Archives of Medical Sciences. Atherosclerotic Diseases最新文献

Introduction: The effect of the type of left ventricular hypertrophy in patients presenting with an acute coronary syndrome (ACS) on long-term outcomes is ill-defined. The purpose of this study was to investigate the prognostic effect of concentric (CH) or eccentric hypertrophy (EH) on adverse outcomes in patients presenting with ACS undergoing percutaneous coronary intervention (PCI).

Material and methods: We analyzed 1-year follow-up data from a single-institution, retrospective, observational study that enrolled 1,153 patients who presented with ACS and were treated with PCI, for whom echocardiographic data were available.

Results: Normal geometry was observed in 718 (62.3%) patients, while 27.2% had CH and 10.5% had EH. The primary endpoint of all-cause death (n = 90, 7.8%) occurred in 6.4%, 8.0%, and 14.9% of patients with no, concentric, or eccentric hypertrophy, respectively (p = 0.005). Major adverse cardiac events (MACE - all-cause death, non-fatal myocardial infarction or stroke or hospitalization for bleeding) occurred in 13.9%, 17.8%, 30.6%, respectively (p < 0.001). Age (HR per year = 1.04 (1.02, 1.05), p < 0.001), female gender (HR = 1.56 (1.12, 2.16), p = 0.008), diabetes (HR = 1.49 (1.07, 2.06), p = 0.02), eccentric hypertrophy (HR = 1.58 (1.006, 2.47), p = 0.047), peak troponin I (HR per 1 ng/ml = 1.004 (1.001, 1.006), p = 0.004) and left ventricular ejection fraction < 50% (HR = 1.57 (1.12, 2.20), p < 0.008) were significant predictors of MACE.

Conclusions: The presence of eccentric hypertrophy in ACS patients undergoing PCI is an independent predictor of adverse outcomes at 1 year.

Introduction: Sialic acid (SA) is an acetylated product of neuraminic acid. It acts as a cofactor of many cell surface receptors (e.g. insulin receptors) and is positively associated with most of the serum acute phase reactants. Sialic acid is an important component of serum, which is elevated in diseases such as diabetes and certain malignancies. Diabetes mellitus (DM) is associated with an increase in SA concentration along with other complications. The present study was undertaken to assess the relationship between serum SA and type 2 diabetes.

Material and methods: A total of 200 type 2 DM patients, 145 males and 55 females, were included in the study. Also, 100 healthy individuals served as the control group. Parameters assessed included serum SA, lipid profile, urine microalbumin, LDL-C, lipoprotein(a), and serum fibrinogen. The relationship between serum SA and diabetic complications viz retinopathy, nephropathy, and neuropathy was also assessed.

Results: Type 2 DM patients had significantly higher levels (p < 0.01) of SA (77.35 ±4.6 mg%) as compared to the control group (68.23 ±7.9 mg%). Increased levels of serum SA were seen in patients with diabetic nephropathy and retinopathy. No correlation was seen between serum SA and diabetic neuropathy.

Conclusions: Elevated serum SA concentration is significantly related to type 2 DM and associated cardiovascular risk factors. Further study of acute-phase response markers and mediators as indicators or predictors of diabetic microvascular complications is therefore justified.

It has been more than a year since the new virus called severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China. The disease it causes was named Coronavirus disease 2019 (COVID-19), and on 11 March 2020 it was declared a pandemic. As the virus continues to spread, the number of patients worldwide has already crossed the 100 million mark with more than 2 million deaths. We sought to provide an update on the progress made in identifying the virus, its pathophysiology, risk factors such as hypertension, diabetes, and smoking, as well as various methods of treatment. Our review also provided an overview of the different vaccines.

Introduction: Ischemic heart disease is the leading cause of death worldwide. In this study, we evaluated the risk factors for Turkish Cypriot ischemic heart disease patients.

Material and methods: In this study we examined 7017 patients, retrospectively. 5.9% of the patients had myocardial infarction coronary artery disease (MICAD) and 94.1% of the patients were control patients. The mean age of the study population was 52, and 39.2% were female. The risk factors considered were: age, sex, hypertension (HT), diabetes mellitus (DM), family history of coronary artery disease, smoking, high total cholesterol levels and obesity.

Results: Consistently with the presumed risk factors, there was a significant difference between MICAD and control groups in our study for smoking, HT, DM and obesity. However, our study revealed no significant difference for high total cholesterol levels in contrast to the current literature. Assessing the risk factors among male and female patient groups separately, both men and women have the highest risk prevalence for hypertension. Smoking is the second most common risk factor among males, whereas it is the family history of coronary heart disease in the female group. HT, DM and obesity were found to be significant risk factors for both males and females in our study group, while family history was revealed to be significant only in women.

Conclusions: Modifiable risk factors such as smoking, hypertension, diabetes mellitus and obesity may be controlled by lifestyle changes and medical therapies, and should be approached with caution for preventing cardiac events. Non-modifiable risk factors such as age, gender, family history and ethnicity should be taken into account for disease prediction.

Flavonoids are a large class of compounds that are widely found in many plants, including plants used in Chinese herbal medicines. Previous studies have revealed that flavonoids possess biomedical activities, including antioxidant, anti-cancer, anti-viral, and anti-inflammatory properties. They also have the functions of lowering lipids, lowering blood sugar, and improving insulin resistance. This article selects four typical compounds of flavonoids, namely baicalin, baicalein, quercetin, and rutin, and reviews their effects and mechanisms of action in improving insulin resistance. With a view for future clinical research on flavonoids as antidiabetic drugs, we therefore provide the theoretical basis for the development and application of flavonoids.

Introduction: Compromise of tissue oxygenation during surgery is associated with increased mortality and morbidity in the postoperative period in patients with congenital cardiac disorders. It may be monitored with near-infrared spectroscopy (NIRS). We aimed to evaluate the tissue oxygenation and factors which may affect it by bilateral cerebral and somatic NIRS levels during cardiopulmonary bypass and to compare the NIRS values of cyanotic and acyanotic patient groups.

Material and methods: Two groups of patients with cyanotic and acyanotic congenital heart diseases were included in the study. Each group consisted of 15 patients between 0 and 5 years of age. All data were collected following anesthesia induction (T1), the 10th (T2) and 30^th min (T3) of cardiopulmonary bypass (CPB), every 30 min during CPB (T4, T5, T6) and 1 h after (TS). Bilateral and somatic NIRS, blood gases, mean arterial pressure, and temperatures were recorded.

Results: Left and right somatic NIRS values in groups at all measurements did not differ significantly. Left and right cerebral NIRS values at T2 and T3 in cyanotic patients were significantly higher than in acyanotic patients. Mean arterial pressure and lactate levels at T1 and T3 measurements were responsible for left cerebral NIRS changes and mean arterial pressure on right cerebral NIRS values.

Conclusions: Monitorization of tissue perfusion has critical importance during CPB of patients with congenital heart defects. Oxygenation may easily and reliably be measured with NIRS. Cerebral and somatic NIRS are more pronounced in cyanotic patients and cerebral NIRS is strongly associated with mean arterial pressure and circulating lactate levels.