Romanian Journal of Internal Medicine最新文献

{"title":"Monosodium urate crystals exposure is associated with limited transcriptional changes in primary human PBMCs.","authors":"Valentin Nica, Medeea Badii, Orsolya Gaal, Georgiana Cabău, Maartje Cleophas, Akshayata Naidu, Ioana Hotea, Tim L Jansen, Cristina Pamfil, Simona Rednic, Radu A Popp, Yang Li, Tania O Crișan, Leo A B Joosten","doi":"10.2478/rjim-2025-0019","DOIUrl":"https://doi.org/10.2478/rjim-2025-0019","url":null,"abstract":"<p><strong>Introduction: </strong>Monosodium urate (MSU) crystals are the primary cause of gout, however the knowledge on MSU crystals exposure and inflammatory changes found in immune cells is diverse, with reports ranging from very limited inflammatory effects to substantial reprogramming of the cells induced by MSU crystals alone. We examine the IL-1β production patterns and the transcriptomic signature in response to MSU crystals alone or in combination with TLR ligands in freshly isolated primary human peripheral blood mononuclear cells (PBMCs).</p><p><strong>Materials and methods: </strong>PBMCs were isolated by density gradient centrifugation and were stimulated for 24 hours with palmitate in the presence or absence of MSU crystals, followed by cytokine production measurement by ELISA. Two bulk RNA-sequencing analyses were performed independently following the same experimental conditions using PBMCs of patients with gout stimulated with medium control, palmitate and LPS in the presence or absence of MSU crystals.</p><p><strong>Results: </strong>MSU crystals alone induced a small but significant increase in IL-1β production in human PBMCs. IL-1β production was significantly increased when PBMCs were stimulated with palmitate and this was further amplified by the palmitate-MSU combination. Of high interest, MSU crystals alone or in combination with other stimuli caused no significant transcriptomic alterations.</p><p><strong>Conclusions: </strong>We confirm the synergistic effect of MSU crystals with palmitate that leads to higher IL-1β production. Transcriptomic analysis shows that MSU crystal exposure is not associated with major transcriptional changes in PBMCs. This suggests that the production of IL-1β in response to MSU crystals may largely be regulated at the post-transcriptional level and additional synergistic stimuli are likely required to fully explain the inflammatory response observed clinically in gout. Moreover, this could also bear relevance for other metabolic disorders associated to hyperuricemia where asymptomatic MSU crystal deposition may be present.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hypereosinophilia Dilemma: What's Beyond Cardiac Involvement?","authors":"Andreea Cristina Ivănescu, Georgeta Camelia Badea, Gheorghe-Andrei Dan","doi":"10.2478/rjim-2025-0018","DOIUrl":"https://doi.org/10.2478/rjim-2025-0018","url":null,"abstract":"<p><p>We present the longitudinal evolution of a previously published case of hypereosinophilic syndrome (HES) with cardiac involvement. A 27-year-old woman initially presented with eosinophilic myocarditis and peripheral neuropathy in the absence of a clear etiology, fulfilling criteria for idiopathic HES. Despite thorough investigations, eosinophilic granulomatosis with polyangiitis (EGPA) could not be confirmed due to the lack of clear criteria. The patient responded favorably to corticosteroids and heart failure treatment, with normalization of eosinophil count and improvement of left ventricular systolic function to near-normal parameters. However, during the following 1.5 years, she developed persistent asthma and subsequently presented with recurrent eosinophilia, severe fatigue, and systemic symptoms. This constellation now fulfilled the American College of Rheumatology and Lanham criteria for EGPA. Pulse therapy with intravenous methylprednisolone was initiated, followed by initiation of Rituximab (500 mg bid), and afterward maintained on a remission protocol consisting of Rituximab and gradual tapering. This protocol led to a clinical and biological improvement. Cardiac function remained unaffected. This updated case highlights the evolving nature of EGPA and reinforces the importance of long-term follow-up in patients with hypereosinophilia and cardiac involvement. Atypical presentations of disease underscore the importance of maintaining a high index of clinical suspicion, accompanied by diligent follow-ups, to ensure accurate and timely diagnosis. Early diagnosis and prompt initiation of therapy remain crucial for improving prognosis and preventing organ damage.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of parameters assessing right ventricular systolic function in patients after an acute myocardial infarction.","authors":"Vladimir Bratu, Ruxandra Copciag, Roxana Rimbas, Dragos Vinereanu","doi":"10.2478/rjim-2025-0017","DOIUrl":"https://doi.org/10.2478/rjim-2025-0017","url":null,"abstract":"<p><strong>Purpose: </strong>To assess reproducibility of 2D echocardiography parameters of right ventricular systolic function, such as tricuspid annular plane systolic excursion, right ventricular systolic wave velocity, fractional area change, and 3D right ventricular ejection fraction, through measurements performed by operators with different levels of experience, in patients with acute myocardial infarction.</p><p><strong>Methods: </strong>Measurements were performed offline, independently, by three echocardiographers with different levels of experience: Reader 1 - advanced (5 years of training in 2DE, 3 years in 3DE); Reader 2 - intermediate (3 years of training in 2DE, 1 year in 3DE); Reader 3 - beginner (1 year of training in 2DE, 3 months in 3DE). Interobserver variability and agreement between readers were compared using Bland-Altman plots, as bias and limits of agreement (LOA), Pearson correlations and intraclass correlation coefficients.</p><p><strong>Results: </strong>63 patients (52 males, 56.8±10.3 years) were analysed. All measurements showed excellent interobserver variability and agreement. Bias values were low, and LOA intervals were narrow, across all assessed parameters. Generally, bias values were lower between the advanced and intermediate readers with the exception of FAC: R1 vs R2 - bias 0.36, LOA -4.9;5.62 (r=0.96, p<0.001); R1 vs R3 - bias 0.09, LOA -6.4;6.6 (r=0.94, p<0.001); R2 vs R3 - bias -0.27, LOA -8.1;7.5 (r=0.91, p<0.001). Pearson correlation coefficients were excellent (>0.88) with significant p-values across all parameters (p<0.001). ICC were also excellent (>0.967).</p><p><strong>Conclusion: </strong>2DE and 3DE parameters of right ventricular (RV) systolic function are highly reproducible, independent of operator experience, in patients presenting with acute myocardial infarction.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality in acute type A aortic dissection - A systematic review based on contemporary registries.","authors":"Diana-Cristina Matei, Cornel Robu, Celia Georgiana Ciobanu, Oliviana Dana Geavlete, Elena-Laura Antohi, RăZvan Ilie Radu, Șerban Bubenek, Vlad Anton Iliescu, Ovidiu Chioncel","doi":"10.2478/rjim-2025-0015","DOIUrl":"10.2478/rjim-2025-0015","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) remains one of the most time-critical cardiovascular emergencies, with early mortality continuing to pose substantial clinical and organizational challenges. Large-scale observational registries offer valuable insights into real-world outcomes across healthcare systems.</p><p><strong>Aim: </strong>To synthesize and compare early mortality rates in patients with ATAAD as reported by national and multicentre registries.</p><p><strong>Methods: </strong>A structured search was conducted in PubMed, Google Scholar and the Cochrane Library for studies published within the last 10 years. We included registry-based studies reporting in-hospital, 30-day, operative or 48-hour mortality following ATAAD. Study characteristics, demographic profiles and preoperative risk factors were extracted.</p><p><strong>Results: </strong>A total of 20 studies, comprising 77,267 patients, were included. In-hospital mortality was reported in 13 registries (n = 50,470), with rates ranging from 5% to 29%. Thirty-day mortality was reported in 5 registries (n = 19,521) and operative mortality in 2 registries (n = 14,825). Substantial variation in outcome definitions and case inclusion criteria limited direct comparability.</p><p><strong>Conclusions: </strong>Early mortality in ATAAD remains high and heterogeneous across registries. Strengthening global registry participation and adopting standardized reporting practices are essential steps toward improving risk stratification, guiding clinical decisions, and advancing equitable care in ATAAD.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"209-220"},"PeriodicalIF":0.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetranectin as a potential biomarker in heart failure with ejection fraction >45%: A prospective cohort study.","authors":"Paula Alexandra Vulciu, Luminita Pilat, Norberth-Istvan Varga, Voicu Dascau, Calin Popa, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Miklos, Maria Puschita","doi":"10.2478/rjim-2025-0014","DOIUrl":"https://doi.org/10.2478/rjim-2025-0014","url":null,"abstract":"<p><strong>Background and objectives: </strong>Heart failure (HF) with left ventricle ejection fraction (LVEF) >45% lacks reliable biomarkers for risk stratification complicating its management, as it encompasses both heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) and mildly reduced ejection fraction (HFmrEF, LVEF 45-49.9%). This study aimed to evaluate serum tetranectin (TETRA) as a novel biomarker for assessing disease severity and predicting mortality in patients with HF with EF >45%.</p><p><strong>Materials and methods: </strong>In a prospective cohort study including 116 patients HF with EF>45% from a single center in Arad, Romania, stratified by NYHA class (G1: NYHA I, n=48; G2: NYHA II, n=37; G3: NYHA III-IV, n=31), serum TETRA levels were measured using ELISA. Echocardiographic parameters (E/e' ratio, LAVI, LAS, GLS, LVEF) and NT-proBNP were assessed at baseline, with all-cause mortality (9 deaths) tracked over a 12-month follow-up.</p><p><strong>Results: </strong>Median TETRA levels decreased with worsening NYHA class (G1: 48.9 ng/mL, G2: 33.2 ng/mL, G3: 27.6 ng/mL; p < 0.001) and correlated negatively with NT-proBNP (rho = -0.66, p < 0.001), E/e' ratio (rho = -0.58, p = 0.003), and LAVI (rho = -0.52, p = 0.010), while positively correlating with LAS (rho = 0.55, p = 0.005). In univariable Cox analysis, lower TETRA levels were associated with higher all-cause mortality (HR = 1.38 per 10 ng/mL decrease, 95% CI: 1.06-1.81, p = 0.045), but this association was not significant after adjustment for age and NT-proBNP (HR = 1.22, 95% CI: 0.94-1.86, p = 0.112).</p><p><strong>Conclusions: </strong>TETRA levels are inversely associated with severity in heart failure with EF>45% and may reflect disease progression.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"63 3","pages":"251-262"},"PeriodicalIF":0.8,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial performance index to assess cardiac function in spondyloarthritis: A systematic review and meta-analysis.","authors":"Steven Alvianto, Faisal Parlindungan, Naomi Niari Dalimunthe, Nicolas Daniel Widjanarko, Yovita Gotama, Ummi Kultsum, Cristopher Efendi","doi":"10.2478/rjim-2025-0013","DOIUrl":"10.2478/rjim-2025-0013","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess cardiac function using the Myocardial Performance Index (MPI) in spondyloarthritis (SpA) patients.</p><p><strong>Material and methods: </strong>A comprehensive literature search was conducted in databases including Medline, ProQuest, Google Scholar, Scopus, and Cochrane Library, focusing on studies relevant to SpA and MPI from 1995 to 2023. The Newcastle Ottawa Scale (NOS) was employed to assess study quality, and meta-analysis computations were conducted utilizing Review Manager 5.4.</p><p><strong>Results: </strong>A total of 11 studies were included in this systematic review and meta-analysis. The spectrum of SpA covered in this review consisted of 1 study on undifferentiated spondyloarthritis (uSpA) and 10 studies on ankylosing spondylitis (AS). Various MPI assessment methods were utilized, including conventional echocardiography and tissue doppler imaging (TDI). In AS patients, both conventional MPI (cMPI) and tissue doppler MPI (tdMPI) values were significantly higher than those of healthy controls (MD= 0.05, 95% CI: 0.01-0.08, p-value=0.006 and MD=0.08, 95%CI: 0.06-0.10, p value<0.00001, respectively). In the uSpA study, there were no significant differences in MPI values between patients and controls with either cMPI or tdMPI.</p><p><strong>Conclusion: </strong>Significant differences in MPI values were observed between AS patients and healthy controls using both cMPI and tdMPI, suggesting that MPI may serve as a useful tool for early detection and management of cardiac dysfunction in AS patients. Further studies were required to validate these findings.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"191-208"},"PeriodicalIF":0.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the prevalence of defecatory disorders in patients with quiescent ulcerative colitis using high-resolution anorectal manometry.","authors":"Khaled Abdel Aty, Ezzat Ali Ali, Mohamed Abdel-Samiee, Eman Hamed Abu El-Soud, Hussein Mahmoud Saad","doi":"10.2478/rjim-2025-0012","DOIUrl":"10.2478/rjim-2025-0012","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) is characterized by recurring episodes of inflammation limited to the mucosal layer of the colon. This work aimed to assess the prevalence of defecatory disorders in patients with quiescent UC using high-resolution anorectal manometry.</p><p><strong>Methods: </strong>This study included 50 UC patients who have documented UC remission or in mild activity (clinically and endoscopically using Mayo score) for the last 6 months, and had persistent symptoms of defecatory disorder (Constipation, faecal incontinence, urgency, rectal pain, and/or sense of incomplete evacuation). All patients were subjected to detailed history taking, systemic physical examination, laboratory investigations, colonoscopy, and high-resolution anorectal manometry. The patient or their relatives provided written consent that was informed. The study was conducted with the approval of the Ethical Committee.</p><p><strong>Results: </strong>There were statistically significant differences regarding the relation between fecal incontinence and with duration of the disease (P= 0.008), while no significant differences were observed with the UC extension or the treatment used. Regarding constipation, urgency, incomplete evacuation, and proctalgia defecatory disorders; it had no statistical significance with the duration of the disease, the UC extension, and the treatment used.</p><p><strong>Conclusion: </strong>UC patients still experience defecatory disorders even at the quiescent stage, and we recommend their evaluation by anorectal manometry.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"221-231"},"PeriodicalIF":0.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between CTLA4-658C>T polymorphism and colorectal cancer in Medan, Indonesia.","authors":"Imelda Rey, Darmadi Darmadi","doi":"10.2478/rjim-2025-0011","DOIUrl":"10.2478/rjim-2025-0011","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a global health concern, including in Indonesia. Genetic factors, particularly those affecting immune regulation and tumor immune evasion, contribute significantly to CRC pathogenesis The cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) gene, which encodes an immune checkpoint receptor, influences T-cell activation and immune response. Certain CTLA4 gene polymorphism has been associated with altered immune function and increased risk of CRC.</p><p><strong>Objectives: </strong>This study aims to explore the potential role of CTLA4-658C>T as a genetic marker for CRC susceptibility.</p><p><strong>Methods: </strong>This case-control study included 60 colorectal cancer (CRC) patients and 60 non-CRC patients from January 2023 to December 2024 at Universitas Sumatera Utara Hospital and its network hospitals. CRC patients aged 18 years or older were included in the case group, while patients with non-CRC findings after colonoscopy served as controls. Patients with systemic diseases (e.g., diabetes, heart or kidney failure, other cancers) were excluded. Data on demographics and CRC characteristics were collected from medical records. Participants were interviewed to complete missing data and provided blood samples for CTLA4-658C>T polymorphism analysis.</p><p><strong>Results: </strong>The CTLA4-658T>C polymorphism was significantly associated with colorectal cancer (CRC). Individuals with the CC+CT genotype had a 2.69-fold higher risk of developing CRC than those with the TT genotype (p=0.022). Additionally, carriers of the C allele had a 2.26-fold higher risk of CRC than those with the T allele (p=0.015).</p><p><strong>Conclusion: </strong>These findings suggest that CTLA4-658C>T may serve as a potential genetic marker for CRC susceptibility, highlighting the role of immune regulation in CRC development.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"242-250"},"PeriodicalIF":0.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of body composition parameters with aortic elastic properties in newly diagnosed type 2 diabetics.","authors":"Turgut Karabag, Işil Isel, Sena Hekimoglu Ustabas, Şebnem Javadova, Özgür Can Usta, Onurcan Turk, Ahmet Oz, M Sait Altintas","doi":"10.2478/rjim-2025-0010","DOIUrl":"10.2478/rjim-2025-0010","url":null,"abstract":"<p><strong>Background: </strong>In individuals with type 2 diabetes mellitus (T2DM), impairments in aortic elastic functions due to vascular remodeling and changes in cardiac morphology and function are observed from the time of diagnosis.</p><p><strong>Objective: </strong>This study investigated alterations in aortic elastic functions in newly diagnosed T2DM patients using transthoracic echocardiography (TTE) and explored their association with various body composition parameters.</p><p><strong>Materials and methods: </strong>A total of 273 newly diagnosed diabetic patients (144 females; mean age: 50.7±12.2 years) and 139 control subjects without any detected diseases (90 females; mean age: 47.1±8.5 years) were included in the study. Echocardiographic parameters and aortic elastic properties were evaluated using TTE. Body composition indices, including Body Mass Index, Waist-to-Hip Ratio, Tri-Ponderal Mass Index (TMI), Visceral Adiposity Index, Body Shape Index, Body Roundness Index, Body Adiposity Index, and Cardiometabolic Index were calculated for all participants.</p><p><strong>Results: </strong>When aortic elastic parameters were evaluated, aortic strain and aortic distensibility were significantly lower in Group 1 compared to Group 2, while the aortic stiffness index was significantly higher in Group 1. Aortic elastic parameters were significantly correlated with most of all body composition indices except for BSI, with the highest correlation observed with TMI (AS; rho=0.490, ASI; rho=0.456, AD; 0.516; p<0.001).</p><p><strong>Conclusion: </strong>In newly diagnosed T2DM patients, aortic elastic functions are impaired at the time of diagnosis compared to the normal population. Among body composition indices; the most significant association was found with TMI. TMI may be considered a potential screening tool not only for evaluating aortic elastic functions but also for identifying other atherosclerotic processes.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"232-241"},"PeriodicalIF":0.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved ASCVD Screening in Diabetes: a Focus on Scoring Models and Detection Techniques.","authors":"Răzvan-Liviu Zanfirescu, Larisa Anghel, Bogdan-Sorin Tudurachi, Alexandra-Mihaela Clement, Alexandra Zăvoi, Laura-Cătălina Benchea, Manuela Ciocoiu, Radu Andy Sascău, Cristian Stătescu, Rodica Radu","doi":"10.2478/rjim-2025-0009","DOIUrl":"10.2478/rjim-2025-0009","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Diabetes accelerates the progression of atherosclerosis through key mechanisms such as insulin resistance, hyperglycemia, dyslipidemia, chronic inflammation, and oxidative stress, significantly increasing the risk of coronary artery disease, stroke, and heart failure. Traditional risk assessment models and treatment strategies often fall short in fully addressing these complexities, leaving a substantial residual cardiovascular risk in diabetic patients. This review focuses on the need for enhanced screening protocols in diabetic populations, examining advanced risk scoring models and detection techniques aimed at improving early identification and management of ASCVD. Also, this study examines the pathophysiological links between diabetes and atherosclerosis, emphasizing the need for enhanced screening protocols. Emerging tools, such as non-invasive imaging techniques (e.g., coronary artery calcium scoring, CCTA) and biomarkers (e.g., polygenic risk scores), offer promise for improved early detection and risk stratification. Additionally, newer therapeutic strategies targeting inflammation and insulin resistance are being explored to mitigate cardiovascular risks in this population. Given the significant cardiovascular risk associated with diabetes, particularly T2DM, these advancements are crucial in reducing morbidity and mortality related to atherosclerotic events.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"127-144"},"PeriodicalIF":1.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}