[Modifiable risk factors for non-cardioembolic transient ischemic attacks. Case control studies in the general population]. / Factores de riesgo modificables para el accidente isquémico transitorio no cardioembólico. Estudio de casos y controles en población general.

INTRODUCTION: Transient ischemic attacks (TIA) often precede a stroke. AIMS: The purpose of this study is to examine the modifiable cardiovascular risk factors for non-cardioembolic TIA. PATIENTS AND METHODS: A population based case control study was conducted in a district within the city of Barcelona. The cases were 103 patients with non-cardioembolic TIA, who had been diagnosed by a neurologist, and with normal CAT or MRI scans. Subjects were paired by age and sex with 193 controls without TIA or stroke, who were selected by simple random sampling from the clinical records file at the centre. The risk factors were studied using a standardized questionnaire that included the following factors which were codified in a dichotomous manner: smoking, arterial hypertension (AHT), hypercholesterolemia, hypertriglyceridemia, obesity, impaired fasting glucose and diabetes mellitus (DM). RESULTS: The average age was 74.6 years and 52.3% of the subjects were females. All the modifiable cardiovascular risk factors were associated to a higher risk of TIA, although only AHT (OR: 1.9; CI 95%: 1.1-3.3) and obesity (OR: 2.1; CI 95%: 1.2-3.6) were associated in a significant way in the univariate analysis. In the multivariate analysis by logistic regression, the modifiable cardiovascular risk factors that were associated in a significant manner were AHT (OR: 1.9; CI 95%: 1.0-3.6), obesity (OR: 2.8; CI 95%: 1.4-12.3) and DM (OR: 1.7; CI 95%: 1.0-2.9). CONCLUSIONS: In the present study, AHT, obesity and DM were seen to be modifiable risk factors for non-cardioembolic TIA.

Factores de riesgo modificables para el accidente isquémico transitorio no cardioembólico. Estudio de casos y controles en población general / Modifiable risk factors for non-cardioembolic transient ischemic attacks. Case-control studies in the general population

Introducción. Frecuentemente, el accidente isquémico transitorio (AIT) precede al ictus. Objetivo. Estudiar factores de riesgo cardiovascular modificables para el AIT no cardioembólico. Pacientes y métodos. Se realizó un estudio de casos y controles de base poblacional, realizado en un barrio urbano de la ciudad de Barcelona. Los casos fueron 103 pacientes con AIT no cardioembólico, diagnosticados por un neurólogo y con TAC o RM normales. Se aparearon por edad y sexo con 193 controles sin AIT ni ictus, seleccionados por muestreo aleatorio simple del archivo de historias clínicas del centro. Los factores de riesgo se estudiaron mediante un cuestionario estandarizado que recogió los siguientes factores codificados de manera dicotómica: tabaquismo, hipertensión arterial (HTA), hipercolesterolemia, hipertrigliceridemia, obesidad, intolerancia a la glucosa en ayuno y diabetes mellitus (DM). Resultados. La edad media fue de 74,6 años, con un 52,3 por ciento de mujeres. Todos los factores de riesgo cardiovascular modificables se asociaron a un superior riesgo de AIT, aunque sólo la HTA (OR = 1,9; IC 95 por ciento = 1,1-3,3) y la obesidad (OR = 2,1; IC 95 por ciento = 1,2-3,6) se asociaron de manera significativa en el análisis univariado. En el análisis multivariante mediante regresión logística, los factores de riesgo cardiovascular modificables asociados de manera significativa fueron la HTA (OR = 1,9; IC 95 por ciento = 1,0-3,6), la obesidad (OR = 2,8; IC 95 por ciento = 1,4-12,3) y la DM (OR = 1,7; IC = 95 por ciento = 1,0-2,9). Conclusiones. En el presente estudio, la HTA, la obesidad y la DM han sido factores de riesgo modificables para el AIT no cardioembólico (AU)

Introduction. Transient ischemic attacks (TIA) often precede a stroke. Aims. The purpose of this study is to examine the modifiable cardiovascular risk factors for non-cardioembolic TIA. Patients and methods. A population-based case-control study was conducted in a district within the city of Barcelona. The cases were 103 patients with non-cardioembolic TIA, who had been diagnosed by a neurologist, and with normal CAT or MRI scans. Subjects were paired by age and sex with 193 controls without TIA or stroke, who were selected by simple random sampling from the clinical records file at the centre. The risk factors were studied using a standardized questionnaire that included the following factors which were codified in a dichotomous manner: smoking, arterial hypertension (AHT), hypercholesterolemia, hypertriglyceridemia, obesity, impaired fasting glucose and diabetes mellitus (DM). Results. The average age was 74.6 years and 52.3% of the subjects were females. All the modifiable cardiovascular risk factors were associated to a higher risk of TIA, although only AHT (OR: 1.9; CI 95%: 1.1-3.3) and obesity (OR: 2.1; CI 95%: 1.2-3.6) were associated in a significant way in the univariate analysis. In the multivariate analysis by logistic regression, the modifiable cardiovascular risk factors that were associated in a significant manner were AHT (OR: 1.9; CI 95%: 1.0-3.6), obesity (OR: 2.8; CI 95%: 1.4-12.3) and DM (OR: 1.7; CI 95%: 1.0-2.9). Conclusions. In the present study, AHT, obesity and DM were seen to be modifiable risk factors for non-cardioembolic TIA (AU)

[Cardiovascular events linked to the new diagnostic categories of diabetes mellitus]. / Episodios cardiovasculares asociados a las nuevas categorías diagnósticas de la diabetes mellitus propuestas por la Asociación Americana de Diabetes.

OBJECTIVE: To study the cardiovascular events linked to the new diagnostic categories of diabetes mellitus proposed by the American Diabetes Association. DESIGN: Descriptive cross-sectional study.Setting. Urban health district.Participants. 2248 patients > 14, selected by simple random sampling from the medical records archive. MAIN MEASUREMENTS: Through the medical records review, patients were classified into those with normal glucaemia, those intolerant to glucose when fasting (IGF) and those with type-2 diabetes mellitus (DM2). Patients were studied for cardiovascular events, ischaemic cardiopathy, cerebrovascular disease and peripheral arteriopathy. The likelihood of such events in patients with IGF and DM2 was compared with normal-glucose patients through logistical regression, adjustment for age, gender, hypertension, hypercholesterolaemia, hypertriglyceridaemia and tobacco dependency. RESULTS: 1677 patients were classified: 1237 with normal glucaemia, 175 with IGF and 265 with DM2. The DM2 patients were more likely to have at least one cardiovascular event (OR, 2.7; 95% CI, 1.7-4.4), ischaemic cardiopathy (OR, 2.0; 95% CI, 1.1-3.6), cerebrovascular disease (OR, 3.0; 95% CI, 1.4-6.6) or peripheral arteriopathy (OR, 2.9; 95% CI, 1.2-7.7). Results reached no statistical significance in patients with IGF, though these were more likely to suffer a cardiovascular event (OR, 1.1; 95% CI, 0.6-2.1), ischaemic cardiopathy (OR, 1.1; 95% CI, 0.3-4.4), cerebrovascular disease (OR, 1.5; 95% CI, 0.5-4.1) or peripheral arteriopathy (OR, 1.2; 95% CI, 0.3-4.6). CONCLUSIONS: Patients with DM2 are more likely to present cardiovascular events, a phenomenon not seen in the case of IGF.

Episodios cardiovasculares asociados a las nuevas categorías diagnósticas de la diabetes mellitus propuestas por la Asociación Americana de Diabetes / Cardiovascular events linked to the new diagnostic categories of diabetes mellitus proposed by the American Diabetes Association

Objetivo. Estudiar los episodios cardiovasculares asociados a las categorías diagnósticas de la diabetes propuestas por la Asociación Americana de Diabetes. Diseño. Estudio descriptivo, transversal. Emplazamiento. Área básica de salud urbana. Participantes. Un total de 2.248 pacientes > 14 años, seleccionados por muestreo aleatorio simple del archivo de historias clínicas (HC). Mediciones principales. Mediante revisión de la HC se clasificó a los pacientes en normoglucemia, intolerancia a la glucosa en ayuno (IGA) y diabetes mellitus tipo 2 (DM2). Se estudió si los pacientes presentaban los episodios cardiovasculares cardiopatía isquémica, enfermedad cerebrovascular y arteriopatía periférica. La probabilidad de presentar dichos episodios en los pacientes con IGA y DM2 respecto a los pacientes normoglucémicos se analizó mediante regresión logística, ajustando por edad, sexo, hipertensión arterial, hipercolesteremia, hipertrigliceridemia y tabaquismo. Resultados. Se clasificó a 1.677 pacientes, de los que 1.237 fueron normoglucémicos, 175 pacientes presentaron IGA y 265 tenían DM2. Los pacientes con DM2 presentaron una probabilidad superior de tener al menos un episodio cardiovascular (OR, 2,7; IC del 95 por ciento, 1,7-4,4), cardiopatía isquémica (OR, 2,0; IC del 95 por ciento, 1,1-3,6), enfermedad cerebrovascular (OR, 3,0; IC del 95 por ciento, 1,46,6) y arteriopatía periférica (OR, 2,9; IC del 95 por ciento, 1,2-7,7). Los resultados no alcanzaron significación estadística en los pacientes con IGA, aunque tuvieron una mayor probabilidad de presentar algún episodio cardiovascular (OR, 1,1; IC del 95 por ciento, 0,6-2,1), cardiopatía isquémica (OR, 1,1; IC del 95 por ciento, 0,3-4,4), enfermedad cerebrovascular (OR, 1,5; IC del 95 por ciento, 0,54,1) y arteriopatía periférica (OR, 1,2; IC del 95 por ciento, 0,3-4,6). Conclusiones. Los pacientes con DM2 tienen una probabilidad superior de presentar episodios cardiovasculares, fenómeno que no se evidencia en la IGA (AU)

[Cardiovascular risk and the new diagnostic categories for diabetes mellitus proposed by the American Diabetes Association]. / Riesgo cardiovascular asociado a las nuevas categorías diagnósticas de la diabetes mellitus propuestas por la Asociación Americana de Diabetes.

OBJECTIVE: To study the cardiovascular risk (CVR) associated with the diagnostic criteria for diabetes proposed by the American Diabetes Association. DESIGN: Cross-sectional, descriptive study. SETTING: Urban health district. PATIENTS: 1840 patients > 14 years old, selected by simple randomised sampling from the clinical records (CR) archive, were studied. METHOD: Through review of the CR, the patients were classified as having: normal glycaemia, disturbed basal glycaemia (DBG) and type-2 diabetes mellitus (DM2). CVR was studied through the simplified Framingham method and the CVR factors of obesity, tobacco dependency, hypertension, hypercholesterolaemia and hypertriglyceridaemia. The likelihood of having high or very high CVR and the CVR factors described in the patients with DBG or DM2 were compared with the same in those with normal glycaemia, through logistical regression with the odds ratio adjusted for age and sex. RESULTS: 1351 patients were classified: 995 with normal glycaemia, 146 with DBG and 210 with DM2. Patients with DBG or DM2 had greater likelihood of high or very high CVR, with some OR at 2.26 (95% CI, 1.39-3.69) and 2.74 (95% CI, 1.81-4.15), respectively. They also had differences (p < 0.05) for obesity (OR, 1.76 and 1.58), hypertension (OR, 1.75 and 2.15) and hypertriglyceridaemia (OR, 1.73 and 2.70), respectively. There were no differences (p > 0.05) for tobacco dependency and hypercholesterolaemia. No differences were found (p > 0.05) between DBG and DM2 for CVR and the CVR factors studied. CONCLUSIONS: Patients with DBG and DM2 are at high CVR.

Riesgo cardiovascular asociado a las nuevas categorías diagnósticas de la diabetes mellitus propuestas por la asociación americana de diabetes / Cardiovascular risk and the new diagnostic categories for diabetes mellitus proposed by the american diabetes association

Objetivo. Estudiar el riesgo cardiovascular (RCV) asociado a las categorías diagnósticas de la diabetes propuestas por la Asociación Americana de Diabetes. Diseño. Estudio descriptivo, transversal. Emplazamiento. Área básica de salud (ABS) urbana. Pacientes. Se estudiaron 1.840 pacientes 15 años, seleccionados por muestreo aleatorio simple del archivo de historias clínicas (HC). Método. Mediante revisión de la HC se clasificó a los pacientes en normoglucemia, glucemia basal alterada (GBA) y diabetes mellitus tipo 2 (DM2). Se estudió el RCV mediante el método de Framingham simplificado y los factores de RCV obesidad, tabaquismo, hipertensión arterial, hipercolesterolemia y hipertrigliceridemia. La probabilidad de tener un RCV elevado o muy elevado y los factores de RCV descritos en los pacientes con GBA y DM2 respecto a los normoglucémicos se estudiaron mediante regresión logística, ajustando la odds ratio (OR) por edad y sexo. Resultados. Se clasificó a 1.351 pacientes: 995 normoglucémicos, 146 pacientes GBA y 210 pacientes DM2. Los pacientes con GBA y DM2 tuvieron una probabilidad superior de presentar un RCV elevado o muy elevado, con unas OR de 2,26 (IC del 95 por ciento, 1,39-3,69) y 2,74 (IC del 95 por ciento, 1,81-4,15), respectivamente. También presentaron diferencias (p 0,05) respecto al tabaquismo y la hipercolesterolemia. No se detectaron diferencias (p > 0,05) entre GBA y DM2 respecto al RVC y los factores de RCV estudiados. Conclusiones. Los pacientes con GBA y DM2 tienen un elevado RCV (AU)