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DM and CAD

Kazuaki Negishi
We are now entering the very exciting era of treatment and management of diabetes mellitus (DM) with the emergence of new therapeutic agents, including sodium-glucose cotransporter 2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitor (DPP-4i). From a cardiology and echocardiography perspective, the existence of diabetic cardiomyopathy has been proven through over four decades of discussion. DM is highly prevalent in patients with heart failure (HF). Independent associations are found after adjusting for hypertension (HTN) and coronary artery disease (CAD)...
February 2018: Cardiovascular Diagnosis and Therapy
Andrea Igoren Guaricci, Delia De Santis, Mariangela Carbone, Giuseppe Muscogiuri, Marco Guglielmo, Andrea Baggiano, Gaetano Serviddio, Gianluca Pontone
The prognostic impact of diabetes mellitus (DM) on cardiovascular outcomes is well known. As a consequence of previous studies showing the high incidence of coronary artery disease (CAD) in diabetic patients and the relatively poor outcome compared to nondiabetic populations, DM is considered as CAD equivalent which means that diabetic patients are labeled as asymptomatic individuals at high cardiovascular risk. Lessons learned from the analysis of prognostic studies over the past decade have challenged this dogma and now support the idea that diabetic population is not uniformly distributed in the highest risk box...
2018: BioMed Research International
Anand Jeevarethinam, Shreenidhi Venuraju, Alain Dumo, Sherezade Ruano, Miranda Rosenthal, Devaki Nair, Mark Cohen, Daniel Darko, Avijit Lahiri, Roby Rakhit
Carotid intima-media thickness (CIMT) measurement and carotid plaque detection by B-mode ultrasound are frequently used as surrogates to predict coronary artery disease (CAD). However, their systematic use in routine clinical management of asymptomatic patients with diabetes mellitus (DM) has not been studied. The aim of the study was to identify carotid parameters that predict cardiovascular events in patients with asymptomatic type 2 DM by evaluating the relation between carotid disease and CAD. This multicenter, observational, prospective study included 259 asymptomatic patients with type 2 DM followed-up for 34 months after measurement of CIMT and carotid plaque with carotid ultrasound, and CAD assessment with computed tomography coronary angiography...
February 27, 2018: American Journal of Cardiology
Jeevan Nagendran, Sabin J Bozso, Colleen M Norris, Finlay A McAlister, Jehangir J Appoo, Michael C Moon, Darren H Freed, Jayan Nagendran
BACKGROUND: The role of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) has been established by large trials; however, these trials largely excluded patients with left ventricular dysfunction (LVD). OBJECTIVES: The aim of this study was to determine whether treatment with PCI or CABG leads to improved outcomes in patients with DM, CAD, and LVD...
February 27, 2018: Journal of the American College of Cardiology
Sheeren Khaled, Rajaa Matahen
BACKGROUND: Acute coronary syndrome (ACS) remains a leading cause of death in the United States. Numerous studies have shown that the degree of LV systolic dysfunction is a major if not the most important determinant of long-term outcome in ACS. OBJECTIVES: To identify the most important risk factors and other clinical predictors which might have impact on left ventricular ejection fraction in patients with ACS. RESULTS: The total patients (299) admitted to our center from July, 2015 till December, 2015; with established diagnosis of ACS were classified in to two groups: Group I: 193 patients with impaired LVEF <40% (64...
January 2018: Indian Heart Journal
Hiroyuki Yamamoto, Naofumi Yoshida, Toshiro Shinke, Hiromasa Otake, Masaru Kuroda, Kazuhiko Sakaguchi, Yushi Hirota, Takayoshi Toba, Hachidai Takahashi, Daisuke Terashita, Kenzo Uzu, Natsuko Tahara, Yuto Shinkura, Kouji Kuroda, Yoshinori Nagasawa, Yuichiro Nagano, Yoshiro Tsukiyama, Ken-Ichi Yanaka, Takuo Emoto, Naoto Sasaki, Tomoya Yamashita, Wataru Ogawa, Ken-Ichi Hirata
BACKGROUND AND AIMS: This study examined the impact of CD14++CD16+ monocytes on coronary plaque vulnerability, as assessed by optical coherence tomography (OCT), and investigated their association with daily glucose fluctuation. Although increased CD14++CD16+ monocyte levels have been reported to increase cardiovascular events, their impact on coronary plaque vulnerability in coronary artery disease (CAD) patients with or without diabetes mellitus (DM) remains unclear. METHODS: This prospective observational study included 50 consecutive patients with CAD, receiving lipid-lowering therapy and undergoing coronary angiography and OCT...
January 17, 2018: Atherosclerosis
Koroush Khalighi, Gang Cheng, Seyedabbas Mirabbasi, Bahar Khalighi, Yin Wu, Wuqiang Fan
BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms have been found to be related with many diseases. Systemic inflammation is now considered as a major predisposition factor for diseases including diabetes mellitus (DM), coronary arterial disease (CAD), stroke, and cancer. This study aimed to investigate whether systemic inflammation is a possible underlying pathogenesis for MTHFR gene polymorphism-related disease. METHODS: A total of 292 patients were enrolled, and single nucleotide polymorphisms for MTHFR C667T and A1298C were genotyped...
February 3, 2018: Journal of Clinical Laboratory Analysis
Qiu-Ting Dong, Ying Gao, Na-Qiong Wu, Yuan-Lin Guo, Cheng-Gang Zhu, Sha Li, Hui-Hui Liu, Ye-Xuan Cao, Hui-Wen Zhang, Xi Zhao, Geng Liu, Qian Dong, Jian-Jun Li
BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) is widely estimated by Friedewald equation (FE) and Enzymatic test (ET), which are affected by several factors. The aim of this study was to observe the impact of diabetic lipid and glucose patterns on the correlation between FE LDL-C (F-LDL) and ET LDL-C (E-LDL) in patients with coronary artery disease (CAD). METHODS AND RESULTS: A total of 8155 CAD patients were consecutively enrolled and their lipid profiles were measured...
January 30, 2018: Journal of Clinical Laboratory Analysis
Debjani S Goswami, Tanuja P Manohar
Introduction: Cardiovascular diseases are becoming the major cause of morbidity and mortality in most of the developing countries including India. Cardiometabolic risk factors play a vital role in causation of coronary artery disease. Present study was carried out to investigate the role of various risk factors in the occurrence of coronary artery disease (CAD) in population from Central India. Settings and Design: This was a hospital-based age and sex matched case-control study, carried out at Lata Mangeshkar Hospital, Nagpur...
October 2017: Journal of the Association of Physicians of India
Alessia Gimelli, Riccardo Liga, Alberto Clemente, Emilio Maria Pasanisi, Brunella Favilli, Paolo Marzullo
Aims: To evaluate the impact of diabetes mellitus (DM) on the accuracy of myocardial perfusion scintigraphy (MPS) in detecting coronary artery disease (CAD). Methods and results: Two hundred and sixteen patients with DM and 432 matched controls were submitted to MPS on a dedicated cardiac camera equipped with cadmium-zinc-telluride (CZT) detectors and coronary angiography. Exercise stress was performed in 442 (68%) patients, while the remainders underwent vasodilator stress...
December 11, 2017: European Heart Journal Cardiovascular Imaging
Karina Wierzbowska-Drabik, Ewa Trzos, Malgorzata Kurpesa, Tomasz Rechcinski, Dawid Miskowiec, Urszula Cieslik-Guerra, Barbara Uznanska-Loch, Maria Sobczak, Jaroslaw Damian Kasprzak
Aims: Diabetes (DM) is a strong cardiovascular risk factor modifying also the left ventricular (LV) function that may be objectively assessed with echocardiographic strain analysis. Although the impact of isolated DM on myocardial deformation has been already studied, few data concern diabetics with coronary artery disease (CAD), especially in all stages of dobutamine stress echocardiography (DSE). We compared LV systolic function during DSE in CAD with and without DM using state-of-the art speckle-tracking quantification and assessed the impact of DM on LV systolic strain...
December 9, 2017: European Heart Journal Cardiovascular Imaging
Xue Bai, Xi-Pei Wang, Guo-Dong He, Bin Zhang, Min Huang, Jia-Li Li, Shi-Long Zhong
Objective A rapid and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay was developed and validated for the simultaneous quantification of rosuvastatin (RST), rosuvastatin-5 S-lactone (RSTL), and N-desmethyl rosuvastatin (DM-RST) in human plasma. Methods Sample was prepared by liquid-liquid extraction with ethyl acetate from 100 μL acidulated buffered plasma. Then analytes were chromatographically separated using an Acquity UPLC HSS T3 column (3.0 mm×100 mm, 1...
December 12, 2017: Drug Research
Pugazhendhi Vijayaraman, Faiz A Subzposh, Angela Naperkowski
Aims: Atrioventricular node ablation (AVNA) and right ventricular pacing (RVP) are effective therapies for patients with atrial fibrillation (AF) and rapid ventricular rates. His bundle pacing (HBP) is a physiologic alternative to RVP. The aim of our study is to assess the feasibility and safety of HBP in patients undergoing AVNA and its effect on left ventricular (LV) function. Methods and results: Permanent HBP is the preferred form of ventricular pacing at our institute...
December 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Donna Chelle V Morales, Sanjeev P Bhavnani, Alan W Ahlberg, Raja C Pullatt, Deborah M Katten, Donna M Polk, Gary V Heller
BACKGROUND: Several publications and guidelines designate diabetes mellitus (DM) as a coronary artery disease (CAD) risk equivalent. The aim of this investigation was to examine DM cardiac risk equivalence from the perspective of stress SPECT myocardial perfusion imaging (MPI). METHODS AND RESULTS: We examined cardiovascular outcomes (cardiac death or nonfatal MI) of 17,499 patients referred for stress SPECT-MPI. Patients were stratified into four categories: non-DM without CAD, non-DM with CAD, DM without CAD, and DM with CAD, and normal or abnormal perfusion...
December 6, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Karam Sadoon Alzuhairi, Peter Søgaard, Jan Ravkilde, Aziza Azimi, Michael Mæng, Lisette Okkels Jensen, Christian Torp-Pedersen
BACKGROUND: Patients with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) are often managed differently than those with obstructive CAD, therefore we aimed in this study to examine the long-term prognosis of patients with NSTEMI according to the degree of CAD on coronary angiography (CAG). METHODS: We examined 8.889 consecutive patients admitted for first time NSTEMI during 2000-2011, to whom CAG was performed...
November 16, 2017: BMC Cardiovascular Disorders
Muhammad Adam, Eddie Y K Ng, Jen Hong Tan, Marabelle L Heng, Jasper W K Tong, U Rajendra Acharya
Diabetes mellitus (DM) is a chronic metabolic disorder that requires regular medical care to prevent severe complications. The elevated blood glucose level affects the eyes, blood vessels, nerves, heart, and kidneys after the onset. The affected blood vessels (usually due to atherosclerosis) may lead to insufficient blood circulation particularly in the lower extremities and nerve damage (neuropathy), which can result in serious foot complications. Hence, an early detection and treatment can prevent foot complications such as ulcerations and amputations...
December 1, 2017: Computers in Biology and Medicine
Gaurav Agarwal, Satish Kumar Singh
Chronic hyperglycaemia of Type 2 Diabetes Mellitus (T2DM) causes long term damage to heart resulting in coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), and sudden death from arrhythmias. A 62 year old male presented to our emergency with complaint of sudden onset giddiness from last 2 hours. This was followed by loss of consciousness. Patient was a known case of T2DM since last 1 year. Family history- patient has two brothers who also have T2DM and both of them also developed Complete Heart Block (CHB) spontaneously...
September 2017: Indian Journal of Endocrinology and Metabolism
Masoumeh Lotfi-Tokaldany, Seyed Hesameddinn Abbasi, Abbasali Karimi, Seyed Ebrahim Kassaian, Tahereh Davarpasand, Arash Jalali, Saeed Sadeghian
AIMS: We investigated the association between Type-2 diabetes mellitus (DM) and the need for revascularization at a 5-year follow-up of young coronary artery disease patients and the role of sex in this regard. METHODS: Among 1121 young (males≤45, and females≤55years) patients (female: 49.7%) from Tehran Heart Center's Premature Coronary Atherosclerosis Cohort, 371(33.1%) had diabetes prior to angiography. Revascularization was considered as either percutaneous coronary intervention or coronary artery bypass graft surgery...
December 2017: Journal of Diabetes and its Complications
Martin Caprnda, Dasa Mesarosova, Pablo Fabuel Ortega, Boris Krahulec, Emmanuel Egom, Luis Rodrigo, Peter Kruzliak, Ioana Mozos, Ludovit Gaspar
BACKGROUND: Presence of macro- and microvascular complications in patients with diabetes mellitus (DM) is not only related to chronic hyperglycemia represented by glycated hemoglobin (HbA1c) but also to acute glycemic fluctuations (glycemic variability, GV). The association between GV and DM complications is not completely clear. Aim of our study was to evaluate GV by MAGE index in patients with type 2 DM and to verify association of MAGE index with presence of macro- and microvascular DM complications...
September 1, 2017: Folia Medica
Shigemasa Tani, Tsukasa Yagi, Wataru Atsumi, Kenji Kawauchi, Rei Matsuo, Atsushi Hirayama
BACKGROUND: The low-density lipoprotein cholesterol/apolipoprotein B (LDL-C/apoB) ratio has conventionally been used as an index of the LDL-particle size. Smaller LDL-particle size is associated with triglyceride (TG) metabolism disorders, often leading to atherogenesis. We investigated the association between the LDL-C/apoB ratio and TG metabolism in coronary artery disease (CAD) patients with diabetes mellitus (DM). METHODS: In the cross-sectional study, the LDL-C/apoB ratio, which provides an estimate of the LDL-particle size, was calculated in 684 consecutive patients with one additional risk factor...
October 2, 2017: Cardiovascular Diabetology
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