ABSTRACT
The study was aimed to define the predictors for peripheral and carotid revascularization in type 2 diabetic population. In all, 279 patients with type 2 diabetes and peripheral arterial disease were enrolled in a cohort longitudinal study. Study population was followed up for 24 months for the need and performance of peripheral or carotid revascularization. Logistic regression analysis was conducted to identify variables predictive of revascularization, when lipid plasma levels, glycemia, arterial hypertension, blood pressures, ankle-brachial index, intima-media thickness, body mass index, waist circumference, and hip distances were put in a model. Total cholesterol and maximal value of carotid intima-media thickness were presented as factors that independently influenced the performed peripheral revascularization. Waist circumference is defined as independent factor associated with carotid endarterectomy. Measurement of carotid intima-media thickness, waist circumference, and plasma lipid levels in type 2 diabetes with manifested peripheral and carotid arterial disease should be recommended in a manner of proper risk stratification of this population.
Subject(s)
Carotid Artery Diseases/surgery , Diabetes Mellitus, Type 2/complications , Peripheral Vascular Diseases/surgery , Vascular Surgical Procedures , Aged , Carotid Arteries/diagnostic imaging , Carotid Artery Diseases/blood , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/etiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnostic imaging , Diabetes Mellitus, Type 2/surgery , Disease Progression , Endarterectomy, Carotid , Female , Humans , Lipids/blood , Logistic Models , Longitudinal Studies , Male , Middle Aged , Peripheral Vascular Diseases/blood , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/etiology , Risk Assessment , Risk Factors , Time Factors , Tunica Intima/diagnostic imaging , Tunica Media/diagnostic imaging , Ultrasonography , Waist CircumferenceABSTRACT
OBJECTIVE: Adjusting pacemaker pulse amplitude influences the longevity of the pacemaker. Our aim was to establish the initial longevity gain. METHODS: Forty randomly selected patients with implanted pacemakers were analyzed. Mean age was 65.58+/-13.7 years. All pacemakers were working on factory settings of pulse amplitude 3.5 V and pulse width of 0.4 ms for average of 3 years before the adjustment. Initial mean longevity was projected to 68.61+/-18.86 months, mean battery voltage 2.78 V, and mean battery current 14.21+/-2.61 microA. RESULTS: Pulse amplitude threshold test was performed and average value of 0.632+/-0.22 V was obtained. Pulse amplitude was programmed to 2.5 V and pulse width was left unchanged. New readings of battery data were obtained. Battery voltage did not show immediate changes, and battery current decreased to 11.53+/-1.98 microA. New average longevity was projected to 81.03+/-19.82 months, which presents a 12.42 months of initial longevity gain with statistical significance at 95% confidence interval (p=0.003). Positive correlation was found between the new pulse amplitude and new values of battery current (p<0.01). CONCLUSION: Pulse amplitude decrease of only 1 V provides significant initial longevity gain of more than a year. If found correlations would have any impact on further longevity gains over longer period of time is yet to be established.
Subject(s)
Bradycardia/therapy , Cardiac Pacing, Artificial , Electrodes, Implanted , Pacemaker, Artificial , Aged , Equipment Design , Female , Humans , Longitudinal Studies , MaleABSTRACT
The aim of the study was to evaluate the prevalence of carotid artery disease in type 2 diabetes patients with coronary artery disease, and to establish the influence of metabolic factors on its occurrence. In all, 145 patients (aged 59.85+/-8.43 years, diabetes duration 8.89+/-6.29 years) were randomly selected in a cross-sectional study. Carotid ultrasound was used for evaluation of the presence of carotid plaque (CP) and stenosis (CS). A logistic regression model was constructed to define the influence of risk factors-- arterial hypertension, systolic blood pressure, weight, waist to hip ratio, high blood glucose and plasma lipid levels. Carotid artery disease was present in these patients with a prevalence of 81.9% for CP, 25.2% for unilateral CS and 13.5% for bilateral CS. The low-density lipoprotein (LDL) cholesterol level was an independent predictor for CS (OR 1.936; 95% CI 1.2413.026). Non-high density lipoprotein (HDL) cholesterol (OR 1.374; 95% CI 1.0351.825) and glycaemia (OR 1.214; 95% CI 1.0221.442) were predictors for carotid plaque.
Subject(s)
Carotid Artery Diseases/etiology , Coronary Artery Disease/complications , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/epidemiology , Aged , Blood Glucose/metabolism , Blood Pressure , Carotid Artery Diseases/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 2/physiopathology , Female , Humans , Lipid Metabolism , Male , Middle Aged , Prevalence , Risk FactorsABSTRACT
In order to assess the predictive value of left ventricular (LV) function on prognosis during 16 years of follow-up we retrospectively/prospectively evaluated 320 patients (mean age 55.9 +/- 9.2 years; 44 women, 276 men) undergoing coronary artery bypass surgery. Patients were divided according to the assessed echocardiographically pre- and postoperative LV ejection fraction (LVEF) into two groups: patients with LV dysfunction (EF < 55%) and patients with preserved LV function (EF >or= 55%). In order to assess the prognostic variables, patients were further subdivided into a group with severely depressed LV function (EF Subject(s)
Coronary Artery Bypass
, Coronary Artery Disease/surgery
, Coronary Artery Disease/complications
, Coronary Artery Disease/physiopathology
, Female
, Humans
, Male
, Middle Aged
, Predictive Value of Tests
, Prognosis
, Stroke Volume
, Ventricular Dysfunction, Left/complications
, Ventricular Function, Left
