The prevalences of HF and ASVD are higher in Turkey when compared with western countries, despite a younger Turkish population. The established predictors of HF are valid for Turkey as well. There is a significant ASVD population in Turkey with similar characteristics and risk factors to HF. Focusing on the early detection and treatment of ASVD may prevent the progression to HF, and therefore would decrease the prevalence of HF in Turkey.
Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A 1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that selfreported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
Results of this study have demonstrated increased levels of circulating IL-6 in patients with coronary ectasia which might indicate a possible role of inflammatory processes. Absence of a significant correlation between the dimensions of the ectatic segments and IL-6 levels might be due to the narrower range of the diameters of the coronary arteries compared with the abdominal aorta.
We investigated the incidence and severity of echocardiographic and clinical abnormalities in patients with psoriasis and their relationship to the severity, duration and type of psoriasis and other related factors. A total of 216 psoriasis patients and 216 control subjects were included in this study. Left and right heart dimensions, wall thicknesses, wall motion abnormalities, valvular disturbances, and systolic and diastolic functions were examined using two-dimensional and Doppler echocardiographic techniques. Left ventricular hypertrophy, left ventricular diastolic dysfunction, left ventricular wall motion abnormalities and valvular pathologies, especially mitral and tricuspid valve prolapse, were significantly more frequent in patients with psoriasis. Systolic and diastolic blood pressures were significantly higher in psoriasis patients. Significant correlations were found between: (i) psoriasis vulgaris and tricuspid valve prolapse; (ii) palmo-plantar psoriasis and valvular pathologies; and (iii) disease duration and left ventricular diastolic dysfunction and systolic and diastolic blood pressures. Physicians should be aware that cardiovascular abnormalities are common in patients with psoriasis.
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