Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

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Background: Canine cardiovascular problems are commonly seen in veterinary medicine. Cardiac abnormalities in canine can be diagnosed by various means like electrochardiography, radiography, blood pressure measurement, echocardiography and biomarkers like troponins and peptides specific for heart.Methods: The present study was conducted to evaluate different biomarkers such as cardiac troponin T (cTnT), atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) for the diagnosis of cardiac diseases in comparison to echocardiography in canine. A total of 40 cases were included in the study, out of which 26 cases found to be positive for cardiac affections as confirmed by echocardiographic examination. Result: The serum concentration of cTnT and BNP were found significantly (P less than 0.05) elevated in dogs having cardiac as well as cardiac along with renal affections. ANP values were significantly (P less than 0.05) increased in dogs having both cardiac and renal diseases as compared to dogs with cardiac diseases only. Biomarkers like cTnT, ANP and BNP were compared with echocardiography (gold standard). The BNP was having the highest sensitivity (88.46%) and specificity (78.57%) as compared to cTnT and ANP. From the study, it is concluded that BNP can be used as suitable biomarker than cTnT and ANP for the diagnosis of cardiac diseases in canine. It can be used as a biomarker for cardiac diseases under field conditions where facilities for echocardiography are not available.

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