The prognosis of patients with coronary artery disease complicated by postload hyperinsulinemia

Background: The long-term prognosis of coronary artery disease (CAD) patients with insulin resistance has not been fully examined. In this study, we investigated the influence of postload hyperinsulinemia (PHI) after a 75-g oral glucose tolerance test (OGTT), on the long-term prognosis of CAD patients. Methods: All study patients were diagnosed as having CAD by coronary angiography. The OGTT was performed for all patients to establish their blood glucose. Measurement of serum insulin was also performed simultaneously. Patients with 2-h insulin level of ?. 64. mU/l after the OGTT were included in the postload hyperinsulinemia (PHI) group, and the others were included in the non-PHI group. The prognosis of 208 patients (96 from the PHI group and 112 from the non-PHI group) was retrospectively investigated. Study end points were the composite of death from any cause, unexpected hospitalization for heart failure, new-onset ACS, angina pectoris requiring PCI or CABG, cerebrovascular disease (CVD), and peripheral artery disease (PAD). Variables were compared using Kaplan-Meier analysis and the log-rank tests. Results: The mean follow-up period was 78.7. months. Cardiovascular events including death were 40.6% in the PHI group and 23.2% in the non-PHI group (log-rank p = 0.0144). CVD, PCI, and CABG occurred continuously from early to late stage of follow-up in the PHI group compared with the non-PHI group. Conclusions: The present study showed that the prognosis of CHD patients with PHI was poor. Thus, it is important to pay attention to these conditions for improving the prognosis of CAD patients

Field experiment of 800× off-axis XR-Köhler concentrator module on a carousel tracker

This paper presents the design and preliminary experimental results of a concentrator-type photovoltaic module based on a free-form off-axis 800×XR-Köhler concentrator. The off-axis XR-Köhler concentrator is one of the advanced concentrators that perform high concentration with a large acceptance angle and excellent irradiance uniformity on a solar cell. As a result of on-sun characterization of the unglazed single-cell unit test rig, the temperature-corrected DC module efficiency was 32.2% at 25 °C without an anti-reflective (AR) coating on the secondary optics, and the acceptance angle was more than ±1.0°. In addition, the non-corrected DC efficiency of an individual cell in a glazed 8-cell unit module mounted on a carousel tracking system was measured. The individual efficiency deviated in the range of 24.3-27.4%, owing to the mirror shape and alignment errors. The resultant series-connected efficiency was approximately 25% at direct normal irradiation (DNI) of 770 W/m2

Impact of Gender on In-hospital Mortality in Patients with Acute Myocardial Infarction in Nagasaki

Acute myocardial infarction (AMI) is one of the leading causes of death in Japan. Immediate reperfusion therapy, includingcoronary intervention, improves patient prognosis. Despite this, females are said to be more prone to poor prognosis. A regional AMI registry in Nagasaki prefecture has been instituted recently that will evaluate whether female gender might predict short-term in-hospital death. Seventeen regional AMI centers enrolled all AMI patients from September 2014 through March 2016. A propensity score (PS) was derived using logistic regression to model the probability of females as a total function of the potential confounding covariates. Two types of PS techniques were used: PS matching and PS stratification. The consistency of in-hospital death was determined between PS matched patients of both genders. Based on PS, patients were ranked and stratified into five groups for the PS stratification. Out of 996 patients, 67 (6.7%) died during hospitalization: 31 (10.4%) out of 298 females and 36 (5.2%) out of 698 males (p < 0.0025). The proportion of cardiac and non-cardiac related death was almost same between genders (25 and 6 in female, 29 and 7 in male, respectively). Among 196 PS matched patients, there was a consistency between genders regarding in-hospital deaths (McNemar test, p = 0.6698). The 717 propensity scored patients had no significant differences between genders among propensity quintiles (Cochran-Mantel-Heanszel test, p = 0.7117). We found that gender alone is not an indicator of short-term in-hospital death in acute myocardial infarction patients

Comparison of the Brachial-ankle Pulse Wave Velocity between Patients with Acute Coronary Syndrome and Effort Angina Pectoris

Objective Coronary artery disease (CAD) is one of the clinical categories of atherosclerotic diseases. There have been reports indicating that the pathological findings of coronary artery plaque differ between acute coronary syndrome (ACS) and effort angina pectoris (EAP). The brachial-ankle pulse wave velocity (baPWV) has been reported to be a good indicator of atherosclerotic disease. However, the baPWV may not be equally effective for evaluating ACS and EAP. In this study, we compared the baPWV in patients with ACS and those with EAP. Methods Two hundred and seventy patients were enrolled in this study. All patients underwent coronary angiography, and were separated into normal (CONT), ACS and EAP groups according to the clinical and coronary angiographic findings. The baPWV was evaluated and the results were compared among the groups. Results The baPWV was significantly higher in the EAP group than in the other groups. The baPWV in the ACS group was almost the same as that of the CONT group and was significantly higher in the EAP group than in the ACS group across almost all age groups. Conclusion The present study showed that the baPWV is high in patients with EAP. In contrast, the baPWV in the ACS group was almost normal and was similar to that of the CONT group. ACS occurs due to plaque rupture induced by atherosis, which may occur independent of sclerosis in the coronary artery. EAP may occur in proportion to systemic arterial sclerosis. The baPWV is suitable for screening for EAP, but not for ACS

Impact of Gender on In-hospital Mortality in Patients with Acute Myocardial Infarction in Nagasaki

Acute myocardial infarction (AMI) is one of the leading causes of death in Japan. Immediate reperfusion therapy, including coronary intervention, improves patient prognosis. Despite this, females are said to be more prone to poor prognosis. A regional AMI registry in Nagasaki prefecture has been instituted recently that will evaluate whether female gender might predict short-term in-hospital death. Seventeen regional AMI centers enrolled all AMI patients from September 2014 through March 2016. A propensity score (PS) was derived using logistic regression to model the probability of females as a total function of the potential confounding covariates. Two types of PS techniques were used: PS matching and PS stratification. The consistency of in-hospital death was determined between PS matched patients of both genders. Based on PS, patients were ranked and stratified into five groups for the PS stratification. Out of 996 patients, 67 (6.7%) died during hospitalization: 31 (10.4%) out of 298 females and 36 (5.2%) out of 698 males (p < 0.0025). The proportion of cardiac and non-cardiac related death was almost same between genders (25 and 6 in female, 29 and 7 in male, respectively). Among 196 PS matched patients, there was a consistency between genders regarding in-hospital deaths (McNemar test, p = 0.6698). The 717 propensity scored patients had no significant differences between genders among propensity quintiles (Cochran-Mantel-Heanszel test, p = 0.7117). We found that gender alone is not an indicator of short-term in-hospital death in acute myocardial infarction patients