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

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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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  • 1. Zhang Y Hu G Yuan Z Chen L. Glycosylated hemoglobin in relationship to cardiovascular outcomes and death in patients with type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2012;7:e42551. doi: 10.1371/journal.pone.0042551.

  • 2. Goldenberg I. Inflammatory markers and the risk of recurrent coronary events: the importance of dynamic risk assessment. Cardiol J. 2007;14:11-13.

  • 3. Erzen B Šabovic M Poredoš P Šebeštjen M Keber I Simcic LS. Inflammation markers in young post-myocardial patients exhibiting various expressions of classic coronary risk factors. Coronary Artery Disease. 2006;17:325-330.

  • 4. Nian M Lee P Khaper N Liu P. Inflammatory cytokines and postmyocardial infarction remodeling. Circ Res. 2004;94:1543-1553. doi: 10.1161/01.RES.0000130526.20854.fa.

  • 5. Biasucci LM Liuzzo G Della Bona R et al. Different Apparent Prognostic Value of hsCRP in Type 2 Diabetic and Nondiabetic Patients with Acute Coronary Syndromes. Clin Chem. 2009;55:365-368. doi: 10.1373/clinchem.2008.119156.

  • 6. Schulze M Rimm E Li T Rifai N. C-reactive protein and incident cardiovascular events among men with diabetes. Diabetes Care. 2004;27:889-894.

  • 7. Peterson LR McKenzie CR Schaffer JE. Diabetic cardiovascular disease: getting to the heart of the matter. J Cardiovasc Transl Res. 2012;5:436-445. doi: 10.1007/s12265-012-9374-7.

  • 8. Yorgun H Canpolat U Hazırolan T et al. Increased epicardial fat tissue is a marker of metabolic syndrome in adult patients. Int J Cardiol. 2013;165:308-313. doi: 10.1016/j. ijcard.2011.08.067.

  • 9. Harada K Amano T Uetani T et al. Cardiac 64-multislice computed tomography reveals increased epicardial fat volume in patients with acute coronary syndrome. Am J Cardiol. 2011;108:1119-1123. doi: 10.1016/j.amjcard.2011.06.012.

  • 10. Yerramasu A Dey D Venuraju S et al. Increased volume of epicardial fat is an independent risk factor for accelerated progression of sub-clinical coronary atherosclerosis. Atherosclerosis. 2012;220:223-230. doi: 10.1016/j. atherosclerosis.2011.09.041.

  • 11. Sabatine MS Morrow DA Jablonski KA et al; PEACE Investigators. Prognostic significance of the Centers for Disease Control/American Heart Association highsensitivity C-reactive protein cut points for cardiovascular and other outcomes in patients with stable coronary artery disease. Circ. 2007;115:1528-1536. doi: 10.1161/ CIRCULATIONAHA.106.649939

  • 12. Soinio M Marniemi J Laakso M Lehto S Ronnemaa T. Highsensitivity C-reactive protein and coronary heart disease mortality in patients with type 2 diabetes. A 7-year followup study. Diabetes Care. 2006;29:329-333.

  • 13. Karaca I Aydin K Yavuzkir M Ilkay E Akbulut M. Predictive value of C-reactive protein in patients with unstable angina pectoris undergoing coronary stent implantation. J Int Med Res. 2005;33:389-396.

  • 14. Wilson MW Marno CR Andrew JB. The novel role of C reactive protein in cardiovascular disease: risk marker or pathyogen. Int J Cardiol. 2006;106:291-297. doi:

  • 15. von Bibra H St John Sutton M. Impact of diabetes on postinfarction heart failure and left ventricular remodeling. Curr Heart Fail Rep. 2011;8:242-251. doi: 10.1007/s11897-011-0070-8.

  • 16. Swiatkiewicz I Kozinski M Magielski P et al. Usefulness of C-reactive protein as a marker of early post-infarct left ventricular systolic dysfunction. Inflamm Res. 2013;61:725-734. doi: 10.1007/s00011-012-0466-2.

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