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Incidence of in-hospital mortality or nonfatal myocardial infarction or nonfatal stroke in 216 diabetics and 552 nondiabetics undergoing percutaneous coronary intervention with stenting

Gamble, Sarah M; Saulle, Leonardo N; Aronow, Wilbert S; Alappat, Rose M; Kalapatapu, Kumar; Pucillo, Anthony L; Monsen, Craig E; Weiss, Melvin B
We investigated the incidence of in-hospital mortality or nonfatal myocardial infarction or nonfatal stroke in 216 patients with diabetes mellitus and in 552 patients without diabetes mellitus (68% men and 32% women, mean age 66 +/- 14 y) who underwent percutaneous coronary intervention with stenting. Symptomatic chest pain was present in 95% of diabetics and in 95% of nondiabetics. Unstable symptoms were present in 67% of diabetics and in 68% of nondiabetics. Aspirin was used in 99% of diabetics and nondiabetics. Clopidogrel was used in 98% of diabetics and nondiabetics. Beta blockers were used in 85% of diabetics and nondiabetics. Lipid-lowering drugs were used in 96% of diabetics and in 95% of nondiabetics. In-hospital mortality occurred in 2 of 216 diabetics (0.9%) and in 2 of 552 nondiabetics (0.4%), P not significant. In-hospital mortality or nonfatal myocardial infarction or nonfatal stroke occurred in 3 of 216 diabetics (1.4%) and in 6 of 552 nondiabetics (1.1%), P not significant.
PMID: 17890930
ISSN: 1075-2765
CID: 834452

Association of diet alone, insulin, sulfonylureas, metformin, and thiazolidinediones with the severity of coronary artery disease in patients with diabetes mellitus

Ravipati, Gautham; Aronow, Wilbert S; Ahn, Chul; Sujata, Kumbar; Saulle, Leonardo N; Channamsetty, Venu; Weiss, Melvin B
Coronary angiography was performed in 152 men and 163 women with diabetes mellitus, mean age 55 +/- 8 years, because of chest pain. Of 67 patients with 3-vessel or 4-vessel coronary artery disease (CAD), 17 (25%) were treated with diet alone, 29 (43%) with insulin, 18 (27%) with sulfonylureas, 12 (18%) with metformin, and 6 (9%) with thiazolidinediones. Of 76 patients with 2-vessel CAD, 20 (26%) were treated with diet alone, 36 (47%) with insulin, 21 (28%) with sulfonylureas, 21 (28%) with metformin, and 11 (14%) with thiazolidinediones. Of 40 patients with 1-vessel CAD, 15 (38%) were treated with diet alone, 11 (28%) with insulin, 8 (20%) with sulfonylureas, 12 (30%) with metformin, and 4 (10%) with thiazolidinediones. Of 132 patients with 0-vessel CAD, 18 (14%) were treated with diet alone, 21 (16%) with insulin, 7 (5%) with sulfonylureas, 75 (56%) with metformin, and 35 (26%) with thiazolidinediones. Cochran-Armitage trend tests were used to examine whether the use of treatment significantly increases or decreases as the number of arteries with CAD increases (P = 0.036 for diet alone; P < 0.0001 for insulin, for sulfonylureas, and for metformin; P = 0.002 for thiazolidinediones).
PMID: 16988534
ISSN: 1075-2765
CID: 834462

Association of hemoglobin A(1c) level with the severity of coronary artery disease in patients with diabetes mellitus

Ravipati, Gautham; Aronow, Wilbert S; Ahn, Chul; Sujata, Kumbar; Saulle, Leonardo N; Weiss, Melvin B
Coronary angiography was performed in 152 men and 163 women with diabetes mellitus (mean age 55 +/- 8 years) because of chest pain. The mean hemoglobin A(1c) level was 6.66 +/- 0.58% in 132 patients with 0-vessel coronary artery disease (CAD), 8.00 +/- 0.84% in 40 patients with 1-vessel CAD, 8.83 +/- 1.45% in 76 patients with 2-vessel CAD, and 10.40 +/- 2.28% in 67 patients with 3- or 4-vessel CAD. There was a significant increasing trend of hemoglobin A(1c) levels over the increasing number of vessels with CAD (p <0.0001).
PMID: 16563896
ISSN: 0002-9149
CID: 834472

Prevalence of silent myocardial ischemia in persons with diabetes mellitus or impaired glucose tolerance and association of hemoglobin A1c with prevalence of silent myocardial ischemia

DeLuca, Albert J; Saulle, Leonardo N; Aronow, Wilbert S; Ravipati, Gautham; Weiss, Melvin B
Silent myocardial ischemia detected by exercise treadmill or pharmacologic sestamibi stress testing was present in 67 of 196 patients (34%) who had diabetes mellitus or impaired glucose tolerance and in 89 of 640 patients (14%) who had normal glucose tolerance (p <0.001). Among those who had diabetes mellitus or impaired glucose tolerance, silent myocardial ischemia was present in 27 of 54 patients (50%) who had a hemoglobin A1c level > or =7.6% and in 39 of 137 patients (28%) with a hemoglobin A1c level <7.6% (p <0.005).
PMID: 15950575
ISSN: 0002-9149
CID: 834482