Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A 1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that selfreported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
V/P SPECT identifies a high prevalence of other cardiopulmonary diseases among patients with a clinical suspicion of PE. Ancillary findings with V/P SPECT clarified patients' symptoms and had an impact on the treatment. These findings were verified by a clinical outcome by the follow-up over three months.
Introduction: Warfarin is the most frequently prescribed anticoagulant. Clinical treatment is demanding because of the narrow therapeutic range and considerable differences between the patients. The aim of this survey is to establish adherence to warfarin in subjects who have been prescribed warfarin as a long-term therapy.Methods: The survey included 30 subjects, and was conducted at local pharmacy store. Statistical processing was carried out using the SPSS (ver. 21.) software. Used for qualitative variables was the Chi-square test, and for quantitative ones the ANOVA test. Data were provided in the form of tables and charts. Level of significance was p=0.05.Results: The survey included 30 subjects, 14 men and 16 women. Of the total number of polled subjects, 15 were informed by a health care professional about the specificities of warfarin use, 7 said they were not informed, while 8 said they did not know. Most compliant in terms of regularly taking their medicines were pensioners, followed by the unemployed, χ2=13.231; p<0.05. The number of subjects within the expected therapeutic INR range was 22 (p<0.05).Conclusion: Strict compliance with the warfarin regimen is important in order to increase its effectiveness, extend the time and strengthen the intensity of anticoagulant action in the body. That is why the target groups of patients, who use warfarin, need additional information before and during therapy, in order to avoid side effects, and at the same time maintain therapeutic efficacy of the medicine throughout the treatment.
Introduction: In patients with acute myocardial infarction (AMI) early risk assessment of development of complications is of great importance. It is proven that aldosterone level has a major role in progression of cardiovascular pathology. Aim: Determination of influence of aldosterone plasma level in the progression of heart disease in patients without signs of heart failure after AMI. Material and Methods: Research included 207 patients, hospitalized in the acute phase of myocardial infarction, and who were divided into two groups: 127 patients with no clinical signs of heart failure and 60 patients with heart failure. Results: The serum aldosterone concentration was 73.4% higher in the group of decompensated patients, 128 pg/mL (75.4-236 pg/mL) in decompensated and 73.7 pg/mL (42.7 -115.25 pg/mL) in compensated. In the group of compensated patients, changes in aldosterone levels showed a statistically significant effect on the incidence of post-infarction angina (p=0.0001) as well as reinfarction (p=0.009). There is a connection between changes in aldosterone plasma level and positive stress test (p=0.012). Conclusion: In patients with AMI, elevated serum aldosterone level can be prognostic factor of the progression of coronary heart disease, development of heart failure, as well of development of post-infarction angina, myocardial reinfarction and pathological finding on the stress test.
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