The Impact of Hypertension and Diabetes on Outcome in Patients Undergoing Percutaneous Coronary Intervention
Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. The American journal of medicine
(Impact Factor: 5).
03/2011; 124(3):265-75. DOI: 10.1016/j.amjmed.2010.09.015
Information relating the outcome of percutaneous coronary intervention to diabetes mellitus or hypertension is limited. The study objective was to describe the outcome in patients undergoing percutaneous coronary intervention in relation to diabetes and hypertension.
Data were extracted from 5 national registers: the Swedish Coronary Angiography and Angioplasty Register (all percutaneous coronary interventions), the Prescribed Drug Registry (all prescribed pharmaceuticals purchased in Swedish pharmacies), the Swedish Hospital Discharge Register (data on myocardial infarction, revascularization, stroke, and congestive heart failure from in-hospital and specialist health care), and the National Population Register and Cause of Death Register (data on death). We included all "first percutaneous coronary interventions" between January 1, 2006, and December 31, 2008 (n=44,268; followed an average of 1.9 [± 0.9] years).
Mortality was 6.4% and highest in patients with diabetes plus hypertension. Hypertension per se did not increase mortality or the risk for repeat intervention, but carried a 10% increased risk for subsequent myocardial infarction, increasing to a 4-fold increase when combined with diabetes. Stroke occurred in 2%; the importance of hypertension was evident in nondiabetic patients, but even stronger in diabetic patients. Congestive heart failure caused hospital admission in 8%, with a negative influence from hypertension with and without diabetes.
After percutaneous coronary intervention and with modern pharmacotherapy, diabetes had a negative effect on the outcome, especially when combined with hypertension. Hypertension per se was not associated with increased mortality but with an increased risk for myocardial infarction, stroke, and congestive heart failure, probably related to widespread coronary artery disease. Improved diabetes care might improve the prognosis.
Available from: sciencedirect.com
[Show abstract] [Hide abstract]
ABSTRACT: The synergistic effect of diabetes mellitus (DM) and hypertension on mid-term outcome among acute myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI) is still controversial.
A total of 2438 patients with acute MI who underwent PCI from January 2007 to November 2010 were studied. Patients were stratified to four groups according to the presence of DM or hypertension and followed up during 12 months. We analyzed the influence of hypertension and DM on major adverse cardiac events (MACE: death, recurrent MI, repeated coronary artery revascularization).
No history of hypertension or DM was found in 35.0%, a history of hypertension in 27.2%, a history of DM in 15.0%, and a history of both disease entities in 22.8%. The rate of MACE was significantly higher in hypertensive DM group (15.9% vs. 22.9% vs. 28.8% vs. 37.0%, log-rank p<0.001). In multivariate analysis, hypertension and DM were meaningful predictors of mid-term mortality, and the combination of the two was a stronger predictor (hazard ratio=1.790; 95% confidence interval=1.313-2.442; p<0.001).
After PCI, acute MI patients with a history of DM or hypertension had a higher mid-term mortality than acute MI patients without such a history. The combination of DM and hypertension appeared to be more strongly associated with mortality than DM or hypertension alone.
Journal of Cardiology 07/2012; 60(4):257-63. DOI:10.1016/j.jjcc.2012.06.003 · 2.78 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Diabetic mellitus (DM) is a major risk factor of morbidity, mortality and economic cost to society. Diabetic patients are at risk of having microvascular or macrovascular disorders of diabetes. Postoperative anemia have wide spectrum of some early complications that require more care in hospitalization stays. Therefore, this study was designed to evaluate effect of preoperative anemia on short-term clinical outcomes in diabetic patients undergoing elective off-pump CABG. This study conducted on 86 diabetic patients underwent elective off-pump CABG surgery from August to October 2011, in Afshar Cardiovascular Center, Yazd, Iran. The patients had hemoglobin concentration between 10-12 mg/dl, patients with preoperative atrial fibrillation and renal and respiratory dysfunction were excluded from this study. Participants were randomly assigned into two groups; the normal group (n=42) that had hemoglobin concentration ~ 12-15 g/dl and the anemic group (n=44) had hemoglobin concentration~7-10 g/dl. We evaluated post-CABG variables including incidence of atrial fibrillation and early morbidity such as infection, vomiting, renal and respiratory dysfunctions, ICU or hospital stay and early mortality. Data were analyzed by ANOVA, Chi-square and Fisher's exact test for quantitative and qualitative variables. The mean age of the patients was 52.51±6.9 years, from all of patients 64 cases (74.4%) were male and 22 cases (445.6%) were female. Postoperative atrial fibrillation was observed in 17 cases (19.8%), 7 cases (16.7%) of whom were in normal group and 10 cases (22.7%) of whom were in anemia group. anemia could significantly increase hospital stay (P=0.0001) but no ICU stay. Preoperative anemia did not affect the incidence of atrial fibrillation and early complications and mortality in patients undergoing off-pump CABG. However, anemia could increase postoperative hospital stay and renal dysfunction significantly.
Acta medica Iranica 09/2012; 50(9):615-8.
Available from: Hussein A.F. Nafakhi
[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study was to assess the impact of hypertension on angiographic results in Iraqi patients with coronary artery disease. Six hundred and ifty seven patients with coronary artery disease (CAD) were submitted to routine coronary angiography in the period from January 2008 to December 2010. A comparison and evaluation have been divided into 2 stages. There was no signiicant association between patients with CAD who had a history of hypertension only with the number and distribution of coronary artery vessels involvement, as well as with morphological severity of coronary lesions. But, there was a statistically signiicant association between hypertension associated with other cardiac risk factors with multiple coronary lesions. Hypertension was signiicantly associated with multiple coronary artery lesions when combined with other cardiac risk factors.
Medicinski glasnik 02/2013; 10(1):136-9. · 0.20 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.