[Coronary artery disease in pre and postmenopausal women. The influence of type 2 diabetes mellitus].
- 作者列表："Gajardo-Navarrete J","Ibieta G","Concha M","Garcés P","Robles I","Vera-Calzaretta A","González-Burboa A","Gajardo I","Gutiérrez M","Villarroel M","Aguayo M
BACKGROUND:Postmenopausal women have higher severity of coronary heart disease (CHD) than premenopausal women and type 2 diabetes mellitus (T2DM) is an independent risk factor. AIM:To assess the severity of CHD in pre and postmenopausal patients undergoing coronary angiography and the impact of T2DM in both groups. MATERIAL AND METHODS:A coronary angiography was performed to 707 women due to suspected CHD during 2013 and 2014. Of these, 579 were older than 55 years and were considered as postmenopausal. Factors such as hypertension, obesity, smoking, creatinine and T2DM were registered. The severity of CHD in coronary angiography was evaluated according to the number of vessels with more than 50% stenosis. RESULTS:Compared to their postmenopausal counterparts, premenopausal women had less frequency of T2DM (31% and 42% p < 0.033), hypertension (52 and 78%, p < 0.001) and alteration of renal function (11 vs. 39%, p < 0.001). Absence of coronary lesions was found in 44 and 32% of premenopausal and postmenopausal women, respectively (p < 0.01). Premenopausal women with T2DM had a higher frequency of multi-vessel disease than those without the disease (25 and 4.5%, p < 0.001). The frequency of multi-vessel disease was higher in postmenopausal than premenopausal women (24 and 11%, p < 0.01). Hypertension, T2DM and renal involvement were associated with a higher frequency multiple vessel disease. CONCLUSIONS:The severity of CHD is higher in postmenopausal women and T2DM is associated with the disease.
背景: 绝经后女性冠心病 (CHD) 的严重程度高于绝经前女性，2型糖尿病 (T2DM) 是其独立危险因素。 目的: 评估接受冠状动脉造影的绝经前后患者CHD的严重程度以及两组中T2DM的影响。 材料和方法: 在2013年和707年期间，对2014名因疑似CHD的女性进行了冠状动脉造影。其中，579的年龄大于55岁，被认为是绝经后的。记录高血压、肥胖、吸烟、肌酐和T2DM等因素。根据血管狭窄程度超过50% 的血管数量评估冠状动脉造影中CHD的严重程度。 结果: 与绝经后妇女相比，绝经前妇女发生T2DM (31% 和42%，p <0.033) 、高血压 (52和78%，p <0.001) 和肾功能改变 (11对39%，p <0.001) 的频率较低。在绝经前和绝经后妇女中，分别有44和32% 的人没有冠状动脉病变 (p <0.01)。绝经前女性T2DM患者多支血管病变发生率高于非绝经女性 (25和4.5%，p <0.001)。绝经后女性多支血管病变的发生率高于绝经前女性 (24和11%，p <0.01)。高血压、T2DM和肾脏受累与较高频率的多支血管病变相关。 结论: 绝经后女性CHD的严重程度较高，T2DM与疾病相关。
METHODS::We present the case of a 61-year-old woman with a large tumoral infiltration extending from the pelvis throughout the inferior vena cava inferior to the right atrium, protruding into the right ventricle and right ventricular outflow tract. She had been treated 10 years before for low-grade endometrial stromal sarcoma by hysterectomy and adnexectomy followed by hormone- and radio-therapy. Due to cancer recurrence, she underwent peritonectomy, appendectomy, and resection of terminal ileum.
METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.