Relation of severe coronary artery narrowing to insulin or thiazolidinedione use in patients with type 2 diabetes mellitus (from the Bypass Angioplasty Revascularization Investigation 2 Diabetes Study).
Relation of severe coronary artery narrowing to insulin or thiazolidinedione use in patients with type 2 diabetes mellitus (from the Bypass Angioplasty Revascularization Investigation 2 Diabetes Study).
复制标题
在2型糖尿病患者中使用胰岛素或噻唑烷二酮使用的严重冠状动脉的关系（来自旁路血管成形术血管血运重组研究2糖尿病研究）。
DOI：
10.1016/j.amjcard.2009.02.046
复制
发表时间：
2009-07-01
影响因子：
2.8
通讯作者：
Jones, Teresa L. Z.
中科院分区：
文献类型：
--
作者：
Pop-Busui, Rodica;Lombardero, Manuel;Lavis, Victor;Forker, Alan;Green, Jennifer;Korytkowski, Mary;Sobel, Burton E.;Jones, Teresa L. Z.
尽管心血管疾病的治疗取得了进展，但糖尿病患者死于冠状动脉疾病（CAD）的比率仍比非糖尿病患者高2至4倍。血糖控制治疗在心血管疾病中的作用是一个反复出现的问题，与其降糖作用无关。我们在旁路血管成形术血运重建研究2型糖尿病（巴里2D）试验中的1，803例受试者中，通过基线时获得的冠状动脉造影片测量，检查了血糖控制治疗与CAD程度的相关性，这些受试者患有2型糖尿病，记录了中度至重度CAD，既往未接受过心脏血运重建手术。通过多元回归模型分析基线血糖控制治疗与冠状动脉狭窄百分比和心肌危险指数之间的关系。与未使用胰岛素的受试者相比，在研究开始时使用胰岛素的受试者的高度狭窄病变（≥70%）减少了23%（p <0.001），心肌危险指数显着降低，尽管心脏危险因素谱更差，不稳定心绞痛更多，并且胰岛素使用者的炎症标志物增加。与未服用噻唑烷二酮类药物（TZD）的受试者相比，服用TZD ≥6个月的受试者高度狭窄病变减少17%（p = 0.02），C反应蛋白、纤维蛋白原和纤溶酶原激活物抑制剂-1水平显著降低。总之，这项2型糖尿病合并CAD患者的横断面研究显示，胰岛素或TZD治疗与高度狭窄病变较少相关，与病程、血糖控制和其他风险因素无关。
Patients with diabetes continue to die of coronary artery disease (CAD) at rates 2 to 4 times higher than patients without diabetes, despite advances in treatment of cardiovascular disease. The role of glycemic control therapies, independent of their glucose-lowering effects, on cardiovascular disease is a recurring question. We examined the association of glycemic control therapies with extent of CAD as measured by coronary angiogram obtained at baseline in 1,803 subjects in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial who had type 2 diabetes mellitus, documented moderate to severe CAD, and no previous cardiac revascularization procedures. The association between glycemic control therapy use recorded at baseline and percent coronary artery stenosis and myocardial jeopardy index was analyzed by multiple regression models. Insulin use at study entry was associated with 23% fewer highly stenotic lesions (≥70%) (p <0.001) and a significantly lower myocardial jeopardy index compared with subjects not on insulin, despite a worse cardiac risk factor profile, more unstable angina, and increased inflammatory markers in insulin users. Subjects taking thiazolidinediones (TZDs) for ≥6 months had 17% fewer highly stenotic lesions (p = 0.02) and significantly lower C-reactive protein, fibrinogen, and plasminogen activator inhibitor-1 levels compared with those not taking TZDs. In conclusion, this cross-sectional study of patients with type 2 diabetes mellitus and CAD showed that treatment with insulin or TZDs was associated with fewer highly stenotic lesions, independent of disease duration, glycemic control, and other risk factors.
登录
查看更多内容
影响因子：
158.5
作者：
Nissen, Steven E.;Wolski, Kathy
通讯作者：
Wolski, Kathy
影响因子：
4.8
作者：
Brooks, Maria Mori;Barsness, Gregory;Tardif, Jean-Claude
通讯作者：
Tardif, Jean-Claude
影响因子：
8.3
作者：
Chen, K;Chen, JW;Mehta, JL
通讯作者：
Mehta, JL
影响因子：
2.8
作者：
Brooks, Maria Mori;Frye, Robert L.;Orchard, Trevor J.
通讯作者：
Orchard, Trevor J.
影响因子：
1.9
作者：
Fisman, EZ;Tenebaum, A;Motro, M
通讯作者：
Motro, M