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screening for cad in diabetes

Andrea Igoren Guaricci, Gianluca Pontone, Laura Fusini, Maria De Luca, Francesco Pio Cafarelli, Marco Guglielmo, Andrea Baggiano, Virginia Beltrama, Giuseppe Muscogiuri, Saima Mushtaq, Edoardo Conte, Giuseppe Guglielmi, Daniele Andreini, Natale Daniele Brunetti, Matteo Di Biase, Antonio L Bartorelli, Mauro Pepi
AIMS: To evaluate the relationship between an incremental model including cardiovascular risk factors, carotid disease, and inflammatory biomarkers to predict the presence of obstructive coronary artery disease (CAD). METHODS AND RESULTS: A total of 134 consecutive and asymptomatic intermediate-risk patients (mean age 61 ± 9 years, 52% men) were enrolled. Each subject underwent circulating levels assessment of interleukin (IL)-2r, IL-6, IL-8, IL-10, high-sensitivity C-reactive protein (hs-CRP) and carotid and coronary artery evaluation using carotid ultrasound and coronary computed tomography angiography (CCTA), respectively...
October 14, 2016: European Heart Journal Cardiovascular Imaging
Ngai-Yin Chan, Chi-Chung Choy
OBJECTIVE: The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. METHODS: In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. RESULTS: 56 (0...
October 12, 2016: Heart: Official Journal of the British Cardiac Society
Ruth E Bates, Mohamed Omer, Sahar S Abdelmoneim, Adelaide M Arruda-Olson, Christopher G Scott, Kent R Bailey, Robert B McCully, Patricia A Pellikka
OBJECTIVE: To evaluate the impact of screening stress testing for coronary artery disease in asymptomatic patients with diabetes in a community-based population. PATIENTS AND METHODS: This observational study included 3146 patients from Olmsted County, Minnesota, with no history of coronary artery disease or cardiac symptoms in whom diabetes was newly diagnosed from January 1, 1992, through December 31, 2008. With combined all-cause mortality and myocardial infarction as the primary outcome, weighted Cox proportional hazards regression was performed with screening stress testing within 2 years of diabetes diagnosis as the time-dependent covariate...
October 6, 2016: Mayo Clinic Proceedings
Joseph Brent Muhlestein, Fidela Ll Moreno
PURPOSE OF REVIEW: It is well known that there is a very high risk of cardiovascular complications among diabetic patients. In spite of all efforts at aggressive control of diabetes and its complications, the incidence of cardiovascular morbidity and mortality remains high, including in patients with no prior symptoms, underscoring a possible advantage for appropriate screening of asymptomatic patients for the presence of obstructive coronary artery disease (CAD). In this article, we sought primarily to review the results of studies designed to evaluate a possible role of coronary computed tomography angiography (CCTA) in the screening of asymptomatic diabetic patients for possible obstructive CAD...
November 2016: Current Atherosclerosis Reports
R A Gangwani, J X Lian, S M McGhee, D Wong, K Kw Li
Diabetes mellitus has become a global epidemic. It causes significant macrovascular complications such as coronary artery disease, peripheral artery disease, and stroke; as well as microvascular complications such as retinopathy, nephropathy, and neuropathy. Diabetic retinopathy is known to be the leading cause of blindness in the working-age population and may be asymptomatic until vision loss occurs. Screening for diabetic retinopathy has been shown to reduce blindness by timely detection and effective laser treatment...
October 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
J Nadel, C J Holloway
HIV infection is now considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). Increased risk of CAD in HIV-infected patients has been associated with the inflammatory sequelae of the infection as well as the greater prevalence of cardiac risk factors in HIV-positive populations and the side effects of life-prolonging antiretroviral therapies. Patients with HIV infection now have a 1.5 to 2-fold greater risk of developing CAD compared with noninfected individuals, raising the independent risk of CAD in HIV infection to levels similar to those in diabetes...
August 24, 2016: HIV Medicine
Tetsuro Tsujimoto, Takehiro Sugiyama, Ritsuko Yamamoto-Honda, Miyako Kishimoto, Hiroshi Noto, Miyako Morooka, Kazuo Kubota, Munehiro Kamimura, Hisao Hara, Hiroshi Kajio, Masafumi Kakei, Mitsuhiko Noda
Glycemic control alone does not reduce cardiovascular events in patients with type 2 diabetes (T2D), and routine screening of all T2D patients for asymptomatic coronary artery disease (CAD) is not effective for preventing acute cardiac events. We examined the effectiveness of an aggressive screening protocol for asymptomatic CAD in T2D patients with advanced vascular complications.We designed a 3-year cohort study investigating the effectiveness of the aggressive coronary screening for T2D patients with advanced vascular complications and no known coronary events using propensity score adjusted analysis at a national center in Japan...
August 2016: Medicine (Baltimore)
Despina Bournele, Dimitris Beis
Cardiovascular disease (CVD) is one of the leading causes of death worldwide. The most significant risk factors associated with the development of heart diseases include genetic and environmental factors such as hypertension, high blood cholesterol levels, diabetes, smoking, and obesity. Coronary artery disease accounts for the highest percentage of CVD deaths and stroke, cardiomyopathies, congenital heart diseases, heart valve defects and arrhythmias follow. The causes, prevention, and treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies published on a weekly basis...
August 8, 2016: Heart Failure Reviews
Hassan Alkhawam, Robert Sogomonian, Mohammed El-Hunjul, Mohamad Kabach, Umer Syed, Neil Vyas, Sumair Ahmad, Timothy J Vittorio
OBJECTIVE: In this study, we assessed the risk factor profile in premature coronary artery disease (CAD) and acute coronary syndrome for adults ≤40 years old. METHODS: A retrospective chart analysis of 397 patients ≤40 years old admitted from 2005 to 2014 for chest pain and who underwent coronary arteriography. RESULTS: Of 397 patients that had undergone coronary arteriography, 54% had CAD while 46% had normal coronary arteries. When compared with patients with normal coronary arteries, patients with CAD were more likely to smoke tobacco, have dyslipidemia, be diabetic, have BMI >30 kg/m(2), have a family history of premature CAD and be male in gender...
September 2016: Future Cardiology
Paul Valensi, Antoine Avignon, Ariane Sultan, Bernard Chanu, Minh Tuan Nguyen, Emmanuel Cosson
BACKGROUND: To investigate whether atherogenic dyslipidemia, a dyslipidemic profile combining elevated triglycerides and low high-density lipoprotein (HDL) cholesterol, is predictive of risk of silent myocardial ischemia (SMI) or angiographic coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes. METHODS: Cohort study in 1080 asymptomatic patients with type 2 diabetes with a normal resting electrocardiogram, at least one additional cardiovascular risk factor and low density lipoprotein (LDL) cholesterol <3...
2016: Cardiovascular Diabetology
Ying Wang, Thomas H Marwick
Type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for cardiovascular diseases and cardiac death. While the increased mortality of patients with DM has traditionally been attributed to coronary artery disease, approximately half of the mortality has other causes, including non-ischemic heart failure (HF). In this context, effective screening and diagnosis of cardiac structural and functional abnormalities are crucial for preventive strategies and for predicting prognosis. This review discusses various echocardiographic diagnostic modalities, including tissue Doppler imaging (TDI) and two-dimensional (2D) speckle-tracking echocardiography (STE) for screening, risk stratification, and guidance of management of patients with T2DM...
September 2016: Current Cardiology Reports
S N Lee, J-Y Cho, Y-M Eun, S-W Song, K-W Moon
OBJECTIVE: Coronary artery disease (CAD) and osteoporosis are major causes of mortality and morbidity in postmenopausal women. We aimed to investigate the association between osteoporosis and CAD in asymptomatic postmenopausal women at a single center. METHODS: This study included 863 postmenopausal women without histories of cardiovascular diseases who visited the Health Promotion Center from June 1, 2004 to May 31, 2015. All subjects were screened for bone mineral density (BMD) by dual-energy X-ray absorptiometry and for the degree of CAD by multidetector computed tomography...
October 2016: Climacteric: the Journal of the International Menopause Society
Shoichi Akazawa, Masayuki Tojikubo, Yuko Nakano, Satoe Nakamura, Hidekazu Tamai, Koji Yonemoto, Eiji Sadasima, Tomohiro Kawasaki, Nobuhiko Koga
AIMS/INTRODUCTION: The usefulness of markers of carotid plaque, such as sum (PS) and maximum (P-max) of the plaque thickness, in combination with intima-media thickness in the common carotid artery (CIMT) for the detection of obstructive coronary artery disease (CAD) was investigated in patients with type 2 diabetes without known CAD. MATERIALS AND METHODS: B-mode ultrasonographic scanning of the carotid artery and multislice computed tomography coronary angiography were carried out in 332 asymptomatic patients with type 2 diabetes...
May 2016: Journal of Diabetes Investigation
Mohammad U Malik, Stuart D Russell, Aliaksei Pustavoitau, Matthews Chacko, Arif M Cosar, Carol B Thompson, Panagiotis Trilianos, Nabil N Dagher, Andrew M Cameron, Ahmet Gurakar
BACKGROUND/PURPOSE: Cardiac morbidities can occur during the peri- and post-liver transplant (LT) period, affecting the long-term survival. The purpose of this study was to identify the potential factors that predict a coronary event post-transplantation. METHODS: Medical records of patients who underwent liver transplantation at Johns Hopkins Hospital between 2009 and 2013 were retrospectively reviewed. We looked at pre-liver transplant cardiac risk factors and the diagnostic tests utilized for coronary artery disease screening...
June 16, 2016: Hepatology International
Kian-Ching Er, Chen-Yang Hsu, Yi-Kung Lee, Ming-Yuan Huang, Yung-Cheng Su
Although the relationship between diabetes and pancreatic cancer has been studied, the effects of glycemic control on pancreatic cancer have never been evaluated. This study investigates the relationship between glycemic control and pancreatic cancer.Data from 1 million National Health Insurance beneficiaries were screened. The study cohort consisted of 46,973 diabetic patients and 652,142 nondiabetic subjects. Of the patients with diabetes, 1114 who had been admitted for hyperglycemic crisis episodes were defined as having poorly controlled diabetes...
June 2016: Medicine (Baltimore)
Won-Jang Kim, Chang Hee Kwon, Seungbong Han, Woo Seok Lee, Joon Won Kang, Jung-Min Ahn, Jong-Young Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%-20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40-79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33...
June 2016: Journal of Korean Medical Science
Shatha S Al-Sharbatti, Yasmeen I Abed, Lujain M Al-Heety, Shaikh A Basha
OBJECTIVES: Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus (DM) and related variables among genetically unrelated couples in Ajman, United Arab Emirates (UAE). METHODS: This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands...
May 2016: Sultan Qaboos University Medical Journal
Sabha Bhatti, Evan Watts, Fahd Syed, Srikanth Vallurupalli, Tarun Pandey, Kedar Jambekar, Wojciech Mazur, Abdul Hakeem
OBJECTIVES: AL amyloidosis affects up to 30% of patients with multiple myeloma (MM), and cardiac involvement is associated with worse outcomes. Traditional screening modalities including EKG, echocardiography and biomarkers have limited value. The aim of this study was to evaluate the clinical and prognostic value of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) imaging in patients with plasma cell dyscrasias and suspected cardiac amyloidosis (CA). METHODS: A total of 251 consecutive patients with plasma cell dyscrasias who underwent CMR were enrolled in this study...
September 2016: European Heart Journal Cardiovascular Imaging
Carlos Augusto F Tavares, Bernardo Leo Wajchjenberg, Carlos Rochitte, Antonio Carlos Lerario
Diabetes is a very frequent disease and it is estimated that its prevalence will continuously increase during the next two decades. The arteriosclerotic process in diabetic patients progresses earlier and more diffusely, and it is more accelerated in the diabetic patient than in the overall population. In diabetic subjects, acute myocardial infarction (AMI) and stroke are the leading causes of death, but the presence of arterial disease is not always detected before the development of the acute arterial event...
April 2016: Archives of Endocrinology and Metabolism
Elena Z Golukhova, Olga Gromova, Marina Grigoryan, Vadim Merzlyakov, Konstantin Shumkov, Leo Bockeria, Victor L Serebruany
BACKGROUND: Prediction and potential prevention of sudden cardiac death (SCD) due to malignant ventricular arrhythmia (MVA) represent an obvious unmet medical need. We estimated the prognostic relevance of numerous biomarkers associated with future MVA development in patients with coronary artery disease (CAD) over 2 years of follow-up. METHODS: Patients with stable documented CAD (n = 97) with a mean age of 61 ± 10 years were prospectively enrolled in a single-center observational cohort study...
2016: Cardiology
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