Mortality After Acute Myocardial Infarction: Significance of Cardiovascular Diabetic Autonomic Neuropathy (CDAN)

Vujosevic, Snezana; Zamaklar, M.; Belada, Natasa; Stamatovic, Sinisa

doi:10.5455/medarh.2012.66.296-299

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…A very good discriminant power of this number was shown, with a possibility of accurate classification of patients with regard to the obstruction in 73% of the cases, thus enabling a large fraction of patients to avoid invasive urodynamic tests. Also, we proved in the earlier study that intravesical prostatic protrusion is also a significant factor in predicting bladder outlet obstruction, and that with the increase of IPP grade, the prevalence of obstruction increases as well, and that grade III IPP shows good correlation with urodynamic factors that determine obstruction (18). At the same time, higher sensitivity and specificity of this factor were proved compared with bladder wall thickness (BWT), although BWT according to other studies shows a very high accuracy in predicting infravesical obstruction (4, 19).…”

Section: Discussionmentioning

confidence: 54%

Does the Combination of Intravesical Prostatic Protrusion and Bladder Outlet Obstruction Number Increase Test Accuracy According to Benign Prostatic Obstruction at the Individual Level?

Aganovic¹,

Prcic²,

Hadžiosmanović³

et al. 2012

Acta Inform Med

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Objective:Determine diagnostic power and intercorrelation between bladder outlet obstruction number (BOON) and intravesical prostatic protrusion (IPP ) as non-invasive predictors of infravesical obstruction in patients with lower urinary tract symptoms due to benign prostatic enlargement.Material and methods:Prospective study during 2009-2010 analyzed data of 110 patients with proven benign prostatic enlargement. Prostate volume and IPP were determined by transabdominal ultrasound, and patients underwent complete urodynamic studies (UDS). BOON was calculated using the formula: prostate volume (cc)-3 x Qmax (ml/s)-0.2 x mean voided volume (ml).Results:There is a statistically significant correlation between the values of IPP and BOON (Spearman’s rank correlation coefficient rho=0.48, p=0.0001). BOON is a more sensitive (sensitivity 82.4%, specificity 66.1%), while IPP is a more specific factor (sensitivity 58.8%, specificity 81.4%) in the group-wise prediction of bladder outlet obstruction (BOO). Positive predictive value in the diagnosis of obstruction increases at the individual level combining the cut-off values for BOON>-30, with IPP >10 mm (PP V 86.8%). Owing to a good correlation of IPP with different definitions of urodynamic obstruction, IPP was included in the BOON formula instead of prostate volume. This number was arbitrarily called BOON2. The combination of IPP >10 mm and cut-off value for BOON2 >-50 showed that 88.6% of the patients were accurately classified in the zone of obstruction (mean IPP 14.9 mm), while BOON2<-50 carried a high NPV.Conclusion:The combination of cut-off values for BOON and IPP increases test accuracy according to BOO at the individual level, thus facilitating clinical decision making regarding diagnostics and optimal choice of therapy in patients with BPE. Owing to its good correlation with obstruction determinants, IPP can be included in the formula for BOON instead of prostate volume.

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Section: Discussionmentioning

confidence: 54%

Does the Combination of Intravesical Prostatic Protrusion and Bladder Outlet Obstruction Number Increase Test Accuracy According to Benign Prostatic Obstruction at the Individual Level?

Aganovic¹,

Prcic²,

Hadžiosmanović³

et al. 2012

Acta Inform Med

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“…The negative effect of CAN on inpatient and long-term mortality after a myocardial infarction was confirmed in a study from Montenegro. Patients with DM and CAN had worse results in all observed variables than DM patients without CAN, while the results of DM patients were generally worse than of non-DM patients 31 . It is difficult to prove that CAN responsible for a death.…”

Section: Discussionmentioning

confidence: 93%

The influence of cardiovascular autonomic neuropathy on mortality in type 1 diabetic patients; 10-year follow-up

Lacigová

Brožová

Cechurová

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aim. The aim of our retrospective study was to answer the question if the presence of cardiovascular autonomic neuropathy (CAN) affects mortality in type 1 diabetic patients during a 10-year follow-up. Methods. Patients with type 1 diabetes mellitus examined for CAN in 2003 were enrolled in this retrospective study. A total of 278 patients were included and divided into two groups according to the presence or absence of CAN (111 CAN+, 167 CAN-). The group characteristics and outcomes were compared at baseline and after ten years (in 2013). Results. In the follow-up period, a total of 18 patients died; CAN+ (14/111; 12.6%) and CAN-(4/167; 2.4%) (P < 0.001). At baseline, the CAN+ patients were older (47 vs. 33 years; P < 0.001), had longer duration of diabetes (20 vs. 12 years; P < 0.05), had worse glycemic control assessed by HbA1c (73 vs. 68 mmol/mol; P < 0.05), higher systolic (130 vs. 120 mmHg; P < 0.001) and diastolic (80 vs. 70 mmHg; P < 0.01) blood pressure and had more diabetic complications. In our analysis we found the strongest predictor of mortality to be the presence of CAN (P < 0.01) and the blood pressure value at baseline (P < 0.05). Other baseline characteristics, including the duration of diabetes, age and the presence of micro-and macrovascular complications were not significant. The statistical analysis was performed using logistic regression step-wise analysis. Conclusions. During the 10-year follow-up, CAN+ patients had a 5-fold higher mortality rate than CAN-patients. The strongest predictor of mortality was the presence of CAN.

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“…Currently, the common belief is that the majority of CA dysfunction is observed in patients with diabetes [1,10,11]. Therefore, most previous studies were conducted to evaluate the CA dysfunction in patients with diabetes only.…”

Section: Introductionmentioning

confidence: 98%

Clinical risk model assessment for cardiovascular autonomic dysfunction in the general Chinese population

Zhang

Tang

Zeng

et al. 2015

J Endocrinol Invest

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CA dysfunction prevalence was high in the general Chinese population, and its prevalence was more frequent in individuals with diabetes, and hypertensive, and metabolic syndrome. Clinical risk models with a high value for predicting CA dysfunction were developed. CA dysfunction has become a major public health problem in China that requires strategies aimed at the prevention and treatment of the disease.

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Mortality After Acute Myocardial Infarction: Significance of Cardiovascular Diabetic Autonomic Neuropathy (CDAN)

Cited by 7 publications

References 27 publications

Does the Combination of Intravesical Prostatic Protrusion and Bladder Outlet Obstruction Number Increase Test Accuracy According to Benign Prostatic Obstruction at the Individual Level?

Does the Combination of Intravesical Prostatic Protrusion and Bladder Outlet Obstruction Number Increase Test Accuracy According to Benign Prostatic Obstruction at the Individual Level?

The influence of cardiovascular autonomic neuropathy on mortality in type 1 diabetic patients; 10-year follow-up

Clinical risk model assessment for cardiovascular autonomic dysfunction in the general Chinese population

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