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2.
Heart Vessels ; 33(2): 102-112, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28815384

RESUMEN

It is not yet clear whether the discordance of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) predicts the follow-up clinical outcome (major adverse cardiovascular events: MACEs) in patients with coronary stent implantation. Among 2015 patients with coronary stent implantation (Fukuoka University [FU]-Registry), excluding those with acute coronary syndrome or hemodialysis, we selected 801 patients who had undergone successful stent implantation with a follow-up until 18 months, and classified them into 3 groups according to baseline LDL-C and non-HDL-C levels [percentile(P)non-HDL-C more than (P)LDL-C, (P)non-HDL-C equal to (P)LDL-C, and (P)non-HDL-C less than (P) LDL-C]. We found that the discordance of (P)LDL-C and (P)non-HDL-C was not a significant predictor of MACEs. Higher LDL-C level was consistently and independently associated with higher incidences of MACEs after controlling for conventional risk factors and the type of stent used by multivariate Cox regression analyses. In conclusion, LDL-C levels are more important than non-HDL-C levels and the discordance of LDL-C and non-HDL-C levels as predictors of MACEs in patients with stable angina after stent implantation.


Asunto(s)
Síndrome Coronario Agudo/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Intervención Coronaria Percutánea , Complicaciones Posoperatorias/epidemiología , Sistema de Registros , Stents , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/cirugía , Anciano , Biomarcadores/sangre , Causas de Muerte/tendencias , Angiografía Coronaria , Vasos Coronarios/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Japón/epidemiología , Masculino , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia/tendencias
3.
Nihon Rinsho ; 74(3): 451-4, 2016 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-27025085

RESUMEN

Subjective memory complaints without objective cognitive impairments are common in elderly people. Recent evidence indicates subjective memory complaints is not merely a sign of a depressive state or an aging phenomenon, but an important risk factor for proceeding to mild cognitive impairment (MCI) and dementia in the future. Even when cognitively intact through the life, people with SMC tend to have more Alzheimer's disease (AD) pathology in the brain, which recently been defined as preclinical AD. Though not having the same clinical significance compared to MCI, we should keep in mind that elderly people with SMC are at risk for future cognitive decline and try to find out what specific biological backgrounds or clinical characters increase this cognitive risk.


Asunto(s)
Enfermedad de Alzheimer/diagnóstico , Disfunción Cognitiva/diagnóstico , Memoria , Humanos , Factores de Riesgo
4.
J Cardiol ; 65(5): 390-6, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25128368

RESUMEN

BACKGROUND: It is not clear whether it is reasonable to use particular drugs for glycemic control in preference to other hypoglycemic agents in terms of the clinical outcome of percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM). METHODS AND RESULTS: Among 2148 patients (2568 lesions) in the FU-Registry, DM patients who underwent PCI (n=758; 922 lesions) were investigated to clarify the effects of various drugs for glycemic control on the clinical outcome [major adverse cardiac events (MACEs): death, myocardial infarction (MI), and target lesion revascularization (TLR)] over approximately 300 days of follow-up (UMIN000005679). The MACEs(+) group (n=165) had a higher usage of insulin (p<0.001) and a lower usage of biguanides (BG, p<0.05) and dipeptidyl peptidase-IV inhibitors (p<0.05) at PCI, compared to the MACEs(-) group (n=593). A multivariate logistic regression analysis showed that low-density lipoprotein cholesterol, insulin use, atherosclerosis obliterans, and lesion reference might be significantly associated with MACEs, while BG use was negatively correlated with MACEs (p=0.04). The cumulative frequency of MACEs in the insulin-treated group was significantly higher (p<0.05) than that in the non-insulin group, and the strongest association between insulin with MACEs was seen in the hemoglobin (Hb) A1c 6.5-7.5% group. There tended to be a negative correlation between the use of insulin and MACEs, with risk ratios of <1, for the HbA1c >8.5% groups. CONCLUSIONS: Among different hypoglycemic agents, treatment with insulin was associated with poor mid-term clinical outcomes in DM patients who underwent PCI, while BG use was negatively correlated with MACEs. It may be reasonable for patients with HbA1c >8.5% to avoid hyperglycemia and glucotoxicity, even through the use of insulin.


Asunto(s)
Biguanidas/uso terapéutico , Diabetes Mellitus/tratamiento farmacológico , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Infarto del Miocardio/terapia , Intervención Coronaria Percutánea , Anciano , Glucemia/metabolismo , Diabetes Mellitus/sangre , Femenino , Estudios de Seguimiento , Hemoglobina Glucada/metabolismo , Humanos , Incidencia , Lipoproteínas LDL/sangre , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Sistema de Registros , Análisis de Regresión , Estudios Retrospectivos , Resultado del Tratamiento
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