Open AccessInflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
Author(s) -
Gabrijela Malešević,
Snježana Popović-Pejičić,
Aleksandra Marković,
Bojana Carić,
Valentina Soldat-Stanković
Publication year - 2022
Publication title -
vojnosanitetski pregled
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 19
eISSN - 2406-0720
pISSN - 0042-8450
DOI - 10.2298/vsp201012010m
Subject(s) - medicine , asymptomatic , diabetes mellitus , logistic regression , disease , type 2 diabetes , cardiology , coronary heart disease , type 2 diabetes mellitus , endocrinology
Background/Aim. A special feature of Coronary Heart Disease (CHD) in patients with type 2 diabetes (T2D) is that it is often asymptomatic and occurs as a consecuence of cardiovascular auotonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as highly sensitive C-reactive protein (hs-CRP) and interleukin 6 (IL-6) which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2D. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2D. Methods: The study included 169 patients with T2D, without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs-CRP and IL-6 were determined by ELISA. Results: IL6 values were significantly higher in patients with positive ergometric test (6.83?1.99 pg/mL) compared to patients with negative ergometric test (3.04?1.39 pg/mL) (p<0.001). We also found that hs-CRP values in patients with positive ergometric test was significantly higher in comparison to patients with negative ergometric test (6.37?2.25 vs 1.67?1.41 mg/L; p <0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, i.e. with their increase in the probability of positive ergometric testing increased too (p <0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90% and the specificity was 86%. Conclusion: hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended in improving cardiovascular risk stratification in asymptomatic patients with T2D.