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M Peltonen,
K Lalic,
A Gilis-Januszewska,
L Perrenoud,
A Pfeiffer,
P Evans,
A C Mesquita,
U Handke,
D Misina,
C McIntosh, [......],
B Paulweber,
S Puhl,
J Herbst,
T Yilmaz,
B Kulzer,
F Muylle,
U Hühmer,
V Dimitrijevic-Sreckovic,
P Djordevic,
A Jotic
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ABSTRACT: We analysed the Finnish Diabetes Prevention Study data in order to evaluate how the new HbA(1c) -based criterion compares with the oral glucose tolerance test in diagnosing Type 2 diabetes among high-risk individuals during a prospective average follow-up of 4 years.
In the Diabetes Prevention Study, 172 men and 350 women who were overweight and had impaired glucose tolerance at baseline were randomized into an intensive lifestyle intervention or a control group. The oral glucose tolerance test and HbA(1c) measurements were performed annually until the diagnosis of diabetes using the World Health Organization 1985 criteria.
The sensitivity of the HbA(1c) ≥ 6.5% (≥ 48 mmol/mol) as a diagnostic criterion for Type 2 diabetes was 35% (95% CI 24%, 47%) in women and 47% (95% CI 31%, 64%) in men compared with diagnosis based on two consecutive oral glucose tolerance tests. The corresponding sensitivities for HbA(1c) ≥ 6.0% (≥ 42 mmol/mol) were 67% (95% CI 55%, 77%) and 68% (95% CI 51%, 82%). The participants with HbA(1c) ≥ 6.5% (≥ 48 mmol/mol) and diabetes based on the oral glucose tolerance test were more obese and had higher fasting glucose and 2-h glucose concentrations than those who had a diabetic oral glucose tolerance test but HbA(1c) < 6.5% (< 48 mmol/mol). There were no differences in the predictive performance of baseline fasting glucose, oral glucose tolerance test and HbA(1c) .
Of those with diabetes diagnosis based on two oral glucose tolerance tests during the Diabetes Prevention Study follow-up, 60% would have remained undiagnosed if diagnosis had been based on HbA(1c) ≥ 6.5% (≥ 48 mmol/mol) criterion.
Diabetic Medicine 01/2011; 28(1):36-42. · 2.90 Impact Factor
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ABSTRACT: Of those with diabetes diagnosis based on two oral glucose tolerance tests during the Diabetes Prevention Study follow-up, 60% would have remained undiagnosed if diagnosis had been based on HbA(1c) ≥ 6.5% (≥ 48 mmol/mol) criterion.
Diabetic medicine : a journal of the British Diabetic Association. 01/2011; 28(1):36-42.
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ABSTRACT: The study aimed to examine the role of the metabolic syndrome (MetS) as a predictor of incident cardiovascular disease (CVD) events and incident diabetes, and to compare the various definitions of MetS.
The population-based Health 2000 Study included 6105 individuals, aged 30-79 years, followed-up for 7 years. CVD during follow-up was defined as coronary death, acute myocardial infarction, coronary revascularization or stroke. MetS was defined according to the International Diabetes Federation (IDF), the 2005 National Cholesterol Education Program-Adult Treatment Panel III (ATP III), the World Health Organization (WHO) and the new Harmonization definitions. The Bayesian information criterion (BIC) was used to compare different Cox proportional-hazards regression models.
The highest prevalence estimates of MetS at baseline were observed with the Harmonization definition: 47.8% in men and 40.7% in women. During the follow-up, 238 cases of incident CVD and 172 cases of incident diabetes were observed. All definitions of MetS were significant predictors for incident CVD and diabetes. BIC suggested that the new Harmonization definition of MetS as one entity was a better predictor of the CVD endpoint than the sum of its components, but not for diabetes. Also, the Harmonization definition of MetS was a better predictor of CVD than the Framingham equation in women, but not in men.
Irrespective of definition, MetS is a significant predictor of incident CVD events and incident diabetes. Also, the new Harmonization definition may be a better predictor of incident CVD than the sum of its components.
Diabetes & Metabolism 11/2010; 36(5):395-401. · 2.41 Impact Factor
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B Paulweber,
P Valensi,
J Lindström,
N M Lalic,
C J Greaves,
M McKee,
K Kissimova-Skarbek,
S Liatis,
E Cosson,
J Szendroedi, [......],
G Terry,
D Tolks,
F Toti,
A Undeutsch,
C Valadas,
D Velickiene,
P Vermunt,
R Weiss,
J Wens,
T Yilmaz
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ABSTRACT: The prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide.
This guideline provides evidence-based recommendations for preventing T2DM.
A European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria.
Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number-needed-to-treat: 6.4 over 1.8-4.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by >or= 5 % lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective.
Prevention using lifestyle modifications in high-risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication.
Hormone and Metabolic Research 04/2010; 42 Suppl 1:S3-36. · 2.19 Impact Factor
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J Lindström,
A Neumann,
K E Sheppard,
A Gilis-Januszewska,
C J Greaves,
U Handke, P Pajunen,
S Puhl,
A Pölönen,
A Rissanen, [......],
G Terry,
D Tolks,
F Toti,
A Undeutsch,
C Valadas,
P Valensi,
P Vermunt,
R Weiss,
J Wens,
T Yilmaz
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ABSTRACT: When we ask people what they value most, health is usually top of the list. While effective care is available for many chronic diseases, the fact remains that for the patient, the tax payer and the whole of society: prevention is better than cure. Diabetes and its complications are a serious threat to the survival and well-being of an increasing number of people. It is predicted that one in ten Europeans aged 20-79 will have developed diabetes by 2030. Once a disease of old age, diabetes is now common among adults of all ages and is beginning to affect adolescents and even children. Diabetes accounts for up to 18 % of total healthcare expenditure in Europe. The good news is that diabetes is preventable. Compelling evidence shows that the onset of diabetes can be prevented or delayed greatly in individuals at high risk (people with impaired glucose regulation). Clinical research has shown a reduction in risk of developing diabetes of over 50 % following relatively modest changes in lifestyle that include adopting a healthy diet, increasing physical activity, and maintaining a healthy body weight. These results have since been reproduced in real-world prevention programmes. Even a delay of a few years in the progression to diabetes is expected to reduce diabetes-related complications, such as heart, kidney and eye disease and, consequently, to reduce the cost to society. A comprehensive approach to diabetes prevention should combine population based primary prevention with programmes targeted at those who are at high risk. This approach should take account of the local circumstances and diversity within modern society (e.g. social inequalities). The challenge goes beyond the healthcare system. We need to encourage collaboration across many different sectors: education providers, non-governmental organisations, the food industry, the media, urban planners and politicians all have a very important role to play. Small changes in lifestyle will bring big changes in health. Through joint efforts, more people will be reached. The time to act is now.
Hormone and Metabolic Research 04/2010; 42 Suppl 1:S37-55. · 2.19 Impact Factor
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P Pajunen,
R Landgraf,
F Muylle,
A Neumann,
J Lindström,
P E Schwarz,
M Peltonen,
T Acosta,
M Adler,
A AlKerwi, [......],
F Toti,
J Tuomilehto,
A Undeutsch,
C Valadas,
P Valensi,
D Velickiene,
P Vermunt,
R Weiss,
J Wens,
T Yilmaz
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ABSTRACT: The marked increase of type 2 diabetes necessitates active development and implementation of efficient prevention programs. A European level action has been taken by launching the IMAGE project to unify and improve the various prevention management concepts, which currently exist within the EU. This report describes the background and the methods used in the development of the IMAGE project quality indicators for diabetes primary prevention programs. It is targeted to the persons responsible for diabetes prevention at different levels of the health care systems.
Development of the quality indicators was conducted by a group of specialists representing different professional groups from several European countries. Indicators and measurement recommendations were produced by the expert group in consensus meetings and further developed by combining evidence and expert opinion.
The quality indicators were developed for different prevention strategies: population level prevention strategy, screening for high risk, and high risk prevention strategy. Totally, 22 quality indicators were generated. They constitute the minimum level of quality assurance recommended for diabetes prevention programs. In addition, 20 scientific evaluation indicators with measurement standards were produced. These micro level indicators describe measurements, which should be used if evaluation, reporting, and scientific analysis are planned.
We hope that these quality tools together with the IMAGE guidelines will provide a useful tool for improving the quality of diabetes prevention in Europe and make different prevention approaches comparable.
Hormone and Metabolic Research 04/2010; 42 Suppl 1:S56-63. · 2.19 Impact Factor
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M Ketonen, P Pajunen,
H Koukkunen,
P Immonen-Räihä,
J Mustonen,
M Mähönen,
M Niemelä,
K Kuulasmaa,
P Palomäki,
M Arstila,
T Vuorenmaa,
A Lehtonen,
S Lehto,
H Miettinen,
J Torppa,
J Tuomilehto,
J Airaksinen,
K Pyörälä,
V Salomaa
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ABSTRACT: To analyse the risk of coronary heart disease (CHD) events and total mortality among patients who had coronary artery bypass graft (CABG) surgery during 1988-1992.
A population-based myocardial infarction (MI) register included data on invasive cardiac procedures among residents of the study area. The subjects aged 35-64 years were followed-up for 12 years for non-fatal and fatal CHD events and all-cause mortality, excluding events within 30 days of the CABG operation. CABG was performed on 1158 men and 215 women.
The overall survival of men who underwent CABG was similar to the survival of the corresponding background population for about ten years but started to worsen after that. At twelve years of follow-up, 23% (n=266, 95% CI 234-298) of the men who had undergone the operation had died, while the expected proportion, based on mortality in the background population, was 20% (n=231, 95% CI 226-237). The CHD mortality of men who had undergone the operation was clearly higher than in the background population. Among women, the mortality after CABG was about twice the expected mortality in the corresponding background population. In Cox proportional hazards models age, smoking, history of MI, body mass index and diabetes were significant predictors of mortality.
The prognosis of male CABG patients did not differ from the prognosis of the corresponding background population for about ten years, but started to deteriorate after that. History of MI prior to CABG and major cardiovascular risk factors was a predictor of an adverse outcome.
International journal of cardiology 03/2008; 124(1):72-9. · 7.08 Impact Factor
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P Pajunen,
H Koukkunen,
M Ketonen,
T Jerkkola,
P Immonen-Räihä,
P Kärjä-Koskenkari,
K Kuulasmaa,
P Palomäki,
J Mustonen,
A Lehtonen,
M Arstila,
T Vuorenmaa,
S Lehto,
H Miettinen,
J Torppa,
J Tuomilehto,
Y A Kesäniemi,
K Pyörälä,
V Salomaa
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ABSTRACT: We compared the risk of acute coronary events in diabetic and non-diabetic persons with and without prior myocardial infarction (MI), stratified by age and sex.
A Finnish MI-register study known as FINAMI recorded incident MIs and coronary deaths (n=6988) among people aged 45 to 74 years in four areas of Finland between 1993 and 2002. The population-based FINRISK surveys were used to estimate the numbers of persons with prior diabetes and prior MI in the population.
Persons with diabetes but no prior MI and persons with prior MI but no diabetes had a markedly greater risk of a coronary event than persons without diabetes and without prior MI. The rate of recurrent MI among non-diabetic men with prior MI was higher than the incidence of first MI among diabetic men aged 45 to 54 years. The rate ratio was 2.14 (95% CI 1.40-3.27) among men aged 50. Among elderly men, diabetes conferred a higher risk than prior MI. Diabetic women had a similar risk of suffering a first MI as non-diabetic women with a prior MI had for suffering a recurrent MI.
Both persons with diabetes but no prior MI, and persons with a prior MI but no diabetes are high-risk individuals. Among men, a prior MI conferred a higher risk of a coronary event than diabetes in the 45-54 year age group, but the situation was reversed in the elderly. Among diabetic women, the risk of suffering a first MI was similar to the risk that non-diabetic women with prior MI had of suffering a recurrent MI.
Diabetologia 01/2006; 48(12):2519-24. · 6.81 Impact Factor
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P Pajunen,
H Koukkunen,
M Ketonen,
T Jerkkola,
P Immonen-Räihä,
P Kärjä-Koskenkari,
M Mähönen,
M Niemelä,
K Kuulasmaa,
P Palomäki, [......],
M Arstila,
T Vuorenmaa,
S Lehto,
H Miettinen,
A Juolevi,
J Torppa,
J Tuomilehto,
Y A Kesäniemi,
K Pyörälä,
V Salomaa
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ABSTRACT: To investigate the incidence of clinical diabetes as determined by the incidence of diabetes drug reimbursements within a 5-year period after the first myocardial infarction (MI) in patients who were non-diabetic at the time of their first MI.
A population-based MI register, FINMONICA/FINAMI, recorded all coronary events in persons of 35-64 years of age between 1988 and 2002 in four study areas in Finland. These records were used to identify subjects sustaining their first MI (n = 2632). Participants of the population-based risk factor survey FINRISK (surveys 1987, 1992, 1997 and 2002), who did not have diabetes or a history of MI, served as the control group (n = 7774). The FINMONICA/FINAMI study records were linked with the National Social Security Institute's drug reimbursement records, which include diabetes medications, using personal identification codes. The records were used to identify subjects who developed diabetes during the 5-year follow-up period (n = 98 in the MI group and n = 79 in the control group).
Sixteen per cent of men and 20% of women sustaining their first MI were known to have diabetes and thus were excluded from this analysis. Non-diabetic men having a first MI were at more than twofold {hazard ratio (HR) 2.3 [95% confidence interval (CI) 1.6-3.4]}, and women fourfold [HR 4.3 (95% CI 2.4-7.5)], risk of developing diabetes mellitus during the next 5 years compared with the control population without MI.
Many patients who do not have diabetes at the time of their first MI develop diabetes in the following 5 years.
Diabetic Medicine 11/2005; 22(10):1334-7. · 2.90 Impact Factor
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ABSTRACT: There has been no previous study to determine the severity and extent of coronary artery disease (CAD) in subjects with no diagnosis or symptoms of CAD at the time of the angiography.
Fifty-three subjects, who were siblings of patients with early onset CAD, underwent coronary angiography. Indices to describe per-patient characteristics of CAD were calculated, based on computer-aided quantitative coronary angiography. Clinical and laboratory characteristics were correlated to the angiographic parameters.
Serum total homocysteine (rho = 0.29, P < 0.05) and creatinine (rho = 0.47, P = 0.001) levels were related to the global atheroma burden index. The median of the atheroma burden index was two times higher in the top homocysteine quartile compared to the lowest quartile. The overall atheroma burden index correlated significantly with the fasting blood glucose level in all subjects. Diabetes, especially when albuminuria was present, was a powerful risk factor. In a multivariate analysis, only age and sex were independent predictors of atheroma burden.
Serum homocysteine and creatinine concentrations, and diabetes with albuminuria were found to be markers of the severity and extent of CAD in subjects of high-risk families without symptoms of CAD.
European Journal of Clinical Investigation 08/2002; 32(7):472-8. · 3.02 Impact Factor
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ABSTRACT: Factors predicting the anatomic distribution and the severity and extent of coronary atherosclerosis in patients with clinically manifest coronary artery disease (CAD) for type-2 diabetic patients could be different than those for nondiabetic patients.
To study the determinants of severity and extent of CAD in consecutive patients with type 2 diabetes mellitus, compared with those for matched nondiabetic patients, undergoing clinically indicated coronary angiography.
Coronary angiograms of 48 men and seven women with type-2 diabetes and an equal number of nondiabetic subjects were analyzed quantitatively. Scores reflecting severity and extent of CAD were compared with potential risk factors using univariate correlation analyses and multivariate regression models.
For the diabetics, a global coronary atheroma burden index was independently and directly related to age (P = 0.022) and to level of intermediate-density lipoprotein cholesterol (P = 0.055), and inversely to level of particles of a subtype of high-density lipoprotein (P = 0.022). Several angiographic indexes were related to the duration of diabetes and control of glycemia. For the nondiabetic group, global atheroma burden was independently related to age (P = 0.028), a history of hypertension (P = 0.028), and concentration of low-density lipoprotein (P = 0.013), and inversely to level of apolipoprotein A-I (P = 0.008). The duration of coronary disease and a history of smoking were also predictive of severe coronary atherosclerosis among nondiabetic patients.
Classical risk factors are strong predictors of the severity and extent of coronary atherosclerosis in nondiabetic patients, but the most important determinants for type-2 diabetic patients are levels of triglyceride-rich lipoproteins and apolipoprotein A-I-containing particles of high-density lipoprotein, and factors directly related to diabetes.
Coronary Artery Disease 04/2001; 12(2):99-106. · 1.24 Impact Factor
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ABSTRACT: To investigate the relation between severity and extent of coronary artery disease (CAD) and in vitro cholesterol efflux capacity.
This study consisted of 46 type 2 diabetic, and 42 nondiabetic men undergoing coronary angiography. Quantitative coronary angiography was used to estimate the severity, extent, and overall "atheroma burden" of CAD. The capacity of patient plasma to induce cholesterol efflux from cultured Fu5AH rat hepatoma cells was measured in vitro.
In the combined study population (n = 88), there was a significant inverse correlation between efflux and global atheroma burden (r = -0.23, p < 0.05). In the diabetic group, the global atheroma burden index was independently associated both with cholesterol efflux and with LpA-I levels. However, in the nondiabetic CAD group this association was lost when efflux and LpA-I levels were included in the same model.
The present study demonstrated that efflux capacity was inversely associated with the severity and extent of CAD. In the diabetic group this association was independent of LpA-I levels, suggesting impaired antiatherogenic potential of these particles in type 2 diabetic patients.
Scandinavian Cardiovascular Journal 03/2001; 35(2):96-100. · 0.93 Impact Factor
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ABSTRACT: Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically in type 1 diabetes, have been published, and neither of them has used computer-aided quantitative coronary angiography. This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients had greater global severity (p < 0.001), global extent (p < 0.001), and global atheroma burden (p < 0.001) indexes than nondiabetic control subjects. Quantitative coronary angiographic-derived indexes of CAD were, on average, 1.4- to 4.3-fold higher in diabetic than in nondiabetic patients. These differences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially women, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients. Our findings, including a loss of sex difference for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women, are not explained by established risk factors.
The American Journal of Cardiology 11/2000; 86(10):1080-5. · 3.37 Impact Factor
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ABSTRACT: Ursodeoxycholic acid (UDCA) has cholesterol lowering and anti-inflammatory effects and bile acids are reported to exert vasodilator effects; all of these properties might be considered desirable in a drug used in the treatment of patients with coronary heart disease. We investigated a hypothesis that UDCA may dilate arteries and the mechanism of action.
We evaluated effects of a 6-week treatment with UDCA in 11 coronary heart disease patients on endothelium-dependent (acetylcholine-induced) and -independent (nitroprusside-induced) vasodilatations in forearm vasculature by strain-gauge plethysmography. Healthy individuals (n=14) served as baseline controls.
The percentage increase by acetylcholine in the flow of the infused arm relative to the non-infused arm of coronary heart disease patients during the trial remained unaltered, but vasodilatation to NG-monomethyl-l-arginine+acetylcholine was improved by 161+/-27% with UDCA vs 83+/-22% with placebo (mean difference 91% [95% CI 35%, 147%], P=0.016).
Six weeks' UDCA therapy improved endothelium-dependent nitric oxide-independent vasodilatation, which might maintain arterial flow in coronary heart disease patients under conditions of impaired nitric oxide production.
British Journal of Clinical Pharmacology 07/1999; 47(6):661-5. · 2.96 Impact Factor
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ABSTRACT: Code division multiple access (CDMA) is a multiple access
technique based on spread spectrum methods. In a downlink signal
processing, only the code of the mobile phone user is known, while the
codes of the interfering users are unknown. In addition, the number of
sources (users and paths) is usually larger than the code length. In
this case, linear methods such as the matched filter fail to estimate
the parameters. Blind source separation or independent component
analysis is an approach offering the solution to this problem. We
introduce blind source separation methods for estimating the symbols in
an AWGN channel. The performance of the methods are based on the facts
that the symbols have finite alphabet and/or are non-Gaussian. We
present an algorithm which can estimate the parameters in an
oversaturated system, i.e. when the number of binary signals can be
larger than the code length. Simulations show that one can estimate the
symbols without any knowledge of the chip sequences
Spread Spectrum Techniques and Applications, 1998. Proceedings., 1998 IEEE 5th International Symposium on; 10/1998
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ABSTRACT: Independent component analysis (ICA) is a useful extension of
standard principal component analysis (PCA). The ICA model is utilized
mainly in blind separation of unknown source signals from their linear
mixtures. In some applications, the mixture coefficients are totally
unknown, while some knowledge about the temporal model exists. CDMA
(code division multiple access) is an example of such an application;
only the code of the mobile phone user is known, while the codes of the
interfering users are unknown. In this case, linear methods such as the
matched filter fail to estimate the parameters. In this work, we
introduce two learning source separation methods for estimating the CDMA
symbols. The first method is based on competitive learning while the
second approach is a batch version of a neural independent component
analyzer. The performance of the first method is based on the fact that
the data have a linear form where the coefficients (sources) of the
linear basis vectors are binary symbols. Due to the very nonlinear
structure of the source process (symbols are clustered), the system
allows oversaturation, i.e. the number of binary signals can be larger
than the code length. The second approach is a batch version of the
neural independent component analyzer. Simulations show that one can
estimate the symbols without any knowledge of the chip sequences
Neural Networks Proceedings, 1998. IEEE World Congress on Computational Intelligence. The 1998 IEEE International Joint Conference on; 06/1998
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ABSTRACT: The question of existence and uniqueness of solutions for
nonlinear independent component analysis (ICA) is addressed. It is shown
that if the space of mixing functions (processes) is not limited, there
exists always an infinity of solutions. In particular, it is shown how
to construct parametrized families of solutions. The indeterminacies
involved are not trivial, as in the linear case. It is also shown how to
utilize results of the complex analysis to obtain uniqueness of
solutions. We show that for two dimensions, the solution is unique up to
a rotation, if the mixing function is constrained to be a conformal
mapping, together with some other assumptions. We also conjecture that
the solution is strictly unique except in some degenerate cases, since
the indeterminacy implied by the rotation is essentially similar to
solving the linear ICA problem
Neural Networks Proceedings, 1998. IEEE World Congress on Computational Intelligence. The 1998 IEEE International Joint Conference on; 06/1998
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ABSTRACT: The angiographic characteristics of coronary artery disease (CAD) in noninsulin-dependent diabetes mellitus (NIDDM) patients were studied by quantitative coronary angiography (QCA). Fifty-seven consecutive NIDDM patients undergoing clinically indicated elective coronary angiography and 57 nondiabetic coronary artery disease (CAD) patients were individually matched for sex, age, and body mass index. Technically adequate coronary angiograms, available for 55 subjects in each group, were analyzed with third-generation QCA software. To evaluate the anatomic severity and extent of CAD, several QCA-derived parameters were incorporated into indexes describing various per-patient features of CAD. These measures reflect CAD severity, extent, and overall "atheroma burden," and were calculated separately for different coronary segments (i.e., left main, proximal, mid, and distal segments), for the different coronary arterial territories (i.e., left main, left anterior descending, left circumflex, and right), and for the entire coronary tree. No significant differences were found between the NIDDM and nondiabetic groups (global severity index, 51 +/- 14 vs 54 +/- 13, p = NS; global extent index, 34 +/- 13 vs 32 +/- 12, p = NS; global atheroma burden index, 27 +/- 16 vs 24 +/- 12, p = NS). We also found no between-group differences in proximal, mid, or distal segments, in separate vessel territories, or in left ventricular function. Our data suggest that CAD patients, with and without NIDDM, who have similar symptoms at a given age, have similar severity and extent of CAD.
The American Journal of Cardiology 10/1997; 80(5):550-6. · 3.37 Impact Factor
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P. Pajunen
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ABSTRACT: Blind separation of unknown sources from their mixtures is
currently a timely research topic in statistical signal processing and
unsupervised neural learning. Several source separation algorithms have
been presented where it is assumed that there are at least as many
sensors as sources. In this paper, a practical algorithm is proposed for
separating binary sources from less sensors than sources. The algorithm
uses constrained competitive learning in the adaptation phase and the
actual separation is achieved by simply selecting the best matching
unit. The algorithm appears to be reasonably robust against small
additive noise
Neural Networks,1997., International Conference on; 07/1997
