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Titolo:
Prediction of major coronary events by coronary risk profile and silent myocardial ischaemia: Prospective follow-up study of primary prevention in 72diabetic patients
Autore:
Torremocha, F; Hadjadj, S; Carrie, F; Rosenberg, T; Herpin, D; Marechaud, R;
Indirizzi:
Univ Hosp, Clin Diabetol, F-86021 Poitiers, France Univ Hosp Poitiers France F-86021 lin Diabetol, F-86021 Poitiers, France Univ Hosp, Dept Nucl Med, F-86021 Poitiers, France Univ Hosp Poitiers France F-86021 ept Nucl Med, F-86021 Poitiers, France Univ Hosp, Dept Cardiol, F-86021 Poitiers, France Univ Hosp Poitiers France F-86021 Dept Cardiol, F-86021 Poitiers, France
Titolo Testata:
DIABETES & METABOLISM
fascicolo: 1, volume: 27, anno: 2001,
pagine: 49 - 57
SICI:
1262-3636(200102)27:1<49:POMCEB>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-DISEASE; CARDIOVASCULAR MORTALITY; MELLITUS; ISCHEMIA; MEN; MICROALBUMINURIA; INFARCTION; MODEL;
Keywords:
coronary heart disease; coronary risk; diabetes; silent myocardial ischaemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Marechaud, R Univ Hosp, Clin Diabetol, BP 577, F-86021 Poitiers, France Univ Hosp BP 577 Poitiers France F-86021 21 Poitiers, France
Citazione:
F. Torremocha et al., "Prediction of major coronary events by coronary risk profile and silent myocardial ischaemia: Prospective follow-up study of primary prevention in 72diabetic patients", DIABETE MET, 27(1), 2001, pp. 49-57

Abstract

The aim of this study was to examine the predictive value of coronary riskprofile (CRP) for major coronary events in patients screened for silent myocardial ischemia (SMI). We studied 72 diabetic patients, aged 41 to 65 years, recruited consecutively at the Poitiers diabetes clinic. All patients had at least one cardiovascular risk factor associated with diabetes mellitus (type 1 diabetes duration greater than or equal to 15 years, dyslipidaemia, smoking, hypertension, micro/macroalbuminuria). A structured questionnaire, physical examinationand resting electrocardiogram provided no evidence of coronary heart disease. SMI was defined as positive exercise electrocardiogram and/or dipyridamole thallium myocardial scintigraphy. CRP was estimated using the Framingham equation adapted to the French population. We defined a high CRP value asannual CRP greater than or equal to 1.5%. Major coronary events (MCE) weredefined as myocardial infarction, ischaemic heart failure, unstable anginaor sudden death. Twenty-one patients with type 1, and 51 with type 2 diabetes were followed up for 39+/-12 months: 30 women and 42 men, aged 55+/-7 years with diabetes duration of 16 +/- 11 years (mean +/- SD). SMI was detected in 8 patients. Major coronary events occurred in 8 patients, 2 of whom had SMI. High CRP was found in 18 patients, 3 of whom had MCE. CRP was significantly higher in those patients with a major coronary event (1.71 +/- 1.11 versus 1.03 +/- 0.56%; p = 0.048), but not in those with SMI (1.19 +/- 0.72 vs 1.09 +/- 0.67%; p = 0.654). In Kaplan-Meier survival analysis, a high CRP was associated with the risk of a major coronary event (log-rank = 5.36; p = 0.021), whereas SMI was not (log-rank = 2.02; p = 0.155). The cumulative incidence of MCE in those patients with high and low CRP was 8.08 (0.49-15.67) vs 2.15 (0.06-4.22) events per 100 patient year of follow-up, respectively. Conclusion: CRP had a good predictive value for major coronary events regardless the presence of SMI. Prevention should therefore be focused primarily on patients with high CRP, wether or not they have SMI.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 03:38:32