BLOOD GLUCOSE CONTROL AFFECTS THE HYPERCOAGULABILITY AND THROMBOSIS EVENT IN PATIENTS WITH TYPE II DIABETES MELLITUS AND CORONARY HEART DISEASE

Xiaming Chen^{1, #}, Su Bu^{2, #}, Xianghai Wang³, Xiang Li⁴, Na Zhang^{5, *}

¹Department of clinical laboratory, Haikou people’s hospital, Haikou, Hainan570208, China - ²Department of cardiothoracic surgery, Xiangyang No.1 people’s Hospital, affiliated hospital of Bubei university of medicine, Xiangyang, Hubei441000, China - ³Department of cardiology, the first affiliated hospital of Wannan medical college, Wuhu, Anhui241001, China - ⁴Department of cardiovascular internal medicine, Luzhoupeopie's hospital, Luzhou, Sichuan646100, China - ⁵Department of internal medicine, the hospital of Wuhan university, Wuhan, Hubei430000, China

Objective: To explore the effect of blood glucose control on the hypercoagulability and thrombosis event in patients with type II diabetes mellitus (T2DM) and coronary heart disease (CHD). 

Methods: Between March 2018 and March 2020, we enrolled a total of 126 patients with T2DM and CHD which were divided according to the level of 2-hour postprandial blood glucose (2hPG) into the high-blood glucose group (2hPG ≥7.80mmol/L) and low-blood glucose group (2hPG <7.80 mmol/L), with 63 patients in each group. Simultaneously, 66 healthy subjects who planned to take physical examinations in Haikou people’s hospital were also enrolled in the Control group. Data regarding the disease history, fasting insulin (FINS) level, fasting blood glucose (FBG), 2hPG, glycosylated hemoglobin(HbA1c), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer (D-D) were collected from all subjects. During the 3-year follow-up, the incidence of thrombosis events and survival rate of patients were compared between the high-blood glucose group and the low-blood glucose group. 

Results: Comparison of the levels of FINS, FBG, 2hPG, HbAlc, PT, APTT, FIB, and D-D among three groups showed that the differences had statistical significance (P <0.05). In the low-blood glucose group and high-blood glucose group, patients had higher levels of FBG, 2hPG, HbAlc, FIB and D-D than those in the Control group, while the levels of FINS, PT and APTT were dramatically lower (all P<0.05). Furthermore, levels of FBG, 2hPG, FIB, and D-D in the high-blood glucose group were much higher than those in the low-blood glucose group, while the levels of FINS, PT, and APTT decreased evidently (all P<0.05). As for the outcome of follow-up, in the low-blood glucose group, the incidence of thrombosis events was 12.72%, significantly lower than 27.01% in the high-blood glucose group (P<0.05), while the survival rate in the low-blood glucose group was much higher than that in the high-blood glucose group (92.06% vs. 80.96%, P<0.05). 

Conclusion: For patients with T2DM and CHD, poor control of blood glucose may result in hypercoagulability and dramatic increases in the incidence rate of thrombosis events and death rate, reflecting the growing importance of blood glucose control for those patients.