Diabetes mellitus is one of the commonest global noncommunicable health-care problem, carrying a predicted pandemic score of 366 million population by 2030. 1 According to the ICMR-INDIAB study, there are 62.4 million people living with diabetes in India alone, making it "diabetic capital" of the world. 2 About 15% of all such patients develop a foot ulcer in their lifetime. 3 Neuropathy and ischemia, two common complications of diabetes, have been implicated as the primary underlying risk-factors in the development of foot-ulcers while hyperglycemia contributes to delayed and impaired wound healing. 4 Treatment of diabetic foot syndrome involves multidisciplinary approach in achieving euglycemia and needs serial debridement/ disarticulation/ amputation as per the grade of ulcer/ foot gangrene, else it could be lifethreatening to the patient.
BackgroundThe risk factors along with demographic and angiographic features associated with aorto-ostial atherosclerotic coronary artery disease usually differ from that of non-aorto-ostial atherosclerotic coronary artery disease.ObjectivesThis study was designed to evaluate etiology of aorto-ostial atherosclerotic coronary artery disease involving left main coronary artery (LMCA), right coronary artery or both with consideration of clinical risk factors, demographic and angiographic features.MethodsA total of 7356 angiograms over 2 years in continuation were analyzed.Results116 patients were found to have aorto-ostial coronary artery disease with prevalence of 1.5. A total of 95 patients who have complete data were analyzed. Mean age was 59 ± 10 years. Prevalence in males was 5.7 times greater than female. Isolated ostial LMCA was 2 times more prevalent than isolated ostial RCA. Hypertension, diabetes and smoking were the main risk factors. 34.7% of the patients had hypercholesterolemia (> 180 mg/dl) and 26.3% of the patients had hypertriglyceridemia (> 150 mg/dl). High TC/HDL (> 3.5) ratio was seen in 77.9% of the patients. When ostial LMCA group was compared with ostial RCA group hypertriglyceridemia (Odds ratio 9.8, 95% CI, 1.7–4.2, P < 0.001) and hypercholesterolemia (Odds ratio 7.05, 95% CI, 1.7–5.7, P < 0.001) emerged as independent risk factors for ostial LMCA disease.ConclusionOverall there is 1.5% prevalence of atherosclerotic aorto-ostial disease of coronary arteries among patients of atherosclerotic coronary artery disease and higher proportions of patients are of male sex. Hypercholesterolemia, hypertriglyceridemia and high TC/HDL ratio can be considered as risk factors for aorto-ostial atherosclerotic coronary artery disease.
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