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Impaired arterial stiffness and inflammatory status in patients with diabetic foot

Session Poster session 1

Speaker Evangelos Oikonomou

Event : ESC Congress 2015

  • Topic : preventive cardiology
  • Sub-topic : Metabolic Syndrome, Insulin, Insulin Resistance
  • Session type : Poster Session

Authors : T Konsola (Athens,GR), G Siasos (Athens,GR), N Tentolouris (Athens,GR), C Kollia (Athens,GR), E Oikonomou (Athens,GR), N Gouliopoulos (Athens,GR), M Zaromitidou (Athens,GR), K Mourouzis (Athens,GR), E Dimitropoulos (Athens,GR), D Tousoulis (Athens,GR)

T. Konsola1 , G. Siasos1 , N. Tentolouris1 , C. Kollia1 , E. Oikonomou1 , N. Gouliopoulos1 , M. Zaromitidou1 , K. Mourouzis1 , E. Dimitropoulos1 , D. Tousoulis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece ,

European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 116

Background: Diabetes Mellitus (DM) is associated with early onset of atherosclerosis and increased arterial stiffness. Macrovascular and microvascular impairment contribute to the development of diabetic foot (DF).

Purpose: To investigate the impact of arterial stiffness and inflammation in the development of DF in subjects with DM type 2.

Methods: We enrolled 124 consecutive subjects with DM. From the study population 30 suffered from DF while the rest were characterized as patients free of DF (NDF). Specialized pathologists have made the diagnosis of DF by clinical examination and specific vascular and neurological tests.Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections.Serum C-reactive protein (CRP) levels was measured as a well established inflammatory biomarker. Creatinine clearance was estimated based on MDRD formula and glycosylated hemoglobin (HbA1c) was measured to evaluate adherence to treatment. Several demographic and clinical characteristics of the participants were collected such as age, gender, body mass index (BMI), smoking habits etc.

Results: There was no difference in age (68±9 years vs. 64±10 years, p=0.08), BMI (28.71 kg/m2 vs. 29.09 kg/m2, p=0.74), MDRD (69±25 ml/min/1.73m2 vs. 76±20 ml/min/1.73m2, p=0.18), male sex prevalence (60% vs. 60% p=0.96), rates of insulin treatment (30% vs. 36%, p=0.55) and in current smoking status (67% vs. 52%, p=0.16) between subjects with DF and NDF. Interestingly, subjects with DF had increased PWV (12.12±2.76m/sec vs. 10.20±2.60m/sec, p=0.001), increased AIx (28.43±6.71% vs. 25.14±10.24%, p=0.04), increased logCRP levels (0.53±0.58mg/L vs. 0.03±0.45mg/L, p=0.004) and increased HbA1c (7.13±1.09% vs. 6.62±0.60%, p=0.04) compared to subjects with NDF. Moreover, HbA1c levels were correlated with PWV (r=0.325, p=0.02).

Conclusion: These findings highlight the contribution of inflammation and vascular dysfunction as it can be expressed by large arteries stiffness, in the development of diabetic foot. Moreover, adherence to treatment may modify arterial stiffness and atherosclerosis progression in subjects with type 2 DM

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