in patients with type 2 diabetes admitted for acute coronary event

Objectives: to investigate the predictive value of arterial stiffness (AS) estimation for long-term recurrences in patients with type 2 diabetes (DM2) following acute coronary event. Patients and methods: prospective observational study involving 119 DM2 patients without history of coronary heart disease admitted with ST-segment elevation myocardial infarction (STEMI). Medical history, anthropometrics, smoking, HbA1c, lipid profile, troponine-I levels, and left ventricular ejection fraction (LVEF) were recorded. Carotid-femoral pulse wave velocity (cf-PWV) was measured 1 month after discharge. Patients were followed up for 36 months or to reach an end-point: cardiovascular death, acute coronary event, angioplasty or hospitalization for acute heart failure. To facilitate analysis, patients were divided into two groups according to cf-PWV, using the accepted cut-off value of 12 m/s. Results: overall, 34 patients had a recurrence. In Kaplan-Meier analysis patients with cf-PWV > 12 m/s had mean time-to-event 353 +/- 43 days compared to 505 +/- 115 days for patients with cf-PWV <= 12 m/s, log rank = 0.0252. In multivariate analysis factors independently associated with recurrence were age (66.53 +/- 6.87 vs. 61.54 +/- 10.77 years, p = 0.015), LVEF (41.66 +/- 8.21 vs. 47.58 +/- 8.11%, p = 0.001) and cf-PWV (13.94 +/- 2.91 vs. 12.35 +/- 2.77 m/s, p = 0.008). Conclusions: AS estimation in patients with DM2 after STEMI discriminate patients at higher risk for 3-year recurrence, and maybe valuable for distinguishing patients likely to require a more rigorous therapeutic intervention. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Impact of the metabolic syndrome and its components combinations on arterial stiffness in Type 2 diabetic men

Aim. Arterial stiffness (AS) is a risk marker of atherosclerosis and coronary artery disease, yet its association with metabolic syndrome (MS) in diabetic patients is not established. The aim of this study was to investigate possible association of MS or its components with AS in diabetic population and to identify the MS definition which better correlates with AS. Methods. Overall, 98 type-2 diabetic men, mean age 64 +/- 10 years, were classified into groups according to the presence of MS, using the National Cholesterol Educational Program-Adult Treatment Panel III (NCEP-ATPIII) and International Diabetes Federation (IDF) definition. AS was estimated using carotid-femoral pulse wave velocity (PWV). For between-group comparisons and correlations between MS and it's components with AS, t-test and Pearson's correlation coefficient were employed, respectively. For multivariable analysis a linear regression model was used. Results. PWV in those with (72.5%) and without NCEP-ATPIII MS was 13.4 +/- 2.9 vs 12 +/- 3.2 m/s (P=NS) and in those with (79.6%) and without IDF MS 13.6 +/- 2.8 vs 11 +/- 3.2 m/s (P=0.036). AS positively correlated with IDF MS (r=0.332, P=0.036), increased blood pressure (r=0.324, P=0.037), and the combination of increased waist circumference according to IDF with hypertension (r=0.380, P=0.013); no correlation with NCEP-ATPIII MS was detected. In multivariable analysis, age, hypertension, and IDF MS were independently associated with AS (beta=2.52, P=0.039). Conclusion. IDF MS is independently associated with increased AS in diabetic men. Additionally, abdominal obesity, hypertension and older age were likely to be associated with increased AS. PWV measurement may be indicated in such patients. [Int Angiol 2009;28:490-5