Changes of Ischemic Heart Disease in Utsunomiya, Japan, Over 10 Years

2003

Circ J

This study aimed to clarify whether body mass index (BMI), waist/hip ratio (WHR) or percent body fat (%fat) is associated with coronary artery disease (CAD) in Chinese type 2 diabetic patients in Taiwan. A total of 463 patients were recruited. BMI and WHR were measured by standard methods and %fat by bioelectrical impedance. CAD was diagnosed as acute myocardial infarction, angina pectoris, or an electrocardiogram showing 'coronary probable or possible' according to the Minnesota codes. Age, sex, diabetes duration, hypertension, smoking, fasting plasma glucose, hemoglobin A(1c),and serum concentrations of total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were treated as confounders. Results showed that 144 patients had CAD. Age, hypertension, HDL-C and %fat were independently associated with CAD. CAD prevalence was 25.5%, 26.8%, 31.9% and 43.0%, respectively, for the first to fourth quartile of %fat (p<0.05). Multivariate-adjusted odds ratio for CAD for every 1% increase in %fat was 1.02 (1.01-1.03); and 1.01 (0.73-1.88), 1.26 (0.69-2.32) and 2.11 (1.09-4.07) for the second to fourth quartile, respectively, compared with the first quartile. BMI and WHR were not associated with CAD in similar analyses. In conclusion, %fat was a better predictor for CAD than BMI and WHR in Chinese type 2 diabetic patients in Taiwan.

Body Composition as a Risk Factor for Coronary Artery Disease in Chinese Type 2 Diabetic Patients in Taiwan

2003

Circ J

Hypertension is the Most Important Component of Metabolic Syndrome in the Association With Ischemic Heart Disease in Taiwanese Type 2 Diabetic Patients

Chong

et al. 2008

Circ J

etabolic syndrome (MS) is characterized by a cluster of risk factors that increase the chance of cardiovascular disease (CVD). They include: glucose intolerance; hypertension; abdominal obesity; and dyslipidemia. 1 The World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III have separately proposed criteria for the clinical diagnosis of MS. 1,2 The WHO defines MS as a condition of insulin resistance and diabetes mellitus (DM) or impaired glucose tolerance with the presence of 2 or more of these components: obesity (body mass index (BMI) ≥30 kg/m 2 and/or waist-to-hip ratio (WHR) >0.9 and >0.85 for men and women, respectively); hypertension (blood pressure ≥140/90 mmHg); dyslipidemia (triglycerides (TG) ≥1. and microalbuminuria (urinary albumin-to-creatinine ratio (ACR) ≥30 g/mg). 1 The NCEP-ATP III criteria differ slightly with those of the WHO. 2 Subjects with type 2 DM (T2DM) show the highest risk of MS and CVD. Therefore understanding any correlation between CVD risk and the number of risk factors in a doseresponsive pattern, or the binary classification of MS or the components of MS, could well differentiate those patients at risk of ischemic heart disease (IHD) from those not at risk. As a result, the purpose of the present study examines the relation between IHD and (1) each component of MS, (2) the number of components of MS and (3) MS itself, in T2DM cases. Methods Study SubjectsThe present study was approved by an ethics committee with subjects participating voluntarily. Taiwan has an established cohort of 93,484 confirmed diabetic patients derived from a national sample of 256,036 patients under National Health Insurance cover, which covers over 96% of the total population. 3,4 A health examination was planned for recruiting 1,400 patients from the main cluster. At random, 4,164 patients were selected from the main cluster and invited to participate in the health examination. A total of 1,441 patients accepted the invitation to this health examination and 1,420 patients were discovered to have T2DM. Among these T2DM patients, 1,296 patients (604 men and 692 women) had complete medical data for analyses in this present study. The mean age was 62.5±11.7 (14-87) years. All subjects were selected at random, thus a selection bias was not Methods and Results A total of 1,296 (604 men and 692 women) subjects with T2DM aged 62.5±11.7 (14-87) years were studied. MS was defined using the World Health Organization modified criteria and included more than 2 of hypertension, obesity, dyslipidemia and microalbuminuria. IHD was diagnosed through history or ischemic electrocardiogram according to the Minnesota codes. Results showed that MS was present in 76.2% and IHD in 36.3% of the patients, respectively. MS increased with age for both sexes, but there was no difference between men and women in the age groups of <45, 45-54 and 55-64 years. However, the prevalence of MS was significantly higher in women (87.7% vs 78.0%) in the age group ≥65 years. IHD prev...

Five-year Long-term Outcomes of Acute Coronary Syndrome with General Practitioner-based Management: Myocardial Infarction Cohort Study by Kanfuzen Study (MIC-K) Study

Kiuchi¹,

Obayashi

Ishikawa³

et al. 2017

J Jpn Coron Assoc

Self Cite

Background: Only a few nationwide studies have focused on the post-discharge treatment and outcomes of acute coronary syndrome (ACS) by general practitioners. Methods and Results: This prospective cohort study was conducted between February 2007 and March 2011. In total, 178 facilities across the country participated in this study, which included 545 patients with ACS who received acute care in cardiovascular centers and were then referred to general practitioners for further care. Clinical follow-up data, of up to 5 years, were obtained. As for patient characteristics, 403 of the 545 patients (73.9%) were men. The mean age of all subjects was 66 ± 11 years. Approximately two-thirds of patients had hypertension and dyslipidemia, and one-third had diabetes mellitus. Only 3.5% of patients had renal dysfunction. In the cardiovascular centers, reperfusion therapy was administered as acute care to 516 of the 545 patients (94.7%). Frequent use of guideline-directed medical therapy was indicated during the in-hospital and post-discharge periods. During the 5-year follow-up period, the cumulative incidence of clinical events was 24.0%, and all-cause mortality was 5.3%. The number of affected vessels was the strongest independent predictor of cardiovascular events. Conclusions: The MIC-K study identified an incidence of clinical events of 24.0%, and that of mortality of 5.3% in patients with ACS who were managed by general practitioners following their discharge from cardiovascular centers. The high rate of reperfusion therapy administered in cardiovascular centers and a low complication rate may have contributed to the favorable outcomes in these patients.