Correlation between HbA1c Levels with Carotid Intima Media Thickness in Newly Diagnosed Type 2 Diabetes Mellitus Patients

Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macrovascular complications such as cardiovascular and cerebrovascular diseases can be detected early, one of them by using an ultrasound examination to assess carotid intima-media thickness (CIMT). HbA1c examination had a strong predictive value for the occurrence of T2DM complications. HbA1c levels are associated with CIMT in the non-DM group. In the T2DM group there was an increase in CIMT compared to the non DM group. HbA1c levels can be used as a predictor of the progression of CIMT improvement in the T2DM group, but there is no study on populations with newly diagnosed T2DM.Aims: This study was conducted to find out the correlation between HbA1c in newly diagnosed T2DM and CIMT.Methods: This was a cross-sectional study with correlation analysis carried out on newly diagnosed T2DM in four Primary Health Centers in the city of Bandung who were randomly selected from July to August 2018. HbA1c measurement was carried out at Dr. Hasan Sadikin hospital. The CIMT examination was done according to the Manheim Consensus by a cardiologist. Pearson correlation analysis was performed to assess the relationship between those two variables.Results: This study involved 32 subjects with a median age of 52 (40 - 60) years. The mean value of CIMT was 0.77±0.22 mm, while the median value of HbA1c was 6.7 (5.2- 12.3). Bivariate analysis showed a moderate positive correlation between HbA1c and CIMT in newly diagnosed patients with T2DM. (r= 0.567, p<0.001).Conclusion: There was a significant positive correlation between HbA1c in newly diagnosed T2DM and CIMT

Correlation between Leptin with Diastolic Function in Young Adult Obesity

Background: Obesity is one of the global health problems with increasing prevalence, and the complication is related to the alteration of the left ventricle. An obese person without symptoms has impaired diastolic function compares to a normal population, but the mechanism is still unclear. One of the evolving theories is caused by chronic inflammation, characterized by the increase of proinflammatory adipocytokines in an obese person. Leptin is a chronic inflammatory marker which is synthesized by all adipose tissues and has a positive correlation with the body mass index. Leptin level are influenced by age except young adult group. The aim of this study is to investigate the correlation between leptin level and diastolic function of the left ventricle in youngadult obese.Method: This study was conducted in a single centre with cross-sectional design. The subject of this study consists of all young adult obese, worked in Dr. Hasan Sadikin General Hospital, between June-August 2018. The diastolic function of the left ventricle was measured by examining the ventricle relaxation (E/mean e’) by tissue doppler imaging method. The examination of leptin level was done by sandwich-ELISA testmethod. Pearson correlation test was done to assess the correlation between those two.Result: This study consisted of 38 patients with the mean of age 30.75±7.25 years old, 68% were males. The mean score of E/mean e’ was 6.49±3.02 ng/mL and the median of leptin was 13.95 (9.1–25.4) mg/L. After data log transformation of leptin was done, there was a significant positive correlation (r= 0.5892, p<0.001) between leptin level and E/mean e’.Conclusion: There was a significant correlation between the level of leptin and diastolic function of the left ventricle in young adult obese

Natrium Urin Petanda Surrogate Brain Natriuretic Peptide Plasma Pasien Infark Miokard dengan Elevasi ST?

Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse events in acute ST Elevation Myocardial Infarc-tion (STEMI). Unfortunately, the cost and availability of BNP assay had hampered its use. Natriuresis is one of the hallmark effect of raised BNP and measuring urinary sodium might offer insight to the plasma BNP. This study aims to search for any correlation between measured plasma BNP and urinary sodium in patients presenting with acute STEMI.Methods. In an observational descriptive analytic study, we selectively in-cluded patients presenting with acute STEMI and checked for plasma BNP and urinary sodium. All patients had no symptoms or therapy of heart failure prior to admission, had no prior MI, had no valvular abnormalities, and had normal renal function. Plasma BNP was tested using immunoassay method from Abbot Diagnostics, while urinary sodium with ionic specific electrode method. Specimen for plasma BNP were taken at the admission while urinary sodium in the next morning, taking account of urine volume. Results. There were 17 patients, 15 were (82.4%) men, with age 55.1+8.2 years old, onset of STEMI 18.6+2.3 hours, and left ventricular ejection fraction (LVEF) 47.6+11.6%. The urinary sodium was 85.1+34.3 mEq/L, and plasma BNP 449.7+48.8 pg/ml. Pearson’s correlation and linear re-gression analysis showed positive correlation between urinary sodium and plasma BNP (r = 0.71). In multivariate analysis, plasma BNP (p&lt;0.01) and LVEF (p&lt;0.05) were the major influencing factors for urinary sodium level.Conclusion.This study revealed a strong correlation between plasma BNP and urinary sodium in patients presenting with acute STEMI. While mea-surement of urinary sodium cannot replace plasma BNP, it might actually reflect plasma BNP level.Latar belakang: Kadar Brain Natriuretic Peptide (BNP) yang tinggi diduga merupakan prediktor kejadian buruk pada infark miokard akut dengan elevasi ST (ST Elevation Myocardial Infarction - STEMI). Akan tetapi pemeriksaan BNP mahal dan tidak mudah didapat, sehingga penggunaannya terbatas. Natriuresis merupakan salah satu efek menonjol dari kenaikan BNP, sehingga kemungkinan pengukuran kadar Natrium dalam urin dapat menggambarkan kadar BNP plasma. Penelitian ini bertujuan untuk melihat hubungan antara kadar BNP plasma dan kadar Natrium urin pasien STEMI akut. Metoda. Penelitian ini merupakan studi analitik deskriptif observasional. Secara selektif disertakan pasien STEMI akut, kemudian diperiksa kadar BNP plasma dan Natrium urin. Semua pasien tak mempunyai keluhan atau mendapat terapi gagal jantung ketika masuk perawatan, juga belum pernah mengalami infark miokard sebelumnya, tak ada kelainan katup, dan fungsi ginjalnya normal. Kadar BNP plasma diukur menggunakan metoda immu-noassaydari Abbot Diagnostics, sedangkan kadar Natrium dalam urin diukur dengan metoda ionic specific electrode.Sampel darah untuk mengukur BNP plasma diambil saat pasien masuk perawatan, sedangkan Natrium urin diukur keesokan harinya, mengingat diperlukan waktu untuk mendapat urin yang cukup jumlahnya.Hasil. Ada 17 pasien yang memenuhi kriteria, 15 (82.4%) laki-laki, dengan usia 55.1+8.2 tahun, onset STEMI 18.6+2.3 jam, dan fraksi ejeksi ventrikel kiri (LVEF) 47.6+11.6%. Kadar Natrium urin 85.1+34.3 mEq/L, dan BNP plasma 449.7+48.8 pg/ml. Analisis hubungan Pearson  dan regresi linier menunjukkan korelasi positif antara Natrium urin dan BNP plasma (r = 0.71). Pada analisis multivariat, terbukti bahwa BNP plasma (p&lt;0.01) dan LVEF (p&lt;0.05) merupakan faktor utama yang mempengaruhi kadar Natrium urin. Kesimpulan. Penelitian ini telah membuktikan adanya hubungan kuat antara BNP plasma dengan Natrium urin pada pasien-pasien STEMI akut. Meskipun pengukuran Natrium urin tak dapat menggantikan BNP plasma, namun sebenarnya dapat merefleksikan kadar BNP plasma

Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients

Background: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of coronary lesions. The relationship between the TG/HDL ratio and the Gensini score was analyzed using multiple linear regression tests against confounding variables.Results: This study involved 60 patients with stable angina pectoris with a mean age of 60±8 years. The mean TG/HDL ratio is 2.56 ± 1.04. The average Gensini score was 51 ± 36. The TG/HDL ratio was significantly associated with the Gensini score (R = 0.637; p <0.001). Analysis of confounding variables showed age, hypertension, and metabolic syndrome had a weak correlation with Gensini score (r values of 0.321, 0.270, and 0.333, p <0.05, respectively), while those correlating with TG/HDL ratios were men, hypertension, and metabolic syndrome (r values of 0.290, 0.287, and 0.362, p <0.05, respectively).Conclusion: TG/HDL ratio was significantly positively correlated significantly with the severity of coronary lesions based on Gensini score in non diabetic stable angina pectoris patients

Electronic Cigarette and Atherosclerosis: A Comprehensive Literature Review of Latest Evidences

Abstract Coronary artery diseases (CAD), also known as coronary heart disease (CHD), are the world’s leading cause of death. The basis of coronary artery disease is the narrowing of the heart coronary artery lumen due to atherosclerosis. The use of electronic cigarettes has increased significantly over the years. However, harmful effects of electronic cigarettes are still not firm. The aim of this article is to review the impact of electronic cigarette and its role in the pathogenesis of atherosclerosis from recent studies. The results showed that several chemical compounds, such as nicotine, propylene glycol, particulate matters, heavy metals, and flavorings, in electronic cigarette induce atherosclerosis with each molecular mechanism that lead to atherosclerosis progression by formation of ROS, endothelial dysfunction, and inflammation. Further research is still needed to determine the exact mechanism and provide more clinical evidence

Electronic Cigarette and Atherosclerosis: A Comprehensive Literature Review of Latest Evidences

Coronary artery diseases (CAD), also known as coronary heart disease (CHD), are the world’s leading cause of death. The basis of coronary artery disease is the narrowing of the heart coronary artery lumen due to atherosclerosis. The use of electronic cigarettes has increased significantly over the years. However, harmful effects of electronic cigarettes are still not firm. The aim of this article is to review the impact of electronic cigarette and its role in the pathogenesis of atherosclerosis from recent studies. The results showed that several chemical compounds, such as nicotine, propylene glycol, particulate matters, heavy metals, and flavorings, in electronic cigarette induce atherosclerosis with each molecular mechanism that lead to atherosclerosis progression by formation of ROS, endothelial dysfunction, and inflammation. Further research is still needed to determine the exact mechanism and provide more clinical evidence