PMID- 28187174
OWN - NLM
STAT- MEDLINE
DCOM- 20170809
LR  - 20190208
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 2
DP  - 2017
TI  - Hyperglycemia effect on coronary disease in patients with metabolic syndrome 
      evaluated by intracoronary ultrasonography.
PG  - e0171733
LID - 10.1371/journal.pone.0171733 [doi]
LID - e0171733
AB  - INTRODUCTION: Metabolic syndrome (MS) is characterized by dyslipidemia, central 
      obesity, hypertension and hyperglycemia. However, type 2 diabetes mellitus (T2DM) 
      may or may not be present in metabolic syndrome. MS and T2DM are considered 
      important cardiovascular risk factors, but the role of hyperglycemia in coronary 
      disease is still contested in the literature. Therefore, we decided to evaluate 
      the effect of hyperglycemia on the severity of coronary disease in MS patients, 
      with or without T2DM, submitted to coronary angiography (CA) and intravascular 
      ultrasonography (IVUS). MATERIALS AND METHODS: This is a cross sectional, 
      observational study with 100 MS patients (50% with T2DM), 60% male. All of the 
      patients had been referred for CA procedures. The obstruction was considered 
      severe when stenosis was greater than 70% and moderate if it was between 50-69%. 
      Patients detected with a moderate obstruction by CA were indicated to IVUS. A 
      minimal luminal area of less than 4mm2 detected by IVUS was also considered 
      severe. IDF criteria were used to define Metabolic Syndrome and T2DM diagnosis 
      was defined according to the American Diabetes Association criteria. Student's 
      t-test and Pearson Chi-square were used for statistical analysis, considering p < 
      0.05 statistically significant. RESULTS AND DISCUSSION: The majority of T2DM 
      patients presented severe arterial lesions (74% vs 22%, p<0.001). Using CA 
      procedure, 12% of T2DM had moderate obstructions, compared to 38% of the 
      non-diabetic group (p< 0.05). 8% of patients with moderate lesions by CA were 
      diagnosed with a luminal area less than 4mm2 using IVUS. This luminal area was 
      significantly smaller in the T2DM group than in the control group (3.8mm2 +/- 2.42. 
      vs 4.6mm2 +/- 2.58, p = 0.03). CONCLUSION: Patients with MS and T2DM submitted to 
      angiography and IVUS, had more severe coronary lesions compared to MS patients 
      without diabetes. This finding suggests that beyond insulin resistance that is 
      present in MS, hyperglycemia may also play a role in the development of 
      atherosclerotic disease. IVUS was useful for diagnosing 8% of severe cases 
      initially considered to be moderate obstructions when using just CA in this 
      scenario.
FAU - Bonamichi, Beatriz Dal Santo Francisco
AU  - Bonamichi BD
AD  - Santa Casa de Sao Paulo Hospital, Internal Medicine Department, Endocrinology 
      Unit, Sao Paulo, Brasil.
FAU - Parente, Erika Bezerra
AU  - Parente EB
AD  - Santa Casa de Sao Paulo Hospital, Internal Medicine Department, Endocrinology 
      Unit, Sao Paulo, Brasil.
FAU - Campos, Ana Carolina Noronha
AU  - Campos AC
AD  - Santa Casa de Sao Paulo Hospital, Internal Medicine Department, Sao Paulo, 
      Brasil.
FAU - Cury, Adriano Namo
AU  - Cury AN
AD  - Santa Casa de Sao Paulo Hospital, Internal Medicine Department, Endocrinology 
      Unit, Sao Paulo, Brasil.
FAU - Salles, Joao Eduardo Nunes
AU  - Salles JE
AD  - Santa Casa de Sao Paulo Hospital, Internal Medicine Department, Endocrinology 
      Unit, Sao Paulo, Brasil.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170210
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Disease/blood/complications/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Hyperglycemia/blood/complications/*diagnostic imaging
MH  - Male
MH  - Metabolic Syndrome/blood/complications/*diagnostic imaging
MH  - Middle Aged
MH  - Ultrasonography
PMC - PMC5302811
COIS- The authors have declared that no competing interests exist.
EDAT- 2017/02/12 06:00
MHDA- 2017/08/10 06:00
PMCR- 2017/02/10
CRDT- 2017/02/11 06:00
PHST- 2016/03/03 00:00 [received]
PHST- 2017/01/25 00:00 [accepted]
PHST- 2017/02/11 06:00 [entrez]
PHST- 2017/02/12 06:00 [pubmed]
PHST- 2017/08/10 06:00 [medline]
PHST- 2017/02/10 00:00 [pmc-release]
AID - PONE-D-16-09122 [pii]
AID - 10.1371/journal.pone.0171733 [doi]
PST - epublish
SO  - PLoS One. 2017 Feb 10;12(2):e0171733. doi: 10.1371/journal.pone.0171733. 
      eCollection 2017.