Avaliação cardiovascular de pacientes diabéticos em ambulatório universitário

Alvarenga, Marcelo Alves; Oliveira, Carolina Soares Viana de; Chacra, Antônio Roberto; Reis, André

doi:10.1590/s0004-27302007000200017

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…High blood glucose levels are caused by an inflammatory and adrenergic response to ischemic stress, which results in catecholamine release and glycogenolysis [1,7] . Hyperglycemia causes an increase in free fatty acids, which causes cardiac arrhythmias and insulin resistance, as well as the chemical inactivation of nitric oxide and the production of oxygen reactive species, resulting in oxidative stress, which causes microvascular and endothelial dysfunction, a prothrombotic state, and vascular inflammation [8][9][10] . It is linked to myocardial metabolic disorders, which cause thrombosis, damage extension, decreased collateral circulation, and ischemic preconditioning [1,7] .…”

Section: Introductionmentioning

confidence: 99%

Assessment of stress hyperglycemia in acute coronary syndrome cases

Chowda¹,

Inamdar²,

Jha³

2023

Int. J. Adv. Res. Med.

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Background: In acute coronary syndrome (ACS), admission hyperglycemia is associated with adverse cardiovascular events in patients. Objective: To assess the prognostic value of stress hyperglycemia for the in-hospital outcome of patients admitted due to ACS. Methods: This study was conducted on 100 patients admitted with Acute Myocardial Infarction in a tertiary care hospital. Patients were categorized according to their blood sugar level stress hyperglycemia present and absent. Results: 64% of the patients were diagnosed with non-ST-elevation myocardial infarction NSTEMI and 36% were diagnosed with STEMI. Lesions most frequently (84.9%) in the left anterior descending artery (LAD) followed by right coronary artery 65% followed by Circumflex artery (54%) followed by Left Main Coronary Artery (3%). Death in stress hyperglycemia group was four times that of those who were not having hyperglycemia. Conclusion: Stress hyperglycemia is an independent predictive factor for in-hospital complications after ACS. The results highlight the need to assess admission blood glucose concentration in all patients admitted due to ACS, including nondiabetic ones, aiming at identifying those at higher risk for complications.

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Section: Introductionmentioning

confidence: 99%

Assessment of stress hyperglycemia in acute coronary syndrome cases

Chowda¹,

Inamdar²,

Jha³

2023

Int. J. Adv. Res. Med.

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The relationship between fasting plasma glucose and MPO in patients with acute coronary syndrome

Zhang

Dong

Wang

et al. 2015

BMC Cardiovasc Disord

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BackgroundInflammation plays a critical role in the progression of atherosclerosis, and hyperglycemia is a common feature in patients with ACS. We investigated the relationship between fasting plasma glucose (FPG) levels and the levels of the inflammatory factor, myeloperoxidase (MPO), in patients with acute coronary syndrome (ACS).MethodA total of 85 patients with no prior history of diabetes mellitus were recruited. The patients were divided into three groups based on their FPG levels as follows: group A, FPG < 5.6 mmol/l; group B, 5.6 mmol/l ≤ FPG < 6.1 mmol/l; and group C, FPG ≥ 6.1 mmol/l. The FPG concentrations and plasma MPO levels were determined, coronary angioplasty was performed, and the Gensini scores were used to evaluate the severity of the coronary lesion. The MPO expression in peripheral blood mononuclear cells (PBMCs) in patients with ACS was determined using western blot analysis.ResultThe results demonstrated that the levels of FPG were significantly and positively correlated with plasma MPO levels, Gensini scores, high sensitive C reaction protein(hs-CRP)levels, leukocyte and neutrophils count. In multivariate regression analyses the FPG levels were positively correlated with plasma MPO levels, Gensini score and hs-CRP. The plasma MPO levels in the group C [68.68(52.62–91.88) U/L] were significantly higher than in the group A [63.04(26.18–97.75) U/L] and group B [58.22(23.95–89.54) U/L]. The plasma hs-CRP concentrations are also higher in group C [42.28 (0.31–169.40) mg/L] than in the group A [12.51(0.28–176.25) mg/L] and group B [14.7 (0.14–89.68) mg/L].ConclusionThis study demonstrates that FPG values are positively correlated with plasma MPO levels, suggesting MPO may play a role in the proatherogenesis of high FPG.

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Hiperglicemia e doença cardiovascular podem coexistir

Chacra

Alvarenga

2008

Arq Bras Endocrinol Metab

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Expressões como "diabetes é uma doença vascular, o paciente com diabetes é um coronariopata em potencial, pacientes com diabetes têm o mesmo risco em desenvolver um evento cardiovascular quando comparados com não-diabéti-cos que já tiveram um infarto do miocárdio" têm sido comumente utilizadas e cada vez mais difundidas. Realmente tem sido recomendado que os pacientes com diabetes tipo 2 sejam considerados portadores de doença coronariana e como tal devam ser tratados, incluindo, por exemplo, metas mais rígidas de controle de colesterol e suas frações e dos níveis pressóricos (prevenção secundária).A causa maior das internações hospitalares de pacientes com diabetes é em razão da doença cardiovascular. A elevada taxa de morbidade e mortalidade nesses pacientes é, sem dúvida, também conseqüência de manifestações de doença cardiovascular. O infarto do miocárdio e o acidente vascular cerebral são as principais causas de morte dos pacientes com diabetes (1-4). Especialistas em cardiologia têm cada vez mais se envolvido no tratamento do diabetes. Por outro lado, endocrinologistas têm também se envolvido mais e mais em estudos sobre a patogênese da aterosclerose, tentando compreender melhor as relações entre, por exemplo, resistência à insulina, adipoquinas, inflamação e desenvolvimento da doença coronariana.Sociedades médicas, como a American Diabetes Association, têm lançado diretrizes para o diagnóstico de doença coronariana em pacientes portadores de diabetes (5,6). Em excelente revisão, Young e col. (7) discutem quais pacientes com diabetes devem ser avaliados. É óbvio que possam existir barreiras econômicas. Um estudo recente realizado no Centro de Diabetes da Universidade Federal de São Paulo (8) demonstrou que a avaliação cardiovascular em um centro universitário está aquém do mínimo necessário. Apesar disso, a maioria dos endocrinologistas, quando existe disponibilidade para tal, tem-se empenhado mais nesse tipo de avaliação. A solicitação do eletrocardiograma de esforço, do ecodopplercardiograma, da cintilografia do miocárdio, da tomografia computadorizada de coronárias e de outros testes cardiológicos tem-se tornado mais freqüente no consultório do endocrinologista.Esse fato demonstra uma mudança de paradigma e expressa que absolutamente não devemos ser "glucocêntricos" ao extremo, mas entender que o desfecho final de qualquer tratamento para diabetes deve ter como objetivo a prevenção da doença cardiovascular. Contudo, e supreendentemente, nenhum agente oral demonstrou, até o momento, atuar na prevenção de eventos cardiovasculares. Atualmente, discute-se mais a segurança de tais agentes em termos de doença cardiovascular do que propriamente a proteção.A importância do tema diabetes e doença cardiovascular pode ser demonstrada pela recente edição dos Arquivos Brasileiros de Endocrinologia e Metabolismo, órgão oficial da Sociedade Brasileira de Endocrinologia e Metabolismo com um número especial dedicado ao tema (9).

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Avaliação cardiovascular de pacientes diabéticos em ambulatório universitário

Abstract: Our data has shown the variability and limitations on boarding diagnosing of DAC in university environment patients and point us the necessity of constructing defined and directed directives for the peculiarities of the Brazilian population and health system.

Cited by 4 publications

References 13 publications

Assessment of stress hyperglycemia in acute coronary syndrome cases

Assessment of stress hyperglycemia in acute coronary syndrome cases

The relationship between fasting plasma glucose and MPO in patients with acute coronary syndrome

Hiperglicemia e doença cardiovascular podem coexistir

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