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Phan K, Mitchell P, Liew G, et al. Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study. J Thorac Dis. 2016;8(7):1532-9doi: 10.21037/jtd.2016.05.61.
Phan, K., Mitchell, P., Liew, G., Plant, A. J., Wang, S. B., Xu, J., Chiha, J., Thiagalingam, A., Burlutsky, G., & Gopinath, B. (2016). Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study. Journal of thoracic disease, 8(7), 1532-9. https://doi.org/10.21037/jtd.2016.05.61
Phan, Kevin, et al. "Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study." Journal of thoracic disease vol. 8,7 (2016): 1532-9. doi: https://doi.org/10.21037/jtd.2016.05.61
Phan K, Mitchell P, Liew G, Plant AJ, Wang SB, Xu J, Chiha J, Thiagalingam A, Burlutsky G, Gopinath B. Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study. J Thorac Dis. 2016 Jul;8(7):1532-9. doi: 10.21037/jtd.2016.05.61. PMID: 27499940; PMCID: PMC4958785.
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J Thorac Dis. 2016 Jul;8(7):1532-9. doi: 10.21037/jtd.2016.05.61.

Severity of coronary artery disease and retinal microvascular signs in patients with diagnosed versus undiagnosed diabetes: cross-sectional study.

Journal of thoracic disease

Kevin Phan, Paul Mitchell, Gerald Liew, Adam J Plant, Sarah B Wang, Joshua Xu, Joseph Chiha, Aravinda Thiagalingam, George Burlutsky, Bamini Gopinath

Affiliations

  1. Centre for Vision Research, Department of Ophthalmology, Westmead Institute for Medical Research, University of Sydney, NSW, Australia.
  2. Centre for Heart Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia.

PMID: 27499940 PMCID: PMC4958785 DOI: 10.21037/jtd.2016.05.61

Abstract

BACKGROUND: There is increasing evidence that a considerable proportion of patients with diabetes remain undiagnosed and untreated, however, it is unclear whether this is associated with more severe coronary artery disease (CAD) and microvasculature changes compared with diagnosed patients. We assessed CAD extent and severity, along with changes to the retinal microvascular structure in participants with undiagnosed versus diagnosed type 2 diabetes.

METHODS: Participants of the Australian Heart Eye Study were stratified into participants with previously diagnosed diabetes (n=489), undiagnosed diabetes (n=76) and no diabetes (n=1,112). Retinal vessel caliber was measured from digital retinal images. Extent and severity of CAD was assessed using Extent and Gensini scores from angiography findings, respectively.

RESULTS: Participants with undiagnosed and diagnosed diabetes versus those with no diabetes (reference group) had increased odds of being in the highest quartile of Gensini scores, multivariate adjusted odds ratios (OR) =7.02 [95% confidence interval (CI), 2.04-24.1] and OR =2.76 (95% CI, 1.67-4.55), respectively. Participants with undiagnosed and diagnosed diabetes versus those with no diabetes also had increased odds of being in the highest quartile of Extent scores, multivariate adjusted OR =7.63 (95% CI, 2.15-27.10) and OR =3.72 (95% CI, 2.22-6.27), respectively. No significant differences were observed in retinal vessel caliber between participants with undiagnosed versus diagnosed diabetes.

CONCLUSIONS: The present study demonstrated that participants with undiagnosed diabetes compared to those with previously diagnosed diabetes, had a stronger likelihood of having more severe and extensive CAD. However, retinal microvascular signs did not differ by diabetes status.

Keywords: Coronary artery disease (CAD); diabetes; microvascular; retinal

References

  1. Diabetes Care. 1993 Apr;16(4):642-52 - PubMed
  2. Diabetes. 1974 Feb;23(2):105-11 - PubMed
  3. Int J Cardiol. 2015 Jan 15;178:96-8 - PubMed
  4. J Diabetes. 2016 Mar;8(2):260-8 - PubMed
  5. J Am Coll Cardiol. 2011 Jul 5;58(2):202-22 - PubMed
  6. Diabetes Care. 1998 Apr;21(4):518-24 - PubMed
  7. Am Heart J. 1990 Jun;119(6):1262-7 - PubMed
  8. Diabetes Care. 2013 Oct;36(10):3002-8 - PubMed
  9. East Mediterr Health J. 2015 May 19;21(3):164-70 - PubMed
  10. Diabetes Care. 2004 Oct;27(10):2568-9; author reply 2569 - PubMed
  11. Circulation. 1979 Jan;59(1):8-13 - PubMed
  12. Circulation. 2005 Oct 18;112(16):2397-402 - PubMed
  13. Perfusion. 2013 May;28(3):232-7 - PubMed
  14. JAMA. 2002 Mar 6;287(9):1153-9 - PubMed
  15. Curr Eye Res. 2003 Sep;27(3):143-9 - PubMed
  16. Int J Cardiol. 2015 Mar 1;182:213-5 - PubMed
  17. Am J Cardiol. 2005 Oct 15;96(8):1107-9 - PubMed
  18. Diabetes Care. 2001 Mar;24(3):447-53 - PubMed
  19. Ophthalmology. 1999 Dec;106(12):2269-80 - PubMed
  20. Diabetes Care. 2015 Jul;38(7):1299-305 - PubMed
  21. Ann Intern Med. 1998 Apr 1;128(7):524-33 - PubMed
  22. EuroIntervention. 2005 Aug;1(2):219-27 - PubMed
  23. Diabetes Res Clin Pract. 2009 Apr;84(1):99-106 - PubMed
  24. Diabetes Care. 1997 Feb;20(2):163-9 - PubMed
  25. Int Heart J. 2005 Jul;46(4):639-46 - PubMed
  26. Eur Heart J. 2007 Aug;28(16):1984-92 - PubMed
  27. Br J Ophthalmol. 2015 Dec;99(12):1601-5 - PubMed
  28. Diabetologia. 2003 Feb;46(2):182-9 - PubMed

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