ID: 12: THE ROLE OF ALCOHOL ABUSE AND TOBACCO USE IN THE INCIDENCE OF EARLY ACUTE CORONAY SYNDROME

2016 ◽  
Vol 64 (4) ◽  
pp. 922.2-923
Author(s):  
H Alkhawam ◽  
M Mariya Fabisevich ◽  
R Sogomonian ◽  
JJ Lieber ◽  
R Madanieh ◽  
...  

BackgroundTobacco abuse and alcohol dependence have been established as risk factors for atherosclerotic heart disease (ASHD). Their potential synergistic effect, however, have not been previously evaluated.Abstract ID: 12 Table 1Alcohol abuse/ DependenceAlcoholic abuse (n=172)Alcoholic- Smoker (n=51)Alcoholic Non-Smoker (n=121)Mean age (years)55.151.156.195% CI(52–58)(48–54.2)(54.6–57.6)Non-Alcohol abuse/DependenceNon-Alcoholic (n=7904)Non-Alcoholic Smoker (n=909)Non-alcoholic Non-smoker (n=6995)Mean age (years)63.856.371.395% CI(63.6–63.9)(55–57.7)(71–71.6)p Value<0.0010.02<0.001Objective/PurposeTo investigate the synergistic role of alcohol abuse/dependence and tobacco use in the early incidence of ACS.MethodsA retrospective chart analyses of 8076 patients diagnosed with ACS between 2000 to 2014, defined by ICD-9 codes for acute MI, alcohol abuse/dependence and tobacco use. Average age of ACS was calculated for the general population. Patients were then divided into 4 subgroups based on alcohol abuse/dependence and tobacco use status as follows: non-alcoholic non-smokers, non-alcoholic smokers, alcoholic non-smokers and alcoholic smokers.ResultsThe mean age of our 8076 ACS patients population was ∼59.5 (95% CI 59.2–59.8). Patients with history of alcohol abuse/dependence appeared to develop ACS ∼8.7 years younger than their non-alcoholic counterparts. When tobacco use is incorporated as a risk factor, those with both alcohol abuse/dependence and tobacco use seemed to develop ACS ∼5 years earlier than those with history of either alone, and ∼20 years earlier when compared to those with neither alcohol abuse/dependence nor tobacco use.(table 1 summarizes mean age of ACS incidence in our study subgroups).ConclusionsAlcohol abuse/dependence appears to be a risk factor for earlier ACS. In our population, the average age of ACS incidence in alcoholic patients was significantly earlier than non-alcoholic patients. Furthermore, alcoholic patients who also used tobacco developed ACS at an even younger age when compared to those who had history of either alcohol abuse/dependence or tobacco use alone, suggesting a possible synergistic effect of these two risk factors in developing early ACS. Healthcare intervention in this population through screening, counseling and education regarding alcohol abuse/dependence and smoking cession is warranted to reduce early ACS.

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hassan Alkhawam ◽  
Raef Madanieh ◽  
Mariya Fabisevich ◽  
Robert Sogomonian ◽  
Mohammed El-Hunjul ◽  
...  

Objective: To investigate the synergistic role of alcohol abuse/dependence and tobacco use in the early incidence of ACS. Methods: A retrospective chart analyses of 8076 patients diagnosed with ACS between 2000 to 2014, defined by ICD-9 codes for acute MI, alcohol abuse/dependence and tobacco use. Average age of ACS was calculated for the general population. Patients were then divided into 4 subgroups based on alcohol abuse/dependence and tobacco use status as follows: non-alcoholic non-smokers, non-alcoholic smokers, alcoholic non-smokers and alcoholic smokers. Results: The mean age of our 8076 ACS patients population was ~59.5 (95% CI 59.2-59.8). Patients with history of alcohol abuse/dependence appeared to develop ACS ~8.7 years younger than their non-alcoholic counterparts. When tobacco use is incorporated as a risk factor, those with both alcohol abuse/dependence and tobacco use seemed to develop ACS ~5 years earlier than those with history of either alone, and ~20 years earlier when compared to those with neither alcohol abuse/dependence nor tobacco use. (Table 1 summarizes mean age of ACS incidence in our study subgroups) Conclusion: Alcohol abuse/dependence appears to be a risk factor for earlier ACS. In our population, the average age of ACS incidence in alcoholic patients was significantly earlier than non-alcoholic patients. Furthermore, alcoholic patients who also used tobacco developed ACS at an even younger age when compared to those who had history of either alcohol abuse/dependence or tobacco use alone, suggesting a possible synergistic effect of these two risk factors in developing early ACS. Healthcare intervention in this population through screening, counseling and education regarding alcohol abuse/dependence and smoking cession is warranted to reduce early ACS morbidity and mortality.


2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.


2022 ◽  
Vol 54 (4) ◽  
pp. 352-356
Author(s):  
Arslan Masood ◽  
Noor Dastgir ◽  
Inam Ur Rehman ◽  
Junaid Rehman ◽  
Aleena Khan ◽  
...  

Objectives: To determine the prevalence, patterns and behavioural attributes of tobacco abuse in patients of acute coronary syndrome (ACS). Furthermore, to assess the interaction of tobacco abuse with other conventional risk factors of cardiovascular disease (CVD). Methodology: This observational study included 230 consecutive patients with ACS. Data was collected regarding total duration and extent of tobacco consumption, “tobacco addiction” and various behavioural patterns related to it. Risk factors profile was acquired for hypertension, diabetes, obesity, family history of premature CVD and dyslipidemia. Odds ratios (OR) with 95% confidence intervals (CI) for these risk factors were calculated for tobacco abusers compared to non-abusers. Results: Among the study population, 63(27.4%) were active tobacco users. Urban residents had lesser odds of being tobacco abusers compared to non-urban residents (0.49, [0.27 – 0.89]). Tobacco abusers had a lower prevalence of hypertension compared to non-abusers (0.44 [0.24 – 0.81]). A similar trend was observed for diabetes, obesity and dyslipidemia, however, the differences could not reach significance thresholds. Cigarette smoking was the commonest mode of tobacco consumption (90.5%). “Tobacco addiction” could be attributed to 84.1% of abusers. Most (82.5%) were willing to give up tobacco abuse and 63.3% had already made attempts at quitting. Conclusion: About one-third of ACS patients were tobacco abusers with the majority being tobacco addicts. Tobacco abuse was observed to be independently implicated as a risk factor in ACS patients. Furthermore, tobacco abuse was inversely related to hypertension translating into a sub-multiplicative / additive impact of hypertension as a risk factor.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Paolo Junior Fantozzi ◽  
Roxanne Bavarian ◽  
Ibon Tamayo ◽  
Marie-Abele Bind ◽  
Sook-Bin Woo ◽  
...  

Abstract Objectives Oral and oropharyngeal squamous cell carcinoma (SCC) is the 10th most common cancer in the United States (8th in males, 13th in females), with an estimated 54,010 new cases expected in 2021, and is primarily associated with smoked tobacco, heavy alcohol consumption, areca nut use and persistent high-risk human papillomavirus (HPV). Family history of cancer (FHC) and family history of head and neck cancer (FHHNC) have been reported to play an important role in the development of OSCC. We aimed to investigate the role of FHC, FHHNC and personal history of cancer in first/second degree-relatives as co-risk factors for oral cancer. Methods This was a retrospective study of patients diagnosed with OSCC at the Division of Oral Medicine and Dentistry at Brigham and Women’s Hospital and at the Division of Head and Neck Oncology at Dana Farber Cancer Institute. Conditional logistic regressions were performed to examine whether OSCC was associated with FHC and FHHNC of FDRs and SDRs, personal history of cancer and secondary risk factors. Results Overall, we did not find an association between FHC, FHHNC and OSCC risk, whereas patients with a cancer history in one of their siblings were 1.6-times more likely to present with an OSCC. When secondary risk factors were considered, patients with a history of oral leukoplakia and dysplasia had a 16-times higher risk of having an OSCC. Conclusions Our study confirmed that a previous history of oral leukoplakia or dysplasia was an independent risk factor for OSCC. A positive family history of cancer in one or more siblings may be an additional risk factor for OSCC.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4722-4722
Author(s):  
Hind Bennani ◽  
Raphaël Coscas ◽  
Marc Coggia ◽  
Patrick Van Dreden ◽  
Marc Vasse ◽  
...  

Abstract Background: Cancer patients are exposed to an increased risk of thrombohemorrhagic events. Whereas patients with solid tumors are prone to venous thromboembolism, acute leukemia may cause coagulopathy associated with thrombocytopenia leading to life-threatening bleeding. Disordered coagulatory system is predominant in AML M3 and to a lesser extent in hyperleukocytic AML M4 and M5. Thromboembolic events are rare in the context of unrecognized AML. Risk factors for arterial thrombosis in AML are not well described. Tissue Factor (TF) is being increasingly acknowledged as an important player in cancer thrombosis. We report a case of non-hyperleukocytic AML M2 revealed by an arterial occlusion with concurrent pulmonary embolism (PE) highlighting the potential role of elevated plasma TF activity as a precipitating event and a risk factor for thrombosis. Clinical Case: A 67-year-old non-smoker patient presented to emergency department because of a 6-hour history of pain in the right lower limb with pallor and coolness. Pulses were abolished in all arteries of the right lower limb without any sensory loss or motor deficit. Contralateral pulses were normal. Clinical examination was otherwise normal. She had no history of intermittent claudication. Past medical history was remarkable for hypertension, thyroid disease and obesity treated two years ago by a gastric bypass surgery complicated by a first episode of PE treated by low molecular weight heparin (LMWH). No further testing for thrombophilia was performed at that time. A total occlusion of the right common and external iliac arteries was confirmed by a CT-scan angiography. The distal arterial tree was healthy. A chest X-ray found bilateral condensations. A helical CT-scan of the chest disclosed bilateral PE with pulmonary infarction. A lung ventilation/perfusion scan confirmed PE. A transthoracic echocardiography found no intracavitary thrombus nor patent foramen ovale. Laboratory values were hemoglobin 9.8 g/dl, WBC 13.8 × 103 µl-1, platelets 60 × 103 µl-1, 80% blasts in the peripheral blood smear. Routine coagulation tests were within usual values (UV). Bone marrow (BM) aspiration found AML M2, myeloblasts were 80% with a cup-like nuclear morphology. Immunophenotyping of BM blasts disclosed CD34 and HLA-DR negativity. The karyotype was normal. Molecular evaluation found NPM1 gene mutation and FLT3 gene internal tandem duplication (FLT3-ITD). Jak2 gene was not mutated. Treatment consisted in LMWH followed by standard induction chemotherapy. Complete remission was achieved after induction followed by 2 courses of consolidation. Of note, the patient still suffers from intermittent claudication of the right leg. Extensive testing for thrombophilia excluded antithrombin, protein C, protein S and protein Z deficiencies, factor II and factor V mutations and antiphospholipid antibody syndrome. Homocysteinemia was normal. Procoagulant activity of intact blasts evaluated by a one-step plasma recalcification time assay was normal. Plasma TF activity was quantified by a one-stage kinetic chromogenic assay. Briefly, this assay is based on the ability of plasma TF to bind to FVIIa and on the capacity of the TF-FVIIa complex to generate FXa. At diagnosis TF activity was elevated at 2.92 pmol (UV<0.45). After remission it returned to normal. Discussion: To the best of our knowledge this is the first report of concurrent arterial and venous thromboses at presentation of AML. Classical risk factors for thrombosis in AML include coagulopathy and hyperleukocytosis yet neither were present here. Laboratory work-up for thrombophilia was negative. The only abnormal finding was an elevated plasma TF activity before chemotherapy. Interestingly, procoagulant activity on circulating blasts was normal, suggesting TF might have been generated from other sources than AML cells such as activated endothelium and/or normal white blood cells (monocytes, polynuclear neutrophils). TF activity returned to baseline after remission, strongly suggesting it was AML-associated either directly or via innate immunity. Conclusion: We report a case of non-hyperleukocytic AML M2 with an unusual presentation including an occlusion of a large artery with concurrent PE. TF activity could be considered in the future as a risk factor for arterial and/or venous thrombosis in AML independently of classical conditions such as hyperleukocytosis and coagulopathy. Disclosures Van Dreden: Diagnostica Stago: Employment.


Author(s):  
Rajiv Kumar Gupta ◽  
Rashmi Kumari ◽  
Bhavna Langer ◽  
Parveen Singh ◽  
Najma Akhtar ◽  
...  

Background: Rapid urbanization and industrialization is leading a massive exodus of migrant workers from rural to urban areas and from one state to another in search of green pastures. The migrant workers living in unsafe environments, working in hazardous conditions and in absence of family/friends makes them vulnerable to indulge in substance abuse. The present study aimed to estimate the prevalence and patterns of smoking in the migrant workers in Jammu region of J and K, India.Methods: All the migrant workers visiting the OPD of Medicine/ Surgery in Government Medical College, Jammu due to any reason were registered. Only those who gave positive history of smoking were interviewed through a questionnaire survey. Data on demographics and details regarding tobacco use were collected.Results: The prevalence of tobacco use was found to be 43.13%. Pattern of tobacco use was found to be significant in relation to the sex of the respondents (p<0.05). Among other variables associated with smoking, monthly income and literacy levels of the migrant workers were found to be statistically significant (p<0.05).Conclusions: The prevalence and patterns observed in the present study needs to further elucidate the role of various risk factors among the migrant workers. These risk factors can be targeted for health promotion as well as intervention for the amelioration of the current smokers.


Author(s):  
Sadhasiva Bhavadeep Kumar Reddy ◽  
Kothareddy Dileep ◽  
Raja Reddy Ramya ◽  
Shripad B Deshpande

Introduction: Peripheral Vascular Disease (PVD) is an important public health problem, due to its insidious course and the associated co-morbidities. Obesity has been implicated as one of the risk factor besides others. However, the reports on obesity are not consistent. Aim: To assess the association between central obesity and PVD along with other risk factors and the present study is undertaken to examine the correlation of central obesity as a risk factor for PVD. Further, the association between other risk factors and PVD was also ascertained. Materials and Methods: A total of 124 subjects were recruited in this case-control study. Ankle Brachial Index (ABI) was measured using peripheral Doppler studies. Patients with ABI <0.9 were taken as cases and with ABI >0.9 were taken as controls. Blood pressure was measured in the sitting position and the authors obtained anthropometric and demographic data. Chi-square test was used as the test of significance and p-value <0.05 to be considered as level of significance. Results: Of the total 124 participants in the study, 62 participants were the cases and 62 participants were controls. Body Mass Index (BMI) was higher in cases with PVD but Waist Circumference (WC) and hip circumference were significantly lower (p-value=0.003 and <0.001 respectively) and Waist-Hip Ratio (WHR) did not show any significant difference between cases and controls. Thus, fat mass is located elsewhere in these individuals, possibly it may be accumulated in the extremities. Other risk factors like history of smoking, history of alcoholism and history of diabetes mellitus had a positively significant association with PVD with p-values <0.001, 0.023 and <0.001 respectively. Conclusion: The results obtained from this data suggests that PVD is not associated with central obesity, instead it provides evidence that PVD correlates with peripheral fat mass. Subsequent studies separating central and peripheral obesity are required to get more clarity on the relationship between obesity and PVD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0247235
Author(s):  
Guillermo A. Tortolero ◽  
Michael R. Brown ◽  
Shreela V. Sharma ◽  
Marcia C. de Oliveira Otto ◽  
Jose-Miguel Yamal ◽  
...  

Understanding sociodemographic, behavioral, clinical, and laboratory risk factors in patients diagnosed with COVID-19 is critically important, and requires building large and diverse COVID-19 cohorts with both retrospective information and prospective follow-up. A large Health Information Exchange (HIE) in Southeast Texas, which assembles and shares electronic health information among providers to facilitate patient care, was leveraged to identify COVID-19 patients, create a cohort, and identify risk factors for both favorable and unfavorable outcomes. The initial sample consists of 8,874 COVID-19 patients ascertained from the pandemic’s onset to June 12th, 2020 and was created for the analyses shown here. We gathered demographic, lifestyle, laboratory, and clinical data from patient’s encounters across the healthcare system. Tobacco use history was examined as a potential risk factor for COVID-19 fatality along with age, gender, race/ethnicity, body mass index (BMI), and number of comorbidities. Of the 8,874 patients included in the cohort, 475 died from COVID-19. Of the 5,356 patients who had information on history of tobacco use, over 26% were current or former tobacco users. Multivariable logistic regression showed that the odds of COVID-19 fatality increased among those who were older (odds ratio = 1.07, 95% CI 1.06, 1.08), male (1.91, 95% CI 1.58, 2.31), and had a history of tobacco use (2.45, 95% CI 1.93, 3.11). History of tobacco use remained significantly associated (1.65, 95% CI 1.27, 2.13) with COVID-19 fatality after adjusting for age, gender, and race/ethnicity. This effort demonstrates the impact of having an HIE to rapidly identify a cohort, aggregate sociodemographic, behavioral, clinical and laboratory data across disparate healthcare providers electronic health record (HER) systems, and follow the cohort over time. These HIE capabilities enable clinical specialists and epidemiologists to conduct outcomes analyses during the current COVID-19 pandemic and beyond. Tobacco use appears to be an important risk factor for COVID-19 related death.


Author(s):  
O. Ojo-Bola ◽  
T. Fagbuyiro ◽  
T. O. Korode ◽  
A. A. Adebowale ◽  
C. T. Omisakin

This study was conducted to determine the seroprevalence of HCV and HIV antibodies in TB confirmed patient attending the Federal Medical Centre (FMC), Ido Ekiti, Ekiti State, Nigeria. A total of 500 tuberculosis confirmed patients were selected by random sampling. Their blood samples were collected and assayed for HCV and HIV antibodies using Clinotech diagnostic Anti-HCV detection test and Abbot determine HIV ½  in conjunction with Chembio HIV ½ STAT-PAK assay kit respectively. Out of 500 TB patients tested, 10(2.0%), 21(4.2%) and 3(0.6%) tested positive to HCV, HIV, and HCV/HIV antibodies respectively. Age group 36-45 was the most prevalence of HCV, HIV, and HCV/HIV antibodies with P-value 0.000, 0.000 and 0.002 respectively. The associated risk factors were alcoholism 14 (45.2%), being the highest identified risk factor, followed by previous unprotected sex, multiple sex partner, previous blood donor, previous transfusion, tattoos, and history of the Sexually transmitted disease being the least risk factor 3 (9.68%). The degree of disparity in regards to HCV, HIV and co-exists of HCV/HIV antibodies between 302 male and 198 female that participated were not statistically significant. (P-value 0.531, 0.549,and 0.824 for HCV, HIV and HCV/HIV antibodies respectively).These findings confirmed that both HCV and HIV can co-exist in TB patients, and may increase the risk of antituberculosis drug-induced hepatotoxicity, if overlooked, there will be a greater risk for TB patients, and these infections will continue to spread through the associated risk factors. However, in managing the TB patients, there is a need to screen for Anti- HCV, as it has been for HIV antibody.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Camps-Vilaro ◽  
S Perez-Fernandez ◽  
R Teira ◽  
V Estrada ◽  
P Domingo ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222]. OnBehalf DARIOS and VACH investigators Background People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain. Methods Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender.  Results We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (&gt;35mg/dL in women and &gt;26mg/dL in men), and a higher prevalence of metabolic syndrome (&gt;10% and &gt;7.8%) and diabetes (&gt;8.5% and &gt;5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table). Conclusions Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension. CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) &lt;0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) &lt;0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) &lt;0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) &lt;0.001 122 (121 - 122) 148 (148 - 164) &lt;0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) &lt;0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) &lt;0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) &lt;0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) &lt;0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) &lt;0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) &lt;0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) &lt;0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) &lt;0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) &lt;0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol


Sign in / Sign up

Export Citation Format

Share Document