This review summarizes the cardiovascular non-inferiority trials of novel antidiabetic drugs performed since 2008, when regulatory agencies started mandating thorough examination of their cardiovascular safety. So far, eight randomized trials on three different drug classes have been completed. Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists may reduce cardiovascular risk and possibly mortality, while dipeptidyl dipeptidase-4 inhibitors may increase the risk of heart failure.
View Article and Find Full Text PDFObjective: To investigate the influence of cardiovascular risk factors, including fasting plasma glucose (FPG), on the association between electrocardiographic (ECG) and echocardiographic left ventricular hypertrophy (LVH) in an elderly population.
Methods: We tested cross-sectional associations between electrocardiographic and echocardiographic LVH, defining LVH according to the Sokolow-Lyon voltage combination, Cornell voltage-duration product, or left ventricular mass index (LVMI). Differences between standardized LVMI and Sokolow-Lyon voltage combination or Cornell voltage-duration product (absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography.
Objective: To examine the impact of follow-up duration on the incremental prognostic yield of a baseline oral glucose tolerance test (OGTT) for predicting type 2 diabetes and to assess the discrimination ability of blood glucose (BG) obtained at different time points during OGTT.
Design: A prospective, population-based cohort study (Malmö Preventive Project) with inclusion of subjects from 1974 to 1992.
Methods: A total of 5256 men without diabetes, who had BG measured at 0, 20, 40, 60, 90, and 120 min during OGTT (30 g/m2 glucose), were followed for 30 years.
Background: To examine whether lower insulin sensitivity as determined by homeostatic model assessment (HOMA-%S) was associated with increased left ventricular mass (LVM) and presence of LV diastolic dysfunction at long-term follow-up, independently of body mass index (BMI), in middle-aged, otherwise healthy males.
Methods: Prospective population-based cohort study with a median (IQR) follow-up time of 28 (27-28) years, in which traditional cardiovascular risk factors, including HOMA-%S and BMI, were assessed at baseline, and echocardiographic determination of LVM and LV diastolic function was performed at follow-up. Associations between risk factors and echocardiographic variables were tested using multivariable linear and binary logistic regression.
Aims: To examine whether increasing fasting plasma glucose (FPG) levels were associated with worsening left ventricular (LV) diastolic function, independently of LV mass index (LVMI) in elderly, otherwise healthy subjects.
Methods And Results: We tested cross-sectional associations between echocardiographically determined averaged E/é ratio/diastolic function, LVMI, cardiovascular risk factors, and FPG categorized as normal (NFG), impaired (IFG), and new-onset diabetes mellitus (DM), in 483 men and 208 women aged 56-79 years without overt cardiovascular disease, who received no cardiovascular, anti-diabetic, or lipid-lowering drugs and had a preserved LV ejection fraction >50%. Median E/é was significantly higher among subjects with diabetes than those without (8 vs.
Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac death.
View Article and Find Full Text PDFIncreased plasma levels of immunoglobulin E (IgE) are encountered in various clinical settings, most often infection or atopic/allergic disease. IgE, however, is neither a sensitive, nor a specific marker for any particular disease. We describe a case of a 52-year-old woman presenting with non-specific symptoms and increased plasma IgE levels on admission.
View Article and Find Full Text PDFBilateral adrenal haemorrhage can occur in the setting of severe clinical sepsis. The clinical presentation may be non-specific, and the degree to which adrenal haemorrhage causes adrenal insufficiency remains unclear. We describe a case of an 18-year-old male presenting with meningococcaemia.
View Article and Find Full Text PDFConsumption of large amounts of liquorice can cause hypertension and hypokalaemia. Liquorice contains glycyrrhetinic acid, which inhibits the enzyme 11 beta-hydroxysteroid dehydrogenase type 2, and ultimately leads to an apparent mineralocorticoid excess syndrome. This case report describes a 50 year-old woman presenting with hypertension and hypokalaemia-induced limb paresis due to chronic liquorice ingestion.
View Article and Find Full Text PDFStatin treatment can cause muscular side effects. It has been suggested that the mechanism is reduced synthesis of coenzyme Q10 (coQ10) and a subsequent dysfunction of the respiratory chain. A literature review resulted in insufficient evidence supporting this theory.
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