scholarly journals Study of effect of diabetes mellitus on classical risk factors for coronary artery disease

Author(s):  
Suchitra Garhwal ◽  
Anil Kumar Poonia ◽  
Veeha Agarwal

Background: Diabetes mellitus (DM) is increasingly prevalent in general population and is associated with increased risk for coronary artery disease (CAD). DM both directly and indirectly increases risk of CAD. Quantum of DM associated increase in classical risk factor for CAD is not exactly described. In present study, association of traditional risk for CAD and DM was analyzed.Methods: Total 150 patients with CAD were enrolled and divided into two group: group 1 with DM (84 patients) and group 2 without DM (66 patients). These two were compared and analyzed for classical risk factors for DM.Results: CAD with DM group had higher prevalence for traditional risk for CAD than CAD alone group: for Hypertension relative prevalence was 67.8 and 36.3% respectively (p<0.05); for Obesity it was 79.7 and 40.9% respectively (p<0.05) and for Dyslipidemia relative prevalence was 75 and 37.8% respectively (p<0.05).Conclusions: DM is major risk for CAD and it is also associated with increased prevalence for hypertension, obesity and dyslipidemia in affected population.

2020 ◽  
Author(s):  
Man Li ◽  
Lei Duan ◽  
Yulun Cai ◽  
Benchuan Hao ◽  
Jianqiao Chen ◽  
...  

Abstract Background: Suppression of tumorigenesis-2 (ST2) is implicated in myocardial overload and has long been recognized as an inflammation marker related to heart failure and acute coronary syndromes, but data on the prognostic value of ST2 in patients with coronary artery disease (CAD) remain limited. This study sought to investigate the prognostic value of ST2 in patients with established coronary artery disease and its predictive value in CAD patients with or without type 2 diabetes mellitus (T2DM).Methods: A total of 3641 consecutive patients were included in this prospective cohort study. The primary end point was major adverse cardiovascular events (MACEs). The secondary end point was all-cause death. The association between ST2 and outcomes was investigated using multivariable Cox regression.Results: During a median follow-up of 6.4 years, 775 patients had the occurrence of MACEs and 275 patients died. Kaplan-Meier survival estimates indicated that the patients with higher levels of ST2 (ST2> 19 ng/ml) had a significantly increased risk of MACEs (log-rank p<0.001) and all-cause death (log-rank p<0.001). Multiple Cox regression models showed that higher level of ST2 was an independent predictor for MACEs developments (HR=1.36, 95% CI 1.17-1.56, p<0.001) and all-cause death (HR=2.01, 95% CI 1.56-2.59, p<0.001). The addition of ST2 to established risk factors significantly improved risk prediction of the composite outcome of MACEs and all-cause death (C-statistic, net reclassification index, and integrated discrimination improvement, all p<0.05). Subgroup analyses showed that ST2 remained a significant predictor of MACEs and all-cause death in patients with and without T2DM in multivariable models.Conclusions: A higher level of ST2 is significantly associated with long-term MACEs and all-cause death in CAD patients with and without T2DM. ST2 may provide incremental prognostic value beyond traditional risk factors.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 442-P
Author(s):  
KAZUYA FUJIHARA ◽  
YASUHIRO MATSUBAYASHI ◽  
MASARU KITAZAWA ◽  
MASAHIKO YAMAMOTO ◽  
TAEKO OSAWA ◽  
...  

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 605
Author(s):  
Hanna K. Al-Makhamreh ◽  
Mohammed Q. Al-Sabbagh ◽  
Ala’ E. Shaban ◽  
Abdelrahman F. Obiedat ◽  
Ayman J. Hammoudeh

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.


2017 ◽  
Vol 11 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Andrea De Lorenzo ◽  
Victor F. Souza ◽  
Leticia Glerian ◽  
Ronaldo SL Lima

Background:Even though diabetes mellitus (DM) has been considered a “Coronary Artery Disease (CAD) equivalent”, that is still controversial, especially in a contemporary population subject to optimized treatment.Objective:We aimed to assess the cardiovascular risk of diabetics by myocardial perfusion scintigraphy (MPS).Methods:Consecutive patients who underwent MPS from 2008 to 2012 were studied. Perfusion scores were calculated, and abnormal MPS was defined as a summed stress score >3. Patients were followed for 3±1 years for all-cause death, which was compared between patients with DM (without known CAD) and patients with known CAD but without DM.Results:Among 3409 patients, 471 (13.8%) were diabetics without known CAD (DM group) and 638 (18.7%) had CAD without diabetes (CAD group). Annualized death rates were not significantly different between DM or CAD patients (0.9vs1.5%, p=0.09). With normal MPS, death rates were 0.7% for DM and 0.6% for CAD (p=0.8). With abnormal MPS, death rates increased similarly in the DM and CAD groups.Conclusions:In diabetic patients without known CAD, the rate of death was not significantly different from patients with prior CAD and without DM. Abnormal MPS increased risk similarly in diabetic patients and in those with CAD. These findings suggest that DM may still be considered a high-risk condition, comparable to known CAD, and effectively stratified by MPS.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mitsuyoshi Takahara ◽  
◽  
Osamu Iida ◽  
Shun Kohsaka ◽  
Yoshimitsu Soga ◽  
...  

Abstract Background Lower-extremity peripheral artery disease (LE-PAD) and coronary artery disease (CAD) are both pathologically rooted in atherosclerosis, and their shared clinical features regarding the exposure to cardiovascular risk factors have been emphasized. However, comparative data of the two cardiovascular diseases (CVDs) were so far lacking. The purpose of this study was to directly compare the clinical profile between cases undergoing endovascular therapy (EVT) for LE-PAD and those undergoing percutaneous coronary intervention (PCI). Methods Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. A total of 1,121,359 cases (103,887 EVT cases for critical limb ischemia [CLI] or intermittent claudication and 1,017,472 PCI cases for acute coronary syndrome [ACS] or stable angina) were analyzed. Heterogeneity in clinical profile between CVDs was evaluated using the C statistic of the logistic regression model for which dependent variable was one CVD versus another, and explanatory variables were clinical profile. When two CVDs were completely discriminated from each other by the developed model, the C statistic (discrimination ability) of the model would be equal to 1, indicating that the two CVDs were completely different in clinical profile. On the other hand, when two CVDs were identical in clinical profile, the developed model would not discriminate them at all, with the C statistic equal to 0.5. Results Mean age was 73.5 ± 9.3 years in LE-PAD patients versus 70.0 ± 11.2 years in CAD patients (P < 0.001). The prevalence of diabetes mellitus and end-stage renal disease was 1.96- and 6.39-times higher in LE-PAD patients than in CAD patients (both P < 0.001). The higher prevalence was observed irrespective of age group. The exposure to other cardiovascular risk factors and the likelihood of cardiovascular risk clustering also varied between the diseases. The between-disease heterogeneity in patient profile was particularly evident between CLI and ACS, with the C statistic equal to 0.833 (95% CI 0.831–0.836). Conclusions The current study, an analysis based on nationwide procedural databases, confirmed that patient profiles were not identical but rather considerably different between clinically significant LE-PAD and CAD warranting revascularization.


Author(s):  
Mundher Jabbar Al-okhedi ◽  
Mohammed Qais Al-ani ◽  
Marrib N Rasheed

Objective: The objective of this study was to investigate the association between proinflammatory cytokines in special, the interleukin-6 (IL-6), and insulin-like growth factor (IGF-1) levels in coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM).Methods: This study was conducted from November 2017 to March 2018 in Anbar, Iraq. We studied a total of 90 individuals (46 men and 44 women) aged between 20 and 87 years. The samples were divided into four groups: CAD patients (n=23), T2DM patients (n=23), coronary artery disease and type 2 diabetes together in the same patient (n=23), and control group (n=21). The concentrations of IL-6 and IGF-1 were determined using a commercially available enzyme-linked immune sorbent assay.Results: The results of the present study showed that there were elevated serum levels of IL-6 and low levels of IGF-1 in all the tested groups, compared with the control. The difference was statistically significant at p<0.05. The results showed a positively correlated between IL-6 and IGF-1 in the CAD group and T2DM group, while it was a negative correlation between serum levels of IL-6 and IGF-1 in the T2DM+CAD group.Conclusion: Elevated levels serum of IL-6 predicts the development of CAD and T2DM. These data support a possible role for inflammation in diabetogenesis and complication of the cardiovascular disease. There is an inverse relationship between the levels serum of IGF-1 and increased risk of CAD and development of T2DM.


2010 ◽  
Vol 69 (3) ◽  
pp. 278-284
Author(s):  
Vadim A. Kuznetsov ◽  
Elena I. Yaroslavskaya ◽  
Marina I. Bessonova ◽  
Ivan S. Bessonov ◽  
Igor P. Zyrianov ◽  
...  

2014 ◽  
Vol 37 (3) ◽  
pp. E3
Author(s):  
Richard Dalyai ◽  
Robert M. Starke ◽  
Nohra Chalouhi ◽  
Thana Theofanis ◽  
Christopher Busack ◽  
...  

Object Cigarette smoking has been well established as a risk factor in vascular pathology, such as cerebral aneurysms. However, tobacco’s implications for patients with cerebral arteriovenous malformations (AVMs) are controversial. The object of this study was to identify predictors of AVM obliteration and risk factors for complications. Methods The authors conducted a retrospective analysis of a prospectively maintained database for all patients with AVMs treated using surgical excision, staged endovascular embolization (with N-butyl-cyanoacrylate or Onyx), stereotactic radiosurgery (Gamma Knife or Linear Accelerator), or a combination thereof between 1994 and 2010. Medical risk factors, such as smoking, abuse of alcohol or intravenous recreational drugs, hypercholesterolemia, diabetes mellitus, hypertension, and coronary artery disease, were documented. A multivariate logistic regression analysis was conducted to detect predictors of periprocedural complications, obliteration, and posttreatment hemorrhage. Results Of 774 patients treated at a single tertiary care cerebrovascular center, 35% initially presented with symptomatic hemorrhage and 57.6% achieved complete obliteration according to digital subtraction angiography (DSA) or MRI. In a multivariate analysis a negative smoking history (OR 1.9, p = 0.006) was a strong independent predictor of AVM obliteration. Of the patients with obliterated AVMs, 31.9% were smokers, whereas 45% were not (p = 0.05). Multivariate analysis of obliteration, after controlling for AVM size and location (eloquent vs noneloquent tissue), revealed that nonsmokers were more likely (0.082) to have obliterated AVMs through radiosurgery. Smoking was not predictive of treatment complications or posttreatment hemorrhage. Abuse of alcohol or intravenous recreational drugs, hypercholesterolemia, diabetes mellitus, and coronary artery disease had no discernible effect on AVM obliteration, periprocedural complications, or posttreatment hemorrhage. Conclusions Cerebral AVM patients with a history of smoking are significantly less likely than those without a smoking history to have complete AVM obliteration on follow-up DSA or MRI. Therefore, patients with AVMs should be strongly advised to quit smoking.


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