الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
Endothelial dysfunction, a hallmark of diabetic vascular disease is associated with increased hypertension and adverse CVD outcomes. The myriad mechanisms contributing to endothelial dysfunction include abnormal nitric oxide biology, increased endothelin and angiotensin II, and reduced prostacyclin activity, all of which contribute to abnormal control of blood flow. In the setting of ACS events, no-reflow after percutaneous intervention reflecting acute endothelial dysfunction occurs more commonly in the presence of diabetes or hyperglycemia and may contribute to increased myocardial jeopardy, resulting in larger infarcts, increased arrhythmia, and worse systolic function.
Abnormalities in lipid metabolism also contribute to the increased atherosclerotic risk associated with diabetes. Diabetic dyslipidemia is characterized by high triglyceride levels, low high-density lipoprotein (HDL) concentration, and increased atherogenic small dense low-density lipoprotein (LDL) particles, each of which is likely to contribute to the accelerated development and progression of atherosclerosis
Initial randomized trial showed that intensive glucose control (A1c<7%) decreases risk for a composite endpoint of all diabetes-related complications and significantly improved micro-vascular disease risk as well as significantly improved risk for MI and for all-cause mortality of obese patients. These observations have recently been extended by the publication of results derived from long-term post-trial follow-up, with an average duration of 10 years after completion of the trial reveal a significantly reduced risk for MI in those originally randomized to intensive control More recently, the results from three trials assessing the CVD effects of more
Summary
85
intensive glucose control among patients with type 2 diabetes at high CVD risk
In recent years, considerable investigative interest has been directed at evaluation of association of HbA1c as a reflection of diabetes control and microalbuminuria as a reflection of microvascular complications of diabetes with the severity of coronary artery disease.
In order to examine the correlation between the control of diabetes mellitus as assessed by HbA1C and the severity of CAD as assessed by coronary angiogram, using the Gensini score and to uncover if there is a relation between microalbuminuria and the severity of CAD .