The Association between Serum Osmolality and Functional Myocardial Ischemia in Patients With Type-2 Diabetes Mellitus

Introduction: Serum osmolality(SO) is crucial to healthy vascular homeostasis, playing a vital role in tissue and organ perfusion. Although the effects of SO among diabetic patients are well known, its contribution to the development of myocardial ischemia or coronary atherosclerosis has not been well described in the literature. Our aim is to demonstrate the association between SO and coronary ischemia development.

Methods: In this study, we enrolled 205 consecutive diabetic patients who underwent coronary angiography and were diagnosed to have intermediate (50-70%) coronary lesions. Two groups were generated depending on a fractional flow reserve value ≤ 80, which is indicative of functional myocardial ischemia. Predictors of functional myocardial ischemia were also investigated.

Results: The multivariate analysis indicated that SO (p=0.043) and syntax score (p=0.013) were independently associated with functional myocardial ischemia. A SO value > 293 demonstrated a sensitivity of 82% and a specificity of 78% for the prediction of functional myocardial ischemia.

Conclusion: In this study, we demonstrated that high SO is associated with functional myocardial ischemia in diabetic patients with intermediate coronary lesions. In diabetic patients, the rheological properties of blood have been changed, which may lead to myocardial ischemia.

Keywords: Coronary artery disease, Osmolality, Functional ischemia.