Postprandial hyperglycemia is a risk factor for cardiovascular disease and mortality. Serum 1,5-anhydroglucitol (1,5-AG) level is an useful clinical marker of glucose metabolism which reflects postprandial hyperglycemia more robustly compared to hemoglobin A1c (HbA1c). Relationship between serum 1,5-AG level and cardiovascular disease has been reported; however, comparison between HbA1c and 1,5-AG as markers of cardiovascular disease was not performed. We included 227 consecutive patients who underwent coronary angiography meeting the following inclusion criteria: (1) patients who had no history of coronary artery disease (CAD); (2) patients without acute coronary syndrome; (3) patients without poorly controlled diabetes mellitus; (4) patients without anemia, liver dysfunction, acute, and chronic renal failure and malnutrition; and (5) patients without adhibition of acarbose or Chinese herbal medicine. We measured HbA1c, glycoalbumin, and 1,5-AG. Serum 1,5-AG was significantly lower in patients with CAD (16.6 ± 8.50 vs. 21.1 ± 7.97 μg/ml, P < 0.001). Multivariable logistic regression analysis showed decrease in serum 1,5-AG was independently associated with the presence of denovo CAD (0.93, 95% CI 0.88-0.98, P = 0.006). Serum 1,5-AG was also independently associated with the presence of denovo CAD in patients without diabetes mellitus (0.94, 95% CI 0.88-0.99, P = 0.046). In conclusion, lower serum 1,5-AG was associated with the presence of denovo CAD. Serum 1,5-AG may identify high cardiovascular risk patients for denovo CAD in both diabetic and non-diabetic patients.
Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp hronic heart failure (HF) is associated with poor clinical outcomes. 1 In HF subjects, hyponatremia has been considered as important in terms of poor prognosis and is associated with plasma arginine vasopressin (AVP) secretion. 2-6 Moreover, cardiac resynchronization therapy (CRT) has played an important role in indicated HF subjects refractory to optimal medical therapy. 7-12 However, almost 30% of recipients show non-responsiveness, 7 which occasionally leads to subsequent HF events. In the past few years, various factors and physiological parameters such as electrocardiographic QRS duration, left bundle branch block and ischemic/non-ischemic cause associated with responsiveness/non-responsiveness to CRT have been explored. However, these parameters are indirect predictors for HF events as described above. To our knowledge, few have assessed the factors associated with HF events in patients receiving CRT. We explored the predictors among the baseline measurements, as well as conventional factors, for exacerbation of HF and with the baseline factors associated with responsiveness/non-responsiveness to CRT.
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Methods
Study PopulationFrom August 2006 to February 2010, 83 consecutive chronic HF patients with an indication for CRT were eligible according to the guideline of the European Society of Cardiology; that is: New York Heart Association (NYHA) classification III or IV even with optimal medical therapy; left ventricular ejection fraction (LVEF) on echocardiogram <35%; QRS duration on electrocardiogram >120 ms. 8 Among them, a small number of patients with QRS duration <120 ms were included because of clinical necessity. Of the 83 eligible patients, 6 were excluded: 1 elderly bedridden woman who was transferred to other institution for long-term in-hospital rehabilitation, 1 bedridden elderly man with a tracheotomy and advanced lung disease who was similarly transferred for taking rehabilitation, and 4 patients with chronic kidney disease on regular hemodialysis. Background: Various factors associated with worsening heart failure (HF) events have been investigated in HF subjects. The purpose of this study was to identify the predictive factor(s) for worsening HF events after cardiac resynchronization therapy (CRT) among baseline parameters, as well as baseline factors associated with responsiveness or non-responsiveness to CRT.
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Methods and Results:Seventy-seven HF patients with an indication for CRT were enrolled. Baseline parameters of blood chemistry, electrocardiogram, echocardiogram and cardiac catheterization before device implantation were measured, and subsequent clinical HF events after CRT were investigated. During the follow-up period (median 601 days), 22 of 77 (29%) recipients had HF events (unscheduled HF hospitalization: 16; use of left ventricular assist system: 1; heart transplantation: 1; cardiac death: 4). In the multivariate Cox proportional hazards model, low serum sodium concen...
Pitavastatin significantly improved fasting and postprandial dyslipidemia and endothelial dysfunction in CAD patients, partly via reducing oxidative stress and increasing plasma adiponectin, although rheological parameters remained unchanged.
This study found that cardiac and non-cardiac mortality risks differed significantly between apical Takotsubo syndrome and anterior acute myocardial infarction. Our findings underscore the importance of differentiating between the two disorders for appropriate management.
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