American heart journal最新文献_第7页

Clinical Outcomes in Non-Obese Caucasian and Hispanic Populations with DM, a Nation-Wide Study

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.010

Sindhu Kishore MD., Leonid Khokhlov MD., Mehwish Kishore MD., Sila Mateo Faxas MD., Kamal Shemisa MD.

The global prevalence of DM is approximately 10.5% and is expected to rise in the next few years. There is limited data on its outcomes stratified by race. Controlling DM will mitigate the risks of atherosclerotic cardiovascular disease. The purpose of this study is to compare differences in clinical outcomes in non-obese Caucasian and Hispanic populations with DM. Conducted as an observational study, it utilized data from the National Inpatient Sample from 2017 to 2020 focusing on non-obese adults over 18 years, with a BMI <30 kg/m^2, and DM diagnosis, excluding those under 18, obese or without DM. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, mechanical ventilation, length of stay, and total cost. Multivariable logistic and Poisson regression analyses determined the clinical outcomes, considering a p-value <0.05 significant. Among 22,300,000 non-obese adults with DM, 64.2% were Caucasians, 13.3% were Hispanics, 3.5% were Asians, 18.8% were AA, and the remaining population belonged to other ethnicities. This study revealed higher rates in the Caucasians for conditions like metabolic syndrome, dyslipidemia, HTN, pHTN, HF, PVD, A.fib, ACS, AKI, stroke, PE, and COPD. The Hispanics were seen to have a higher incidence of anemia, CKD, and severe sepsis. In terms of primary and secondary outcomes, Hispanics were higher. The findings undermine the importance of racial differences in such conditions and more in-depth studies are needed to extrapolate the gaps in care.

{"title":"Clinical Outcomes in Non-Obese Caucasian and Hispanic Populations with DM, a Nation-Wide Study","authors":"Sindhu Kishore MD., Leonid Khokhlov MD., Mehwish Kishore MD., Sila Mateo Faxas MD., Kamal Shemisa MD.","doi":"10.1016/j.ahj.2024.09.010","DOIUrl":"10.1016/j.ahj.2024.09.010","url":null,"abstract":"<div><div>The global prevalence of DM is approximately 10.5% and is expected to rise in the next few years. There is limited data on its outcomes stratified by race. Controlling DM will mitigate the risks of atherosclerotic cardiovascular disease. The purpose of this study is to compare differences in clinical outcomes in non-obese Caucasian and Hispanic populations with DM. Conducted as an observational study, it utilized data from the National Inpatient Sample from 2017 to 2020 focusing on non-obese adults over 18 years, with a BMI <30 kg/m^2, and DM diagnosis, excluding those under 18, obese or without DM. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, mechanical ventilation, length of stay, and total cost. Multivariable logistic and Poisson regression analyses determined the clinical outcomes, considering a p-value <0.05 significant. Among 22,300,000 non-obese adults with DM, 64.2% were Caucasians, 13.3% were Hispanics, 3.5% were Asians, 18.8% were AA, and the remaining population belonged to other ethnicities. This study revealed higher rates in the Caucasians for conditions like metabolic syndrome, dyslipidemia, HTN, pHTN, HF, PVD, A.fib, ACS, AKI, stroke, PE, and COPD. The Hispanics were seen to have a higher incidence of anemia, CKD, and severe sepsis. In terms of primary and secondary outcomes, Hispanics were higher. The findings undermine the importance of racial differences in such conditions and more in-depth studies are needed to extrapolate the gaps in care.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 1-2"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gender Differences in the Impact of Type 2 Diabetes on Long-Term Mortality in Patients with Heart Failure and Preserved Ejection Fraction

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.011

Yethindra Vityala , Altynai Zhumabekova , Chethan raj Gundoji , Sushmitha Bhavanthi , Sai Praneeth Duvvuri , Krishna Chaitanya Meduri , Rithwik Goud Burri , Nagasree Golla , Tugolbai Tagaev

Background: Type 2 diabetes (T2D) is frequently present as a comorbid condition in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). Recent investigations have demonstrated that females with diabetes are more susceptible to the development of HF compared to males. Nevertheless, there is a lack of extensive research on the prospects of T2D patients with HF, specifically in relation to gender.

Objective: We examined the varying effect of T2DM on overall mortality in males compared to females with HFpEF following hospitalization for acute HF.

Methods: This prospective study included 266 patients with HFpEF who were admitted to and discharged from our hospital after being diagnosed with acute HF. This study employed a Multivariate Cox regression model to assess the association between gender, T2D, and the risk of long-term overall morbidity. Hazard ratios (HR) were used to express risk estimation.

Results: The average age of the group was 68.3±7.2 years and 151 (56.8%) were female. The prevalence of T2D was comparable between males and females (47.2% vs. 53.7%; p=0.168). Following a median follow-up period of 4.2 years (with an interquartile range of 2.0-7.4 years), 158 (59.4%) patients reported mortality. In females, T2D was associated with a significantly increased risk of death from any cause (HR=2.62; 95% confidence interval, 2.36-3.16; P<0.002). However, in males, there was no significant association between T2D and mortality (HR=2.08; 95% confidence interval, 1.69-2.49; P=0.087).

Conclusions: Following the diagnosis of acute HF in patients with HFpEF, females with T2D had an increased risk of mortality.

{"title":"Gender Differences in the Impact of Type 2 Diabetes on Long-Term Mortality in Patients with Heart Failure and Preserved Ejection Fraction","authors":"Yethindra Vityala , Altynai Zhumabekova , Chethan raj Gundoji , Sushmitha Bhavanthi , Sai Praneeth Duvvuri , Krishna Chaitanya Meduri , Rithwik Goud Burri , Nagasree Golla , Tugolbai Tagaev","doi":"10.1016/j.ahj.2024.09.011","DOIUrl":"10.1016/j.ahj.2024.09.011","url":null,"abstract":"<div><div><strong>Background:</strong> Type 2 diabetes (T2D) is frequently present as a comorbid condition in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). Recent investigations have demonstrated that females with diabetes are more susceptible to the development of HF compared to males. Nevertheless, there is a lack of extensive research on the prospects of T2D patients with HF, specifically in relation to gender.</div><div><strong>Objective:</strong> We examined the varying effect of T2DM on overall mortality in males compared to females with HFpEF following hospitalization for acute HF.</div><div><strong>Methods:</strong> This prospective study included 266 patients with HFpEF who were admitted to and discharged from our hospital after being diagnosed with acute HF. This study employed a Multivariate Cox regression model to assess the association between gender, T2D, and the risk of long-term overall morbidity. Hazard ratios (HR) were used to express risk estimation.</div><div><strong>Results:</strong> The average age of the group was 68.3±7.2 years and 151 (56.8%) were female. The prevalence of T2D was comparable between males and females (47.2% vs. 53.7%; p=0.168). Following a median follow-up period of 4.2 years (with an interquartile range of 2.0-7.4 years), 158 (59.4%) patients reported mortality. In females, T2D was associated with a significantly increased risk of death from any cause (HR=2.62; 95% confidence interval, 2.36-3.16; P<0.002). However, in males, there was no significant association between T2D and mortality (HR=2.08; 95% confidence interval, 1.69-2.49; P=0.087).</div><div><strong>Conclusions:</strong> Following the diagnosis of acute HF in patients with HFpEF, females with T2D had an increased risk of mortality.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 2"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of Racial and Regional Disparities in Sudden Cardiac Death Related Mortality, Trends in Patients with Type 2 Diabetes Mellitus: 1999-2020.

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.023

Shaaf Ahmad

Subnormal glycemic control, as is seen in Type 2 Diabetes Mellitus (T2DM), has been established as a risk factor of sudden cardiac death (SCD) due to the microvascular complications of T2DM affecting the heart's conduction system, instigating arrhythmias. With increasing incidence of SCD in diabetics in the U.S., the racial and rural-urban disparities remain less well-established. This paper examines the difference in mortality trends when stratified by these two demographics.

CDC WONDER database was queried from 1999-2020 to obtain SCD related mortality trends data in diabetics. Age-adjusted mortality rates (AAMR) per 100,000 were obtained using the U.S. population in 2000 as the standard. Joinpoint regression was employed to ascertain differences in interracial trends & rural vs urban cities.

12,545 diabetics suffered from sudden cardiac death in the past 2 decades, with West Virginia (AAMR: 0.37) and Tennessee (AAMR: 0.38) recording the highest rates. Overall AAMR upturned from 1999 (AAMR: 0.14) to 2020 (AAMR: 0.22). Mortality rates were higher in the African Americans (AAMR: 0.21 [0.19,0.22]; AAPC: 2.2 [0.56,4.27]) than Whites: (AAMR: 0.17 [0.16,0.17]; AAPC: 2.3 [1.3,3.78]), AAPC declined for Hispanics (AAPC: -0.62 [-4.7,3.6]). Midwest (AAMR: 0.22 [0.21,0.23]) had the highest rates, followed by South (AAMR: 0.16 [0.16,0.17]), Northeast (AAMR: 0.14 [0.1,0.18]) and West (AAMR: 0.09 [0.09,0.1]). AAMR in rural counties (AAMR: 0.32 [0.31,0.34]; AAPC: 3.6 [2.6,5.2]) was 3.5 times higher than in large metropolitans (AAMR: 0.09 [0.09,0.1]; AAPC: 1.9 [0.8,3.5]).

Racial disparity alongside three-fold higher AAMRs in rural counties require robust mechanisms of healthcare delivery to impoverished regions and entities.

{"title":"Analysis of Racial and Regional Disparities in Sudden Cardiac Death Related Mortality, Trends in Patients with Type 2 Diabetes Mellitus: 1999-2020.","authors":"Shaaf Ahmad","doi":"10.1016/j.ahj.2024.09.023","DOIUrl":"10.1016/j.ahj.2024.09.023","url":null,"abstract":"<div><div>Subnormal glycemic control, as is seen in Type 2 Diabetes Mellitus (T2DM), has been established as a risk factor of sudden cardiac death (SCD) due to the microvascular complications of T2DM affecting the heart's conduction system, instigating arrhythmias. With increasing incidence of SCD in diabetics in the U.S., the racial and rural-urban disparities remain less well-established. This paper examines the difference in mortality trends when stratified by these two demographics.</div><div>CDC WONDER database was queried from 1999-2020 to obtain SCD related mortality trends data in diabetics. Age-adjusted mortality rates (AAMR) per 100,000 were obtained using the U.S. population in 2000 as the standard. Joinpoint regression was employed to ascertain differences in interracial trends & rural vs urban cities.</div><div>12,545 diabetics suffered from sudden cardiac death in the past 2 decades, with West Virginia (AAMR: 0.37) and Tennessee (AAMR: 0.38) recording the highest rates. Overall AAMR upturned from 1999 (AAMR: 0.14) to 2020 (AAMR: 0.22). Mortality rates were higher in the African Americans (AAMR: 0.21 [0.19,0.22]; AAPC: 2.2 [0.56,4.27]) than Whites: (AAMR: 0.17 [0.16,0.17]; AAPC: 2.3 [1.3,3.78]), AAPC declined for Hispanics (AAPC: -0.62 [-4.7,3.6]). Midwest (AAMR: 0.22 [0.21,0.23]) had the highest rates, followed by South (AAMR: 0.16 [0.16,0.17]), Northeast (AAMR: 0.14 [0.1,0.18]) and West (AAMR: 0.09 [0.09,0.1]). AAMR in rural counties (AAMR: 0.32 [0.31,0.34]; AAPC: 3.6 [2.6,5.2]) was 3.5 times higher than in large metropolitans (AAMR: 0.09 [0.09,0.1]; AAPC: 1.9 [0.8,3.5]).</div><div>Racial disparity alongside three-fold higher AAMRs in rural counties require robust mechanisms of healthcare delivery to impoverished regions and entities.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 8-9"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obicetrapib Treatment Increases Pre-Beta1 HDL and Lipophilic Antioxidants in the Ocean and Rose2 Studies

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.014

E. Niesor, M. Ditmarsch, S. Rezzi, S. Canarelli, A. Hodgson, P. Hänggi, J. Kastelei 4

Background and Aims: Non-lipidated ApoA1 (pre-beta1 HDL) captures cholesterol and lipophilic antioxidants via ABCA1. HDL particles transport antioxidants to tissues such as retina and brain. The effect of HDL raising interventions on pre-beta1 HDL levels and the distribution of lipophilic antioxidants amongst lipoproteins is unknown. CETP-inhibition was hypothesized to reduce the antioxidant capacity of HDL, although direct evidence was never presented. This is now addressed in phase II studies of the novel CETP-inhibitor obicetrapib

Methods: Plasma samples from two phase II studies with obicetrapib were used to measure changes in pre-beta1 HDL by ELISA with a selective antibody to ApoA1 aa 137-144 (LQEKLSPL).. Lipophilic antioxidants were quantified in plasma, non-HDL, and HDL-fractions by ULPC ms-ms.

Results: In both studies, no significant changes occurred in placebo groups but, in the obicetrapib treated groups, plasma pre-beta1 HDL increased by 12% (p<0.04) and 24% (p<0.03). In OCEAN, plasma ApoA1 and HDL-C levels correlated with increasing levels of antioxidants in the HDL fraction.

In ROSE2, α-tocopherol was raised in plasma by 16% (p<0.003) and in HDL by 58% (p<0.00003). In both studies pre-beta1 HDL in obicetrapib treated patients was correlated with α-tocopherol in plasma.

Conclusions: CETP inhibition with obicetrapib increases pre-beta1 HDL, impacts excess cholesterol efflux, and also raises important HDL antioxidants. Thus, these results support the potential therapeutic use of obicetrapib in diseases with high unmet medical need that are associated with low HDL and low levels of lipophilic antioxidants in plasma and tissues, such as AMD, neurodegenerative disorders, and sickle cell anemia.

{"title":"Obicetrapib Treatment Increases Pre-Beta1 HDL and Lipophilic Antioxidants in the Ocean and Rose2 Studies","authors":"E. Niesor, M. Ditmarsch, S. Rezzi, S. Canarelli, A. Hodgson, P. Hänggi, J. Kastelei 4","doi":"10.1016/j.ahj.2024.09.014","DOIUrl":"10.1016/j.ahj.2024.09.014","url":null,"abstract":"<div><div><strong>Background and Aims:</strong> Non-lipidated ApoA1 (pre-beta1 HDL) captures cholesterol and lipophilic antioxidants via ABCA1. HDL particles transport antioxidants to tissues such as retina and brain. The effect of HDL raising interventions on pre-beta1 HDL levels and the distribution of lipophilic antioxidants amongst lipoproteins is unknown. CETP-inhibition was hypothesized to reduce the antioxidant capacity of HDL, although direct evidence was never presented. This is now addressed in phase II studies of the novel CETP-inhibitor obicetrapib</div><div><strong>Methods:</strong> Plasma samples from two phase II studies with obicetrapib were used to measure changes in pre-beta1 HDL by ELISA with a selective antibody to ApoA1 aa 137-144 (LQEKLSPL).. Lipophilic antioxidants were quantified in plasma, non-HDL, and HDL-fractions by ULPC ms-ms.</div><div><strong>Results:</strong> In both studies, no significant changes occurred in placebo groups but, in the obicetrapib treated groups, plasma pre-beta1 HDL increased by 12% (p<0.04) and 24% (p<0.03). In OCEAN, plasma ApoA1 and HDL-C levels correlated with increasing levels of antioxidants in the HDL fraction.</div><div>In ROSE2, α-tocopherol was raised in plasma by 16% (p<0.003) and in HDL by 58% (p<0.00003). In both studies pre-beta1 HDL in obicetrapib treated patients was correlated with α-tocopherol in plasma.</div><div><strong>Conclusions:</strong> CETP inhibition with obicetrapib increases pre-beta1 HDL, impacts excess cholesterol efflux, and also raises important HDL antioxidants. Thus, these results support the potential therapeutic use of obicetrapib in diseases with high unmet medical need that are associated with low HDL and low levels of lipophilic antioxidants in plasma and tissues, such as AMD, neurodegenerative disorders, and sickle cell anemia.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 4"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.024

Shaaf Ahmad

COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.

CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.

A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).

COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.

{"title":"Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder","authors":"Shaaf Ahmad","doi":"10.1016/j.ahj.2024.09.024","DOIUrl":"10.1016/j.ahj.2024.09.024","url":null,"abstract":"<div><div>COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.</div><div>CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.</div><div>A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).</div><div>COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 9"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantifying the Impact: Burden of Ischemic Heart Disease Attributable to Kidney Dysfunction in the United States Over last Three Decades

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.020

Kush Varsadiya, Ashwinikumar Shandilya, Harsha Choudary Pudhota, Saif Syed, Adan Irfan, Patel dhruval, Mohit Lakkimsetti, Vishrant Amin, Juhi Patel, Hardik Dineshbhai Desai

Background: Ischemic Heart Disease (IHD) remains the primary cause of death and disability in the United States. Among various risk factors, the role of Kidney Dysfunction (KD) in exacerbating IHD has not been fully explored, particularly on a state-by-state basis. This study seeks to delineate the consistent burden of IHD attributable to KD throughout the U.S from 1990 to 2019.

Method: We estimated the deaths, Disability Adjusted Life Years (DALYs), and Years Lived with Disability (YLDs) by age, sex, year, and location across the U.S. These were quantified in absolute numbers and age-standardized rates (ASR) per 100,000 people.

Results: The study found significant increases in the annual percentage change (APC) from 2010-2019: deaths rose by 17% (95% Uncertainty Interval [UI]: 14-20%), DALYs by 18% (15-22%), and YLDs by 21% (16-27%). State-specific increases in age-standardized mortality rates (ASMR) were highest in Vermont at 5%, followed by New Mexico at 3%. Conversely, the District of Columbia saw a significant decrease of 16%. Vermont also showed the largest rise in DALY rates at 7%, and Florida in YLD rates at 3%. The age group of 90-94 years exhibited the highest number of deaths, while the 75-79 age group showed the greatest DALYs in 2019. Men consistently bore a heavier burden than women, with significant differences in APC across deaths, DALYs, and YLDs from 2010-2019.

Conclusion: IHD due to KD accounted for 16.67% of all IHD deaths in 2019, with older adults and men experiencing a markedly increased burden. These findings underscore the need for integrated care approaches and strong health policies to effectively manage the interplay between these serious health conditions.

{"title":"Quantifying the Impact: Burden of Ischemic Heart Disease Attributable to Kidney Dysfunction in the United States Over last Three Decades","authors":"Kush Varsadiya, Ashwinikumar Shandilya, Harsha Choudary Pudhota, Saif Syed, Adan Irfan, Patel dhruval, Mohit Lakkimsetti, Vishrant Amin, Juhi Patel, Hardik Dineshbhai Desai","doi":"10.1016/j.ahj.2024.09.020","DOIUrl":"10.1016/j.ahj.2024.09.020","url":null,"abstract":"<div><div><strong>Background:</strong> Ischemic Heart Disease (IHD) remains the primary cause of death and disability in the United States. Among various risk factors, the role of Kidney Dysfunction (KD) in exacerbating IHD has not been fully explored, particularly on a state-by-state basis. This study seeks to delineate the consistent burden of IHD attributable to KD throughout the U.S from 1990 to 2019.</div><div><strong>Method:</strong> We estimated the deaths, Disability Adjusted Life Years (DALYs), and Years Lived with Disability (YLDs) by age, sex, year, and location across the U.S. These were quantified in absolute numbers and age-standardized rates (ASR) per 100,000 people.</div><div><strong>Results:</strong> The study found significant increases in the annual percentage change (APC) from 2010-2019: deaths rose by 17% (95% Uncertainty Interval [UI]: 14-20%), DALYs by 18% (15-22%), and YLDs by 21% (16-27%). State-specific increases in age-standardized mortality rates (ASMR) were highest in Vermont at 5%, followed by New Mexico at 3%. Conversely, the District of Columbia saw a significant decrease of 16%. Vermont also showed the largest rise in DALY rates at 7%, and Florida in YLD rates at 3%. The age group of 90-94 years exhibited the highest number of deaths, while the 75-79 age group showed the greatest DALYs in 2019. Men consistently bore a heavier burden than women, with significant differences in APC across deaths, DALYs, and YLDs from 2010-2019.</div><div><strong>Conclusion:</strong> IHD due to KD accounted for 16.67% of all IHD deaths in 2019, with older adults and men experiencing a markedly increased burden. These findings underscore the need for integrated care approaches and strong health policies to effectively manage the interplay between these serious health conditions.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 7"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Eligibility for Anti-Obesity Medications through Medicare for Older Adults with Overweight or Obesity

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.022

Ashwin K. Chetty, Mihir Khunte, Alissa S. Chen MD, MPH, Ania M. Jastreboff MD, PhD, Harlan M. Krumholz MD, SM, Yuan Lu ScD

Medicare covered anti-obesity medications (AOMs) only for type 2 diabetes until March 2024, when the agency announced that AOMs with additional indications will be covered under Medicare Part D. Consequently, Medicare beneficiaries with overweight or obesity can be eligible for AOMs if they concurrently have type 2 diabetes or cardiovascular disease (CVD). To assess the potential impact of Medicare's March guidance, we estimated the number of US adults aged ≥65 years with overweight or obesity who were eligible for Medicare coverage of AOMs before and after Medicare's March 2024 guidance, stratified by sociodemographic status. We pooled data from the National Health and Nutrition Examination Survey from January 2011 to March 2020, including participants aged ≥65 years with a BMI ≥27 kg/m2. The study sample included 3,385 participants aged ≥65 with overweight or obesity, representing 26,552,194 adults. Among this population, 45.8% (95% CI, 43.4-48.2) or 12.2 million people had diabetes or cardiovascular disease and were eligible for AOMs through Medicare post-March 2024. In contrast, 33.8% (95% CI, 31.6-36.0%) or 9.0 million people had diabetes and were eligible for AOMs through Medicare pre-March 2024. Older age, male sex, and White race were associated with greater expansion in AOM eligibility due to Medicare's March guidance. Older age, male sex, identifying as a minority race/ethnicity, lower income, and less education were associated with greater AOM eligibility rates post-March 2024. These findings demonstrate that across sociodemographic groups Medicare's guidance significantly expanded the population of beneficiaries eligible for AOMs, but about half of older adults with overweight or obesity remain ineligible for AOMs through Medicare.

{"title":"Eligibility for Anti-Obesity Medications through Medicare for Older Adults with Overweight or Obesity","authors":"Ashwin K. Chetty, Mihir Khunte, Alissa S. Chen MD, MPH, Ania M. Jastreboff MD, PhD, Harlan M. Krumholz MD, SM, Yuan Lu ScD","doi":"10.1016/j.ahj.2024.09.022","DOIUrl":"10.1016/j.ahj.2024.09.022","url":null,"abstract":"<div><div>Medicare covered anti-obesity medications (AOMs) only for type 2 diabetes until March 2024, when the agency announced that AOMs with additional indications will be covered under Medicare Part D. Consequently, Medicare beneficiaries with overweight or obesity can be eligible for AOMs if they concurrently have type 2 diabetes or cardiovascular disease (CVD). To assess the potential impact of Medicare's March guidance, we estimated the number of US adults aged ≥65 years with overweight or obesity who were eligible for Medicare coverage of AOMs before and after Medicare's March 2024 guidance, stratified by sociodemographic status. We pooled data from the National Health and Nutrition Examination Survey from January 2011 to March 2020, including participants aged ≥65 years with a BMI ≥27 kg/m2. The study sample included 3,385 participants aged ≥65 with overweight or obesity, representing 26,552,194 adults. Among this population, 45.8% (95% CI, 43.4-48.2) or 12.2 million people had diabetes or cardiovascular disease and were eligible for AOMs through Medicare post-March 2024. In contrast, 33.8% (95% CI, 31.6-36.0%) or 9.0 million people had diabetes and were eligible for AOMs through Medicare pre-March 2024. Older age, male sex, and White race were associated with greater expansion in AOM eligibility due to Medicare's March guidance. Older age, male sex, identifying as a minority race/ethnicity, lower income, and less education were associated with greater AOM eligibility rates post-March 2024. These findings demonstrate that across sociodemographic groups Medicare's guidance significantly expanded the population of beneficiaries eligible for AOMs, but about half of older adults with overweight or obesity remain ineligible for AOMs through Medicare.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 8"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obicetrapib Alone and in Combination with Ezetimibe Reduces Non-HDL-Cholesterol by Enhanced LDL-Receptor-Mediated VLDL Clearance and Increased Net Fecal Sterol Excretion in ApoE*3-Leiden.CETP Mice

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.017

José A. Inia, Nanda Keijzer, Nicole Worms, Anita van Nieuwkoop, Marc Ditmarsch, J. Wouter Jukema, Albert K. Groen, John Kastelein, Elsbet J. Pieterman, Hans M.G. Princen

Background and Aims: Obicetrapib is a selective cholesteryl ester transfer protein (CETP) inhibitor in clinical development for the treatment of hypercholesterolemia and cardiovascular risk. It reduces apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) and increases high-density lipoprotein cholesterol (HDL-C). Ezetimibe reduces absorption of biliary and dietary cholesterol from the small intestine, also reducing LDL-C levels. The current study elucidates the mechanism for decreases in non-HDL-C by obicetrapib alone and with ezetimibe in a mouse model for hyperlipidemia and atherosclerosis.

Methods: Female ApoE*3-Leiden.CETP transgenic mice were fed a Western diet with 0.05% w/w cholesterol (equivalent to daily human intake) or this diet containing obicetrapib (2 mg/kg/day), ezetimibe (1 mg/kg/day), or obicetrapib with ezetimibe.

Results: Obicetrapib, ezetimibe, and the combination reduced total plasma cholesterol levels (-42%, -23% and -62%).Obicetrapib alone and in combination with ezetimibe nearly completely blocked CETP activity (-99% and -100%) resulting in increased HDL-C (+260% and +245%) and ApoA1 (98% and 81%). Obicetrapib, ezetimibe, and the combination enhanced clearance of VLDL-like particles (half-life: -44%, -23% and -57%) and enhanced hepatic LDL receptor expression (+63% and +74%). Increased bile acid excretion in obicetrapib-treated mice (+41%) and increased neutral sterol excretion in ezetimibe-treated mice was observed, and was more pronounced in combination with obicetrapib (+68% and +100%), resulting in a net fecal sterol loss.

Conclusions: Obicetrapib alone and with ezetimibe reduced non-HDL-C levels by increased VLDL lipolysis, increased VLDL clearance and elevated LDL receptor levels, and enhanced fecal bile acid and neutral sterol excretion.

{"title":"Obicetrapib Alone and in Combination with Ezetimibe Reduces Non-HDL-Cholesterol by Enhanced LDL-Receptor-Mediated VLDL Clearance and Increased Net Fecal Sterol Excretion in ApoE*3-Leiden.CETP Mice","authors":"José A. Inia, Nanda Keijzer, Nicole Worms, Anita van Nieuwkoop, Marc Ditmarsch, J. Wouter Jukema, Albert K. Groen, John Kastelein, Elsbet J. Pieterman, Hans M.G. Princen","doi":"10.1016/j.ahj.2024.09.017","DOIUrl":"10.1016/j.ahj.2024.09.017","url":null,"abstract":"<div><div><strong>Background and Aims:</strong> Obicetrapib is a selective cholesteryl ester transfer protein (CETP) inhibitor in clinical development for the treatment of hypercholesterolemia and cardiovascular risk. It reduces apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) and increases high-density lipoprotein cholesterol (HDL-C). Ezetimibe reduces absorption of biliary and dietary cholesterol from the small intestine, also reducing LDL-C levels. The current study elucidates the mechanism for decreases in non-HDL-C by obicetrapib alone and with ezetimibe in a mouse model for hyperlipidemia and atherosclerosis.</div><div><strong>Methods:</strong> Female ApoE*3-Leiden.CETP transgenic mice were fed a Western diet with 0.05% w/w cholesterol (equivalent to daily human intake) or this diet containing obicetrapib (2 mg/kg/day), ezetimibe (1 mg/kg/day), or obicetrapib with ezetimibe.</div><div><strong>Results:</strong> Obicetrapib, ezetimibe, and the combination reduced total plasma cholesterol levels (-42%, -23% and -62%).Obicetrapib alone and in combination with ezetimibe nearly completely blocked CETP activity (-99% and -100%) resulting in increased HDL-C (+260% and +245%) and ApoA1 (98% and 81%). Obicetrapib, ezetimibe, and the combination enhanced clearance of VLDL-like particles (half-life: -44%, -23% and -57%) and enhanced hepatic LDL receptor expression (+63% and +74%). Increased bile acid excretion in obicetrapib-treated mice (+41%) and increased neutral sterol excretion in ezetimibe-treated mice was observed, and was more pronounced in combination with obicetrapib (+68% and +100%), resulting in a net fecal sterol loss.</div><div><strong>Conclusions:</strong> Obicetrapib alone and with ezetimibe reduced non-HDL-C levels by increased VLDL lipolysis, increased VLDL clearance and elevated LDL receptor levels, and enhanced fecal bile acid and neutral sterol excretion.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 5-6"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Racial and Ethnical Disparities in Dietary Intakes Among Adults with Diagnosed Diabetes: National Health and Nutrition Examination Survey 2011-2020

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.018

Xinghan Liu, Hsin-Chieh Yeh

Backgrounds: Diet holds crucial significance in the management and prevention of type 2 diabetes. This study aims to compare dietary intake of key macronutrients and micronutrients across different race/ethnicity among adults with diabetes.

Method: A cross-sectional analysis was conducted in 3,120 adults with diagnosed diabetes using the NHANES data from 2010 to March 2020. Type 2 diabetes was defined based on self-reported diagnosis or the use of anti-diabetic medications. Participants diagnosed with diabetes at age < 25years were assumed to have type 1 diabetes and were excluded. Race/ethnicity were categorized into White, Black, Asian, Mexican and other Hispanic adults. We compared the energy-adjusted nutrient intakes by race/ethnicity group and adjusted for sex and age.

Results: There were significant differences in various nutrient intakes across race/ethnicity in adults with diabetes . Compared to White adults, Black adults were less likely to consume saturated fatty acids, calcium, zinc, and potassium; Asian adults had higher carbohydrate, fiber, magnesium, and sodium intakes but lower sugar, fat, saturated fatty acids, cholesterol, and calcium consumptions; Mexican adults had higher fiber and magnesium intakes but a lower sugar intake; other Hispanic adults had lower intakes of total fat, saturated fatty acids and monounsaturated fatty acids.(all p<0.01.)

Conclusion: There were significant racial/ethnical differences in dietary intake among various racial and ethnic groups in the US population. Tailored approaches through racial and ethnic considerations may

{"title":"Racial and Ethnical Disparities in Dietary Intakes Among Adults with Diagnosed Diabetes: National Health and Nutrition Examination Survey 2011-2020","authors":"Xinghan Liu, Hsin-Chieh Yeh","doi":"10.1016/j.ahj.2024.09.018","DOIUrl":"10.1016/j.ahj.2024.09.018","url":null,"abstract":"<div><div><strong>Backgrounds:</strong> Diet holds crucial significance in the management and prevention of type 2 diabetes. This study aims to compare dietary intake of key macronutrients and micronutrients across different race/ethnicity among adults with diabetes.</div><div><strong>Method:</strong> A cross-sectional analysis was conducted in 3,120 adults with diagnosed diabetes using the NHANES data from 2010 to March 2020. Type 2 diabetes was defined based on self-reported diagnosis or the use of anti-diabetic medications. Participants diagnosed with diabetes at age < 25years were assumed to have type 1 diabetes and were excluded. Race/ethnicity were categorized into White, Black, Asian, Mexican and other Hispanic adults. We compared the energy-adjusted nutrient intakes by race/ethnicity group and adjusted for sex and age.</div><div><strong>Results:</strong> There were significant differences in various nutrient intakes across race/ethnicity in adults with diabetes . Compared to White adults, Black adults were less likely to consume saturated fatty acids, calcium, zinc, and potassium; Asian adults had higher carbohydrate, fiber, magnesium, and sodium intakes but lower sugar, fat, saturated fatty acids, cholesterol, and calcium consumptions; Mexican adults had higher fiber and magnesium intakes but a lower sugar intake; other Hispanic adults had lower intakes of total fat, saturated fatty acids and monounsaturated fatty acids.(all p<0.01.)</div><div><strong>Conclusion:</strong> There were significant racial/ethnical differences in dietary intake among various racial and ethnic groups in the US population. Tailored approaches through racial and ethnic considerations may</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Page 6"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microalbuminuria in Patients with Type 2 Diabetes Mellitus Treated with a Phytoformula as Adjuvant.

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal

Pub Date : 2024-12-01 DOI: 10.1016/j.ahj.2024.09.019

Nidia Angélica García Espinoza DACM , Hugo Morales Tello DACM , Ricardo Sacchi Córdova BS , Nicasio Morales Sarabia BS , Jair Isaí Ortega Gaxiola PhD , José Alfredo Primelles Gingele BS , María Magdalena Valencia Gutiérrez MD, MPH , Erick Ayala Calvillo PhD , Cesar Ochoa Martinez MD, PhD

Introduction: Diabetic nephropathy develops in 40% of patients 10 years after the diagnosis of diabetes, with albuminuria >300mg/dl (>200µg/min) more than twice in 3-6 months. (1) Strict glycemic control reduces mortality by 48% (2) and macroalbuminuria by 50%. The Terrabrio SAPI de CV group developed the Elevaté® Body Balance phytoformula made with Shilajit (Asphaltum punjabianum), Chaga (Inonotus obliquus), Moringa (Moringa oleifera), Berberine (Berberina vulgaris, Coptis chinensis French) and Bayetilla (Hamelia patens) used in traditional herbal medicine.

Objective: To evaluate changes in albuminuria in patients with DM2 treated with a phytoformula as adjuvant therapy.

Methods: A controlled clinical trial was conducted in 269 patients with DM2 treated with oral hypoglycemic agents plus 1.5 g/day of the phytoformulation under treatment for 90 days; a sub analysis of 20 patients with albuminuria was performed.

Results: In the 20 patients with albuminuria, age was 53.20 (49.25-58) years, 12(60%) women and 8(40%) men; time of diagnosis of DM2 was 7.41±4.36 years, treated with metformin 16(80%), sulfonylureas 19(95%) and insulin 3(15%); 3-month changes in waist from 95.85±9. 82 to 93.80±10.34 with p 0.044; HbA1c from 9.82±1.24 to 7.28±1.70 with p 0.0001; BUN from 10.44±3.43 to 12.30±5.53 with p 0.023; Albuminuria from 43.50±36.45 to 30±35.39 with p 0.0001; GFR from 93.57±14.54 to 93.85±18.56 with p 0.908, with no differences in BMI, blood pressure, urea, and creatinine. Correlation was 0.795 between HbAc1 and albuminuria.

Conclusions: Phytoformula reduced waist, HbA1c and albuminuria at 3 months; no changes in BMI and GFR were present.

{"title":"Microalbuminuria in Patients with Type 2 Diabetes Mellitus Treated with a Phytoformula as Adjuvant.","authors":"Nidia Angélica García Espinoza DACM , Hugo Morales Tello DACM , Ricardo Sacchi Córdova BS , Nicasio Morales Sarabia BS , Jair Isaí Ortega Gaxiola PhD , José Alfredo Primelles Gingele BS , María Magdalena Valencia Gutiérrez MD, MPH , Erick Ayala Calvillo PhD , Cesar Ochoa Martinez MD, PhD","doi":"10.1016/j.ahj.2024.09.019","DOIUrl":"10.1016/j.ahj.2024.09.019","url":null,"abstract":"<div><div><strong>Introduction:</strong> Diabetic nephropathy develops in 40% of patients 10 years after the diagnosis of diabetes, with albuminuria >300mg/dl (>200µg/min) more than twice in 3-6 months. (1) Strict glycemic control reduces mortality by 48% (2) and macroalbuminuria by 50%. The Terrabrio SAPI de CV group developed the Elevaté® Body Balance phytoformula made with Shilajit (Asphaltum punjabianum), Chaga (Inonotus obliquus), Moringa (Moringa oleifera), Berberine (Berberina vulgaris, Coptis chinensis French) and Bayetilla (Hamelia patens) used in traditional herbal medicine.</div><div><strong>Objective:</strong> To evaluate changes in albuminuria in patients with DM2 treated with a phytoformula as adjuvant therapy.</div><div><strong>Methods:</strong> A controlled clinical trial was conducted in 269 patients with DM2 treated with oral hypoglycemic agents plus 1.5 g/day of the phytoformulation under treatment for 90 days; a sub analysis of 20 patients with albuminuria was performed.</div><div><strong>Results:</strong> In the 20 patients with albuminuria, age was 53.20 (49.25-58) years, 12(60%) women and 8(40%) men; time of diagnosis of DM2 was 7.41±4.36 years, treated with metformin 16(80%), sulfonylureas 19(95%) and insulin 3(15%); 3-month changes in waist from 95.85±9. 82 to 93.80±10.34 with p 0.044; HbA1c from 9.82±1.24 to 7.28±1.70 with p 0.0001; BUN from 10.44±3.43 to 12.30±5.53 with p 0.023; Albuminuria from 43.50±36.45 to 30±35.39 with p 0.0001; GFR from 93.57±14.54 to 93.85±18.56 with p 0.908, with no differences in BMI, blood pressure, urea, and creatinine. Correlation was 0.795 between HbAc1 and albuminuria.</div><div><strong>Conclusions:</strong> Phytoformula reduced waist, HbA1c and albuminuria at 3 months; no changes in BMI and GFR were present.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 6-7"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0