The Challenge of Dysglycemia and Coronary Heart Disease.
The prevalence of type 2 diabetes mellitus (T2DM) is increasing globally, and although there is a small increase in the incidence of type 1 diabetes mellitus, T2DM accounts for 95% of all individuals with diabetes. There seems to be a curvilinear relation between post-oral glucose tolerance test, glucose levels and the risk for cardiovascular disease, and the risk increases already in the non-diabetic range of glucose levels.
There are several mechanisms linking diabetes to an increased risk of cardiovascular disease. Patients with T2DM are prone to atherothrombosis, which increases the risk of cardiovascular events and mortality. Another important factor contributing to the increased risk of coronary events in patients with T2DM is dysregulation of factors involved in coagulation and platelet activation. There is a strong association between T2DM and impaired myocardial perfusion after PPCI. Of note, diabetes mellitus seems to abolish the beneficial effect of PPCI on the long-term risk of reinfarction compared with fibrinolysis.
Strategies which help to restore microvascular endothelial function may thus improve diabetic control, as well as reduce microvascular complications such as myocardial microvascular dysfunction in ACS setting. The prevalence of dysglycemia is high in patients with coronary heart disease, and it contributes to increased risk for poor clinical outcome. In order to identify targets, modulation of which may improve cardiovascular prognosis in patients with dysglycaemia and ACS, the mechanisms of no-reflow after PPCI and their relationship with hyperglycaemia Furthermore, new treatment strategies targeting myocardial perfusion after percutaneous coronary.
Heart Res Open J. 2017; 4(2): e6-e8. doi: 10.17140/HROJ-4-e008
