Severely impaired microvascular reactivity in diabetic patients with an acute coronary syndrome.
BACKGROUND
Microvascular function is impaired in patients with stable coronary artery disease. The aim was to study microvascular function in patients with diabetes and acute coronary syndrome (ACS).


METHODS
Microvascular function was evaluated in 83 patients by laser Doppler fluxmetry (LDF) [PU; perfusion unit, median (interquartile range)] measuring resting LDF and peak LDF following a six min heating of the skin to 44 °C at the foot, respectively. All patients with ACS and without previously known diabetes underwent oral glucose tolerance test. Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls.


RESULTS
Peak LDF was significantly (P = 0.03) lower in patients with ACS and diabetes (n = 22; 72 (52)) and diabetes without coronary artery disease (n = 39; 69 (51)) as compared to patients with ACS without diabetes (n = 46; 97 (60)), and patients without ACS (n = 15; 140 (121)), respectively. Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)).


CONCLUSIONS
Microvascular reactivity is severely impaired in patients with diabetes and ACS. Diabetes has a major influence on microvascular function in patients with coronary artery disease.
Dept of Cardiology, Danderyd University Hospital Corp, 182 88, Stockholm, Sweden. nikolaos.ostlund-papadogeorgos@ds.se.
Nikolaos
http://orcid.org/0000-0003-0960-3281
N
Östlund Papadogeorgos
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Gun
G
Jörneskog
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Mattias
M
Bengtsson
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Thomas
T
Kahan
Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Majid
M
Kalani
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000502:physiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012867:Skin / Q000098:blood supply
D001786:Blood Glucose
Acute coronary syndrome; Coronary artery disease; Diabetes mellitus; Laser Doppler fluxmetry; Microvascular reactivity