Cardiovascular Endocrinology & Metabolism最新文献

We evaluated if admissiontriglyceride-glucose index (TyG index) correlated with the anatomical synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score 2 in non-ST elevation myocardial infarction (NSTEMI), nondiabetic patients.

Methods: SYNTAX score 2 (SSII) was retrospectively evaluated in 260 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. The TyG index was calculated using the following equation: log [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. We stratified patients according to tertiles of SSII (≤21.5, 21.5-30.6, and ≥30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively.

Results: The average age of the patients was 57.2 ± 10.9 years; 135 patients (52.2%) were males. The average TyG index was 8.68 ± 0.12, and SSII was 18.9 ± 9.9. A moderate correlation was found between TyG index and SSII (r = 0.347; P < 0.001) and TyG index was independent risk factors for SSII high [odds ratio (OR), 6.0; 95% CI, 2.7-17.0; P < 0.001].

Conclusion: In nondiabetic patients with NSTEMI, TyG index correlated with the SSII.

Obesity is a major risk factor for cardiovascular disease, yet management remains poor. Cardiologists and healthcare professionals treating people with high cardiovascular risk are in a position to address overweight and obesity to improve cardiovascular health. There are several treatment options for obesity, which are associated with numerous health benefits. Modest weight reductions of 5-10% improve cardiovascular risk factors, with greater weight loss bringing about greater benefits. Anti-obesity medications can support weight reduction when lifestyle modifications alone are insufficient. The weight loss induced by these treatments can improve cardiovascular risk, and some therapies - such as glucagon-like-peptide-1 analogues - may promote these benefits independently of weight loss. Bariatric surgery can induce greater weight losses than other treatment modalities and is associated with numerous health benefits, but newer medications such as semaglutide and those in development, such as tirzepatide, produce robust weight loss efficacy that is approaching that of bariatric surgery. Healthcare professionals must approach this disease with compassion and collaborate with patients to develop sustainable plans that improve health and maintain weight loss over the long term.

Rapid urbanization has led to an exponential increase in lifestyle-associated metabolic disorders presenting a huge socioeconomic burden. Waya is a digital prevention program that guides overweight and obese individuals to maintain a healthy lifestyle through exercise, diet, and educational videos.

Objectives and aims: We aimed to study the demographic patterns of the Waya cohort and examine the prevalence of diabetes (the most common lifestyle-associated metabolic disorder) and its risk factors in comparison to the GEDA 2014/2015-European Health Interview Survey population.

Methods: Waya participants who registered by 1 October 2020 and who answered at least one health survey question were included in this study. Factors such as obesity, hypertension, and diabetes between the two populations were compared using Chi-square test.

Results: Of the 837 participants, 86.1% were women. The proportion of obese participants was higher in Waya than in the German Health Update (GEDA) cohort (women: 39.4% vs. 18%, P < 0.05; men: 37.1% vs. 18.3%, P < 0.05), whereas the proportion of participants with hypertension (women: 12.1% vs. 30.9% in GEDA, P < 0.05; men: 22.4% vs. 32.8% in GEDA, P < 0.05) was lower. The proportion of women with diabetes was low in our cohort (3.9% vs. 7% in GEDA, P < 0.05); however, the proportion of men with diabetes remained the same between the two groups. We observed significant differences between the GEDA and Waya cohorts due to changes in the prevalence pattern over time or target bias of the digital program.

Conclusion: These findings showcase the usability of Waya in collecting real-world insights, which will be beneficial in monitoring the prevalence of chronic metabolic disorders and associated risk factors over time.

Upper gastrointestinal (UGI) bleeding after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in ordinary patients is a common complication and poses a dilemma for clinical doctors to treat. In patients with renal impairment, that is more difficult and has rarely been reported. This case report involves an 82-year-old man who received regular hemodialysis and underwent PCI for acute inferior wall ST-segment elevation myocardial infarction. On the third day after PCI, the patient developed acute UGI bleeding, and gastroscopy confirmed that he had developed compound gastroduodenal ulcers (active stage) with hyperemia of the surrounding mucosa. After fasting, blood transfusion, acid inhibition, gastric protection and symptomatic support treatment, the patient's UGI bleeding remained uncontrolled. Finally, upper gastrointestinal bleeding was stopped by empiric transcatheter arterial embolization (TAE). The patient's condition was controlled through active treatment, and he was eventually discharged from the hospital. Bleeding complications after coronary stenting often present a dilemma, particularly in patients with renal impairment. Therefore, patients such as this should be thoroughly evaluated before any treatment. In the case of no obvious hemorrhagic spots found on endoscopic examination and failure of conservative medical treatment, empiric transcatheter arterial embolization TAE is a well-tolerated and effective treatment for UGI bleeding.

Introduction: The use of personalised care planning has been effective at improving health outcomes for people with long-term health conditions.

Methods: We analysed data in relation to changes in BMI/HbA1c. The sample was made up of (n = 36) participants randomised to either the active intervention group (App+usual care) or the control group (usual care).

Results: The average HbA1c percentage change for the treatment group was 9.5%, but just -2% for the control (usual care) group (P = 0.015 for the difference). The average percentage change in BMI for the treatment group was -0.4%, but 0.1% for the control group (P = 0.03 for the difference).

Conclusion: These preliminary findings point to how the provision of personalised plans of care, support and education linked to a mobile app, can result in HbA1c and BMI reduction over a 6-month period. While the results are preliminary, they portend the potential for digital plans of care to enhance T2DM management.