Risk factors of_acute_coronary_syndrome_among_bangladeshi_people_2

This study examined risk factors for acute coronary syndrome in 200 patients in Bangladesh compared to 200 controls. Several significant risk factors were identified for the patients compared to controls. These included lower income, more sedentary work, higher rates of smoking tobacco and consuming non-smoke tobacco, lower fruit consumption, higher rates of diabetes, known dyslipidemia, higher waist-hip ratio, and history of heart attack. Multivariate analysis identified the most significant independent risk factors as previous smoking, high waist-hip ratio, history of hypertension, and lower income.

Health & Medicine

Abstract
Two hundred consecutive patients of acute coronary syndrome aged 30-80 years (inclusive) admitted to the coronary
care unit of National institute of Cardiovascular Diseases, Dhaka, were prospectively recruited as cases. Two hundred
controls were prospectively selected either from individuals attending in the Shaheed Suhrawardy Medical College
Hospital, admitted for elective surgery or in medicine ward for conditions that were unlikely to confound a comparative
analysis. The Cases had significantly lower yearly incomes than controls, and significantly higher number of cases is
occupied as sedentary worker. Smoking was an important risk factor. About 70% of cases and 45% of controls smoked
previously cigarettes. Consumption of non smoke tobacco is another risk factor. The high risk of IHD in developing
countries attributed to low consumption of fruit and vegetables, and in our study regular consumption of fruits (taking
fruit at least 4 days a week) shows 20.5% cases and 33% of controls (OR 0.524, 95%CI 0.333-0.823) and p value was
0.005. Around 23.5% of the cases were diabetic compared with 4.5% of controls. We found 5% cases and 1.5%
controls having known dyslipidemia. Although the body-mass index of cases was 24.68±3.06 Kg/M² and controls
20.54±4.37 Kg/M². The WHR was also significantly greater in cases 0.98±0.05M vs. controls 0.93±0.102M (p<0.001).
About 31% of cases and 2% of controls had past history of myocardial infarction. The most predictive independent
variables were previous smoking (p<0.001), WHR (p<0.001), history of hypertension (p<0.001), and income (p<0.001).
Smoking and WHR were associated with the highest risks. The variables revealed to be significantly associated with
acute coronary syndrome by bivariate analyses were all entered into the model directly. Eleven variables entered into
the model. Of them Age, occupation, family income (yearly), fruit consumption, known hypertension, known DM, known
dyslipidemia, previous MI, previous smoking, BMI and Waist and hip ratio were found to be the independent predictors
of acute coronary syndrome. The study found that smoking tobacco, diabetes mellitus, hypertension, visceral obesity
and less fruit intake are the important factors of acute coronary syndrome in Bangladesh.
Authors
Selim S, Rahman R, Yasmin R, Karim N, Chowdhury SH, Lona H, Nabi SG, Shafi T
Institution
Dr Shahjada Selim, Department of Endocrinology & Metabolism, BIRDEM, Dhaka, Bangladesh.
Source
Mymensingh medical journal : MMJ 22:3 2013 Jul pg 513-21
Pub Type(s)
Journal Article
Language
eng
PubMed ID
23982542
Risk Factors of Acute Coronary Syndrome among Bangladeshi
People.
Unbound MEDLINE
http://www.unboundmedicine.com/medline/print_citation/23982542/Ris...
1 of 1 9/8/2013 11:27 AM

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$Interheart risk modifiable factors in micardio infraction 2004$ $Interheart risk modifiable factors in micardio infraction 2004$

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PARUL UNIVERSITY

The aim of the study was to evaluate the clinical and biochemical characteristics of geriatric patients with type 2 diabetes mellitus (DM) attending tertiary care teaching hospital, SVIMS, Tirupati. OBJECTIVES: To document clinical features, biochemical parameters and anti-diabetic medications received as per records. METHODOLOGY: This retrospective study was performed in Department of Endocrinology in SVIMS, Tirupati, over a period of 6 months. Demograghic details, laboratory parameters and pharmacotherapy details were collected in the pre-designed annexure form. RESULTS: A total of 100 diabetic elderly patients were included in the study. Out of which 57 were men, 43 were women. Most of them were under the age group of 60-64 years followed by other age groups. 28 patients were having the diabetes duration of 11-15 years. Some of them were having diabetic complications (such as diabetic retinopathy, diabetic neuropathy, diabetic nephropathy). Among 100 patients, 32 patients were normal weight, 22 patients were overweight, 28 patients were obese-I, 18 patients were obese-II. About 85% of patients were having high lipid levels. Some patients were on Oral Hypoglycemic Agents (OHAS), some patients were using both Insulin & OHAS.CONCLUSION: The present study comprised of 100 elderly type 2 diabetic patients in which males were higher in number when compared to females, most of the patients were in the age of group of 60-64 years. Hypertension was the most common co-morbidity associated with DM followed by Coronary Artery Disease (CAD). Diabetic neuropathy was the most prevalent complication followed by Diabetic retinopathy and diabetic nephropathy. In this study 46% of the patients were obese. Most of the patients were on OHAS alone, some were on OHAS and Insulin combination therapy while very few were on insulin therapy alone. Dyslipidemia was present in 85% of the patients and the most common form of dyslipidemia was low HDL and high LD

Nhanes ASCVD cost study

John Frias Morales, DrBA, MS

This study uses consecutive National Health and Nutrition Examination Surveys (NHANES) data from 2003-2012 to concurrently model obese body size (c.f., normal weight) main effects, moderated by nondiabetic moderate 10-year ASCVD risk (c.f., 30-year and diabetic), on total medical cost outcomes. • Minors, seniors 76+, outlier diseases, and pregnant women were excluded, resulting in 192,447,424 weighted or 22,510 unweighted participants.

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The document discusses various methods for treating diabetes through replacing or regenerating insulin-producing cells, including pancreas and islet cell transplantation, stem cell therapy, and gene therapy. Pancreas transplantation provides the best outcomes but requires lifelong immunosuppression. Islet cell transplantation has improved but success rates decline over time. Stem cells show promise for treating both type 1 and type 2 diabetes by replenishing beta cells, but challenges remain around immune responses and insulin resistance. Gene therapy also offers potential for treating diabetes by replacing insulin genes or suppressing autoreactive immune cells. Further research is still needed but cell and gene-based therapies may eventually provide cures or better treatment options than current insulin management approaches.

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