Effect of Blood Glucose Level of Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease on the Hypercoagulability and Thromboembolism
Effect of Blood Glucose Level of Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease on the Hypercoagulability and Thromboembolism
Qing Cao1, Wei Jiao2, Huihui Lu1, Jing Zhang2, Meiling Ren3, Yan Xu1* and Shuyang Hu1*
ABSTRACT
The objective of this study was to investigate the effect of blood glucose level of patients with type II diabetes mellitus and coronary heart disease (CHD) on the hypercoagulability and thromboembolism. A total of 236 patients with type II diabetes mellitus and CHD who were treated in 904 Hospital of Joint Logistic Support Force of PLA were enrolled between January 2018 and January 2020. These patients, according to their 2 h postprandial glucose (2hPG), were divided into the hyperglycemia group (n = 126) and hypoglycemia group (n = 112). Patients in the hypoglycemia and hyperglycemia groups had higher levels of fasting blood glucose (FBG), 2 hPG and glycosylated hemoglobin (HbA1c) when comparing to their counterparts in the control group, with a lower level of fasting insulin (FINS) in serum (all P < 0.05); levels of plasma fibrinogen (Fb) and D-dimers (D-D) in serum of patients in the hyperglycemia group were much higher than those in the hypoglycemia group, while serum plasma prothrombin time (PT) and activated partial thromboplastin time (APTT) were much shorter than those in the hypoglycemia group (all P < 0.05). Thrombus precursor protein (TpP), P-selectin (Ps), maximum platelet aggregation rate (MAR) and mean platelet volume (MPV) of patients in the hypoglycemia and hyperglycemia group were all higher than their counterparts in the control group, while those in the hyperglycemia group were also higher than the hypoglycemia group (all P < 0.05). Besides, incidence rate of thromboembolism in the hypoglycemia group was much lower than that in the hyperglycemia group (P < 0.05). During the 2-year follow-up, survival rate of patients in the hypoglycemia group was much higher than that in the hyperglycemia group (P < 0.05). It was concluded that for CHD patients with type II diabetes mellitus, poor management of blood glucose may result in the elevation in platelet activation, further inducing the hypercoagulability of blood and increases in the incidence rate of thromboembolism and death rate, suggesting that CHD patients with type II diabetes mellitus should pay more attention to the management of blood glucose and monitor the platelet function and activation of thrombin, thereby minimizing the incidence of acute thromboembolism.
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