scholarly journals Glycated Hemoglobin and short-term Prognosis in Patients with Acute Coronary Syndrome with Diabetes Mellitus: A Prospective Cohort Study

2021 ◽  
Vol 17 (2) ◽  
pp. 108-113
Author(s):  
Fysal Faruq ◽  
Syed Ali Ahsan ◽  
Manzoor Mahmood ◽  
MRM Mandal ◽  
Kamruzzaman Siddiki ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Glycaemic Control ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Coronary Syndrome ◽  
Good Glycaemic Control

Background: Data on the association between glycemic control after percutaneous coronary intervention (PCI) and clinical outcomes are limited and controversial in diabetic patients. Objective:The aim of the study was to assess the impact of good glycaemic control on three months clinical outcomes in diabetic acute coronary syndrome (ACS) patients undergoing PCI, from a Bangladesh health service perspective. Materials and methods:This prospective cohort study which was conducted in UCC, BSMMU included 346 consecutive diabetic ACS patients who underwent PCI at department of cardiology, BSMMU. Diabetic patients were categorized into two groups based on their 3 months HbA1c levels: 169 (48.84%) diabetics with good glycaemic control (HbA1c < 7%) and 177 (51.16%) diabetics with poor glycaemic control (HbA1c ≥7%).The outcome was major adverse cardiovascular events (MACEs), defined as cardiac death, myocardial infarction (MI), definite stent thrombosis, target vessel revascularization and stroke. Results: At 3 months follow up, patients with poor glycaemic control had a significantly higher incidence of MI (6.2% vs 1.2%; p=0.021). No other adverse events were found significantly different between the groups at 3 months of PCI. Conclusion:Good glycaemic control to obtain HbA1c level <7% in diabetic ACS patients undergoing coronary artery stenting may be beneficial in reducing the risk of MACEs and improvement of clinical outcome after PCI during 3 months follow up. University Heart Journal Vol. 17, No. 2, Jul 2021; 108-113

scholarly journals Sex Differences in the Risk of Developing Acute Coronary Syndrome in Patients With Sleep Disorders: A Population-Based Cohort Study

2016 ◽  
Vol 11 (5) ◽  
pp. 1560-1568
Author(s):  
Wei-Sheng Chung ◽  
Hsuan-Hung Lin
Keyword(s):  
Acute Coronary Syndrome ◽  
Sex Differences ◽  
Cohort Study ◽  
Sleep Disorders ◽  
Population Based ◽  
Coronary Syndrome ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Middle Aged Adults

Studies that focus on the relationship between sex and the risk of acute coronary syndrome (ACS) are scant. The current study investigated the effects of sex differences in the risk of developing ACS in patients with sleep disorders (SDs). This longitudinal population-based cohort study evaluated the incidence and risk of ACS development in 40,232 men and 65,519 women newly diagnosed with SDs between 2002 and 2008 from the Longitudinal Health Insurance Database. The follow-up period began from the entry date and ended on the date of an ACS event or December 31, 2010. Univariable and multivariable Cox proportional hazard regression models were conducted to estimate the sex differences in the risk of ACS. Men with SDs exhibited an increased incidence of ACS compared with women with SDs in all age- and comorbidity-specific subgroups. After covariates were adjusted, the men with SDs exhibited a 1.48-fold adjusted hazard ratio (aHR) of ACS compared with the women with SDs (95% confidence interval [CI] = 1.36-1.60). After age group stratification, the men with SDs in the young adult group exhibited the highest risk of subsequent ACS development compared with the women with SDs (aHR = 2.07, 95% CI = 1.69-2.55), followed by those in middle-aged adults (aHR = 1.52, 95% CI = 1.32-1.76) and older adults groups (aHR = 1.24, 95% CI = 1.11-1.39). This study determined that men with SDs, particularly young men, are at a higher risk of subsequent ACS development compared with women with SDs.

scholarly journals Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study

QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 657-665 ◽  
Author(s):  
X Wang ◽  
H Xu ◽  
H Jiang ◽  
L Wang ◽  
C Lu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Close Contact ◽  
Post Discharge ◽  
Global Pandemic ◽  
Discharged Patients ◽  
Suspected Recurrence

Summary Background Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described. Aim To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge. Design A prospective cohort study. Methods Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks. Results Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks post-discharge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study. Conclusion The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.

scholarly journals Short-term effectiveness of precise safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral lumbar spinal canal stenosis: a prospective cohort study

2020 ◽  
Author(s):  
Yu Wang ◽  
Mingyan Deng ◽  
Hao Wu ◽  
Ye Wu ◽  
Chuan Guo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Spinal Canal ◽  
Leg Pain ◽  
Short Term ◽  
Postoperative Mri ◽  
The Mean ◽  
Lumbar Spinal

Abstract Purpose This prospective cohort study reports on a new technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes.Methods The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, three months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability.Results All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at three months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit(p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit(p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up.Conclusion DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2.Trial registration Chinese Clinical Trial Registry (ChiCTR1800019551). Registered 18 November 2018.

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