Endocrine Abstracts

JOINT1432

Introduction: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (Dm²). Endothelial dysfunction, a hallmark of diabetes-related vascular complications, plays a central role in the pathophysiology of CVD. Last two decades due to cardiovascular intervention management improved CVD outcomes and early mortality cases were prevented among patients with Dm². We aimed to analyse data from literature how that improvement reflected in endothelial dysfunction especially in patients after stent placement.

Materials and Methods: Published data from the past two decades from sources such as MEDLINE, PubMed, Scopus, and Web of Science were systematically analyzed to evaluate the endothelial function in patients after stent placement.

Results: According to data from literature, as mechanisms of endothelial dysfunction in Dm² patients were considered inflammation, endothelial-mesenchymal transition, oxidative stress as well as cell death. In numerous studies reduced synthesis and accelerated breakdown of nitrogen monoxide was linked to endothelial dysfunction in diabetics with CVD. Furthermore, emerging evidence highlights the role of Asymmetric Dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide synthase (eNOS), as a biomarker and risk factor for endothelial dysfunction. Elevated ADMA levels are associated with increased cardiovascular mortality in patients with coronary artery disease. Coronary stenting in diabetes individuals seen as an effective operation, exhibiting a high angiographic and clinical success rate comparable to that of non-diabetic patients. The significant developments in PCI devices (bare-metal stents and first- and second-generation drug-eluting stents), alongside technological innovations, clinical experiences, and supplementary pharmacotherapies, have substantially enhanced PCI results over time, especially in patients with diabetes mellitus complicated with coronary artery disease. However, in reviewed literature, T2DM patients had a higher prevalence of in-hospital myocardial infarction and an increased requirement for supplementary cardiac revascularization and need for thorough glycemic control after the operation. In terms of therapeutic targets in T2DM patients with CVD most of the research suggested metformin, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, miRNA, and stem cells, which possess potential for clinical application.

Conclusion: This study addresses a critical gap in understanding the endothelial function and diabetes complications in T2DM patients after undergoing coronary stent placement. Its findings will contribute to better clinical management and reduced burden of diabetes-related complications.