scholarly journals Myocardial revascularization in diabetic patients presenting with critical limbischemia

2010 ◽  
Vol 13 (4) ◽  
pp. 25-29
Author(s):  
Ivan Ivanovich Dedov ◽  
Victor Yur'evich Kalashnikov ◽  
Konstantin Vladimirovich Melkozerov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Critical Limb Ischemia ◽  
Myocardial Revascularization ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Preoperative Risk Assessment ◽  
Therapeutic Modalities ◽  
Optimal Drug ◽  
Patients With Diabetes

The frequency of diabetic complications remains high despite the development of improved therapeutic modalities. Macroangiopathy continues to bethe predominant complication while coronary heart disease is the main cause of mortality.This paper considers clinical features of diabetic patientswith coronary heart disease and critical limb ischemia; various aspects of optimal drug therapy, preoperative examination and diagnostics precedingvascular non-cardiac surgery; preoperative risk assessment; indications for coronary angiography and myocardial revascularization. The authors emphasizethe importance of development of algorithms for the treatment of patients with diabetes, critical limb ischemia, and coronary heart disease.

scholarly journals Dyslipidemia: A Trigger for Coronary Heart Disease in Romanian Patients with Diabetes

Metabolites ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 195 ◽  
Author(s):  
Mihnea-Alexandru Găman ◽  
Matei-Alexandru Cozma ◽  
Elena-Codruța Dobrică ◽  
Nicolae Bacalbașa ◽  
Ovidiu Gabriel Bratu ◽  
...  
Keyword(s):  
Gender Differences ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Statin Prescription ◽  
And Gender ◽  
Internal Medicine Clinic

Previous studies have reported age and gender disparities in the occurrence and therapeutic approach of dyslipidemia and (or) coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate these differences in Romanian patients with T2DM. A cross-sectional, observational, retrospective study was conducted using the medical records of T2DM patients who attended the outpatient facility of the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania for routine check-ups in a six-month period. We analyzed the records of 217 diabetic patients (mean age 69 ± 11 years; 51.15% women). We found no significant gender differences in the occurrence of dyslipidemia, CHD or CHD + dyslipidemia or in terms of statin prescription. However; patients aged 65 years or older were significantly more affected by dyslipidemia, CHD or CHD + dyslipidemia, versus subjects aged <65 years. Further, they were more likely to be prescribed statin therapy (p < 0.0001 for all). Statins were prescribed to 67.24% of the patients with dyslipidemia; 61.01% of the subjects with CHD; and to 91.48% of the patients who had both conditions. e recorded no gender differences in the occurrence of CHD and (or) dyslipidemia in Romanian T2DM patients. Patients aged 65 years or older had a higher prevalence of CHD and/or dyslipidemia, and were more likely to be prescribed statins, versus younger counterparts. However, many T2DM patients with CHD and (or) dyslipidemia were undertreated: Nearly 33% of the subjects with dyslipidemia, and nearly 40% of the ones with CHD were not prescribed statins.

scholarly journals The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Burak Çildağ ◽  
Ömer Faruk Kutsi Köseoğlu
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Below The Knee ◽  
Limb Preservation ◽  
Significant Difference ◽  
Patients With Diabetes

Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005). Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

scholarly journals GAMBARAN KADAR ALBUMINURIA PADA SUBJEK DIABETES MELITUS DENGAN DAN TANPA PENYAKIT JANTUNG KORONER

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Sandy Cendra ◽  
Emma Moeis ◽  
Yuanita Langi
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Renal Physiology ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Female Patients ◽  
Patients With Diabetes ◽  
Male Patients ◽  
Diabetes Melitus

Abstract: Albuminuria is a marker of the decline in renal physiology and function of endothelial. Endothelial dysfunction is an early pathogenesis of coronary heart disease (CHD). High coronary heart disease complications in patients with diabetes mellitus (DM). Objective To know the description and differences in levels of albuminuria in diabetic patients with and without CHD inpoli Metabolic and Endocrine and poli Heart BLU. RSU. Prof. dr. R. D Kandou Manado. Research Method: Cross Sectional descriptive analytic study conducted in patients with diabetes mellitus pieces with and without coronary heart disease in Poli Endocrine Metabolic and poli heart BLU. RSU. Prof. dr. R. D Kandou Manado period November 2012 - November 2013. Results: From 34 patients with diabetes mellitus found the number of diabetic patients with CHD were 17 patients and 17 patients for diabetes without CHD, which consisted of 14 male patients and 20 female patients. The distribution of the sample based on CHD and sex, showed that diabetic patients with CHD were 9 men (26.47%) and 8 women (23.53%). As for diabetic patients without CHD as many as 5 male patients (14.70%) and 12 female patients (35.30%). Distribution of the study sample by CHD and RAKU categories showed diabetic patients with CHD were 7 patients (20.59%) and normal RAKU 10 patients (29.41%) RAKU abnormal. As for diabetic patients without CHD by 16 patients (47.06%) and 1 patient RAKU normal (2.94%) RAKU abnormal. Conclusion: Albuminuria occurs more frequently in patients with diabetes mellitus with coronary heart disease than diabetes mellitus without coronary heart diseaseKeywords: Albuminuria, diabetes mellitus, coronary heart disease.    Abstrak: Albuminuria merupakan petanda terjadinya penurunan faal ginjal dan disfungsi endotel. Disfungsi endotel merupakan patogenesis awal penyakit jantung koroner (PJK). Komplikasi penyakit jantung koroner tinggi pada pasien diabetes melitus (DM). Tujuan: Untuk mengetahui gambaran dan perbedaan kadar albuminuria pada pasien DM dengan dan tanpa PJK di Poli Endokrin Metabolik dan Poli Jantung BLU. RSU. Prof. dr. R. D Kandou  Manado. Metode Penelitian: Dilakukan penelitian deskriptif analitik lintang potong pada penderita diabetes melitus dengan dan tanpa penyakit jantung koroner di Poli Endokrin Metabolik dan Poli Jantung BLU.RSU. Prof. dr. R. D Kandou  Manado periode November 2012 – November 2013. Hasil: Dari 34 pasien Diabetes Melitus ditemukan jumlah pasien DM dengan PJK sebanyak 17 pasien dan 17 pasien untuk DM tanpa PJK, yang terdiri atas 14 orang pasien laki-laki dan 20 pasien wanita. Distribusi sampel berdasarkan PJK dan jenis kelamin, didapatkan hasil pasien DM dengan PJK yaitu sebanyak 9 orang laki-laki (26,47 %) dan 8  orang perempuan (23,53%). Sedangkan untuk pasien DM tanpa PJK yaitu sebanyak 5 orang pasien laki-laki (14,70%) dan 12 orang pasien perempuan (35,30%). Distribusi sampel penelitian berdasarkan PJK dan RAKU Kategori didapatkan hasil pasien DM dengan PJK sebanyak 7 pasien (20,59%) RAKU normal dan 10 pasien (29,41%) RAKU abnormal. Sedangkan untuk pasien DM tanpa PJK sebanyak 16 pasien (47,06%) RAKU normal dan 1 pasien (2,94%) RAKU abnormal. Simpulan: Albuminuria lebih banyak terjadi pada pasien diabetes melitus dengan penyakit jantung koroner dibandingkan diabetes melitus tanpa penyakit jantung koroner Kata kunci: Albuminuria, diabetes melitus, penyakit jantung koroner.

scholarly journals Efficacy of Lipid-Lowering Therapy During Cardiac Rehabilitation in Patients With Diabetes Mellitus and Coronary Heart Disease

2021 ◽  
Author(s):  
Thomas Wittlinger ◽  
Bernhard Schwaab ◽  
Heinz Voeller ◽  
Christa Bongarth ◽  
Viktoria Heinze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Cholesterol Levels ◽  
Patients With Diabetes

Abstract BackgroundCardiac rehabilitation (CR) in patients with coronary heart disease (CHD) aims to increase adherence to a healthy lifestyle and to secondary preventive medication. CR is able to improve quality of life and prognosis in CHD patients. This is particularly relevant for CHD patients with diabetes mellitus.DesignA prospective, multicenter registry study with patients from six rehabilitation centers in Germany.MethodsDuring CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry.ResultsIn 369 patients (33.9 %), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95 % CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95 % CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413).ConclusionWithin 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.

CURRENT ASPECTS OF CORONARY HEART DISEASE DIAGNOSIS AND TREATMENT

2020 ◽  
pp. 5-10
Author(s):  
O. M. Korzh
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Drug Therapy ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Disease Diagnosis ◽  
Percutaneous Coronary Angioplasty ◽  
Mortality And Morbidity ◽  
Intravascular Thrombosis

Among the cardiovascular diseases associated with atherosclerosis, chronic coronary heart disease, including angina, is the most common form. It is the myocardium lesion that develops as a result of an imbalance between the coronary circulation and metabolic needs of heart muscle. The presence of angina symptoms often indicates a pronounced narrowing of one or more coronary arteries, but also occurs in non−obstructive arterial impairment and even in normal coronary arteries. Factors of functional damage to the coronary arteries are spasm, temporary platelet aggregation and intravascular thrombosis. Today there are opportunities not only to use the therapy with proven effectiveness, aimed at reducing the risk of complications, including fatal, but also to treat angina (ischemia), which improves the patient's life quality. The drug protocol includes the ones with a proven positive effect on this disease prognosis, which are mandatory if there are no direct contraindications to use, as well as a large group of antianginal or anti−ischemic drugs. The choice of a particular drug or its combinations with other drugs is carried out in accordance with generally accepted recommendations: taking into account the individual approach, the severity of angina, hemodynamic parameters (heart rate and blood pressure, presence of comorbid conditions). If drug therapy is ineffective, the option of coronary myocardial revascularization (percutaneous coronary angioplasty or coronary artery bypass grafting) is considered. Due to the high mortality and morbidity rates of coronary heart disease worldwide, one of the priorities of practical health care is the prevention of diseases caused by atherosclerosis. Key words: coronary heart disease, angina, family physician, prognosis, drug therapy.

scholarly journals Multimodal Diagnostics of Microrheologic Alterations in Blood of Coronary Heart Disease and Diabetic Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 76
Author(s):  
Anastasia Maslianitsyna ◽  
Petr Ermolinskiy ◽  
Andrei Lugovtsov ◽  
Alexandra Pigurenko ◽  
Maria Sasonko ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Optical Methods ◽  
Diabetic Patients ◽  
Aggregation Index ◽  
Significant Difference

Coronary heart disease (CHD) has serious implications for human health and needs to be diagnosed as early as possible. In this article in vivo and in vitro optical methods are used to study blood properties related to the aggregation of red blood cells in patients with CHD and comorbidities such as type 2 diabetes mellitus (T2DM). The results show not only a significant difference of the aggregation in patients compared to healthy people, but also a correspondence between in vivo and in vitro parameters. Red blood cells aggregate in CHD patients faster and more numerously; in particular the aggregation index increases by 20 ± 7%. The presence of T2DM also significantly elevates aggregation in CHD patients. This work demonstrates multimodal diagnostics and monitoring of patients with socially significant pathologies.

scholarly journals BMI and Coronary Heart Disease Risk Among Low-Income and Underinsured Diabetic Patients

Diabetes Care ◽  
2014 ◽  
Vol 37 (12) ◽  
pp. 3204-3212 ◽  
Author(s):  
Nan Li ◽  
Peter T. Katzmarzyk ◽  
Ronald Horswell ◽  
Yonggang Zhang ◽  
Weiqin Li ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Low Income ◽  
Coronary Heart Disease Risk ◽  
Disease Risk ◽  
Diabetic Patients ◽  
Heart Disease Risk

Long-Term Clinical Outcomes of Infrapopliteal Drug-Eluting Stent Placement for Critical Limb Ischemia in Diabetic Patients

2015 ◽  
Vol 26 (10) ◽  
pp. 1423-1430 ◽  
Author(s):  
Stavros Spiliopoulos ◽  
Vasiliki Theodosiadou ◽  
Konstantinos Katsanos ◽  
Panagiotis Kitrou ◽  
George C. Kagadis ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Critical Limb Ischemia ◽  
Stent Placement ◽  
Limb Ischemia ◽  
Drug Eluting Stent ◽  
Diabetic Patients ◽  
Drug Eluting

scholarly journals Lack of association between peroxisome proliferator-activated receptor-gamma-2 gene variants and the occurrence of coronary heart disease in patients with diabetes mellitus

2002 ◽  
pp. 545-551 ◽  
Author(s):  
M Bluher ◽  
T Klemm ◽  
T Gerike ◽  
H Krankenberg ◽  
G Schuler ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Multiple Logistic Regression Analysis ◽  
Peroxisome Proliferator ◽  
Haemoglobin A1c ◽  
Peroxisome Proliferator Activated Receptor ◽  
Patients With Diabetes ◽  
Reduced Risk

OBJECTIVE: Recent evidence indicates that peroxisome proliferator-activated receptor-gamma (PPARgamma) is expressed at high levels in foam cells of atherosclerotic lesions, that PPARgamma agonists may directly modulate vessel wall function and that mutations in the PPARgamma-2 gene are associated with a reduced risk of coronary artery disease. METHODS: We investigated whether known variants in the PPARgamma-2 gene are associated with the occurrence of coronary heart disease (CHD) in 365 patients with type 2 diabetes, prospectively characterised for the presence or absence of CHD. The Pro115Gln, Pro12Ala, Pro467Leu, Val290Met mutations and two polymorphisms C478T and C161T of the PPARgamma-2 gene were examined using PCR, denaturing gradient gel electrophoresis and direct sequencing. RESULTS: The distribution of the Pro12Ala, Ala12Ala, C161T and T161T variants was not significantly different between patients with and without CHD, independent of the gender. The Pro12Ala (P=0.011) and the Ala12Ala (P=0.006) variant were associated with a higher body mass index (BMI) compared with the Pro12Pro genotype. A multiple logistic regression analysis introducing the typical risk factors for CHD (age, sex, hypertension, smoking, BMI >26 kg/m2, elevated low density lipoprotein cholesterol and haemoglobin A1c >7%) identified age >60, male gender, hypertension and a higher BMI, but not the PPARgamma-2 variants, as significant risk factors for CHD in our study groups. CONCLUSION: The PPARgamma-2 genotype was not associated with an increased or reduced risk of the occurrence of CHD and can therefore not be regarded as an independent risk factor for CHD in patients with diabetes mellitus.

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