Cited by 16Nitric Oxide and Endothelin EffectsDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Disease Prevention

Impact of glycemic variability on coronary and peripheral endothelial dysfunction in patients with coronary artery disease

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Tateishi, Kazuya, Saito, Yuichi, Kitahara, Hideki, Kobayashi, Yoshio·2022·Journal of Cardiology

Abstract

Background Previous studies have reported that glucose variability leads to endothelial dysfunction and progression of coronary atherosclerosis. However, few studies have directly evaluated the relation between glucose variability and coronary endothelial function in patients with coronary artery disease (CAD).Methods A total of 38 patients with chronic CAD and a history of coronary drug-eluting stent implantation were enroled. Coronary endothelial function was evaluated by measuring the coronary vasoreactivity using quantitative coronary angiography in the segment distal to implanted stent in response to intracoronary acetylcholine (ACh) infusion (10-7 mol/l). Peripheral endothelial function was also assessed with reactive hyperemia index (RHI). The mean amplitude of glycemic excursion (MAGE) was calculated as a primary metric of glucose variability using a flash glucose monitoring system.Results Of 38 patients, 17 (45%) had diabetes mellitus. The mean levels of glycated hemoglobin, MAGE, and RHI were 6.3 ± 0.8%, 71.4 ± 29.8 mg/dl, and 1.85 ± 0.63. In the distal segment to coronary stent, lumen diameter was constricted by 0.6 ± 7.3% in response to intracoronary ACh infusion compared to that at baseline. While peripheral endothelial function assessed with RHI was not significantly associated with MAGE (r = -0.16, p = 0.35), coronary endothelial function was correlated with MAGE (r = -0.38, p = 0.02).Conclusion Greater glucose variability was significantly associated with coronary rather than peripheral endothelial dysfunction in patients with CAD, suggesting an impact of glucose variability on coronary atherosclerosis.

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Crossref · 10.1016/j.jjcc.2021.08.009

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Authors
Tateishi, K., Saito, Y., Kitahara, H., & Kobayashi, Y.
Affiliations
Chiba University (JP)
Corresponding author
Tateishi, Kazuya
Venue
Journal of Cardiology
Publisher
Elsevier BV
Published
2022-01
Volume
79
Issue
1
Pages
65-70
ISSN
0914-5087 (ISSN-L)
OpenAlex
W3198740020
Cited by
16
References
47
Citations by year
2026: 3 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 4
FWCI
1.25
Type
journal article
Language
en
Open access
Locations
  • Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
glycemic variability, endothelial dysfunction, coronary endothelial function, peripheral endothelial function, coronary artery disease, mean amplitude of glycemic excursions, coronary vasoreactivity, acetylcholine, reactive hyperemia index, drug-eluting stents, diabetes mellitus, HbA1c
MeSH terms
Blood Glucose, Coronary Artery Disease, Endothelium, Vascular, Humans, Blood Glucose Self-Monitoring, Coronary Angiography, Drug-Eluting Stents

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