APOA1 (-75 G>A and 83 C>T) and APOB (2488 C>T) polymorphisms and their association with myocardial infarction, lipids and apolipoproteins in patients with type 2 diabetes mellitus.

Introduction: The increased risk of myocardial infarction (MI) in type 2 diabetes mellitus (T2DM) is well documented. Polymorphisms in APOA1 and APOB genes allow us to identify new genetic markers in the Mexican population with T2DM and MI. Material and methods: We studied 135 patients with DMT2 and MI (DI); another 85 non-infarcted diabetic individuals with DMT2 but without previous ischemic events (NID) and 242 healthy subjects (HS). All three groups were selected with the aim to investigate the association between the polymorphisms and infarction when T2DM is present or absent. Results: -75 G>A polymorphism: Differences were found in genotype distribution between DI and NID individuals (OR = 2.01, 95% CI: 1.117-3.623, p = 0.019) with an increased risk for A in the dominant model (OR = 1.77, 95% CI: 1.020-3.084, p = 0.042); also concentrations of ApoA-I for A/A were lower in comparison with G/A (p = 0.038) and LDL-C and HDL-C levels were lower in G/A compared to G/G carriers. 83 C>T polymorphism of APOA1: For DI individuals, HDL-C was lower in T/T compared to C/C and triglyceride levels were lower in C/T compared to C/C carriers. Conclusions: The -75 G>A APOA1 polymorphism could be considered as a susceptibility factor for myocardial infarction in individuals with T2DM and 2488 C>T APOB polymorphism is associated with changes in HDL-C and LDL-C and triglycerides in the same group.

[Obstructive sleep apnea syndrome and hypertension. Evidence of their relationship]. / Apnea obstructiva del sueño e hipertensión arterial. Las evidencias de su relación.

The purpose of this review is to analyze the relation between obstructive sleep apnea and hypertension. We present epidemiological data of the respiratory disorder and its association with high blood pressure, as well as physiopathological interactions between both conditions, the diagnostic methods, and the impact of treatment on pathophysiology and prognosis.

En esta revisión se analiza la relación entre la apnea obstructiva del sueño y la hipertensión arterial sistémica. Se exponen las evidencias epidemiológicas de la alteración respiratoria y de su asociación con la hipertensión arterial, las interacciones fisiopatológicas entre ambas condiciones, los métodos diagnósticos y el impacto del tratamiento sobre la fisiopatología y el pronóstico.

Apnea obstructiva del sueño y cardiopatía isquémica: Las evidencias de su relación / Obstructive sleep apnea syndrome and ischemic heart disease: Evidence of their relationship

El propósito de esta revisión es analizar la relación entre la apnea obstructiva del sueño y la enfermedad arterial coronaria. Se exponen las evidencias epidemiológicas del trastorno respiratorio y de su asociación con la cardiopatía isquémica, los factores comunes de riesgo cardiovascular, las interacciones fisiopatológicas entre ambos trastornos, la evolución clínica y el efecto del tratamiento sobre la fisiopatología y el pronóstico.

The purpose of this review is to analyse the relation between obstructive sleep apnea and coronary disease. We present epidemiological data on the respiratory disorder and its association with ischemic cardiopathy, as well as common cardiovascular risk factors, physiopathological interactions between both conditions, clinical evolution and impact of treatment on prognosis.

[Obstructive sleep apnea syndrome and ischemic heart disease. Evidence of their relationship]. / Apnea obstructiva del sueño y cardiopatía isquémica. Las evidencias de su relación.

The purpose of this review is to analyse the relation between obstructive sleep apnea and coronary disease. We present epidemiological data on the respiratory disorder and its association with ischemic cardiopathy, as well as common cardiovascular risk factors, physiopathological interactions between both conditions, clinical evolution and impact of treatment on prognosis.

Prevalencia de eventos cardiacos duros en pacientes estratificados con ecocardiograma de estrés con dobutamina / Prevalence of cardiac events in patients stratified by dobutamine stress echocardiogram

Introducción: El ecocardiograma de estrés con dobutamina (ESD) es una herramienta ampliamente utilizada para la estratificación de riesgo en pacientes que presentaron un evento coronario agudo. Objetivos: Describir la prevalencia de muerte súbita, infarto agudo al miocardio con elevación del ST (IAMCEST), infarto agudo al miocardio sin elevación del ST (IAMSEST) y la angina inestable (AI) en pacientes estratificados con ESD en nuestro centro durante el año 2007, en un periodo de seguimiento de dos años. Material y métodos: Estudio transversal, analítico, descriptivo, utilizando como unidades de observación los registros ecocardiográficos de estrés con dobutamina de pacientes evaluados en el Centro Médico Nacional de Occidente durante el año 2007. Resultados: Se analizaron 142 registros de ESD, 79 con resultado positivo. La prevalencia en pacientes con 1 a 2 segmentos afectados fue de 42%, con 0% de mortalidad, la prevalencia en pacientes con 3 a 4 segmentos afectados fue de 32.25%, con 0% de mortalidad y en pacientes con 5 o más segmentos afectados que fueron revascularizados fue 0% contra 14.3% en los pacientes del mismo grupo que no fueron revascularizados. Conclusiones: Los resultados no difieren a lo esperado, pero creemos que los pacientes con ESD positivo de riesgo bajo e intermedio son vigilados menos estrechamente y los de alto riesgo muestran menor prevalencia ya que son rápidamente revascularizados.

Introduction: The dobutamine stress echocardiogram is a widely used tool for risk stratification in patients experiencing an acute coronary event. Purpose: To describe the prevalence of sudden death, acute myocardial infarction with ST-elevation, acute myocardial infarction without ST elevation and unstable angina in patients stratified by ESD in our hospital during 2007, in a follow-up period of two years. Material and methods: Cross-sectional study, analytical, descriptive, using as units of observation records dobutamine stress echocardiography in patients evaluated in the Western National Medical Center in 2007. Results: We analyzed 142 records of ESD, 79 positive studies. Patients with positive ESD were divided according to the affected segments, the prevalence in patients with 1 to 2 segments affected was 42%, with 0% mortality, the prevalence in patients with 3 to 4 segments affected was 32.25%, with 0 % mortality, in patients with 5 or more affected segments revascularized was 0% versus 14.3% in the same group of patients who were not revascularized. Conclusions: The results is not different than expected, but we believe that patients with positive ESD at low and intermediate risk are less closely monitored, and high-risk patients have fewer prevalence as they are rapidly revascularized.