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    Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus

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    Author
    Yahagi, K.
    Kolodgie, F.D.
    Lutter, C.
    Date
    2017
    Journal
    Arteriosclerosis, Thrombosis, and Vascular Biology
    Publisher
    Lippincott Williams and Wilkins
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://www.doi.org/10.1161/ATVBAHA.116.306256
    Abstract
    The continuing increase in the prevalence of diabetes mellitus in the general population is predicted to result in a higher incidence of cardiovascular disease. Although the mechanisms of diabetes mellitus-associated progression of atherosclerosis are not fully understood, at clinical and pathological levels, there is an appreciation of increased disease burden and higher levels of arterial calcification in these subjects. Plaques within the coronary arteries of patients with diabetes mellitus generally exhibit larger necrotic cores and significantly greater inflammation consisting mainly of macrophages and T lymphocytes relative to patients without diabetes mellitus. Moreover, there is a higher incidence of healed plaque ruptures and positive remodeling in hearts from subjects with type 1 diabetes mellitus and type 2 diabetes mellitus, suggesting a more active atherogenic process. Lesion calcification in the coronary, carotid, and other arterial beds is also more extensive. Although the role of coronary artery calcification in identifying cardiovascular disease and predicting its outcome is undeniable, our understanding of how key hormonal and physiological alterations associated with diabetes mellitus such as insulin resistance and hyperglycemia influence the process of vascular calcification continues to grow. Important drivers of atherosclerotic calcification in diabetes mellitus include oxidative stress, endothelial dysfunction, alterations in mineral metabolism, increased inflammatory cytokine production, and release of osteoprogenitor cells from the marrow into the circulation. Our review will focus on the pathophysiology of type 1 diabetes mellitus- and type 2 diabetes mellitus-associated vascular disease with particular focus on coronary and carotid atherosclerotic calcification. Copyright 2016 American Heart Association, Inc.
    Keyword
    atherosclerosis
    carotid arteries
    coronary artery disease
    death, sudden
    diabetes mellitus
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85002168805&doi=10.1161%2fATVBAHA.116.306256&partnerID=40&md5=0a3cfb2146f81a89056e134ae8731d31; http://hdl.handle.net/10713/10047
    ae974a485f413a2113503eed53cd6c53
    10.1161/ATVBAHA.116.306256
    Scopus Count
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    UMB Open Access Articles 2017

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