PMID- 29201152 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220311 IS - 1758-5996 (Print) IS - 1758-5996 (Electronic) IS - 1758-5996 (Linking) VI - 9 DP - 2017 TI - Myocardial injury in diabetic patients with multivessel coronary artery disease after revascularization interventions. PG - 92 LID - 10.1186/s13098-017-0292-3 [doi] LID - 92 AB - BACKGROUND: Diabetic patients may be more susceptible to myocardial injury after coronary interventions. Thus, the aim of this study was to assess the release of cardiac biomarkers, CK-MB and troponin, and the findings of new late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in patients with type 2 diabetes mellitus after elective revascularization procedures for multivessel coronary artery disease (CAD). METHODS: Patients with multivessel CAD and preserved systolic ventricular function underwent either elective percutaneous coronary intervention (PCI), off-pump or on-pump bypass surgery (CABG). Troponin and CK-MB were systematically collected at baseline, 6, 12, 24, 36, 48 and 72 h after the procedures. CMR with LGE was performed before and after the interventions. Patients were stratified according to diabetes status at study entry. Biomarkers and CMR results were compared between diabetic and nondiabetics patients. Analyses of correlation were also performed among glycemic and glycated hemoglobin (A1c) levels and troponin and CK-MB peak levels. Patients were also stratified into tertiles of fasting glycemia and A1c levels and were compared in terms of periprocedural myocardial infarction (PMI) on CMR. RESULTS: Ninety (44.5%) of the 202 patients had diabetes mellitus at study entry. After interventions, median peak troponin was 2.18 (0.47, 5.14) and 2.24 (0.69, 5.42) ng/mL (P = 0.81), and median peak CK-MB was 14.1 (6.8, 31.7) and 14.0 (4.2, 29.8) ng/mL (P = 0.43), in diabetic and nondiabetic patients, respectively. The release of troponin and CK-MB over time was statistically similar in both groups and in the three treatments, besides PCI. New LGE on CMR indicated that new myocardial fibrosis was present in 18.9 and 17.3% (P = 0.91), and myocardial edema in 15.5 and 22.9% (P = 0.39) in diabetic and nondiabetic patients, respectively. The incidence of PMI in the glycemia tertiles was 17.9% versus 19.3% versus 18.7% (P = 0.98), and in the A1c tertiles was 19.1% versus 13.3% versus 22.2% (P = 0.88). CONCLUSIONS: In this study, diabetes mellitus did not add risk of myocardial injury after revascularization interventions in patients with multivessel coronary artery disease. Trial Registration Name of Registry: Evaluation of cardiac biomarker elevation after percutaneous coronary intervention or coronary artery bypass graft; URL: http://www.controlled-trials.com.ISRCTN09454308. FAU - Rezende, Paulo Cury AU - Rezende PC AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Hueb, Whady AU - Hueb W AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Rahmi, Rosa Maria AU - Rahmi RM AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Scudeler, Thiago Luis AU - Scudeler TL AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - de Azevedo, Diogo Freitas Cardoso AU - de Azevedo DFC AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Garzillo, Cibele Larrosa AU - Garzillo CL AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Segre, Carlos Alexandre Wainrober AU - Segre CAW AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Ramires, Jose Antonio Franchini AU - Ramires JAF AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Filho, Roberto Kalil AU - Filho RK AD - Heart Institute (InCor) of the University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, 44, AB sala 114, Cerqueira Cesar, Sao Paulo, SP CEP 05403-900 Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 LA - eng PT - Journal Article DEP - 20171121 PL - England TA - Diabetol Metab Syndr JT - Diabetology & metabolic syndrome JID - 101488958 PMC - PMC5697213 OTO - NOTNLM OT - Coronary artery bypass OT - Coronary artery disease OT - Myocardial infarction OT - Percutaneous coronary intervention OT - Type 2 diabetes mellitus EDAT- 2017/12/05 06:00 MHDA- 2017/12/05 06:01 PMCR- 2017/11/21 CRDT- 2017/12/05 06:00 PHST- 2017/07/19 00:00 [received] PHST- 2017/11/15 00:00 [accepted] PHST- 2017/12/05 06:00 [entrez] PHST- 2017/12/05 06:00 [pubmed] PHST- 2017/12/05 06:01 [medline] PHST- 2017/11/21 00:00 [pmc-release] AID - 292 [pii] AID - 10.1186/s13098-017-0292-3 [doi] PST - epublish SO - Diabetol Metab Syndr. 2017 Nov 21;9:92. doi: 10.1186/s13098-017-0292-3. eCollection 2017.