Prediction by Low Plasma HbA(1c) of Mortality, Cardiac and Noncardiac Disease Risk: Modulation by Diabetic Status and Sex

Aim The aim of the study was to evaluate the predictive value of HbA(1c) for risk of overall mortality or a composite endpoint of death and nonfatal events

Low Serum Uric Acid Predicts Risk of a Composite Disease Endpoint

Background and objectives: Mortality may increase in hypouricemia as well as inhyperuricemia. We assessed the predictive value of low serum uric acid (SUA) levels on the risk of overall mortality or a composite endpoint of death and nonfatal events. Materials and Methods: In 1013 community-based middle-aged adults, free of uncontrolled diabetes and coronary heart disease at baseline, the association of sex-specific SUA tertiles with defined outcomes was evaluated prospectively by logistic regression, stratified to gender and presence of type-2 diabetes, using recent criteria. Results: Totally, 43 deaths and additional incident nonfatal events in 157 cases were recorded at a median 3.4 years' follow-up. Multivariable linear regression disclosed SUA to be significantly associated among non-diabetic individuals positively with creatinine, triglycerides, and body mass index in women further with fasted glucose. In multivariable-adjusted logistic regression analysis, sex-specifically dichotomized baseline uric acid (<5.1 and <4.1 mg/dL vs. higher values) significantly predicted the non-fatal events in the whole sample (relative risk (RR) 1.51 [95% confidence interval (CI) 1.02; 2.26]), as well as in men, while composite endpoint in the whole sample tended to rise (RR 1.38). Compared with the intermediate one, the top and bottom SUA tertiles combined tended to confer mortality risk (RR 2.40 [95% CI 0.89; 6.51]). Adverse outcomes in diabetic women were predicted by tertiles 2 and 3. Conclusions: Inverse association of SUA with adverse outcomes, especially in men, is consistent with the involvement of uric acid mass in autoimmune activation. The positive association of uric acid with adverse outcomes in diabetic women is likely mediated by concomitant high-density lipoprotein dysfunction

Renal "hyperfiltrators" are at elevated risk of death and chronic diseases

Background: The definition of glomerular hyperfiltration has not been agreed upon and the pathophysiological mechanisms have not been well explored. Low serum creatinine concentrations may be associated with increased risk of coronary heart disease (CHD) or cardiopulmonary events the impact of which needs further study

Fasting glycemia and glycated hemoglobin categories: Relationship to serum lipoprotein(a) level and disparity in 2 geographic regional groups of Turkey

Objective: The goal of the present study was to determine covariates of serum lipoprotein (Lp) (a) within fasting glucose and glycated hemoglobin (HbA1c) categories, and to detect features that were different among covariates based on residence in Marmara and Central Anatolia (Marm-CA) regions or remaining 5 geographic regions of Turkey

Turkish Adult Risk Factor survey 2014: Overall mortality and coronary disease incidence in Turkey's geographic regions

Objective: This study aimed to examine the overall and coronary mortality in the 2014 Turkish Adult Risk Factor Study survey, and the distribution of cumulative mortality and incident coronary heart disease (CHD) across 7 geographic regions

Sex-Specific Predictors of Metabolic Syndrome Independent of Its Components

To what extent is the metabolic syndrome (MetS) determined beyond its recognized components? In 1702, middle-aged men and women without MetS at baseline, MetS development was identified in 546 participants at a mean of 10.1-year follow-up. Participants subsequently developing MetS had, beyond higher values of MetS traits, significantly higher total and low-density lipoprotein cholesterol, apolipoprotein B, C-reactive protein (CRP), -glutamyl transferase (GGT), and lower high-density lipoprotein cholesterol. Females were significantly more frequent never smokers and males had lower values of total testosterone. In logistic regression analyses, adjusted for sex, age, and smoking status, MetS was predicted disparately in the sexes, whereas males exhibited, beyond abdominal obesity, CRP, GGT, and sex hormone-binding globulin (SHBG) as independent predictors, abdominal obesity was not an independent predictor in females in whom other than age, CRP conferred MetS risk, whereas SHBG was and current smoking tended to be protective. A surrogate of hepatic steatosis proved a major mediator of abdominal obesity in determining incident MetS (relative risk, 5.6 [95% confidence interval, 3.4-9.3]) in each sex. We confirm that GGT and SHBG are novel independent MetS determinants. Hepatic steatosis is the major predictor of MetS mediating adiposity in each sex. Abdominal obesity is not an independent determinant in Turkish women in whom autoimmune activation seems to prevail before MetS development

Fatty liver disease: Disparate predictive ability for cardiometabolic risk and all-cause mortality

AIM: To assess the association of a surrogate of fatty liver disease (FLD) with incident type-2 diabetes, coronary heart disease, and all-cause mortality

Long-term prognostic significance of pentraxin-3 in patients with acute myocardial infarction: 5-year prospective cohort study

Objective: A predictive role of serum Pentraxin 3 (PTX3) for short-term adverse cardiovascular events including mortality in acute myocardial infarction (AMI) was reported in recent studies. The aim of the study was to investigate long-term prognostic significance of serum PTX3 in an AMI with 5-year follow-up period in this study

Wartość prognostyczna stężenia rezystyny w surowicy u chorych z ostrym zawałem serca

Background: Resistin is a novel adipokine that is suggested to be involved in inflammatory conditions and atherosclerosis.Aim: To investigate the prognostic importance of resistin in acute myocardial infarction (AMI) patients.Methods: Resistin levels were measured in a population of 132 patients with AMI, of whom 72 (54%) had a diagnosis of ST elevation myocardial infarction (STEMI), and 60 (46%) had non-ST elevation myocardial infarction (NSTEMI). Thirty-three consecutive subjects who were referred to elective coronary angiography due to chest pain evaluation with normal coronary angiograms served as controls. All patients were followed-up for the occurrence of major adverse cardiac events (MACE).Results: There was a significant increase in serum resistin levels in patients with AMI compared to controls (3.71 ± 4.20 vs. 2.00 ± 1.05, p = 0.001, respectively). However, serum resistin levels were similar in patients with STEMI and NSTEMI. (4.26 ± 5.11 vs. 3.06 ± 2.64, p = 0.49, respectively). The patients with MACE had significantly higher levels of serum resistin levels compared to either the AMI or the control group (6.35 ± 5.47, p = 0.005, respectively). Logistic regression analysis revealed that resistin, left ventricular ejection fraction, and coronary artery bypass graft were independent predictors of MACE in AMI patients (OR = 1.11, 95% CI 1.01–1.22, p = 0.03 and OR = 3.84, 95% CI 1.26–11.71, p = 0.018, respectively).Conclusions: Serum resistin level was increased in patients with AMI and constituted a risk factor for MACE in this group.Wstęp: Rezystyna jest nową adipokiną, która prawdopodobnie uczestniczy w procesach zapalnych i rozwoju miażdżycy.Cel: Celem niniejszego badania była ocena wartości prognostycznej rezystyny u chorych z ostrym zawałem serca (AMI).Metody: Zmierzono stężenia rezystyny w populacji złożonej ze 132 chorych z AMI, spośród których u 72 (54%) osób rozpoznano zawał serca z uniesieniem odcinka ST (STEMI), a u 60 (46%) — zawał serca bez uniesienia odcinka ST (NSTEMI). Grupę kontrolną stanowiło 33 kolejnych pacjentów skierowanych na angiografię wieńcową w trybie planowym z powodu bólu w klatce piersiowej, u których wykazano prawidłowy obraz tętnic wieńcowych. Wszystkich chorych obserwowano pod kątem wystąpienia poważnych niepożądanych zdarzeń sercowych (MACE).Wyniki: U pacjentów z AMI stwierdzono istotne zwiększenie stężenia rezystyny w surowicy w porównaniu z osobami z grupykontrolnej (odpowiednio 3,71 ± 4,20 vs. 2,00 ± 1,05; p = 0,001). Jednak u chorych ze STEMI i NSTEMI stężenia rezystyny były podobne (odpowiednio 4,26 ± 5,11 vs. 3,06 ± 2,64; p = 0,49). U pacjentów z MACE stężenia rezystyny w surowicy (6,35 ± 5,47; p = 0,005) były istotnie wyższe niż u chorych z AMI i osób z grupy kontrolnej. W analizie regresji logistycznej wykazano, że stężenie rezystyny, frakcja wyrzutowa lewej komory i pomostowanie aortalno-wieńcowe były niezależnymi czynnikami predykcyjnymi MACE u chorych z AMI (odpowiednio: OR = 1,11; 95% CI 1,01–1,22; p = 0,03 i OR = 3,84; 95% CI 1,26–11,71; p = 0,018).Wnioski: Stężenie rezystyny w surowicy było zwiększone u chorych z AMI i stanowiło czynnik ryzyka MACE w tej grupie chorych

The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

WOS: 000423237800009PubMed ID: 28443575Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy. Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey. Study Design: Cross-sectional study. Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of the effect of warfarin and fooddrug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5% +/- 22.9 in the WARFARIN-TR study. There were statistically significant differences between regions in terms of time in therapeutic range (p<0.001). The highest rate was reported in the Marmara region (54.99%+/- 20.91) and the lowest was in the South-eastern Anatolia region (41.95 +/- 24.15) (p< 0.001). Bleeding events were most frequently seen in Eastern Anatolia (41.6%), with major bleeding in the Aegean region (5.11%) and South-eastern Anatolia (5.36%). There were statistically significant differences between the regions in terms of awareness (p< 0.001). Conclusion: Statistically significant differences were observed in terms of the efficacy, safety and awareness of warfarin therapy according to different geographical regions in Turkey