ABSTRACT
Background and Objective: Everolimus-eluting stents, compared with bare metal stents, reduced the risk of restenosis in clinical trials with strict inclusion and exclusion criteria. The objective of this study was to determine the three months clinical outcomes of Everolimus Eluting Stents in patients with stable angina pectoris in Pakistani population
Methods: It was a descriptive cross-sectional study and the data was collected from Catheterization Laboratory Cardiology Department Lady Readings Hospital Peshawar. Our study included all the patients with stable coronary artery disease who had received Everolimus eluting stents from August, 2013 to April, 2014. Total study duration was 09 months. The primary end points were the rate of target vessel revascularization, myocardial infarction at three months. All those patients who received Everolimus coronary stents were recalled after three months from the index procedure and enquired about target vessel revascularization [TVR], myocardial infarction and hospitalization over the last three months. Data analysis was done using SPSS version 16
Results: Our study included 378 patients with stable ischemic heart disease who underwent revascularization with Everolimus eluting stent.These patients were followed up for a period of 3 months for target vessel revascularization [TVR] and myocardial infarction [MI]. Mean age was 57.04+/-9.307, males were [72%]. Left Anterior Descending [LAD] and Left circumflex [LCx] were the predominant vessels vascularized. Mean length of Everolimus eluting stent was 21.91+/- 4.6 while mean diameter of stent was 2.90+/-0.248. Thirteen [3.4%] patients had TVR and 14 [3.7%] patients had MI during three months follow up after PCI. TVR and MI were prevalent in patients who received longer Everolimus stents as compared to those who received shorter stents at three months, and the difference between the two was statistically significant
Conclusion: Short-term results from this study suggest that real-world outcomes among 378 patients are comparable to those reported in other registries and trials, and safety outcomes as measured by rates of TVR, MI were low. The long-term safety of Everolimus-eluting stents needs to be ascertained in large, randomized trials
ABSTRACT
Background and Objectives: Lipoprotein-A has been recognized as a risk factor for ischemic heart diseases. Myocardial infarction [MI] is common complication of ischemic heart disease. Diabetes play an incremental role in the development of coronary artery disease [CAD], however still there are conflicting data regarding the relationship of Lipoprotein-B and MI. We therefore wanted to evaluate the relationship of Lipo-B, MI and diabetes mellitus. Our objective was to determine the non-fasting Apo-lipoprotein B and triglycerides level among type II diabetic patients with ischemic heart disease and to compare with type II diabetic without ischemic heart disease
Methods: This was cross sectional study where two groups of patients were recruited in the study, Group-I included patient with Ischemic Heart Disease and diabetes while Group-II comprised of diabetes without Ischemic Heart Disease. Age, sex and basic demographic matching was done between the two groups. Data were collected using random sample. The comparative approach was used to see the role of diabetes in the elevation of Apo-lipoprotein B level, which is a risk factor for Ischemic heart diseases
Results: Two hundred forty eight patients [Cases: 123 Diabetic with myocardial infarction and [Control: 125 Diabetic without myocardial infarction] were included in the study. Mean Apo-B among diabetic patients with myocardial infarction was high [68.3+/-24.23 ng/ml] compared to non-cardiac patients [49.97+/-33.880 ng/ml] with a p <0.000. Marked difference was also observed in triglycerides levels where it was found very high [301.4+/-55.1 mg/dL] in patients of diabetes with myocardial infarction as compared to subjects without MI [137.7+/-84.7 mg/dL]. There was positive correlation between Apo-lipoprotein and Triglycerides [P value=039]
Conclusion: Based on the study result it was concluded that Apo-lipoprotein and triglycerides in diabetic patients with myocardial infarction, had higher levels compared to diabetic patients without Myocardial infarction and this could be a consequence of increase in age, insulin resistance and deficiency of insulin in the body. We also found positive correlation between Apolipoprotein and Triglycerides
ABSTRACT
Objective: To compare the severity of carotid artery disease in diabetic and non-diabetic patients undergoing coronary artery bypass grafting. Methods: From January to June 2008, 379 patients undergoing elective coronary artery bypass surgery were preoperatively evaluated for the presence of carotid stenoses by duplex scanning. Patients were divided into two groups, Group I, 156 [41.2%] diabetic patients and Group II, 223 [58.8%] non-diabetic patients. Results: There were 314 [82.8%] males and 65 [17.2%] females with a mean age of 57.2 +/- 9.1 years. In diabetic group there were 125 [80.1%] males and 31 [19.9%] females with a mean age of 56.3 +/- 8.9 years. Left main stem stenosis was present in 59 [37.8%] diabetics and 45 [20.2%] non-diabetics [p<0.0001]. Diffuse disease in left anterior descending [LAD] artery was observed in more diabetic patients 72 [46.2%] as compared to non-diabetics 83 [37.2%] [p<0.295]. Single tight stenosis in LAD was observed in more non-diabetics. Significant carotid artery stenosis was observed in 50 [13.2%] patients. Carotid artery stenosis was observed in 30 [19.2%] diabetics as compared to 20 [9%] non-diabetics [p<0.004]. Analysis of percentage stenosis of carotid artery disease in the study population revealed that >70% stenosis was present in 20 [5.3%] with 13 [8.3%] diabetics and 7 [3.1%] non-diabetics [p<0.025]. Stenosis of 50 70% was observed in 30 [7.9%] of which 17 [10.9%] were diabetics and 13 [5.8%] were non-diabetics. Conclusion: Presence of diabetes mellitus is associated with diffuse coronary artery disease and significant carotid artery disease in patients undergoing coronary artery bypass grafting