scholarly journals RISK FACTORS OF MAJOR CARDIOVASCULAR EVENTS IN LONG-TERM PERIOD OF CORONARY BYPASS IN PATIENTS WITH ISCHEMIC HEART DISEASE AND 2ND TYPE DIABETES MELLITUS

Author(s):  
A. N. Sumin ◽  
N. A. Bezdenezhnykh ◽  
A. V. Bezdenezhnykh ◽  
S. V. Ivanov ◽  
O. L. Barbarash
2011 ◽  
Vol 1 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Abdullah M. Krawagh ◽  
Abdullah M. Alzahrani ◽  
Tariq A. Naser

This study addresses the prevalence of ischemic heart disease, hypertension and long-term complications of diabetes mellitus among patients attending the diabetic clinic and their relation to glycemic control. Methods: A study was conducted on a cross-section on all consecutive patients attending the diabetic clinic at King Khalid National Guard Hospital in Jeddah, Saudi Arabia, from January 2007 to January 2008. The degree of glycemic control was gauged using blood level of glycosylated hemoglobin (HbA1C) and classified into good (less 7%), fair (7.1-8%), poor (8.1-9%) and very poor (greater than 9%). All patients were screened for hypertension, ischemic heart disease and microvascular complications. Results: Two hundred and ten patients were recruited in the study. Glycemic control was good in 17 (8.1%), fair in 49 (23.2%), poor in 56 (26.6%) and very poor in 88 (41.9%). There was high prevalence of retinopathy (76; 36%), microalbuminuria (80; 37.9%), neuropathy (108; 51.2%) and ischemic heart disease (51; 24.2%), especially among patients with poor and very poor control. Although the presence of hypertension, frank nephropathy and peripheral vascular disease was also disturbingly high among diabetic patients, their frequency was the same among good, fair, poor and very poor glycemic control groups. Conclusion: The prevalence of long-term complications of diabetes mellitus was alarmingly high among Saudi nationals. Microvascular complications and ischemic heart disease were also noticed to be more common in diabetics with poor and very poor glycemic control. This emphasizes the need of national awareness program about the gravity of the problem.


2012 ◽  
Vol 15 (1) ◽  
pp. 19-24
Author(s):  
Natalya Ivanovna Volkova ◽  
Andrey Vladimirovich Kharakhashyan ◽  
Yulia Alekseevna Sorokina ◽  
Il'ya Yur'evich Davidenko

Aims. Development of assessment model for type 2 diabetes mellitus (DM) patient stratification for painless ischemic heart disease(IHD). Materials and methods. 258 patients with DM type 2 participated in this study (109 male and 149 female) of mean age 58.4?8.5 withDM experience of 7.9?6.1 years. All participants were subdivided into three groups: first - DM type 2 without history of painless IHD(138 individuals); second - DM type 2 with diagnosed painless IHD (50 individuals); third - DM type 2 with painful myocardialischemia. We assessed "classic" risk factors for IHD, immediately connected with DM comorbidity, as well as "additional" risk factors,potentially capable of provoking both painless and painful IHD. In addition, we screened our patients for structural abnormalitiesof heart by means of echocardiography. Painless IHD was diagnosed by treadmill-tests or Holter monitoring with submaximal exercise.Accumulated data was statistically processed with the use of Spearman's rank correlation, as well as binary logistic regression method.Results were deemed statistically significant at р


2014 ◽  
Vol 5 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Pijush Kanti Mandal ◽  
Arpan Kumar Day ◽  
Subhraprakash Pramanik ◽  
Shovan Kumar Das ◽  
Sumit Khotick ◽  
...  

Background: To study the prevalence and associated cardiovascular risk factors of ‘Resistant’ hypertension (RHT) in hypertensive patients of India.Methods: A descriptive cross-sectional observational study was carried out among 300 hypertensive patients attending ‘Hypertension Clinic’ and providing informed written consent from October 2013 to December 2013 at Burdwan Medical College and hospital, Burdwan, West Bengal in India. A pre-tested interviewer-administered questionnaire was used for data collection. Results: The prevalence of Resistant hypertension was 23.33% among all hypertensives. The patients with Resistant hypertension were significantly associated with older age groups (>55 years) (77.1% vs. 38.3%, p value <0.001, OR 5.446, 95% CI 2.935 and 10.104), Obesity (BMI > 27.5 kg/m2) (67.1% vs. 45.7%, p value 0.002, OR 2.433, 95% CI 1.387 and 4.268), Diabetes mellitus (72.9% vs. 45.2%, p value <0.001, OR 3.252, 95% CI 1.808 and 5.851), Prolonged hypertension (>10 years; 74.3% vs. 43.9%, p value <0.001, OR 3.690, 95% CI 2.033 and 6.696) and co-morbidity like Ischemic Heart Disease (60% vs. 44.8%, p value 0.026, OR 1.850, 95% CI 1.073 and 3.187) as risk factors as compared to patients with non-resistant hypertension. Conclusions: Nearly one fourth of the hypertensive persons were suffering from Resistant hypertension, which was significantly associated with the presence of older age, obesity, diabetes mellitus, longer duration of hypertension and co-morbidity like Ischemic Heart Disease as risk factors. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9737 Asian Journal of Medical Sciences 2014 Vol.5(4); 1-5


Author(s):  
Elena V. NEVZOROVA ◽  
Andrey K. ZASYADKO ◽  
Oksana N. ZAGUMENNOVA

Introduction. The relevance of the study of diabetes mellitus is due to social importance due to the high prevalence and progression of the disease in the form of late vascular complications, the first among which is vascular angiopathies. The results of studies on the dynamics of carbohydrate and lipid metabolism in the development of microvascular complications of 2 type diabetes mellitus remain quite contradictory. At the same time, the range of risk factors for the development of microvascular complications of 2 type diabetes mellitus and the strength of their effects vary greatly between studies and regions. Due to these circumstances, we are interested in studying the risk factors of developing microvascular complications of 2 type sugar diabetes as one of the main fatal complications of 2 type diabetes mellitus. Purpose and objectives. The most significant risk factors for developing microvascular complications of 2 type diabetes mellitus are determined using multi-factor regression analysis. Materials and methods. We used a multiple logistical regression model. Main results. As a result of multi-factor regression analysis, we determined the most significant risk factors for developing microvascular complications of 2 type diabetes mellitus: unsatisfactory compensation of carbohydrate and lipid metabolism, presence of arterial hypertension and dyslipidemia.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Paul B Tabereaux ◽  
Todd M Brown ◽  
Jose Osorio ◽  
G. N Kay ◽  
Dawn M Bravada

Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States; however a paucity of population-based data about nonwhite individuals exist. The objectives of this study were to compare hospitalizations among Whites and African Americans (AA) and to determine whether race is an independent predictor of hospitalization for AF in the United States. Methods: Data was obtained from the National Hospital Discharge Survey (years 1996 –2005) and included hospitalizations with a principal diagnosis of AF for patients aged ≥18 yrs and race designated as either White or AA. Codes from the International Classification of Diseases -9th revision were used to define AF (427.31), hypertension (401– 405), ischemic heart disease (410 – 414), diabetes mellitus (250), heart failure (425,428) and valvular heart disease (424). Multivariable analysis with logistic regression was used to identify factors that were independently associated with AF hospitalizations Results: Among 297,962,043 hospitalizations between 1996 –2005, 3,676,787 (1.2%) had a principal diagnosis of AF. Among the hospitalizations for AF, white race was more common than AA race (2,393,659/186,904,962 of whites (1.3% of white’s hospitalized) and 209,788/33,972,665 of African Americans (0.6% of AA’s hospitalized), p<0.0001). After adjusting for the most common risk factors for AF (age, sex, hypertension, ischemic heart disease, diabetes mellitus, heart failure and valvular heart disease) AA race was independently associated with a decreased odds of hospitalizations for AF (Table 1 : adjusted OR=0.49, 95%CI 0.46 – 0.51). Conclusions: After adjusting for the most common risk factors for AF, the odds of hospitalization for AF in AA’s remained half that of whites. Race may be a novel and unaccounted risk factor for atrial fibrillation.


2011 ◽  
Vol 1 (1) ◽  
pp. 29-33
Author(s):  
Abdullah M. Krawagh ◽  
Abdullah M. Alzahrani ◽  
Tariq A. Naser

This study addresses the prevalence of ischemic heart disease, hypertension and long-term complications of diabetes mellitus among patients attending the diabetic clinic and their relation to glycemic control. Methods: A study was conducted on a cross-section on all consecutive patients attending the diabetic clinic at King Khalid National Guard Hospital in Jeddah, Saudi Arabia, from January 2007 to January 2008. The degree of glycemic control was gauged using blood level of glycosylated hemoglobin (HbA1C) and classified into good (less 7%), fair (7.1-8%), poor (8.1-9%) and very poor (greater than 9%). All patients were screened for hypertension, ischemic heart disease and microvascular complications. Results: Two hundred and ten patients were recruited in the study. Glycemic control was good in 17 (8.1%), fair in 49 (23.2%), poor in 56 (26.6%) and very poor in 88 (41.9%). There was high prevalence of retinopathy (76; 36%), microalbuminuria (80; 37.9%), neuropathy (108; 51.2%) and ischemic heart disease (51; 24.2%), especially among patients with poor and very poor control. Although the presence of hypertension, frank nephropathy and peripheral vascular disease was also disturbingly high among diabetic patients, their frequency was the same among good, fair, poor and very poor glycemic control groups. Conclusion: The prevalence of long-term complications of diabetes mellitus was alarmingly high among Saudi nationals. Microvascular complications and ischemic heart disease were also noticed to be more common in diabetics with poor and very poor glycemic control. This emphasizes the need of national awareness program about the gravity of the problem.


2012 ◽  
Vol 67 (1) ◽  
pp. 14-19 ◽  
Author(s):  
R. S. Akchurin ◽  
E. E. Vlasova ◽  
K. V. Mershin

Nearly 40-year experience of surgical treatment of coronary heart disease testifies to higher coronary heart disease (CHD) morbidity and mortality rates among diabetes mellitus patients in comparison to non-diabetic patients. At the same time, comparative study of CHD treatment methods efficacy in diabetes mellitus patients has shown that surgery is preferred to angioplasty, especially in the most severe cases – in presence of coronary occlusion, insulin-dependent diabetes and left-ventricle dysfunction. More inferior results of coronary bypass surgery in diabetic patients in comaparison to non-diabetic were conditional on a more pronounced arterial calcinosis and diffuse distal arterial involvement, as well as more severe aortal ateromatosis, flebopathy and more often wound infection occurrence. In the department of cardio-vascular surgery in Russian cardiologic scientific productive complex a quarter of all patients waiting for the coronary bypass surgery are diabetic. Selection algorithm, preoperation preparation, peculiarities of surgical technique and principles of postoperative supervision of these patients were specially designed. With adequate preparation, remission of diabetes and use of microsurgery, postoperative prognosis for these patients (both stratified and real) is comparative to that for the main group of patients. One-year follow up after the bypass surgery data testifies to the low difference in autovenous and autoarterial shunt patency in diabetic and non-diabetic patients. Long-term (10 years) survival rate is significantly lower in the group of diabetic patients. Proposed cardioprotective postoperative strategy is designed to improve both short and long-term efficacy of surgical revascularization in CHD patients with concomitant diabetes mellitus.


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