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Non-invasive, Complex Examination of Micro- and Macrovascular System of Patients with Type 1 Diabetes Mellitus with or Without Vascular Complications

LIST OF ABBREVIATIONS: AIX augmentation index BMI body mass index C control ChF change of flow CV cardiovascular CVD cardiovascular disease DM diabetes mellitus DM I type 1 diabetes mellitus DMC diabetes with complications DMW diabetes without complications FBF forearm blood flow HbA1c Hamoglobin A1c IQR interquartile range IU international unit M median PORH Postocclusive reactive hyperemia PU perfusion unit PWV pulse wave velocity sE-selectin soluble endothelial-leukocyte adhesion molecule 1 sICAM-1 soluble

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Prognostic Value of Epicardial Fat Thickness as a Biomarker of Increased Inflammatory. Status in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction

Abstract

Introduction: The prognostic value of epicardial fat thickness (EFT) and inflammatory biomarkers such as hs-CRP have not been fully investigated in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM). The study aim was to assess the correlation between the EFT, the persistence of elevated circulating levels of hs-CRP at 7 ± 2 days after an AMI and the amplitude of the left ventricular (LV) remodeling, in patients with type 2 DM. Methods: The study included 98 patients (45 with type 2 DM and 43 with no DM): Group 1 included 22 low-to-intermediate risk patients (hsCRP <3 mg/l) and Group 2 had 23 high-risk, (hsCRP >3 mg/l) patients. EFT, LV function and remodeling were assessed at baseline and at six months after AMI in both groups. Results: In the diabetic population, the EFT was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02) and significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p <0.0001). The levels of circulating hs-CRP, at baseline, significantly correlated with the RI at six months (r = 0.39, p <0.001). Also, in the diabetic population, the epicardial fat thickness was significantly higher in patients who developed ventricular remodeling as compared with those who did not (8.02 ± 1.80 mm vs. 6.65 ± 2.17 mm, p = 0.02). The epicardial adipose tissue thickness significantly correlated with the circulating levels of hs-CRP (r = 0.6251, p <0.0001), while in the non-diabetic population, EFT was not significantly higher in patients who developed ventricular remodeling as compared with those who did not (71.38 ± 9.09 vs. 67.4 ± 10.17, p = 0.23). Multivariate analysis identified the hs-CRP values (OR: 4.09, p = 0.03) and the EFT (OR: 6.11, p = 0.01) as significant independent predictors for LV remodeling in diabetic population. Conclusions: A larger EFT is associated with a more severe remodeling and impairment of ventricular function in patients with type 2 DM and AMI.

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Response to “Prognostic Value of Epicardial Fat Thickness as a Biomarker of Increased Inflammatory Status in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction”

REFERENCES 1. Opincariu D, Mester A, Dobra M, et al. Prognostic Value of Epicardial Fat Thickness as a Biomarker of Increased Inflammatory Status in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction. Journal of Cardiovascular Emergencies. 2015;1(2):11-18. DOI: 10.1515/jce-2016-0003. 2. Iacobellis G, Willens HJ. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009;22(12):1311-1319. quiz 417-8. DOI: 10.1016/j.echo.2009.10.013. 3. Saura D, Oliva MJ, Rodriguez D, et al

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Epicardial Adipose Tissue – A New Biomarker of Cardiovascular Risk

suspected coronary artery disease. J Nucl Cardiol. 2015;22:325-333. doi: 10.1007/s12350-014-0004-4. 11. Tanindi A, Erkan AF, Ekici B. Epicardial adipose tissue thickness can be used to predict major adverse cardiac events. Coron Artery Dis. 2015;26:686-691. doi: 10.1097/ MCA.0000000000000296. 12. Chun H, Suh E, Byun AR, Park HR, Shim KW. Epicardial fat thickness is associated to type 2 diabetes mellitus in Korean men: a cross-sectional study. Cardiovasc Diabetol. 2015;14:46. doi: 10.1186/s12933-015-0210-7. 13. Opincariu D

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Factors Associated with In-hospital Mortality in Patients with Acute Coronary Syndrome

Am Coll Cardiol Intv. 2013;6:115-125. 10. Alonso J, Bueno H, Bardají, A et al. Influence of sex on acute coronary syndrome mortality and treatment in Spain. Rev Esp Cardiol Supl. 2008; 8:8D-22D. 11. Fuster V, Farkouh ME. Coronary Syndromes and Diabetes Mellitus. Circulation. 2008;118:1607-1608. 12. Park JS, Cha KS, Lee DS, et al. Culprit or multivessel revascularisation in ST-elevation myocardial infarction with cardiogenic shock. Heart. 2015;101:1225-1232. 13. Awad HH, Anderson FA Jr, Gore JM et al

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Characteristics of Neoatherosclerosis Within Implanted Coronary Stents in Patients with Acute Coronary Syndromes

References 1. Chieffo A, Foglieni C, Nodari RL, et al. Histopathology of clinical coronary restenosis in drug eluting versus bare metal stents. Am J Cardiol. 2009;104:1660-1667. doi:10.1016/j. amjcard.2009.07.041. 2. Suzuki N , Nanda H, Angiolillo DJ, et al. Assessment of potential realtionship between wall shear stress and sirolimus - eluting stent implantation in patients with diabetes mellitus. Int J Cardiovasc Imaging. 2008;24:357-364. doi 10.1007/s10554-007-9274-0. 3. Oikava YJ, Costa M, Matsuno S, et al

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Morphological Features and Plaque Composition in Culprit Atheromatous Plaques of Patients with Acute Coronary Syndromes

with type 2 diabetes mellitus. Acta Endocrinologica. 2011;7:59-68. doi: https://doi.org/10.4183/aeb.2011.59 .

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Mean Platelet Volume Predicts Short-term Prognosis in Young Patients with St-segment Elevation Myocardial Infarction

. Immature platelets in patients with acute coronary syndromes. Thromb Haemost. 2009;101:151-156. 41. Funck-Jensen KL, Dalsgaard J, Grove EL, Hvas AM, Kristensen SD. Increased platelet aggregation and turnover in the acute phase of ST-elevation myocardial infarction. Platelets. 2013;24:528-537. doi: 10.3109/09537104.2012.738838. 42. Tschoepe D, Roesen P, Esser J, et al. Large platelets circulate in an activated state in diabetes mellitus. Semin Thromb Hemost. 1991;17:433-438. doi: 10.1055/s-2007-1002650. 43. Debili N, Masse JM, Katz A, Guichard J, Breton

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Nuclear Transcription Factor Kappa B (NF-кB) and Molecular Damage Mechanisms in Acute Cardiovascular Diseases. A Review

Res. 2010;106:1035-1039. doi: 10.1161/CIRCRESAHA.110.218297. 64. Caporali A, Meloni M, Vo C, et al. Deregulation of microRNA-503 Contributes to Diabetes Mellitus-Induced Impairment of Endothelial Function and Reparative Angiogenesis After Limb Ischemia. Circulation. 2011;123:282-291. doi: 10.1161/CIRCULATIONAHA.110.952325. 65. Liu C, Liu N, Cao B, et al. CircRNAs as Potential Biomarkers in Gastrointestinal Tract Tumors : Opportunities and Challenges. Clin Lab. 2018;64:141-145. doi: 10.7754/Clin.Lab.2017.170731. 66. Giden R, Gökdemir MT, Erel Ö, et

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Original research. The Assessment of Epicardial Adipose Tissue in Acute Coronary Syndrome Patients. A Systematic Review

Increased Inflammatory Status in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction. Journal of Cardiovascular Emergencies. 2016;2:11-18. doi: 10.1515/jce-2016-0003. 50. Takase H, Dohi Y, Okado T, Hashimoto T, Goto Y, Kimura G. Effects of ezetimibe on visceral fat in the metabolic syndrome: a randomized controlled study. Euro J Clin Invest. 2012;42:1287-1294. doi: 10.1111/eci.12000. 51. Kim M, Tanaka K, Kim M, et al. Epicardial fat tissue: relationship with cardiorespiratory fitness in men. Med Sci Sports Exerc. 2010

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