BACKGROUND: Epidemiologic evidence suggests that the complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes. Prediabetes is defined as people with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), some of whom in fact already have the characteristic microvascular changes resulting from diabetes itself. METHODS AND RESULTS: This study was conducted on 108 patients presenting to Ain Shams University Catheterization Laboratory for elective percutaneous coronary intervention using bare metal stents (48 diabetic patients, 30 pre-diabetic patients and 30 non-diabetic patients). All patients underwent bare metal stent deployment either preceded by balloon dilatation or not. Follow-up was done at three and six months for major adverse cardiac & cerebral events (cardiovascular death, acute coronary syndrome, cerebrovascular stroke, target vessel revascularization). RESULTS: Our findings demonstrate that there was no statistically significant difference between patients of the three different study groups regarding composite end point of death, stroke, acute coronary syndrome and target vessel revascularization at three months follow-up (diabetics = 18.8%, pre-diabetics = 13.3%, non diabetics = 3.3%, p-value = 0.1), but there was a highly statistical difference between them regarding acute coronary syndrome (diabetics = 43%, pre-diabetics = 26%, non diabetics = 10%, p-value = 0.006) at six months follow-up. CONCLUSION: Prediabetes, though not a disease entity by itself is associated with of risk for both macrovascular and increasingly, microvascular pathology. It is important to identify these conditions to prevent incident diabetes and to take measures to stop the vascular complications. Our study findings revealed that complications of diabetes may begin early as patients are suffering impaired glucose homeostasis, which warrants further evaluation in larger studies.
BACKGROUND: Epidemiologic evidence suggests that the complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes. Prediabetes is defined as people with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), some of whom in fact already have the characteristic microvascular changes resulting from diabetes itself. METHODS AND RESULTS: This study was conducted on 108 patients presenting to Ain Shams University Catheterization Laboratory for elective percutaneous coronary intervention using bare metal stents (48 diabeticpatients, 30 pre-diabeticpatients and 30 non-diabeticpatients). All patients underwent bare metal stent deployment either preceded by balloon dilatation or not. Follow-up was done at three and six months for major adverse cardiac & cerebral events (cardiovascular death, acute coronary syndrome, cerebrovascular stroke, target vessel revascularization). RESULTS: Our findings demonstrate that there was no statistically significant difference between patients of the three different study groups regarding composite end point of death, stroke, acute coronary syndrome and target vessel revascularization at three months follow-up (diabetics = 18.8%, pre-diabetics = 13.3%, non diabetics = 3.3%, p-value = 0.1), but there was a highly statistical difference between them regarding acute coronary syndrome (diabetics = 43%, pre-diabetics = 26%, non diabetics = 10%, p-value = 0.006) at six months follow-up. CONCLUSION:Prediabetes, though not a disease entity by itself is associated with of risk for both macrovascular and increasingly, microvascular pathology. It is important to identify these conditions to prevent incident diabetes and to take measures to stop the vascular complications. Our study findings revealed that complications of diabetes may begin early as patients are suffering impaired glucose homeostasis, which warrants further evaluation in larger studies.
Authors: Patrick W Serruys; Andrew T L Ong; Lex A van Herwerden; J Eduardo Sousa; Adib Jatene; Johannes J R M Bonnier; Jacques P M A Schönberger; Nigel Buller; Robert Bonser; Clemens Disco; Bianca Backx; Paul G Hugenholtz; Brian G Firth; Felix Unger Journal: J Am Coll Cardiol Date: 2005-08-16 Impact factor: 24.094
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
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Authors: Jaana Lindström; Pirjo Ilanne-Parikka; Markku Peltonen; Sirkka Aunola; Johan G Eriksson; Katri Hemiö; Helena Hämäläinen; Pirjo Härkönen; Sirkka Keinänen-Kiukaanniemi; Mauri Laakso; Anne Louheranta; Marjo Mannelin; Merja Paturi; Jouko Sundvall; Timo T Valle; Matti Uusitupa; Jaakko Tuomilehto Journal: Lancet Date: 2006-11-11 Impact factor: 79.321
Authors: Roberto A Corpus; Peter B George; John A House; Simon R Dixon; Steven C Ajluni; William H Devlin; Gerald C Timmis; Mamtha Balasubramaniam; William W O'Neill Journal: J Am Coll Cardiol Date: 2004-01-07 Impact factor: 24.094
Authors: Tien Y Wong; Gerald Liew; Robyn J Tapp; Maria Inês Schmidt; Jie Jin Wang; Paul Mitchell; Ronald Klein; Barbara E K Klein; Paul Zimmet; Jonathan Shaw Journal: Lancet Date: 2008-03-01 Impact factor: 79.321