The role of diabetes mellitus and hypertriglyceridaemia as coronary risk factors in treated hypertension: 15 years of follow-up of antihypertensive treatment in middle-aged men in the Primary Prevention Trial in Göteborg, Sweden

1994 ◽  
Vol 235 (3) ◽  
pp. 217-227 ◽  
Author(s):  
O. Samuelsson ◽  
T. Hednert ◽  
B. Persson ◽  
O. Andersson ◽  
G. Berglund ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Primary Prevention ◽  
Antihypertensive Treatment ◽  
Prevention Trial ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Primary Prevention Trial

scholarly journals Vitamin B12 and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT)

2020 ◽  
Vol 8 (1) ◽  
pp. e001423
Author(s):  
Lishun Liu ◽  
Xiao Huang ◽  
Binyan Wang ◽  
Yun Song ◽  
Tengfei Lin ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Positive Association ◽  
Prevention Trial ◽  
Vitamin B ◽  
Longitudinal Analyses ◽  
Primary Prevention Trial ◽  
Cross Sectional ◽  
Onset Diabetes ◽  
New Onset

IntroductionPrevious studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12 with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12–diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.Research design and methodsThis report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.ResultsAt baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12 deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12 levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12 and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12 measurements, we found a positive association between an increase in vitamin B12 and an increase in FBG.ConclusionsIn this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12 and its longitudinal trajectory in order to better elucidate the role of vitamin B12 in the development of diabetes. Such findings would have important clinical and public health implications.

Frequency of risk factors in patients of acute coronary syndrome due to coronary ectasia

2020 ◽  
Vol 28 (6) ◽  
pp. 312-315
Author(s):  
Noor Dastgir ◽  
Arslan Masood ◽  
Ahmed Muqeet ◽  
Gul Zaman Khan Niazi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Age Groups ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Coronary Syndrome ◽  
Coronary Ectasia ◽  
Few Data

Background Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. Methods The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20–50 years and 82 (52.90%) were 51–80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. Results Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. Conclusion Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.

Prediction of coronary artery disease in patients undergoing carotid endarterectomy

2005 ◽  
Vol 103 (4) ◽  
pp. 593-596 ◽  
Author(s):  
Toshifumi Shimada ◽  
Kazunori Toyoda ◽  
Tooru Inoue ◽  
Masahiro Kamouchi ◽  
Takahiro Matsumoto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Independent Predictor ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Peripheral Artery ◽  
Content Type ◽  
Artery Disease ◽  
Fine Print

Object. The authors determined the factors that predict the coexistence of coronary artery disease (CAD) in patients who undergo carotid endarterectomy (CEA). Methods. Data from 200 consecutive Japanese patients who underwent CEA for extracranial carotid artery stenosis were studied. Among 73 patients with CAD, 35 (48%) had three-vessel or left main CAD (that is, severe CAD). Peripheral artery disease was an independent predictor of CAD (odds ratio [OR] 2.61, 95% confidence interval [CI] 1.08–6.3). In addition, diabetes mellitus ([DM]; OR 2.8, 95% CI 1.24–6.32) and peripheral artery disease (PAD) (OR 2.83, 95% CI 1.05–7.57) were independent predictors of severe CAD in the 200 patients. The percentage of patients with CAD as well as those with the severe form of the disease increased stepwise as the number of major coronary risk factors in patients increased. Asymptomatic CAD was newly detected during the pre-CEA assessment in 18 (25%) of the 73 patients in whom CAD was eventually diagnosed. Diabetes mellitus was an independent predictor of occult CAD among the 200 patients (OR 4.83, 95% CI 1.53–15.2). Conclusions. In patients with DM, PAD, or multiple major coronary risk factors who have been scheduled for CEA, one should carefully search for concomitant CAD, especially severe CAD, even when the patient has had no previous episode of angina.

The feasibility of a newly developed local network system for cardiac rehabilitation (the CR-GNet) in disease management and physical fitness after acute coronary syndrome

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
T Ando ◽  
T Watanabe ◽  
S Matsuo ◽  
T Samejima ◽  
J Yamagishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Disease Management ◽  
Oxygen Uptake ◽  
Peak Oxygen Uptake ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Grant-in-aid from.jpgu Prefecture Background The newly developed Cardiac Rehabilitation.jpgu Network (CR-GNet) has been implemented to create a regional alliance network and to provide periodic follow-up examinations to enhance the disease management in patients with cardiovascular disease. The effectiveness of a network like this support system has not yet been evaluated in Japan. Purpose We aimed to examine the feasibility of the CR-GNet in disease management, assisting patients in attaining physical fitness and its impact on long-term outcomes after acute coronary syndrome (ACS). Methods We enrolled 47 patients with ACS in the CR-GNet between February 2016 and September 2019; of these, 37, 29, and 21 patients underwent follow-up assessments for exercise capacity (peak oxygen uptake) at 3 months, 6 months, and 1 year after discharge, respectively. Major adverse cardiac events (MACE) were defined as the composite of death from cardiac causes, cardiac arrest, myocardial infarction, and rehospitalization due to unstable or progressive angina. MACE were compared with controls who were not registered in the CR-GNet. Results The coronary risk factors, except blood pressure, improved at 3 and 6 months, and 1 year after discharge. These risk factors in each patient significantly reduced from 2.9 at admission to 1.6, 1.4, and 1.9 at 3 months, 6 months, and 1 year after discharge (p &lt; 0.05), respectively. Peak oxygen uptake was significantly higher at 3 months, 6 months, and 1 year after discharge to 17.5 ± 4.9 ml/kg/min, 17.9 ± 5.1 ml/kg/min, and 17.5 ± 5.5 ml/kg/min, respectively, than that at discharge (14.7 ± 3.6 ml/kg/min) (p &lt; 0.05). During follow-up, there was no significant difference; MACE did not occur in any patients in the CR-GNet but occurred in controls. Conclusions The CR-GNet is a feasible option for long-term management of ACS patients. The prognostic impact of the CR-GNet needs further investigation with a larger sample size and longer follow-up. Table1 At admission 3 months 6 months 1 year Average number 2.9 1.6* 1.4** 1.9*** † Average number of coronary risk factors for all patients (n = 21) p = 0.004, vs. at admission; **p = 0.001, vs. at admission; ***p = 0.011, vs. at admission; †p = 0.035, vs. at 6 months

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