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Peripheral arterial endothelial dysfunction predicts future cardiovascular events in diabetic patients with albuminuria: a prospective cohort study
Cited 11 time in
Web of Science
Cited 14 time in Scopus
- Authors
- Issue Date
- 2020-06-13
- Publisher
- BMC
- Citation
- Cardiovascular Diabetology. 2020 Jun 13;19(1):82
- Keywords
- Reactive hyperemia ; Endothelial function ; Type 2 diabetes ; Ischemic heart disease ; Nonfatal stroke ; Heart failure ; Chronic kidney disease
- Abstract
- Background
Reactive hyperemia-peripheral arterial tonometry (RH-PAT) is a noninvasive and simple test for evaluating the endothelial function. There has been sparse evidence on the usefulness of the RH-PAT index (RHI) in predicting future cardiovascular diseases among diabetic patients.
Methods
Asymptomatic diabetic patients with albuminuria were selected; their medical history and laboratory findings were evaluated every 3 to 4months, respectively. The primary outcome was a composite of three-point major adverse cardiovascular events (3-point MACE): death from cardiovascular causes, acute coronary events, or nonfatal stroke. On the contrary, secondary outcomes included a composite of 3-point MACE, hospitalization for heart failure, or chronic kidney disease (CKD) progression. RHI was measured using the Endo-PAT2000 at the baseline. RHI < 1.67 was considered to indicate peripheral endothelial dysfunction (PED).
Results
In total, 149 subjects were included (mean age, 61.8 ± 9.2years; duration of diabetes was 12years). During the follow-up period (median, 49.7months), of the 149 subjects, primary outcomes were detected in 12 (1 [2.3%] and 11 [10.5%] of those without and with PED, respectively). The presence of PED in baseline measurements significantly increased both primary and secondary outcomes, following adjustment for age, sex, hypertension, glycated hemoglobin, low-density lipoprotein cholesterol, triglyceride, systolic blood pressure, baseline estimated glomerular filtration rate, overt proteinuria, duration of diabetes, premedical history of ischemic events, anti-platelet agents, and smoking history (hazard ratio [HR]: 10.95; 95% confidence interval CI 1.00–119.91 for the primary outcome; HR, 4.12; 95% CI 1.37–12.41 for secondary outcome). In addition, PED could predict secondary outcomes independent of the risk score according to the American College of Cardiology/American Heart Association (HR: 3.24; 95% CI 1.14–9.17).
Conclusions
PED can independently predict future cardiovascular events among diabetic patients with albuminuria.
- ISSN
- 1475-2840
- Language
- English
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