scholarly journals Impact of Admission Glycated Hemoglobin on Angiographic Characteristics and Short Term Clinical Outcomes of Non-diabetic patients with Acute ST Elevation Myocardial Infarction

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A I Elabd ◽  
H G M Helmi ◽  
E M A Alfiky ◽  
R A Y Bassily
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
Study Population ◽  
St Elevation ◽  
Artery Disease

Abstract Background Coronary artery disease is the most important cause of death in industrialized countries. Diabetes mellitus is one of the most important modifiable risk factors of coronary artery disease. It increases the risk of coronary artery disease by 2 to 4-fold. Interestingly, this increased risk is not confined to patients with DM, but non-diabetic patients with impaired glucose tolerance (IGT) also may have an increased incidence of cardiovascular complications. Moreover, increased admission glucose levels may be related to a higher mortality rates in patients with acute myocardial infarction (AMI), regardless of diabetic status. Objective To assess the prognostic impact of admission HbA1c in patients without known diabetes mellitus who were admitted with acute ST elevation myocardial infarction, on outcome of 1ry PCI and short-term outcome of adverse cardiac events. Material and Methods This is an observational, this study was conducted at Coronary care unit & coronary catheterization lab unit of cardiology department in Ain Shams University & specialized hospitals. The study period was 6 months (From 1-9-2018 till 1-3-2019). Results 100 patients without prior diagnosis of DM were included in our study population Three categories of patients were created according to HbA1c level: Group 1 (< 5.7%): 46 patients (46%); Group 2 (5.5 to 6.4%): 38patients (38%); Group 3 (>6.5%): 16 patients (16%). Baseline characteristics of the study population are shown in Table 1. The mean age of our sample was 55.06 ± 11.73 years and 96% were males. There was highly statistically significant difference found between DM groups regarding SYNTAX score with P-value (0.002) & another highly significant difference in EF between the 3 groups. Conclusion The present study showed that admission higher HbA1c level in non-diabetic patients presented by acute STEMI is associated with more severe CAD, lower rate of complete revascularization TIMI 3, and higher incidence of adverse cardiac events and mortality. Introducing measurement of HbA1c in the CCU seems to be a simple method to obtain important information on mortality risk.

scholarly journals Prognostic Value of Atherosclerotic Extent in Diabetic Patients with Non-Obstructive Coronary Artery Disease

2020 ◽  
Author(s):  
Zinuan Liu ◽  
Yipu Ding ◽  
Guanhua Dou ◽  
Xia Yang ◽  
Xi Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Sensitivity Analysis ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Obstructive Coronary Artery Disease ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background: The prognostic value of non-obstructive CAD has always been underestimated due to its moderate stenosis. Whether the atherosclerotic extent is related to the prognosis in this group of people is uncertain, especially in the presence of diabetes. We aim to investigate the prognostic value of atherosclerotic extent in diabetic patients with non-obstructive coronary artery disease (CAD).Method: The analysis was based on a single center cohort of diabetic patients referred for coronary computed tomography angiography (CCTA) due to suspect CAD. Major adverse cardiac events (MACEs) were recorded, including cardiovascular death, non-fatal myocardial infarction, stroke and unstable angina (UA) requiring hospitalization. Four groups were defined based on coronary stenosis combined with segment involvement score (SIS), a semiquantitative index of the extent of atherosclerosis, including normal, non-obstructive SIS<3, non-obstructive SIS≥3 and obstructive. Time to event was estimated by using multivariable Cox proportional hazards models. Leidon risk score was used to replace SIS for sensitivity analysis.Results: In total, 1241 patients were included (age 60.2±10.4 years, 54.1% male), experiencing 131 MACEs (10.6%) during a median follow-up of 2.6 years. Diabetic patients with non-obstructive CAD accounts for 50.2% of included population（N=623）. In multi-variate Cox model adjusting for age, gender, hyperlipidemia and presence of high-risk plaque, hazard ratio (HR) for SIS < 3 and SIS ≥ 3 in non-obstructive CAD were 1.84 (95%CI: 0.70-4.79) and 3.71 (95%CI: 1.37-10.00) respectively.The latter showed a higher risk of cardiac adverse events than the former group（HR：2.02 95%CI:1.11-3.68, p＝0.021）, while HR for obstructive CAD was 5.46 (95%CI: 2.18-13.69). Sensitivity analysis was performed using Leidon Risk Score instead of SIS. After adjustment, HR for Leidon ≥ 5 with non-obstructive disease was 1.92（95% CI: 1.06-3.48 p=0.032）in comparison to the non-obstructive group of Leidon < 5.Conclusion: In diabetic patients with non-obstructive CAD, atherosclerotic extent was associated with higher risk of major adverse cardiac events at long-term follow-up. Efforts should be made to determine risk stratification for the management of DM patients with non-obstructive CAD.

P885Cardiovascular events in patients with suspected ST-elevation myocardial infarction and no obstructive coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Andersson ◽  
L S Laustsen ◽  
A Laustsen ◽  
F Pedersen ◽  
L E Bang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
St Elevation Myocardial Infarction ◽  
Receiver Operating Curve ◽  
Significant Difference ◽  
St Elevation ◽  
Coronary Procedures ◽  
Artery Disease

Abstract Background Patients with suspected ST-elevation myocardial infarction (STEMI) and no obstructive coronary artery disease (CAD) comprise a heterogeneous group with varying prognoses. Purpose To evaluate the prognostic value of cardiac troponin T (cTnT) in patients with suspected STEMI and no obstructive CAD. Methods Patients with suspected STEMI and no obstructive (<50% diameter stenosis) CAD were consecutively included from 2009–2014. Patients were classified as having normal cTnT, dynamic cTnT elevation, or stationary cTnT elevation. All patients were followed with respect to major adverse cardiovascular events (MACE), cardiovascular readmission, and repeat coronary procedures, until 1 year after discharge. Results The study included 502 patients with suspected STEMI and no obstructive CAD: 165 (33%) had normal cTnT, 293 (58%) had dynamic cTnT elevation and 44 (9%) had stationary cTnT elevation. Within one year after admission, 40 (8%) had MACE, 81 (16%) had cardiovascular readmission, and 8 (2%) underwent repeat coronary procedures. The risk of MACE was elevated in patients with stationary cTnT elevation compared with normal cTnT (OR 13.6, 95% CI 2.3–80.2, p=0.004). There was no statistically significant difference between those with dynamic cTnT elevation and normal cTnT (OR 2.9, 95% CI 0.6–14.0, p=0.189). Adding cTnT pattern to a conventional risk model, area under the receiver operating curve for predicting the 1-year risk of MACE improved significantly (80% vs. 85%, p=0.004, Figure 1). Figure 1 Conclusion In patients with suspected STEMI and no obstructive CAD, cTnT pattern during acute hospitalization is associated with the 1-year risk of MACE and improves risk prediction for the individual patient. Acknowledgement/Funding The Danish Heart Foundation, the A.P. Møller Foundation, the Foundation of Reinholdt W. Jorck and Wife, Rigshospitalet's Research Foundation

Association of Haemoglobin A1c Level with the Severity of Coronary Artery Disease in Non-diabetic Patients with Non-STSegment Elevation Myocardial Infarction

2021 ◽  
Vol 35 (2) ◽  
pp. 134-139
Author(s):  
Md Mamunuzzaman ◽  
Mahboob Ali ◽  
Mir Jamal Uddin ◽  
Shaila Nabi ◽  
Kajal Kumar Karmoker ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Gensini Score ◽  
Group I ◽  
St Elevation ◽  
Group Ii ◽  
Artery Disease ◽  
Vessel Score

Background: In nondiabetic patients with non-STsegment– elevation myocardial infarction, hyperglycemia may be associated with adverse outcome. Objective: To find out the association between HbA1c levels and the severity of coronary artery disease in non-diabetic patients with non-ST-segment elevation myocardial infarction Methods: This cross sectional analytical study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, during the period from July, 2012 to May, 2013. This study was done with an aim to find out the association between the HbA1c level and the angiographic severity of coronary artery disease in patients with non-ST- elevation myocardial infarction without diabetes mellitus. A total of 170 patients with NSTEMI without diabetes mellitus who agreed to undergo coronary angiography were included in the study. Eighty five patients were selected having HbA1c <5.7% (Group I) and 85 patients were selected having HbA1c ranging from 5.7% to 6.4% (Group II). Severity of the Coronary Artery Disease (CAD) was assessed by angiographic vessel score, and Gensini score. Results: The mean age of the studied patients was 51.0±9.0 years ranging from 30 to 80 years and male to female ratio was 4.5:1. The incidence of hypertension and level of RBS were significantly higher in group II than group I. The HbA1c level increased in accordance with the vessel score increment. There was a significant difference of the mean value of HbA1c among the vessel involvement groups. In this study mild CAD (scored”36) was significantly higher in group I and moderate to severe CAD (score>36) was significantly higher in group II according to Gensini score. This study showed a positive correlation between HbA1c and vessel score (r=0.47, p=0.01) and also between HbA1c and Gensini score (r=0.41, p=0.01). Conclusion: Elevated HbA1c levels in non-diabetic non- ST- elevation myocardial infarction patients are associated with the severity of coronary artery disease. Bangladesh Heart Journal 2020; 35(2) : 134-139

scholarly journals Epidemiology and prognostic implications of panic disorder and generalized anxiety disorder in patients with coronary artery disease: rationale and design for a longitudinal cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guillaume Foldes-Busque ◽  
Clermont E. Dionne ◽  
Stéphane Turcotte ◽  
Phillip J. Tully ◽  
Marie-Andrée Tremblay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Cohort Study ◽  
Coronary Artery ◽  
Anxiety Disorder ◽  
Generalized Anxiety ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background Anxiety is associated with poorer prognosis in patients with coronary artery disease (CAD). Due to their severity and chronic course, anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder (PD), are of considerable interest and clinical importance in this population. This study has two main objectives: (1) to estimate the prevalence and incidence of GAD and PD in patients with CAD over a 2-year period and (2) to prospectively assess the association between PD or GAD and adverse cardiac events, treatment adherence, CAD-related health behaviors, quality of life and psychological distress. Design/Method This is a longitudinal cohort study in which 3610 participants will be recruited following a CAD-related revascularization procedure. They will complete an interview and questionnaires at 5 time points over a 2-year period (baseline and follow-ups after 3, 6, 12 and 24 months). The presence of PD or GAD, adherence to recommended treatments, health behaviors, quality of life and psychological distress will be assessed at each time point. Data regarding mortality and adverse cardiac events will be collected with a combination of interviews and review of medical files. Discussion This study will provide essential information on the prevalence and incidence of anxiety disorders in patients with CAD and on the consequences of these comorbidities. Such data is necessary in order to develop clear clinical recommendations for the management of PD and GAD in patients with CAD. This will help improve the prognosis of patients suffering from both conditions.

Sign in / Sign up

Export Citation Format

Share Document