Impaired microcirculation in the skin as a tool for cardiovascular risk stratification in primary care with special emphasis on type 2 diabetes and pre-diabetes

The general aim is to clarify if impaired microcirculation measured in the skin can be a useful and clinically relevant predictor for progression of atherosclerosis in the coronary arteries and cardiovascular disease (CVD) in primary care.Microcirculatory assessmentWe have developed a unique tool for microcirculatory measurements by using a multimodal optical instrument for comprehensive microcirculatory assessment.

The system acquires microcirculation oxygen saturation and blood flow noninvasively using a fiberoptic probe placed in contact with the skin tissue. This system has been used in SCAPIS Linköping.

The assessment of microvascular function included 3,809 participants examined exclusively at Linköping University hospital, between 2016 and 2018 as a local add-on study to SCAPIS.The natural progression of microcirculatory dysfunction and atherosclerosis in the coronary arteries will characterized by a re-examination of the SCAPIS study population starting by 2024.We will integrate data from microvascular function, arterial stiffness and atherosclerosis in the coronary arteries by using data from coronary computed tomography angiography.SignificanceIf microcirculatory dysfunction predicts the progression of atherosclerosis in the coronary arteries and subsequent CVD, the measurement of microcirculation might be included in future risk algorithms for cardiovascular risk stratification of patients with diabetes and the general population for use in primary care.