5198HbA1C correlates subclinical atherosclerosis in non-diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
W.-T Wang ◽  
P.-F Hsu ◽  
Y.-J Wang ◽  
Y.-Z Ding ◽  
T.-L Liou ◽  
...  
Keyword(s):  
High Risk ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Smoking Habit ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Lipid Parameters

Abstract Objective We investigated the association of lipid parameters and coronary atherosclerosis related to normal blood sugar (BS) and impaired fasting glucose (IFG), and factors contributing to coronary atherosclerosis. Methods We analyzed 1209 non-diabetic subjects who underwent coronary computed tomography angiography (CCTA). Atherosclerotic plaque pattern severity and patterns were evaluated based on serum glucose values. The association between low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) and plaque patterns in non-diabetic subjects were also analyzed. Results Non-diabetic subjects (age: 58.6±9.7 years; 861 male) were enrolled. Higher glucose levels were correlated with a higher prevalence of mixed plaque, significant (>50% stenosis) high-risk plaque, and calcified plaque in non-diabetic patients. Although serum LDL-C levels were mostly controlled by statin use, atherosclerotic plaques progressed, with increasing A1c values. Multivariate logistic regression analysis showed that age, male gender and A1C were independently associated with the presence of significant mixed plaques after considering BMI, blood pressure, renal function, lipid parameters, uric acid, and smoking habit. Conclusions Although decreasing HDL-C and increasing TG correlated with the presence and severity of coronary atherosclerosis, increasing A1c is independently associated with the presence of high-risk plaque in non-diabetes even if LDL-C is controlled by statin therapy.

scholarly journals Cardiovascular risk profile in Olympic athletes: an unexpected and underestimated risk scenario

2018 ◽  
Vol 53 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Flavio D’Ascenzi ◽  
Stefano Caselli ◽  
Federico Alvino ◽  
Barbara Digiacinto ◽  
Erika Lemme ◽  
...  
Keyword(s):  
Risk Factors ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Smoking Habit ◽  
Large Population ◽  
Positive Family History ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Olympic Athletes

BackgroundPrevalence of cardiovascular (CV) risk factors has been poorly explored in subjects regularly engaged in high-intensity exercise programmes. Our aim was, therefore, to assess the prevalence and distribution of CV risk factors in a large population of competitive athletes, to derive the characteristics of athlete’s lifestyle associated with the best CV profile.Methods1058 Olympic athletes (656 males, 402 females), consecutively evaluated in the period 2014–2016, represent the study population. Prevalence and distribution of CV risk factors was assessed, in relation to age, body size and sport.FindingsDyslipidemia was the most common risk (32%), followed by increased waist circumference (25%), positive family history (18%), smoking habit (8%), hypertension (3.8%) and hyperglycaemia (0.3%). Large subset of athletes (418, 40%) had none or 1 (414, 39%) risk factor, while only a few (39, 3.7%) had 3/4 CV risk factors. The group without risks largely comprised endurance athletes (34%). Ageing was associated with higher total and low-density lipoprotein cholesterol, triglycerides (p<0.001) and glycaemia (p=0.002) and lower high-density lipoprotein cholesterol. On multivariate logistic regression analysis, age, BMI and body fat were identified as independent predictors of increased CV risk.InterpretationDyslipidemia and increased waist circumference are common in elite athletes (32% and 25%, respectively). A large proportion (40%) of athletes, mostly endurance, are totally free from risk factors. Only a minority (3%) presents a high CV risk, largely expression of lifestyle and related to modifiable CV risk factors.

scholarly journals Independent role of low-density lipoprotein cholesterol in subclinical coronary atherosclerosis in the absence of traditional cardiovascular risk factors

2019 ◽  
Vol 20 (8) ◽  
pp. 866-872 ◽  
Author(s):  
Ki-Bum Won ◽  
Gyung-Min Park ◽  
Yu Jin Yang ◽  
Soe Hee Ann ◽  
Yong-Giun Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Abstract Aims Individuals without traditional cardiovascular risk factors (CVRFs) still experience adverse events in clinical practice. This study evaluated the predictors of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Methods and results A total of 1250 (52.8 ± 6.5 years, 46.9% male) asymptomatic individuals without CVRFs who underwent coronary computed tomographic angiography for a general health examination were analysed. The following were considered as traditional CVRFs: systolic/diastolic blood pressure ≥140/90 mmHg; fasting glucose ≥126 mg/dL; total cholesterol ≥240 mg/dL; low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL; high-density lipoprotein cholesterol <40 mg/dL; body mass index ≥25.0 kg/m2; current smoking status; and previous medical history of hypertension, diabetes, and dyslipidaemia. Subclinical atherosclerosis, defined as the presence of any coronary plaque, was present in 20.6% cases; the incidences of non-calcified, calcified, and mixed plaque were 9.6%, 12.6%, and 2.6%, respectively. Multivariate regression analysis showed that LDL-C level [odds ratio (OR): 1.008; 95% confidence interval (CI): 1.001–1.015], together with age (OR: 1.101; 95% CI: 1.075–1.128) and male sex (OR: 5.574; 95% CI: 3.310–9.388), was associated with the presence of subclinical atherosclerosis (All P < 0.05). LDL-C level was significantly associated with an increased risk of calcified plaques rather than non-calcified or mixed plaques. Conclusion LDL-C, even at levels currently considered within normal range, is independently associated with the presence of subclinical coronary atherosclerosis in individuals without traditional CVRFs. Our results suggest that a stricter control of LDL-C levels may be necessary for primary prevention in individuals who are conventionally considered healthy.

scholarly journals Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

2018 ◽  
Vol 6 (8) ◽  
pp. 2626 ◽  
Author(s):  
Arjun Baidya ◽  
Rishad Ahmed
Keyword(s):  
Plasma Glucose ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Glycated Haemoglobin ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Lipid Parameters

Background: Present study assessed the effect of early addition of hydroxychloroquine to metformin and sulfonylurea in inadequately controlled T2DM patients as compared to up titration of the metformin or sulfonylurea (glimepiride) doses.Methods: Patients with glycated haemoglobin (HbA1c) between ≥7.0 to ≤9.0% and on metformin 1000mg/day and glimepiride 2mg/day for at least 12 weeks were analysed for this study. Patients were randomized into three groups, in one group (n=55) metformin dose was up titrated to 2000mg daily and in second group (n=55) hydroxychloroquine (HCQ) 400mg was added along with other and in third group (n=55) glimepiride dose was up titrated to 4mg. Fasting plasma glucose (FPG), post prandial plasma glucose (PPG) and glycated haemoglobin (HbA1c) were measured at baseline and after 12 and 24 weeks. Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and Triglyceride were measured at baseline and after 6 months. Authors have analysed the data of 150 patients as rest were either lost in follow up or discontinue therapy.Results: After 24 weeks, the mean HbA1c was 6.5% in hydroxychloroquine group (p<0.001) versus 6.8% in metformin 2000mg group (p<0.001) and 6.7% in glimepiride 4mg group (p<0.001). There was also a modest reduction in lipid parameters (p<0.001) with no change in serum creatinine level and a marginal reduction in body weight in the HCQ group. Incidence of confirmed hypoglycemia was significantly lower in patients of HCQ group compared to glimepiride group in this study.Conclusions: Hydroxychloroquine as add on to metformin and glimepiride combination during the early course of treatment helps in achieving glycaemic target and can consider as an option rather up titrating the dose of metformin or glimepiride.

scholarly journals Prediction of subclinical coronary atherosclerosis in patients with high and very high cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Pogosova ◽  
NP Kachanova ◽  
YM Yufereva ◽  
OY Sokolova ◽  
IE Koltunov ◽  
...  
Keyword(s):  
Family History ◽  
Ct Angiography ◽  
Coronary Atherosclerosis ◽  
Subclinical Atherosclerosis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diagnostic Model ◽  
History Of ◽  
Hs Crp ◽  
Very High

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis has a long subclinical period. It’s early detection may offer a possibility of timely initiation of preventive interventions Purpose To develop a diagnostic rule for detection of patients (pts) with high probability of subclinical atherosclerosis among those with high or very high cardiovascular (CV) risk. Methods This cross-sectional study enrolled 52 pts (32 men [62%]), aged 40 to 65 years [mean age 54.6 ± 8.0]) with high or very high CV risk (5-9 and ≥10% by The Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT) angiography and calcium scoring. Traditional risk factors (RFs) (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose),  ankle-brachial index,  stress-test, carotid plaques according to ultrasound were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. Results All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n = 21) had any non-obstructive lesions or calcium score &gt;0, pts in the control group (n = 31) had intact coronary arteries. The groups did not differ in age or gender. 26 multiple linear logistic models for any subclinical atherosclerosis were developed based on obtained diagnostic features. Taking into account R-square = 0.344 (p = 0.0008), the best fitting model was follows:  subclinical coronary atherosclerosis= -1.576 + 0.234 x SCORE ≥5%  + 0.541 x hs CRP &gt;2 g/l + 0.015 x heart rate  (bpm) + 0.311 family history of premature CVD.  The developed algorithm had sensitivity of 63% and  specificity of 80%. Conclusions The created diagnostic model diagnostic model suggests the presence of subclinical coronary atherosclerosis in patients with high / very high CV risk with a high degree of probability. This easy-to-use method can be used in routine clinical practice to improve risk stratification and management choices in high-risk pts.

Eligibility for PCSK9 inhibitors based on the 2019 ESC/EAS and 2018 ACC/AHA guidelines

2020 ◽  
pp. 204748732094010
Author(s):  
Konstantinos C Koskinas ◽  
Baris Gencer ◽  
David Nanchen ◽  
Mattia Branca ◽  
David Carballo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherosclerotic Cardiovascular Disease ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Coronary Syndrome ◽  
Coronary Syndromes

Aims The 2018 American College of Cardiology (ACC)/American Heart Association (AHA) and 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) lipid guidelines recently updated their recommendations regarding proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i). We assessed the potential eligibility for PCSK9i according to the new guidelines in patients with acute coronary syndromes. Methods and results We analysed a contemporary, prospective Swiss cohort of patients hospitalised for acute coronary syndromes. We modelled a statin intensification effect and an incremental ezetimibe effect on low-density lipoprotein-cholesterol levels among patients who were not on high-intensity statins or ezetimibe. One year after the index acute coronary syndrome event, treatment eligibility for PCSK9i was defined as low-density lipoprotein-cholesterol of 1.4 mmol/l or greater according to ESC/EAS guidelines. For ACC/AHA guidelines, treatment eligibility was defined as low-density lipoprotein-cholesterol of 1.8 mmol/l or greater in the presence of very high-risk atherosclerotic cardiovascular disease, defined by multiple major atherosclerotic cardiovascular disease events and/or high-risk conditions. Of 2521 patients, 93.2% were treated with statins (53% high-intensity statins) and 7.3% with ezetimibe at 1 year, and 54.9% had very high-risk atherosclerotic cardiovascular disease. Low-density lipoprotein-cholesterol levels less than 1.8 mmol/l and less than 1.4 mmol/l at 1 year were observed in 37.5% and 15.7% of patients, respectively. After modelling the statin intensification and ezetimibe effects, these numbers increased to 76.1% and 49%, respectively. The proportion of patients eligible for PCSK9i was 51% according to ESC/EAS criteria versus 14% according to ACC/AHA criteria. Conclusions In this analysis, the 2019 ESC/EAS guidelines rendered half of all post-acute coronary syndrome patients potentially eligible for PCSK9i treatment, as compared to a three-fold lower eligibility rate based on the 2018 ACC/AHA guidelines.

scholarly journals Lipid Profile of Type 2 Diabetic and Hypertensive Patients in the Jamaican Population

2010 ◽  
Vol 2 (01) ◽  
pp. 025-030 ◽  
Author(s):  
Lorenzo Gordon ◽  
Dalip Ragoobirsingh ◽  
Errol Y St A Morrison ◽  
Eric Choo-Kang ◽  
Donovan McGrowder ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Type 2 Diabetic

ABSTRACT Aims: Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

scholarly journals Validity of a Novel Method for Estimation of Low-Density Lipoprotein Cholesterol Levels in Diabetic Patients

2016 ◽  
Vol 23 (12) ◽  
pp. 1355-1364 ◽  
Author(s):  
Hideto Chaen ◽  
Shigesumi Kinchiku ◽  
Masaaki Miyata ◽  
Shoko Kajiya ◽  
Hitoshi Uenomachi ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Cholesterol Levels ◽  
Novel Method
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