Coronary Disease Patients Research Articles

Lung functional status in patients with CHD AND dyslipidemia

Aim: The lung functional status study in patients with dyslipidemia in coronary hearth disease (CHD) patients.

Effect of Infusion of High-Density Lipoprotein Mimetic Containing Recombinant Apolipoprotein A-I Milano on Coronary Disease in Patients With an Acute Coronary Syndrome in the MILANO-PILOT Trial

Infusing a high-density lipoprotein mimetic containing apolipoprotein A-I Milano demonstrated potential atheroma regression in patients following an acute coronary syndrome. To our knowledge, the effect of infusing a new mimetic preparation (MDCO-216) with contemporary statin therapy is unknown. To determine the effect of infusing MDCO-216 on coronary atherosclerosis progression. This double-blind, randomized clinical trial conducted in 22 hospitals in Canada and Europe compared the effects of 5 weekly intravenous infusions of MDCO-216 at a dose of 20 mg/kg weekly (n = 59) with placebo (n = 67) in statin-treated patients with an acute coronary syndrome. The primary efficacy measure was the nominal change in percent atheroma volume (PAV) from baseline to day 36 as measured by serial intravascular ultrasonography. The secondary efficacy measures were the nominal changes in normalized total atheroma volume (TAV), atheroma volume in the most diseased 10-mm segment, and the percentage of patients who demonstrated plaque regression. Safety and tolerability were also evaluated. Among 122 randomized patients (mean [SD] age, 61.8 [10.4] years; 93 men [76.2%]; 61 [50.0%] with prior statin use; and a mean [SD] low-density lipoprotein cholesterol [LDL-C] level of 87.6 [40.5] mg/dL [to convert to millimoles per liter, multiply by 0.0259]), 113 (92.6%) had evaluable imaging results at follow-up. The receiving-treatment LDL-C levels were comparable with the placebo and MDCO-216 (68.6 vs 70.5 mg/dL; difference, -2.5 mg/dL; 95% CI, -10.1 to 5.0; P = .51). A reduction in high-density lipoprotein cholesterol levels was observed in MDCO, but not placebo patients (-3.3 vs 3.0 mg/dL [to convert to millimoles per liter, multiply by 0.0259]; difference, -6.3 mg/dL; 95% CI, -8.5 to -4.1; P < .001). Percent atheroma volume, which was adjusted for baseline values, decreased 0.94% with the placebo and 0.21% with MDCO-216 (difference, 0.73%; 95% CI, -0.07 to 1.52; P = .07). Normalized TAV decreased 7.9 mm3 with the placebo and 6.4 mm3 with MDCO-216 (difference, 1.6 mm3; 95% CI, -5.6 to 8.7; P = .67), and atheroma volume in the most diseased segment decreased 1.8 mm3 with the placebo and 2.2 mm3 with MDCO-216 (difference 0.4 mm3; 95% CI, -4.4 to 3.5; P = .83). A similar percentage of patients demonstrated a regression of PAV (67.2% vs 55.8%; P = .21) and TAV (68.9% vs 71.2%; P = .79) in the placebo and MDCO-216 groups, respectively. Among patients with an acute coronary syndrome, infusing MDCO-216 did not produce an incremental plaque regression in the setting of contemporary statin therapy. ClinicalTrials.gov Identifier: NCT02678923.

Effects of extended nursing on compliance of clopidogrel in elderly coronary disease with percutaneous coronary intervention

Objective To explore the effects of extended nursing on compliance of clopidogrel in elderly coronary disease with percutaneous coronary intervention (PCI) . Methods From August 2015 to August 2016, we selected a total of 100 elderly patients with coronary disease met the inclusion criteria at Cardiovascular Hospital, He'nan Provincial People's Hospital by convenience sampling. All of the patients were divided into control group and observation group by the random number, 50 cases in each group. Elderly coronary disease patients with PCI of two groups were all treated with clopidogrel. Patients of observation group accepted standardized extended nursing, while patients of control group were treated with conventional intervention. We observed and compared the medicine compliance of patients between observation group and control group. Results Three, six and twelve months post discharge, the scores of regular rehabilitation, taking medicine at a regular time, proper exercise and diet change of patients in observation group after extended nursing were all higher than those in control group with significant differences (t=8.522, 5.020, 5.088, 4.456; P<0.01) ; the proportions of taking medicine on time correctly of patients in observation group were higher than those in control group with significant differences (χ2=5.983, 8.306, 7.865; P<0.05) ; that showed the medicine compliance of observation group was better than that of control group. Conclusions The application of extended nursing in elderly coronary disease patients with clopidogrel after PCI could effectively improve the compliance of clopidogrel. It is worth to be spread in clinic. Key words: Aged; Coronary heart disease; Clopidogrel; Extended nursing; Percutaneous coronary intervention; Medicine compliance

Levels of soluble tumor necrosis factor receptor 1 and 2, gender, and risk of myocardial infarction in Northern Sweden

Background and aimsSoluble receptors for tumor necrosis factor alpha (sTNFR1 and sTNFR2) have been associated with cardiovascular diseases, and some evidence points towards a difference in associated risk between men and women. We aimed to study the association between sTNFR1 and sTNFR2 and incident myocardial infarctions (MI) and to explore the influence of established cardiovascular risk factors in men and women. MethodsWe conducted a nested case control study in three large Swedish cohorts, including 533 myocardial infarction cases, and 1003 age-, sex- and cohort-matched controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. ResultsAn association between circulating sTNFR1 and sTNFR2 and an increased risk for MI was found when comparing cases and controls. The odds ratios were significant after adjustment for established cardiovascular risk factors and C-reactive protein in women (OR 1.44, 95% CI 1.08–1.93 for TNFR1, and 1.61, 95% CI 1.11–2.34 for TNFR2), but was abolished in men. Women with a combination of elevated CRP and values in the upper quartile of TNFR1 or TNFR2 had a 5-fold higher risk of myocardial infarction versus those with normal CRP and values in the lower three quartiles of TNFR1 or TNFR2. ConclusionsAs the risk estimates for TNFR1 and TNFR2 were higher and remained significant after adjustments for established cardiovascular risk factors in women but not in men, a potential role for TNFR1 and TNFR2 in identifying women with a higher MI risk is possible. The future clinical role of TNFR1 and TNFR2 in combination with CRP to identify high risk patients for coronary heart disease has yet to be determined.

Oxidative stress and kidney injury in trans-radial catheterization.

Oxidative stress is linked to coronary artery disease and is a major mechanism in contrast-induced nephropathy. Trans-radial approach in coronary angiography (CA) with minimized peri-procedural bleeding is expected to reduce acute kidney injury incidence. In the present study, oxidative stress patterns observed in radial CA and their associations with early manifestations of kidney injury are described. A total of 20 stable coronary disease patients submitted to CA and 17 sex-matched patients undergoing computed tomography for myoskeletal reasons were enrolled. Reduced glutathione, catalase, thiobarbituric acid reactive species (TBARS) levels and total anti-oxidant status were measured at various time points postangiography. In ischemic patients baseline TBARS levels were 2-fold lower compared to controls, while carbonyls levels were 35% higher. Glutathione was almost 4-fold lower than the control group. Glutathione and lipid peroxidation in ischemic patients gradually increased after contrast medium administration and reached 180% (P<0.001) and 20% (P=0.021) after 4–6 h, respectively. Four patients presented early evidence of contrast-induced nephropathy postangiography, while no control patient developed acute kidney injury. In the multiple logistic regression analysis, only the creatinine levels at baseline influenced the frequency of early contrast-induced nephropathy development (β =0.36, 95% CI: 0.285–0.438, P=0.01). Glutathione low levels were dominant in the baseline values of ischemic patients who developed contrast-induced nephropathy. Glutathione levels rapidly increased while protein oxidation decreased at the expense of lipid peroxidation. In conclusion, early oxidative stress changes occur in trans-radial CA patients with a mild profile, sufficient to mobilize patient antioxidant defenses.

Epicardial fat thickness and severity of coronary heart disease in patients with diabetes mellitus type II.

BACKGROUNDClinical imaging studies have demonstrated a strong direct correlation between epicardial fat and abdominal visceral adiposity. There are several studies about positive correlation of epicardial fat and atherosclerotic coronary disease in general population. This study aimed to evaluate the association of epicardial fat thickness with atherosclerotic coronary disease in patients with diabetes mellitus type II.METHODSThis cross-sectional observational study involved 80 patients with diabetes mellitus type II. The patients were chosen using simple sampling method from patients with diabetes mellitus who were referred for angiography because of suspected coronary artery disease. The severity of coronary atherosclerotic lesions was evaluated using modified Gensini scoring system. Epicardial fat thickness was measured by transthoracic echocardiography within 90 days after coronary angiography. Multiple linear regression method was used to evaluate the association between mean epicardial fat thickness and Gensini score.RESULTSAfter adjustment for the effects of body mass index (BMI), age, angina, and sex, there was a significant association between Gensini score and epicardial fat thickness (β = 0.825; P < 0.001). Patients with higher blood pressure and higher body mass index also had a higher Gensini score (P < 0.010).CONCLUSIONIn patients with diabetes mellitus type II, there is a positive association between epicardial fat thickness and severity of coronary artery disease. So, by echocardiography evaluation of epicardial fat thickness, we could have an estimation of the severity of coronary arteries diseases before using more invasive techniques.

Accuracy of the TIMI and GRACE scores in predicting coronary disease in patients with non-ST-elevation acute coronary syndrome

Accuracy of the TIMI and GRACE scores in predicting coronary disease in patients with non-ST-elevation acute coronary syndrome

Accuracy of the TIMI and GRACE scores in predicting coronary disease in patients with non-ST-elevation acute coronary syndrome

IntroductionThe GRACE and TIMI scores have been well validated for assessment of prognosis in non-ST-elevation acute coronary syndrome (NSTE-ACS). However, their value in predicting coronary artery disease (CAD) has been little studied. We aimed to assess the relationship between these scores and the extent of coronary disease. MethodsWe analyzed 238 consecutive patients admitted for NSTE-ACS and undergoing a coronary angiogram during hospitalization. The severity of CAD was assessed using the SYNTAX score. Obstructive CAD was defined as ≥50% stenosis in the left main or ≥70% stenosis in other vessels. Severe CAD was defined as a SYNTAX score >32. The Pearson test was used to assess the correlation between scores. ResultsThe SYNTAX score was higher in patients at high risk (GRACE score: p<0.001 and TIMI score: p=0.001). Moreover, there was a significant positive correlation between the GRACE and SYNTAX scores (r=0.23, p<0.001) as well as between TIMI and SYNTAX (r=0.2, p=0.002). Both clinical scores can predict obstructive CAD moderately well (area under the curve [AUC] for GRACE score: 0.599, p=0.015; TIMI score: AUC 0.639, p=0.001) but not severe disease. A GRACE score of 120 and a TIMI score of 2 were predictive of obstructive CAD with, respectively, a sensitivity of 57% and 75.7% and a specificity of 61.8% and 47.9%. ConclusionThe GRACE and TIMI scores correlate moderately with the extent of coronary disease assessed by the SYNTAX score. They can predict obstructive CAD but not severe disease.

The development of islamic caring model to improve psycho spiritual comfort of coronary disease patients

Objectives: Caring is the essence of the nursing process delivered by nurses in diverse cultural settings exceptionally is Islamic caring. This research aims to develop an Islamic caring model for the psycho-spiritual comfort of coronary disease patients. Method: The research method used was analytic observational with a cross-sectional design. This research recruited 70 clients from the population of the heart disease patients in three Islamic hospitals by using simple random sampling. Data were collected by questionnaire and analyzed by Partial Least Squares-Structural Equation Modeling (PLS-SEM). Results: The research showed that there were influences from the nursing and service factors towards Islamic caring with a value of t= 7.79; 2.06. There was influence from Islamic caring towards psycho-spiritual comfort with a value of t= 2.85. Conclusions: The Islamic caring model is a nurse�s behavior that emphasizes Islamic values that include the characteristics of maintaining confidence, compassion, and competence to enhance the patients� psycho-spiritual comfort. © 2018, Indian Journal of Public Health Research and Development. All rights reserved.

Coronary disease in patients eligible for percutaneous aortic valve replacement: what we should and should not do, from clinical evidence to common sense

Coronary disease in patients eligible for percutaneous aortic valve replacement: what we should and should not do, from clinical evidence to common sense

Utilidad del strain sistólico pico longitudinal bidimensional en pacientes con diagnóstico clínico de infarto del miocardio sin elevación del ST

ObjectivesTo evaluate the usefulness of two-dimensional longitudinal peak systolic strain to detect significant coronary disease in patients with a diagnosis of acute myocardial infarction without ST elevation, and its ability to identify the artery responsible for the coronary event. MethodsA descriptive, observational, and cross-sectional study was conducted between March and November 2015 on patients with a clinical diagnosis of acute myocardial infarction without ST elevation, and on whom the two-dimensional longitudinal peak systolic strain of the left ventricle was evaluated prior to coronary angiography. ResultsThe longitudinal strain was evaluated in 28 patients who fulfilled selection criteria. For the ROC curve analysis, a cut-off point of ≥ -18.8% for the overall strain was identified, with a sensitivity of 85% and a specificity of 75% to recognise the presence of angiographically significant coronary disease. A cut-off point of ≥ -17.8% of overall strain identified significant lesions, with a specificity of 100%. For the segmental analysis, a cut-off point of ≥ 3 segments with a strain ≥ -14% was established, finding a sensitivity of 90% and a specificity of 87.5% for the diagnosis of significant coronary disease. ConclusionsThe evaluated echocardiographic technique, when applied to patients with a clinical diagnosis of myocardial infarction without ST elevation, was shown to be useful in identifying significant coronary disease, but was unable to find the vessel responsible for the acute event.

Triple Therapy Versus Dual Antiplatelet Therapy for Patients with Atrial Fibrillation and Acute Coronary Syndromes: A Systematic Literature Review.

Background: Patients with acute coronary syndromes (ACS) and a history of atrial fibril-lation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS.Methods: We searched Medline, Medline pending, EMBASE and Evidence-Based Medicine Re-views databases for studies published between January 2000 to December 2016 in AF patients with ACS that compared DAPT and TT that reported ischaemic and/or bleeding outcomes. Studies that were not purely an AF population were excluded.Results: Ten studies were included in the review, all of which were observational, 8 of which were retrospective. None of the studies detailed the specifics of treatment allocation. All but one were of AF patients with a mix of stable coronary disease and ACS patients. TT was associated with in-creased bleeding when compared to DAPT, with adjusted odds ratios ranging from 1.25 to 6.84. While the largest study reported a reduction in stroke associated with TT (odds ratio 0.67), two other studies reported non-significant increases in stroke with TT. Variable composite ischaemic endpoints were reported, none showing a statistical significant difference between DAPT and TT.Conclusion: In patients with ACS and AF, TT is likely to be associated with increased risk of bleed-ing, without a clear reduction in ischaemic endpoints. The quality of the evidence to support current guidelines for this patient group was generally poor.

Influence of aspirin/clopidogrel treatment on platelet aggregation rate and analysis of drug resistance in the patients with coronary heart disease

Objective To investigate the influence of aspirin and/or clopidogrel treatment on platelet aggregation rate in coronary heart disease (CHD) patients, and discuss the factors related to anti-platelet drug resistance. Methods A total of 160 patients with CHD and received aspirin and/or clopidogrel treatment were enrolled in the Second Xiangya Hospital, Central South University, and were divided into stable coronary heart disease (SCHD) group (n=90) and acute coronary syndrome (ACS) group (n=70). Meanwhile, non-coronary heart disease (NCHD) patients who did not receive anti-platelet drug treatment were enrolled as controls (n=50). Clinical data of the subjects were recorded. The maximum platelet aggregation rate induced by arachidonic acid (MAR-AA) and adenosine diphosphate (MAR-ADP) were evaluated with sequential platelet counting method. The factors related to drug resistance were analyzed with Logistic regression analysis. Results Compared to NCHD group, there were lower MAR-AA and MAR-ADP in two groups of CHD (all P<0.05). In ACS patients, MAR-AA and MAR-ADP are significantly lower (P<0.05) in patients who receive the aspirin and clopidogrel. The rate of anti-platelet drug resistance in ACS group was significantly higher than that in SCHD group (20.0% vs 10.0%, P<0.05). Multivariate logistic regression analysis showed that low HDL-C (<1.0 mmol/L) was an independent risk factor related to the anti-platelet drug resistance (OR=4.36, 95% CI: 1.36-14.02, P=0.025). Conclusions The antiplatelet treatment with aspirin and/or clopidogrel can significantly reduce the platelet reactivity in CHD patients, but some patients still present anti-platelet drug resistance. The combination of aspirin and clopidogrel is better. The rate of drug resistance in ACS patients is high. Low HDL-C might be associated with anti-platelet drug resistance. Key words: Aspirin/TU; Ticlopidine/AA/TU; Coronary disease/DT; Platelet aggregation/DE; Drug resistance

What the results of Acarbose Cardiovascular Evaluation(ACE) Study will be

The prevalence of prediabetes is increasing rapidly in China, and with higher prevalence in coronary heart disease and hypertension patients. Diabetes can be controlled and prevented, previous studies have confirmed that lifestyle interventions and drug interventions can delay the progression of prediabetes to diabetes, and acarbose can be used for the primary prevention of cardiovascular events in impaired glucose tolerance(IGT) and diabetic patients, but benefits of drug intervention for secondary prevention of cardiovascular disease in IGT population are uncertain. The Acarbose Cardiovascular Evaluation(ACE) Study is a multicentre, randomized, placebo-controlled, double-blind study, with the aim of assessing the use of acarbose to reduce the risk of cardiovascular events and the onset of diabetes in IGT patients with cardiovascular disease in China , the results will be very meaningful and valuable for the prevention and treatment of diabetes. We will predict the results of ACE Study based on previous evidences. (Chin J Endocrinol Metab, 2017, 33: 705-708) Key words: Acarbose; Prediabetes; Cardiovascular outcome

P6424Abnormal QRS and QTc durations and the risk of sudden cardiac death among coronary disease patients

P6424Abnormal QRS and QTc durations and the risk of sudden cardiac death among coronary disease patients

Disease cognition and medical coping style of coronary heart disease patients with type-D personality

Objective To analyze the disease cognition and medical coping style of coronary heart disease (CHD) patients with type D personality, so as to improve patients′ cognition and prognosis. Methods A total of 242 CHD patients of the Second Xiangya Hospital of Central South University were recruited from March 2015 to March 2016. They were investigated by type D scale (DS14) , disease perception and medical coping style questionnaires. The disease cognition and medical coping style were compared between CHD patients with and without type-D personality. Results Among 242 CHD patients, there were 44 CHD patients with type-D personality (18.18%) and 198 CHD patients without type-D personality (81.82%) . There was no significant difference between patients with type-D personality and patients without type D personality in age, gender, working status and marital status (P>0.05) ; the frequency of exercise in patients without type-D personality was better than patients with type-D personality (P 0.05) . The score of yield dimension of patients between two groups was statistically significant different (P 0.05) . Conclusions Health education should be developed target the characteristics of disease cognition and coping style of CHD patients with type-D personality, so as to improve their life style, disease cognition and prognosis. Key words: Coronary heart disease; Type-D personality; Disease cognition; Coping style

Analysis of curative effect of trimetazidine in the treatment of coronary heart disease patients with heart failure

Objective To explore the clinical effect of trimetazidine in the treatment of coronary heart disease(CHD) patients with heart failure. Methods 80 CHD patients with heart failure cases in our hospital from April 2015 to January 2016 were selected as the research subjects.According to the random lottery method, they were divided into two groups.The control group(n=40) adopted routine comprehensive treatment, the treatment group(n=40) was given trimetazidine on the basis of conventional treatment.The clinical curative effect and heart function index before and after the treatment, exercise tolerance and the change of vascular endothelial function were compared between the two groups. Results The total effective rate of the treatment group was 97.50%(39/40), which was higher than 77.50%(31/40) of the control group(χ2=3.98, P=3.98). After treatment, the systolic blood pressure, left ventricular end systolic diameter and left ventricular end-diastolic diameter in the treatment group were less than the control group, while the left ventricular ejection fraction was greater than the control group, the differences between the two groups were statistically significant (all P 0.05). The 6 min walking distance of the treatment group after treatment was (375.67±28.48)m, which of the control group was (306.18±25.71)m, the difference was statistically significant(t=11.451, P=11.451), and the 6 min walking distance before treatment had no statistically significant difference (t=0.013, P=0.013). In the treatment group after treatment, the vascular endothelial function index was (2.32±0.36)mg/L, which of the control group was (2.95±0.16)mg/L, the difference was statistically significant(t=10.114, P=10.114), while the two groups before treatment had no statistically significant difference in endothelial function index (t=0.126, P=0.126). Conclusion The clinical effect of trimetazidine in the treatment of CHD patients with heart failure is sure, and it can effectively relieve symptoms of heart failure patients, improve the cardiac function, improve their exercise tolerance, which can be used as an ideal drug in CHD patients with heart failure. Key words: Heart Failure; Coronary Artery Disease; Trimetazidine; Cardiac Function Tests

Arterial stiffness and cognitive function.

Arterial stiffness is an independent predictor of morbidity (infarction, fatal stroke) and cardiovascular mortality, especially in elderly, hypertensive patients with pre-terminal renal insufficiency and in coronary disease patients. The gold standard of its measurement is the pulse wave velocity assessment. The important increase in arterial stiffness that occurs during midlife is associated with the occurrence of severe cardiovascular and cerebrovascular events and also cognitive decline. The causal relationship between stiffening of the arterial tree and cognitive disorders has not yet been clearly established, however, many studies show a relationship between higher levels of aortic stiffness and poorer performance on cognitive memory tests. Arterial stiffness is associated with microvascular alterations, with an increase in microvascular resistance, an increase in leukoaraisosis and also medial temporal lobe atrophy. These damages contribute to dementia pathogenesis (including Alzheimer's disease) and confirm the importance of early detection and management of arterial stiffness increase.

Feedback teaching effect on the exercise compliance of the patients with coronary heart disease

Objective To explore the effect of feedback teaching on the exercise compliance of the patients with coronary heart disease. Methods Thirty-eight coronary heart disease (CHD) patients who met the criteria and were treated in the department of geriatric cardiology in 304 clinical department of People's Liberation Army General Hospital from June 2014 to December 2014 were included into the control group. Forty-one coronary heart disease patients who met the criteria and were treated in the department of geriatric cardiology in 304 clinical department of People's Liberation Army General Hospital from January 2015 to July 2015 were included into the observation group. The patients in the control group received the routine health education. The patients in the observation group received the feedback teaching nursing model based on the routine nursing. The state of mind, the exercise compliance, the grasp of exercise knowledge and the situation of illness improvement of the patients after the intervention were compared between the two groups. Results Before the intervention, no significant difference of the seven dimensions in the state of mind was found between the two groups (P>0.05) .After the intervention the improvement situations of seven dimensions were all better in the observation group compared to the control group (t=4.658, 4.251, 3.318, 6.123, 4.587, 5.487, 4.982; P 0.05) . Before the intervention, no significant difference was found in terms of the exercise compliance, the qualification rate of exercise knowledge and the time of daily exercise between the two groups (P>0.05) . After the intervention the exercise compliance, the qualification rate of exercise knowledge and the time of daily exercise in the observation group and the control group were all significantly higher than those before the intervention (P<0.05) . However, the improvement situation in the observation group was significantly better than that in the control group (t=3.965, 4.521, 4.689; P<0.01) . In the observation group, 21 patients were improved and the improvement rate was 51.22%. In the control group, 6 patients were improved and the improvement rate was 15.79%. The difference between the two groups was statistically significant (χ2=10.235, P<0.05) . Conclusions For the patients with coronary heart disease, the feedback teaching education model based on the routine health education can improve the exercise compliance of the patients, improve the illness and the state of mind, in order to improve the quality of life. Key words: Coronary heart disease; Feedback teaching; Exercise compliance

Hyperglycemia effect on coronary disease in patients with metabolic syndrome evaluated by intracoronary ultrasonography.

IntroductionMetabolic syndrome (MS) is characterized by dyslipidemia, central obesity, hypertension and hyperglycemia. However, type 2 diabetes mellitus (T2DM) may or may not be present in metabolic syndrome. MS and T2DM are considered important cardiovascular risk factors, but the role of hyperglycemia in coronary disease is still contested in the literature. Therefore, we decided to evaluate the effect of hyperglycemia on the severity of coronary disease in MS patients, with or without T2DM, submitted to coronary angiography (CA) and intravascular ultrasonography (IVUS).Materials and methodsThis is a cross sectional, observational study with 100 MS patients (50% with T2DM), 60% male. All of the patients had been referred for CA procedures. The obstruction was considered severe when stenosis was greater than 70% and moderate if it was between 50–69%. Patients detected with a moderate obstruction by CA were indicated to IVUS. A minimal luminal area of less than 4mm2 detected by IVUS was also considered severe. IDF criteria were used to define Metabolic Syndrome and T2DM diagnosis was defined according to the American Diabetes Association criteria. Student’s t-test and Pearson Chi-square were used for statistical analysis, considering p < 0.05 statistically significant.Results and discussionThe majority of T2DM patients presented severe arterial lesions (74% vs 22%, p<0.001). Using CA procedure, 12% of T2DM had moderate obstructions, compared to 38% of the non-diabetic group (p< 0.05). 8% of patients with moderate lesions by CA were diagnosed with a luminal area less than 4mm2 using IVUS. This luminal area was significantly smaller in the T2DM group than in the control group (3.8mm2 ± 2.42. vs 4.6mm2 ± 2.58, p = 0.03).ConclusionPatients with MS and T2DM submitted to angiography and IVUS, had more severe coronary lesions compared to MS patients without diabetes. This finding suggests that beyond insulin resistance that is present in MS, hyperglycemia may also play a role in the development of atherosclerotic disease. IVUS was useful for diagnosing 8% of severe cases initially considered to be moderate obstructions when using just CA in this scenario.