ABSTRACT
Background: The objective was to measure the correlation between carotid intima medial thickness (CIMT) with duration of type 2 diabetes mellitus (DM) and its correlation with biochemical markers and body mass index (BMI). Methods: The study was conducted in a tertiary care hospital in Kolkata. Total 100 patients were selected randomly who met the inclusion criteria. Among total patients, 20 cases were newly detected type 2 DM patients and 80 were cases of established diabetes, with different duration of DM. CIMT was measured by carotid artery ultrasonography using an echo tomography system having midfrequency of 7.5MhZ and detection limit of 0.1mm. Duration of diabetes was measured as present age minus age of detection of DM. BMI was measured by the guideline of WHO. The parameters were estimated such as microalbuminuria by radioimmunoassay, fasting blood sugar (FBS) level and HbA1C by HPLC method, uric acid by uricase method. Data was collected using a predetermined proforma and statistical analyses were done. Results: Duration of DM was positively correlated with CIMT and association was statistically significant (P<0.02). There was increase in CCA-IMT and ICA-IMT across increasing level of FBS and HbA1c (P<0.01). Microalbuminuria is considered a novel atherosclerotic risk factor, was found significantly associated with mean CIMT (P<0.001). CIMT was also significantly associated with HbA1C (P<0.001). The significantly (P<0.01) increased level of uric acid indicated higher carotid plaque. Conclusion: CIMT is an objective measure of subclinical atherosclerosis, which is a non- invasive, less expensive, duration and reproducible way of demonstrating subclinical atherosclerosis. Thus, it can serve as a window for atherosclerosis status in other major arteries like coronary artery and cerebral arteries. The CIMT is closely associated with several markers viz. uric acid, blood sugar, HbA1c, albumin and BMI during the progression of type 2 DM.
ABSTRACT
Background: Cardiac troponin (CTnT) and creatinine kinase myocardial isoform (CKMB) are suitable marker for myocardial injury following percutaneous coronary intervention (PCI). Elevation of these markers lead to major adverse cardiac events (MACEs). The objective was to detect the elevation of serum CTnT and CKMB during post-PCI period and identify MACE during six-month followed up among patients in eastern Indian. Methods: In present study, 100 patients were randomly selected for coronary angioplasty between April2012 to March2013. All the cases were referred to catheterization laboratory for elective PCI for single vessel or multivessel in native coronary artery. The CTnT and CKMB parameters were estimated as per standard protocol. The categorization was done on the basis of baseline (normal value), ≤3time and >3time elevation for both the biomarkers and respective MACEs as MACE-1, MACE-2, MACE-3, MACE-4 and MACE-5 were determined. Results: There were more MACE in patients in six month follow up who sustainned >3times elevation in CTnT and CKMB during pos-PCI period. There was highly significant correlation (P<0.001 and P<0.01) with increasing trend of CTnT and CKMB elevation and risk of MACEs. MACEs were significantly (P<0.001 and P<0.01) correlated with diabetes mellitus, hypertension, renal dysfunction, fluoroscopy time, stent length, left ventricular ejection fraction and type of lesion. It was also observed that more hospital stay led to elevation of CTnT and CKMB. Conclusions: It is concluded that the elevation of CTnT and CKMB in serum during post-PCI can predict MACEs in six-month follow up in stable ischaemic heart disease.