[Survival of diabetic patients with known coronary artery disease]. / Sobrevida de pacientes diabéticos con enfermedad coronaria conocida.

BACKGROUND: The risk of cardiovascular diseases is two to four times higher in diabetic patients. AIM: To study the severity of coronary disease and survival of patients with diabetes mellitus, compared to matched controls without diabetes. PATIENTS AND METHODS: A retrospective review of all coronary angiographies performed at a private hospital. All diabetic patients with coronary lesions over 50% were considered as the index group. Non diabetic patients with coronary artery lesions over 50% and with similar demographic features and risk factors to the diabetic patients group, were studied as controls. A follow up was done reviewing clinical records and by telephone interviews. Mortality was obtained reviewing death certificates. RESULTS: Seventy seven diabetic patients (48 male, mean age 61+/-10 years and 129 non diabetic subjets (87 males, mean age 61+/-10 years) were studied. Mean follow up in diabetic and non diabetic patients was 1,270 and 1,340 days respectively. Diabetic patients had a higher frequency of multiple vessel disease than their non diabetic counterparts (69 and 52% respectively, p<0.003). Ejection fraction was 61 and 65% in diabetics and non diabetics. General mortality was 15.5 and 2.3% in diabetics and non diabetic respectively (p<0.01). Cardiovascular mortality was 9.1 and 0.8% in diabetics and non diabetics respectively (p 0.002). CONCLUSIONS: Diabetic patients with coronary artery disease have a lower survival and more extensive coronary artery lesions than non diabetic patients with similar age, sex and overall coronary risk.

Sobrevida de pacientes diabÚticos con enfermedad coronaria conocida / Severity of arterial lesions and survival of diabetic patients with coronary artery disease, compared to non diabetic patients

Background : The risk of cardiovascular diseases is two to four times higher in diabetic patients. Aim: To study the severity of coronary disease and survival of patients with diabetes mellitus, compared to matched controls without diabetes. Patients and methods: A retrospective review of all coronary angiographies performed at a private hospital. All diabetic patients with coronary lesions over 50 percent were considered as the index group. Non diabetic patients with coronary artery lesions over 50 percent and with similar demographic features and risk factors to the diabetic patients group, were studied as controls. A follow up was done reviewing clinical records and by telephone interviews. Mortality was obtained reviewing death certificates. Results: Seventy seven diabetic patients (48 male, mean age 61±10 years and 129 non diabetic subjets (87 males, eman age 61±10 years) were studied. Mean follow up in diabetic and non diabetic patients was 1,270 and 1,340 days respectively. Diabetic patients had a higher frequency of multiple vessel disease than their non diabetic counterparts (69 and 52 percent respectively, p <0.003). Ejection fraction was 61 and 65 percent in diabetics and non diabetics. General mortality was 15.5 and 2.3 percent in diabetics and non diabetic respectively (p <0.01). Cardiovascular mortality was 9.1 and 0.8 percent in diabetics and non diabetics respectively (p 0.002). Conclusions: Diabetic patients with coronary artery disease have a lower survival and more extensive coronary artery lesions than non diabetic patients with similar age, sex and overall coronary risk (Rev MÚd Chile 2004; 132: 331-6).

Partículas lipoproteicas LpA-I, LpA-I: A-II y LpB en enfermedad coronaria / Lipoprotein particles LpA-I, LpA-I: A-II and LpB in patients with coronary artery disease

Background: High density lipoproteins are an heterogeneous population of particles. Two main subpopulations have been identified, one contains Apo A-I and Apo A-II and is denominated LpA-I:A-II and another one contains only Apo A-I and is denominated LpA-I. Aim: To measure the concentrations of these particles in patients with stable coronary artery disease. Patients and Methods: Serum lipids, A-I and B apolipoproteins, LpA-I, LpA-I:A-II and LpB particles were measured in 73 men aged 33 to 82 years with angiographically documented coronary artery disease (CAD) and 33 control subjects aged 39 to 76 years. LpA-I, LpA-I:A-II and LpB were measured by a noncompetitive enzyme linked immunoassay using previously characterized monoclonal antibodies against ApoA-I, ApoA-II and apoB. Results: Patients with CAD had significantly higher mean levels of LDL cholesterol than the control group (p= 0.038). The mean concentration of LpA-I particles in patients with CAD was significantly lower (p= 0.031) than in control subjects, while the concentration of LpA-I:A-II particles was significantly higher (p=0.016). The percentage of coronary stenosis correlated negatively with LpA-I and positively with LpA-I:A-II. The best relative risk (RR) indicator in these patients was LDL-cholesterol. The relative risk increases 2.5 fold when LpA-I falls below the cut-off level. Likewise, the relative risk increases 3-fold when LpA-I:A-II raises over the cut-off level. Conclusions: Our findings indicate that the quantification of LpA-I and LpA-I:A-II particles might allow a more accurate evaluation of the CAD risk than HDL cholesterol. LpA-I might represent the antiatherogenic fraction of HDL

Conducta fumadora de los estudiantes ingresados a la universidad de Concepción entre los años 1985-1990 / Smoking behavior of students enrolled at the university of Concepción between 1985-1990

Se analiza la prevalencia, tendencia y algunas características de la conducta fumadora de 10.450 estudiantes al momento de ingresar a la Universidad de Concepción, entre los años 1985 a 1990. Los datos se obtuvieron año a año, a través de un cuestionario aplicado al formalizar la inscripción de asignaturas en el primer año de la Universidad. La prevalencia de estudiantes fumadores fue de 39.9 porciento en el año 1985 y de 32.7 porciento en el año 1990. La disminución fue más notoria en el sexo masculino que de 42.1 porciento en 1985 descendió a 34.6 porciento en 1990, en cambio en el sexo femenino de 33.8 porciento en 1985 descendió a 30.7 porciento en 1990. La edad de inicio de consumo de cigarrillos fue a los 12 años de edad, con mayor incidencia entre los 14 a 15 años. En relación a la prueba de aptitud académica se observó que a menor puntaje hubo mayor porcentaje de estudiantes fumadores. En relación a la carrera universitaria, el mayor pocentaje de fumadores, se presentó en las Facultades de Educación, Humanidades y Arte; y el menor porcentaje en las Facultades de Medicina y Odontología. En el inicio del fumar influyeron los(as) amigos(as) y los(as) hermanos(as). Los fumadores contaron en un alto porcentaje con el permiso de sus padres para fumar y con mayor número de personas fumadoras en el hogar en relación a los no fumadores. Un tercio de los fumadores, fumaba más de 20 cigarrillos por semana