Use of Vascular Assessments and Novel Biomarkers to Predict Cardiovascular Events in Type 2 Diabetes: The SUMMIT VIP Study
Autor: | Kim M. Gooding, Faisel Khan, Kunihiko Aizawa, Jan Nilsson, Margaretha Persson, Francesco Casanova, Harry Björkbacka, Michaela Kozakova, Phillip E. Gates, Helen M. Colhoun, Carlo Palombo, Helen C. Looker, Jasmina Kravic, S. Pinnola, Cecilia Kennbäck, Angela C. Shore, Gerd Östling, Andrea Natali, Jill J. F. Belch, Fiona Dove, Elena Venturi, Isabel Gonçalves |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
Carotid-femoral pulse wave velocity flow-mediated vasodilation medicine.medical_specialty Carotid intima-media thicknes Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes Disease 030204 cardiovascular system & hematology Carotid Intima-Media Thickness Risk Assessment Clinical cardiovascular disease Cohort Studies 03 medical and health sciences 0302 clinical medicine Vascular Stiffness Predictive Value of Tests Risk Factors Internal medicine Diabetes mellitus Internal Medicine medicine Humans Ankle Brachial Index Aged inflammatory biomarkers Advanced and Specialized Nursing Carotid plaque flow-mediated vasodilation inflammatory biomarkers business.industry Endothelial Cells Middle Aged medicine.disease Prognosis Plaque Atherosclerotic Diabetes Mellitus Type 2 Cardiovascular Diseases Predictive value of tests Cohort Arterial stiffness Cardiology Female business Risk assessment Biomarkers Cohort study |
Zdroj: | 2018, ' Use of Vascular Assessments and Novel Biomarkers to Predict Cardiovascular Events in Type 2 Diabetes : The SUMMIT VIP Study ', Diabetes Care, vol. 41, no. 10, pp. 2212-2219 . https://doi.org/10.2337/dc18-0185 |
Popis: | OBJECTIVE Cardiovascular disease (CVD) risk prediction represents an increasing clinical challenge in the treatment of diabetes. We used a panel of vascular imaging, functional assessments, and biomarkers reflecting different disease mechanisms to identify clinically useful markers of risk for cardiovascular (CV) events in subjects with type 2 diabetes (T2D) with or without manifest CVD. RESEARCH DESIGN AND METHODS The study cohort consisted of 936 subjects with T2D recruited at four European centers. Carotid intima-media thickness and plaque area, ankle-brachial pressure index, arterial stiffness, endothelial function, and circulating biomarkers were analyzed at baseline, and CV events were monitored during a 3-year follow-up period. RESULTS The CV event rate in subjects with T2D was higher in those with (n = 440) than in those without (n = 496) manifest CVD at baseline (5.53 vs. 2.15/100 life-years, P < 0.0001). New CV events in subjects with T2D with manifest CVD were associated with higher baseline levels of inflammatory biomarkers (interleukin 6, chemokine ligand 3, pentraxin 3, and hs-CRP) and endothelial mitogens (hepatocyte growth factor and vascular endothelial growth factor A), whereas CV events in subjects with T2D without manifest CVD were associated with more severe baseline atherosclerosis (median carotid plaque area 30.4 mm2 [16.1–92.2] vs. 19.5 mm2 [9.5–40.5], P = 0.01). Conventional risk factors, as well as measurements of arterial stiffness and endothelial reactivity, were not associated with CV events. CONCLUSIONS Our observations demonstrate that markers of inflammation and endothelial stress reflect CV risk in subjects with T2D with manifest CVD, whereas the risk for CV events in subjects with T2D without manifest CVD is primarily related to the severity of atherosclerosis. |
Databáze: | OpenAIRE |
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