全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Role of CIMT, eGFR, and Serum HbA1c in Predicting CAD in Non-Diabetic Patients Undergoing Elective Coronary Angiography

DOI: 10.4236/wjcd.2018.81001, PP. 1-10

Keywords: CAD, CIMT, eGFR, HbA1c, SYNTAX Score

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Pre-diabetic state, renal function, atherosclerosis burden are the major predictors for development of coronary artery disease (CAD). Present study aims to analyze the role of carotid intima-media thickness (CIMT),?glomerular filtration rate (eGFR) and serum glycosylated hemoglobin?(HbA1c) levels in predicting CAD on coronary angiography in non-diabetic patients. Methods: CAD and its severity according to SYNTAX score (SX score) was evaluated in 450 non-diabetic patients hospitalized with acute coronary syndrome or stable angina and underwent coronary angiography. CIMT, eGFR, and serum HbA1c values were obtained during admission. Spearman correlation and linear regression were used in the analysis of the data. Receiver operating characteristic (ROC) curve was constructed to calculate cutoff values, area under curve (AUC), sensitivity and specificity. Results:Statistically significant positive correlation was observed between HbA1c (r: 0.242, p = 0.001); CIMT (r: 0.231, p = 0.001), patient’s age (r: 0.148, p = 0.002) and SX score, whereas eGFR was negatively correlated (r: -0.148, p = 0.002). On regression analysis, CIMT, eGFR, HbA1c and patient’s age collectively predicted 36% of change in the SYNTAX score. Patient’s age > 56 years (AUC = 0.622), CIMT > 0.86 mm (AUC = 0.642), HbA1c > 6 (AUC = 0.620), eGFR < 92 ml/min/1.73 m2 (AUC = 0.601) were the cutoff values on ROC curve

References

[1]  Gupta, R., Joshi, P., Mohan, V., Reddy, K.S. and Yusuf, S. (2008) Epidemiology and Causation of Coronary Heart Disease and Stroke in India. Heart, 94, 16-26.
https://doi.org/10.1136/hrt.2007.132951
[2]  Ajay, V.S. and Prabhakaran, D. (2010) Coronary Heart Disease in Indians: Implications of the INTERHEART Study. Indian Journal of Medical Research, 132, 561-566.
[3]  Misra, A., Nigam, P., Hills, A.P., et al. (2012) Consensus Physical Activity Guidelines for Asian Indians. Diabetes Technology & Therapeutics, 14, 83-98.
https://doi.org/10.1089/dia.2011.0111
[4]  Deepa, R., Arvind, K. and Mohan, V. (2002) Diabetes and Risk Factors for Coronary Artery Disease. Current Science, 83, 1497-505.
[5]  Castelli, W.P. (1988) Cardiovascular Disease in Women. American Journal of Obstetrics & Gynecology, 158, 1553-1560.
https://doi.org/10.1016/0002-9378(88)90189-5
[6]  Cho, E., Rimm, E.B., Stampfer, M.J., Willett, W.C. and Hu, F.B. (2002) The Impact of Diabetes Mellitus and Prior Myocardial Infarction on Mortality from All Causes and from Coronary Heart Disease in Men. Journal of the American College of Cardiology, 40, 954-960.
https://doi.org/10.1016/S0735-1097(02)02044-2
[7]  Rossing, P., Hougaard, P., Borch-Johnsen, K. and Parving, H.H. (1996) Predictors of Mortality in Insulin Dependent Diabetes: 10 Year Observational Follow Up Study. BMJ, 313, 779-784.
https://doi.org/10.1136/bmj.313.7060.779
[8]  Gall, M.A., Borch-Johnsen, K., Hougaard, P., Nielsen, F.S., Parving, H.H. (1995) Albuminuria and Poor Glycemic Control Predict Mortality in NIDDM. Diabetes, 44, 1303-1309.
https://doi.org/10.2337/diab.44.11.1303
[9]  Sarnak, M.J., Levey, A.S., Schoolwerth, A.C., et al. (2003) Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation, 108, 2154-2169.
https://doi.org/10.1161/01.CIR.0000095676.90936.80
[10]  Muntner, P., He, J., Hamm, L., Loria, C. and Whelton, P.K. (2002) Renal Insufficiency and Subsequent Death Resulting from Cardiovascular Disease in the United States. Journal of the American Society of Nephrology, 13, 745-753.
[11]  Foley, R.N., Murray, A.M., Li, S., Herzog, C.A., McBean, A.M. and Eggers, P.W. (2005) Chronic Kidney Disease and the Risk for Cardiovascular Disease, Renal Replacement, and Death in the United States Medicare Population, 1998 to 1999. Journal of the American Society of Nephrology, 16, 489-495.
https://doi.org/10.1681/ASN.2004030203
[12]  Rahman, M., Pressel, S., Davis, B.R., et al. (2006) Cardiovascular Outcomes in High-Risk Hypertensive Patients Stratified by Baseline Glomerular Filtration Rate. Annals of Internal Medicine, 144, 172-180.
https://doi.org/10.7326/0003-4819-144-3-200602070-00005
[13]  van der Velde, M., Matsushita, K., Coresh, J., et al. (2011) Lower Estimated Glomerular Filtration Rate and Higher Albuminuria Are Associated with All-Cause and Cardiovascular Mortality. A Collaborative Meta-Analysis of High-Risk Population Cohorts. Kidney International, 79, 1341-1352.
https://doi.org/10.1038/ki.2010.536
[14]  Segura, J., Campo, C., Gil, P., et al. (2004) Development of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients. Journal of the American Society of Nephrology, 15, 1616-1622.
https://doi.org/10.1097/01.ASN.0000127045.14709.75
[15]  Knobler, H., Zornitzki, T., Vered, S., et al. (2004) Reduced Glomerular Filtration Rate in Asymptomatic Diabetic Patients: Predictor of Increased Risk for Cardiac Events Independent of Albuminuria. Journal of the American College of Cardiology, 44, 2142-2148.
https://doi.org/10.1016/j.jacc.2004.09.006
[16]  Levey, A.S., Bosch, J.P., Lewis, J.B., Greene, T., Rogers, N. and Roth, D. (1999) A More Accurate Method to Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation. Modification of Diet in Renal Disease Study Group. Annals of Internal Medicine, 130, 461-470.
https://doi.org/10.7326/0003-4819-130-6-199903160-00002
[17]  Mehraj, I., et al. (2014) Association of HbA1c with Prevalence and Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Patients in Kashmir. Asian Journal of Science and Technology, 5, 230-232.
[18]  Ayhan, S.S., et al. (2012) Glycated Haemoglobin Is Correlated with the Severity of Coronary Artery Disease Independently of Traditional Risk Factors in Young Patients. Polish Journal of Endocrinology, 63, 367-371.
[19]  Jia, E.-Z., et al. (2014) Hemoglobin A1c Risk Score for the Prediction of Coronary Artery Disease in Subjects with Angiographically Diagnosed Coronary Atherosclerosis. Cellular Physiology and Biochemistry, 34, 672-680.
https://doi.org/10.1159/000363032
[20]  Dilley, J., et al. (2007) Association of A1C with Cardiovascular Disease and Metabolic Syndrome in Asian Indians with Normal Glucose Tolerance. Diabetes Care, 30, 1527-1532.
https://doi.org/10.2337/dc06-2414
[21]  Mohan, V., Ravikumar, R., Shanthi Rani, S. and Deepa, R. (2000) Intima-Media Thickness of the Carotid Artery in South Indian Diabetic & Non-Diabetic Subjects: The Chennai Urban Population Study (CUPS). Diabetologia, 43, 494-499.
https://doi.org/10.1007/s001250051334
[22]  Heiss, G., Sharrett, A.R., Barnes, R., Chambless, L.E., Szklo, M. and Alzola, C. (1991) Carotid Atherosclerosis Measured by B-Mode Ultrasound in Populations: Associations with Cardiovascular Risk Factors in the ARIC Study. American Journal of Epidemiology, 134, 250-256.
https://doi.org/10.1093/oxfordjournals.aje.a116078
[23]  Kuller, L., Borhani, N., Furberg, C., Gardin, J., Manolio, T., O’Leary, D., et al. (1994) Prevalence of Subclinical Atherosclerosis and Cardiovascular Disease and Association with Risk Factors in the Cardiovascular Health Study. American Journal of Epidemiology, 139, 1164-1179.
https://doi.org/10.1093/oxfordjournals.aje.a116963
[24]  Burke, G.L., Evans, G.W., Riley, W.A., Sharrett, A.R., Howard, G., Barnes, R.W., et al. (1995) Arterial Wall Thickness Is Associated with Prevalent Cardiovascular Disease in Middle-Aged Adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke, 26, 386-391.
https://doi.org/10.1161/01.STR.26.3.386
[25]  Visona, A., Pesavento, R., Lusiani, L., Bonanome, A., Cernetti, C., Rossi, M., et al. (1996) Intimal Medial Thickening of Common Carotid Artery as Indicator of Coronary Artery Disease. Angiology, 47, 61-66.
https://doi.org/10.1177/000331979604700109
[26]  Hansa, G., Bhargava, K., Bansal, M., Tandon, S. and Kasliwal, R.R. (2003) Carotid Intima-Media Thickness and Coronary Artery Disease: An Indian Perspective. Asian Cardiovascular and Thoracic Annals, 11, 217-221.
https://doi.org/10.1177/021849230301100308
[27]  Bots, M.L., Baldassarre, D., Simon, A., de Groot, E., O’Leary, D.H., Riley, W., et al. (2007) Carotid Intima-Media Thickness and Coronary Atherosclerosis: Weak or Strong Relations? European Heart Journal, 28, 398-406.
https://doi.org/10.1093/eurheartj/ehl482
[28]  Budoff, M. (2011) Atherosclerosis: Should We Use CIMT Testing? New Insights from Framingham. Nature Reviews Cardiology, 8, 615-616.
https://doi.org/10.1038/nrcardio.2011.144
[29]  Jos’e Pedro, L., et al. (2007) Glomerular Filtration Rate and Coronary Artery Disease Burden in Patients with Acute Coronary Syndrome. Clinical Cardiology, 30, 464-468.
https://doi.org/10.1002/clc.20145

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133