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Cardiovascular Disease Risk Factors and Diabetes – The Emerging Controversies

Nada Kostić, Tamara Kostić

(Department of Endocrinology, Clinic of Internal Medicine, University Hospital Center “Dr Dragiša Mišović”, Belgrade, Serbia)

Med Sci Tech 2017; 58:56-61

DOI: 10.12659/MST.905072

BACKGROUND: Patients with type 2 diabetes mellitus have higher risk of cardiovascular morbidity and mortality. Still, there remain some gaps in our understanding of the mechanisms and impact that some risk factors have on the development of cardiovascular disease in these patients. The aim of this study was to assess the relationship between conventional risk factors for coronary artery disease (CAD), as well as current use of therapeutic agents and cardiovascular events in diabetic patients.
MATERIAL AND METHODS: This cross-sectional study included 315 patients with diabetes type 2 (154 males and 161 females, average age 64.94±13.85 years) distributed in 2 groups according to the presence of CAD. Clinically relevant data were collected from patients’ histories. Total serum cholesterol and triglycerides were determined by the enzymatic methods. HDL cholesterol was determined directly by enzymatic method and HbA1c by the Turbidimetric Inhibition Immunoassay (TINIA) method.
RESULTS: Patients with CAD were significantly older (p<0.01) and less physically active (p<0.01). Female patients more often had angina pectoris (p=0.005), while males more often (p=0.002) had history of myocardial infarction. Hypertension, heart failure, peripheral arterial occlusive disease, and previous cerebrovascular insult were associated with higher prevalence of CAD (p<0.01). Patients with CAD had significantly higher HDL (p<0.05) and triglyceride (p<0.05) blood levels. Patients treated with insulin, statins, ACE inhibitors, beta blockers, or diuretics significantly more often had CAD (p<0.01).
CONCLUSIONS: We confirmed some previously known associations between conventional risk and protective factors for CAD in diabetic patients, but also raised questions concerning the cardioprotective effect of statins.

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