Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.
Finite element analysis (FEA) is used to predict the dynamic performance of an offshore fish cage and submerged moorinq grid system. The system kas been deployed at an exposed demonstration site in 55 meters of uxuer south of the Isles ofShoals, New Hampshire. Computer simulations were performed to investigate the dynamics of the cage motion and to calculate moorinq line tensions. The results were used to establish the baseline design specifications and to evaluate the ooeraü performance of the system.Both surface and submerqed positions of the net pen are considered. It is shoum that the extreme environmentalloading conditions at the demonstration site produce 60%less mooring tension in the case of a submerged cage. According to the analysis, the case uihen one offour mooring legs becomes disabled will not produce the failure of the mooring system.The problem. of adequate modeling of net is addressed. A simple technique is proposed to approximate the effect of netting on the overall dynamic response offish cage/ mooring systems.
Aim: We aimed to investigate the association of estimated whole blood viscosity (WBV) with hemodynamic parameters and prognosis in patients with heart failure with reduced ejection fraction. Materials & methods: Total of 542 patients were included and followed-up for median 13 months. Results: The WBV parameters had negative relationship with right atrium pressure and positive correlation with cardiac index. The WBV parameters were found to be independent predictors of composite end point (CEP) and all-cause mortality. Every one cP increases of WBV(h) and WBV(l) were associated with 17 and 1% reductions of CEP. In Kaplan–Meier analysis, patients with low WBV quartiles were found to have significantly more CEP. Conclusion: Being an easily accessible and costless prognosticator, WBV seems to be a novel marker for determining prognosis and an emerging tool to individualize heart failure with reduced ejection fraction management.
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