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Type II diabetes mellitus is independently associated with non-rheumatic aortic valve disease. Since women were underrepresented in our study, our results apply only to diabetic men. The cause of this association is not known. CONDENSE ABSTRACT:The role of Diabetes as an independent risk factor for aortic stenosis or regurgitation has been controversial. We used PTF documents containing discharge diagnosis using ICD-9 codes of inpatient treatment from Veterans Health Administration Hospitals (VA) were analysed.( DM (n=293,124), a control group with hypertension (HTN) but no DM (n=552,623)). The occurrence of non-rheumatic aortic valve disease in DM patients was studied in comparison with the control. Non-rheumatic aortic valve disease diagnosis was present in 7,322 (2.5%) of DM patients vs. 10,906 (2.0%) in the control group. Using multivariate analysis, DM remained strongly associated with non-rheumatic aortic valve disease: (odds ratio (OR): 2.23, 95%; confidential interval (CI): 2.16 to 2.30 p<0. 0001). Since women were underrepresented in our study, our results apply only to diabetic men.

Postmenopausal women have an increased risk of cardiovascular disease, which is believed to correlate with lower estrogen level. There are conflicting data regarding hormone replacement therapy (HRT) based on the timing of this therapy. After large randomized trials showed no cardiovascular benefit of hormone replacement, estrogen replacement therapy was dramatically reduced even though starting hormone replacement in early postmenopausal period had shown significant benefit. There are hardly any reviews discussing in detail the effect of HRT on cardiovascular system while briefly discussing other effects of this therapy in postmenopausal women. The novelty of this review is the comprehensive discussion of this effect that can help researchers and clinicians to design future research or trials. In this manuscript, the effect of HRT on cardiovascular system in clinical trials and basic science will be reported and potentially erroneous conclusions drawn by various studies will be discussed. Furthermore, various noncardiovascular effect of HRT will be analyzed.

Background: Non-ST-segment myocardial infarction (NSTEMI) is one of the major causes of hospital admissions. Mortality trend in patients with NSTEMI over the years has not been studied well. The goal of this study is to explore age-adjusted long-term mortality trends from NSTEMI in the United States using a very large database. Methods: We used the National Inpatient Sample (NIS) database, a component of the Health Care Cost and Utilization (HCUP) project, for this study. International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify NSTEMI cases in patients >40 years old. Age-adjusted mortality rates for NSTEMI cases were calculated by multiplying the age-specific mortality rates of NSTEMI by age-specific weights. Results: A total of 1,400,234 patients above the age of 40 years were identified. The mean age of this cohort was 77.1 ± 10.7 years, with a total of 179,361 deaths being reported over this 16-year period. Among patients who died, 51.2% were men and 48.8% were women. The age-adjusted mortality from NSTEMI declined from 1988 (727 per 100,000) to 2004 (305 per 100,000) until the middle of the decade when mortality from NSTEMI started leveling off. Total mortality decreased from 29.6% in 1988 to 11.3% in 2004. Conclusions: Our analysis showed a significant reduction in the age-adjusted and total mortality for NSTEMI over the years studied. The cause of this trend is not known but most likely reflects advancement in the treatment of patients with acute coronary syndrome.