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Muoghalu CG, Ofoegbu CC, Ekong NE, Ebirim DA, Alex-Ojei ST, Alqahtani F. Systematic Review of the Efficacy of Orbital Atherectomy in Improving the Outcome of Percutaneous Corornary Intervention in People With Diabetes. Cureus 2023; 15:e50153. [PMID: 38186553 PMCID: PMC10771627 DOI: 10.7759/cureus.50153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
The optimal approach to deal with severe coronary artery calcification (CAC) in people with diabetes remains ill-defined. People with diabetes have a significant risk of developing severe vessel calcification and coronary artery disease (CAD). CAD is the leading cause of death in people with diabetes. Individuals with diabetes mainly present with severe multivessel stenosis, diffuse coronary calcification, and severe atherosclerosis, which are poor prognostic factors of revascularization procedures. Studies have shown that the revascularization of arteries in people with diabetes often results in worse outcomes than in people without diabetes. Coronary artery bypass grafting (CABG) has been recommended as the standard of care for people with DM and complex anatomic diseases, including left main CAD. However, percutaneous coronary intervention (PCI) is more acceptable to patients in clinical practice because of decreased trauma and rapid recovery. Severe CAC has traditionally been challenging for PCI and a frequent indication for surgical revascularization. This study aims to determine the effectiveness of orbital atherectomy (OA) in improving PCI outcomes in patients with diabetes and identify possible adverse effects that preclude its use. The study is reported according to PRISMA and analyzed according to Cochrane guidelines on synthesis without meta-analysis. A comprehensive literature search of EMBASE, Scopus, Web of Science, Cochrane Library, CINAHL, and MEDLINE was conducted for studies that utilized OA before PCI in people with diabetes. A reference list of the eligible articles was also screened. A narrative synthesis was done by representing the data on the effect direction plot, followed by vote counting. Eighteen studies were included in the analysis. Success rate/successful stent delivery was >90%, while freedom from angiographic complication and major adverse cardiovascular and cerebrovascular events (MACCE) were both >80% on the effect direction plot for people with diabetes and those without diabetes. People with diabetes had low event rates similar to those without diabetes. OA appears to be a viable treatment approach for people with diabetes. However, RCTs with a longer duration of follow-up are required to establish the appropriate treatment strategy for severe CAC in people with diabetes.
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Affiliation(s)
| | - Cosmas C Ofoegbu
- Health Sciences, Central Washington College, Enugu, NGA
- Community and Family Medicine, Allith General Hospital, Allith, SAU
| | | | - Danvictor A Ebirim
- Department of Medicine, Federal University Teaching Hospital, Owerri, NGA
| | - Sandra T Alex-Ojei
- Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, NGA
| | - Foziyah Alqahtani
- Department of Cardiac Technology, Imam Abdurahman Bin Faisal University, Dammam, SAU
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Liu X, Li T, Xu H, Wang C, Ma X, Huang H, Hu Y, Chu H. Hyperglycemia may increase deep vein thrombosis in trauma patients with lower limb fracture. Front Cardiovasc Med 2022; 9:944506. [PMID: 36158801 PMCID: PMC9498976 DOI: 10.3389/fcvm.2022.944506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Diabetes mellitus is associated with prothrombotic states and thrombotic events. This study examined the association between preoperative glucose levels and deep vein thrombosis (DVT) in trauma patients undergoing surgery for lower limb fracture. Data from 1,591 patients who underwent fracture surgery between January 2017 and March 2022 at the Affiliated Hospital of Qingdao University were queried from institutional electronic medical records. A total study population of 1,086 patients was identified, comprising 138 patients who experienced DVT and 948 controls. The primary outcome was DVT. Multiple logistic regression analyses were performed and a receiver operating characteristic (ROC) curve was generated. Age, D-dimer level, preoperative RBC count, and preoperative glucose level were independent predictors of DVT. The two highest categories of D-dimer level (≥ 960, < 2,102; ≥ 2,102 ng/ml) increased the odds ratio for DVT by 4.215 times [95% confidence interval (CI) 1.820–9.761] and 7.896 times (95% CI 3.449–18.074), respectively, compared with the lowest reference category (< 490 ng/ml). The area under the curve (AUC) for the preoperative glucose level was 0.605. Hyperglycemia (glucose ≥ 6.1, < 7.0 mmol/l) increased the odds of DVT by 1.889-fold [95% CI (1.085–3.291); p < 0.0001] compared with euglycemia (glucose < 6.1 mmol/l). We therefore observed an association between preoperative hyperglycemia and DVT in patients with lower limb fractures. There are several modalities for controlling hyperglycemia, offering potential targets for future improvement.
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Affiliation(s)
- Xiaojie Liu
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tiajun Li
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hui Xu
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Haichen Chu,
| | - Chunhua Wang
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaojun Ma
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hui Huang
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanling Hu
- Department of Orthopedic, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haichen Chu
- Department of Anestheiology, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Haichen Chu,
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Liu X, Chu H, Ji Y, Bosnjak Z, Ao H, Li T. Which BMI for Diabetes Patients is Better? From the View of the Adipose Tissue Macrophage-Derived Exosome. Diabetes Metab Syndr Obes 2022; 15:141-153. [PMID: 35046685 PMCID: PMC8763208 DOI: 10.2147/dmso.s345890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Diabetes, as a group of metabolic diseases, can elevate blood glucose, thus leading to the development of life-threatening complications. It is difficult to define the outcome for diabetics with different BMI. This review will illustrate the adipose tissue macrophage-derived exosome in the diabetics with different BMI. PATIENTS AND METHODS Insulin resistance in peripheral tissues can cause diabetes. The peripheral tissues include liver, muscle, or the adipose depots. Communication between these organs is fatal to the maintenance of glucose homeostasis. This review will illustrate this communication. Obesity is closely linked with diabetes. There are different changes in fat distribution in diabetic patients. Adipose tissue macrophages can secrete various hormones, including adiponectin, leptin, resistin and other classical cytokines, such as TNF-α and IL-6. Studies illustrated that exosomes from the adipose tissue, can modulate inter-organ cross-talk by regulating gene expression in other tissues. RESULTS Adipose tissue macrophages exosomes links thin and fat individuals in the development of diabetes. CONCLUSION The molecular pathways initiated by exosomes such as miRNA in the situations of metabolic stress could help us gain a deeper knowledge of the pathophysiology of diabetes.
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Affiliation(s)
- Xiaojie Liu
- Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
- Departments of Medicine and Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Haichen Chu
- Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Yuzhi Ji
- Obstetrics, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Zeljko Bosnjak
- Departments of Medicine and Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hushan Ao
- Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Hushan Ao Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing, People’s Republic of ChinaTel/Fax +86-10-68006210 Email
| | - Tianjun Li
- Department of Oncology, Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
- Tianjun Li Department of Oncology, Affiliated Hospital of Qingdao University, No. 59 Haier Road, Laoshan District, Qingdao, Shandong Province, People’s Republic of ChinaTel/Fax +86-10-82913035 Email
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Mohammadi E, Behnam B, Mohammadinejad R, Guest PC, Simental-Mendía LE, Sahebkar A. Antidiabetic Properties of Curcumin: Insights on New Mechanisms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1291:151-164. [PMID: 34331689 DOI: 10.1007/978-3-030-56153-6_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Plant extracts have been used to treat a wide range of human diseases. Curcumin, a bioactive polyphenol derived from Curcuma longa L., exhibits therapeutic effects against diabetes while only negligible adverse effects have been observed. Antioxidant and anti-inflammatory properties of curcumin are the main and well-recognized pharmacological effects that might explain its antidiabetic effects. Additionally, curcumin may regulate novel signaling molecules and enzymes involved in the pathophysiology of diabetes, including glucagon-like peptide-1, dipeptidyl peptidase-4, glucose transporters, alpha-glycosidase, alpha-amylase, and peroxisome proliferator-activated receptor gamma (PPARγ). Recent findings from in vitro and in vivo studies on novel signaling pathways involved in the potential beneficial effects of curcumin for the treatment of diabetes are discussed in this review.
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Affiliation(s)
- Elahe Mohammadi
- Student Research Committee, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Behzad Behnam
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran. .,Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran. .,Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Reza Mohammadinejad
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. .,Halal Research Center of IRI, FDA, Tehran, Iran.
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Ferraris VA. Commentary: Are you too thin or too fat to have an open-chest cardiac operation? Probably not, but there are risks that you should know about. J Thorac Cardiovasc Surg 2020; 160:421-422. [DOI: 10.1016/j.jtcvs.2019.07.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022]
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Zhai C, Cong H, Hou K, Hu Y, Zhang J, Zhang Y. Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studies. Diabetol Metab Syndr 2019; 11:110. [PMID: 31890044 PMCID: PMC6923849 DOI: 10.1186/s13098-019-0506-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The optimal revascularization technique in diabetic patients with complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD), remains controversial. The current study aimed to compare adverse clinical endpoints of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM). METHODS Relevant studies were found from MEDLINE, OVID, Science Direct, Embase and the Cochrane Central database from January 2010 to April 2019. Risk ratio (RR) with 95% confidence interval (CI) was used to express the pooled effect on discontinuous variables. Outcomes evaluated were all-cause mortality, major adverse cardiac/cerebrovascular events (MACCE), cardiac death, myocardial infarction, stroke, and repeat revascularization. RESULTS Sixteen studies were included (18,224 patients). PCI was associated with the increase risk for MACCE (RR 1.59, 95% CI 1.38-1.85), cardiac death (RR 1.76, 95% CI 1.11-2.80), MI (RR 1.98, 95% CI 1.53-2.57), repeat revascularization (RR 2.61, 95% CI 2.08-3.29). The risks for all-cause mortality (RR 1.23, 95% CI 1.00-1.52) and stroke (RR 0.71, 95% CI 0.48-1.03) were similar between two strategies. Stratified analysis based on studies design and duration of follow-up showed largely similar findings with the overall analyses, except for a significant increased risk of all-cause mortality (RR 1.32, 95% CI 1.04-1.67) in long-term group, and CABG was associated with a higher stroke rate compared to PCI, which are results that were found in RCTs (RR 0.47, 95% CI 0.28-0.79) and mid-term groups (RR 0.39, 95% CI 0.23-0.66). CONCLUSIONS CABG was superior to PCI for diabetic patients with complex CAD (including left main CAD and/or MVD), but might be associated with a higher risk of stroke mid-term follow-up.Number of Protocol registration PROSPERO CRD 42019138505.
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Affiliation(s)
- ChuanNan Zhai
- School of Medicine, NanKai University, Weijin Road No. 94, Nankai District, Tianjin, 300071 China
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
| | - HongLiang Cong
- School of Medicine, NanKai University, Weijin Road No. 94, Nankai District, Tianjin, 300071 China
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
| | - Kai Hou
- School of Medicine, NanKai University, Weijin Road No. 94, Nankai District, Tianjin, 300071 China
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
| | - YueCheng Hu
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
| | - JingXia Zhang
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
| | - YingYi Zhang
- Department of Cardiology, Tianjin Chest Hospital, Taierzhuang South Road No. 291, Jinnan District, Tianjin, 300350 China
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Ferraro B, Donniacuo M, Sodano L, Ferraraccio F, Maisto R, Gulotta E, Pieretti G, D'Amico M, Trotta MC, Rinaldi B. Addition of the Aldose Reductase Inhibitor Benzofuroxane Derivative BF-5m to Prolonged and Moderate Exercise Training Enhanced Protection of the Rat Heart From Type-1 Diabetes. Front Pharmacol 2019; 10:392. [PMID: 31040781 PMCID: PMC6476970 DOI: 10.3389/fphar.2019.00392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/29/2019] [Indexed: 11/30/2022] Open
Abstract
Moderate exercise training may not be sufficient to exert beneficial effects on the cardiovascular system because of the long-term multifactorial etiology of diabetic complications. The addition of a proper pharmacological tool to the physical exercise should improve the outcomes of the diabetic damage. Here it is shown that 8 weeks exercise training of type 1 diabetic Sprague-Dawley (SD) rats resulted in a significantly increased heart rate, a 14% increase in the left ventricular ejection fraction (LVEF) increased plasma insulin levels and a 13% decrease in plasma glucose with respect to sedentary animals. The training also resulted in a 22% reduction in cardiac QT interval from a diabetic sedentary value of 185 ± 19 ms. Treatment of trained rats with the new antioxidant and NO-releasing aldose reductase 2 inhibitor 5(6)-(benzo[d]thiazol-2-ylmethoxy) benzofuroxane BF-5m, 20 mg/kg/day, added a further and significant (P < 0.01 vs. sedentary) increase of the LVEF up to 38% at 8 week time point. The long QT interval recorded in trained rats was reduced to further 12% by addition to the training of pharmacological treatment with 20 mg/kg/day BF-5m. At this time, the association of the two treatments improved the expression into the cardiac tissue of sarcoplasmic reticulum Ca2+ ATPase 2 (SERCA2) and manganese superoxide dismutase (MnSOD), and reduced the fibrosis.
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Affiliation(s)
- Bartolo Ferraro
- Institute for Cardiovascular Prevention (IPEK), Ludwig Maximilian University of Munich, Munich, Germany.,DZHK, Partner Site Munich Heart Alliance, Munich, Germany
| | - Maria Donniacuo
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
| | - Loredana Sodano
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
| | - Franca Ferraraccio
- Department of Clinical, Public and Preventive Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Rosa Maisto
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
| | - Eliana Gulotta
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Gorizio Pieretti
- Multidisciplinary Department of Surgical and Dental Specialities, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michele D'Amico
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
| | - Barbara Rinaldi
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli", Naples, Italy
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