Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients

Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of...

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Main Authors: Malešević Gabrijela, Popović-Pejičić Snježana, Marković Aleksandra, Soldat-Stanković Valentina
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2022-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdf
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author Malešević Gabrijela
Popović-Pejičić Snježana
Marković Aleksandra
Soldat-Stanković Valentina
author_facet Malešević Gabrijela
Popović-Pejičić Snježana
Marković Aleksandra
Soldat-Stanković Valentina
author_sort Malešević Gabrijela
collection DOAJ
description Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. 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 T2DM. Methods. The study included 169 patients with T2DM 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. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ± 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ± 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a 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, ie, with their increase, the probability of a positive ergometric test also increases (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 for improving cardiovascular risk stratification in asymptomatic patients with T2DM.
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spelling doaj-art-c977a632443c4eca8b7da718049110bf2025-08-20T03:05:18ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202022-01-0179658459010.2298/VSP201012010M0042-84502100010MInflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patientsMalešević Gabrijela0Popović-Pejičić Snježana1Marković Aleksandra2Soldat-Stanković Valentina3University Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaBackground/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. 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 T2DM. Methods. The study included 169 patients with T2DM 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. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ± 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ± 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a 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, ie, with their increase, the probability of a positive ergometric test also increases (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 for improving cardiovascular risk stratification in asymptomatic patients with T2DM.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdfbiomarkersc-reactive proteincoronary diseasediabetes mellitus, type 2interleukin-6prognosis
spellingShingle Malešević Gabrijela
Popović-Pejičić Snježana
Marković Aleksandra
Soldat-Stanković Valentina
Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
Vojnosanitetski Pregled
biomarkers
c-reactive protein
coronary disease
diabetes mellitus, type 2
interleukin-6
prognosis
title Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
title_full Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
title_fullStr Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
title_full_unstemmed Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
title_short Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
title_sort inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
topic biomarkers
c-reactive protein
coronary disease
diabetes mellitus, type 2
interleukin-6
prognosis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdf
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AT markovicaleksandra inflammatorycardiovascularriskmarkersandsilentmyocardialischemiaintype2diabeticpatients
AT soldatstankovicvalentina inflammatorycardiovascularriskmarkersandsilentmyocardialischemiaintype2diabeticpatients