Abstract:
BACKGROUND:Diabetes mellitus is a major public health problem in the United States. We assess the prevalence of diabetes in Dallas County, quantify the association between diabetes and subclinical cardiovascular disease, and assess the use of evidence-based cardiovascular disease risk-modifying therapies. METHODS:This study uses data from 3392 participants aged 30 to 65 years from the Dallas Heart Study, a probability-based, multiethnic sample of residents living in Dallas County, Texas. Three primary outcomes were examined: (1) diabetes prevalence, (2) adjusted odds ratios for detectable coronary calcium stratified by diabetes diagnosis status, and (3) rates of use of evidence-based cardiovascular disease risk-modifying therapies among subjects with diabetes stratified by diabetes diagnosis status. RESULTS:The estimated prevalence of diabetes in Dallas County was 7.8%, with >40% of diabetic patients undiagnosed before participation in the Dallas Heart Study. Both previously diagnosed and previously undiagnosed diabetes were independently associated with the presence of coronary artery calcium (diagnosed: OR 3.55, 95% CI 1.56-8.05) (undiagnosed: OR 2.98, 95% CI 1.39-6.39). The rates of use of aspirin, angiotensin-converting enzyme inhibitors, and statins were suboptimal, and blood pressure and low-density lipoprotein cholesterol targets were rarely met, especially among subjects with previously undiagnosed diabetes. CONCLUSIONS:Diabetes is prevalent and is associated with subclinical cardiovascular disease; this association is present even at the time of diagnosis. Despite the cardiovascular risk associated with diabetes, evidence-based risk-modifying therapies continue to be underused, and therapeutic targets remain unmet, especially among people unaware of their diabetes diagnosis.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Das SR,Vaeth PA,Stanek HG,de Lemos JA,Dobbins RL,McGuire DKdoi
10.1016/j.ahj.2005.10.016subject
Has Abstractpub_date
2006-05-01 00:00:00pages
1087-93issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00981-6journal_volume
151pub_type
杂志文章abstract::Metoprolol or placebo was gradually withdrawn during 1 week in 115 patients participating in a 3-year, double-blind, postinfarction study. During the first month after withdrawal mental symptoms and increased cardiac symptoms occurred significantly more frequently in the metoprolol group. Disabling symptoms requiring ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(84)90408-3
更新日期:1984-09-01 00:00:00
abstract::Sequential bedside electrophysiologic testing was performed over 22 hours at intervals of 1 to 2 hours in 13 patients with left-sided Kent bundles to assess possible daily variations in the capacity to electrically induce reciprocating tachycardia. In all patients the tachycardia involved the accessory pathway in retr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90499-6
更新日期:1987-08-01 00:00:00
abstract::Patients with impaired glucose tolerance (IGT) have increased risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Lifestyle modification and medication can prevent or delay progression to diabetes (PD), but whether such interventions also reduce the risk of CVD has not been rigorously...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2008.05.017
更新日期:2008-10-01 00:00:00
abstract::One hundred thirty-three patients with dilated heart failure, 80 with coronary artery disease, and 53 with idiopathic dilated cardiomyopathy were followed for a mean of 29 months. Patients with ischemic heart disease had a worse prognosis than those classified as having idiopathic cardiomyopathy. Features from history...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80242-x
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Beta-endorphin has been reported to play a role in the mechanism of silent myocardial ischemia. OBJECTIVES:Plasma beta-endorphin levels during coronary angioplasty-induced silent and symptomatic myocardial ischemia were compared with those during exercise-induced silent ischemia. METHODS AND RESULTS:The st...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70039-0
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown. METHODS:Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.06.020
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Despite advances in treatment of cardiogenic shock (CS), the incidence of this serious complication of acute ST-elevation myocardial infarction (STEMI) has stayed relatively constant, and rates of mortality, although somewhat improved in recent decades, remain dauntingly high. Although both percutaneous coro...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2009.10.035
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Embolization of atherothrombotic material is common during percutaneous coronary intervention (PCI) in acute myocardial infarction (MI). This may lead to distal vessel occlusion resulting in impaired myocardial perfusion, which is associated with larger infarct size and increased mortality. Adj...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.11.010
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Myocardial contractile reserve has been shown to provide important prognostic information in patients with heart failure. We hypothesized that myocardial contractile reserve would predict left ventricular (LV) reverse remodeling after cardiac resynchronization therapy (CRT). METHODS:Thirty-one consecutive p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.035
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The purpose of the current study was to determine whether survival after revascularization (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty) is influenced by the extent of electrocardiographic (ECG) evidence of previous myocardial infarction (MI) in patients with ischemic ca...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.119996
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:We sought to systematically evaluate whether percutaneous revascularization is associated with additional clinical benefit in patients with renal artery stenosis (RAS) as compared with medical management alone. METHODS:We included randomized controlled trials that compared percutaneous revascularization in ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2010.12.006
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Single center studies using serial cerebral diffusion-weighted magnetic resonance imaging in patients having cardiac catheterization have suggested that cerebral microembolism might be responsible for silent cerebral infarct (SCI) as high as 15% to 22%. We evaluated in a multicenter trial the incidence of SC...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.04.005
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Chronic infection with Chlamydia pneumoniae (Cpn) has been associated with atherosclerotic cardiovascular disease in sero-epidemiological, pathological and animal-model studies. Inflammation and immune activation has been proposed as the pathophysiological link between chronic infection and atherosclerosis. ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00101-7
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Patients with kidney failure have a heavy burden of coronary artery disease. The results of preventive, diagnostic, and therapeutic measures developed in nonuremic populations cannot automatically be extrapolated to this unique group of patients. METHODS AND RESULTS:Articles were reviewed if they contained ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.105300
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Recently revised American College of Cardiology/American Heart Association guidelines have suggested that exercise test scores be used in decisions concerning patients with suspected coronary artery disease (CAD). Pretest and exercise test scores derived for use in women without known CAD have not been teste...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2003.12.034
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS:We identified patients with heart failure and reduced ejection fraction who were ≥65 years old, e...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2013.03.007
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:The study aimed to analyze the use of intensive lipid-lowering therapy (I-LLT) at discharge in a broad population of patients hospitalized with acute coronary syndrome (ACS). BACKGROUND:Early and intensive statin therapy in ACS has been shown to reduce cardiovascular morbidity and mortality. Utilization and...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.12.014
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to describe the effect of intravenous metoprolol on the intensity of chest pain before hospital admission in patients with suspected acute myocardial infarction AMI). METHODS AND RESULTS:Two hundred sixty-two patients with acute chest pain and suspected AMI were randomly assigned b...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(99)70405-9
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The objective was to report recent trends in the incidence, adoption of evidence-based treatment, and clinical outcomes for first-time hospitalization for acute myocardial infarction. METHODS:This is a large retrospective population-based cohort study using medical administrative data (International Classif...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.08.026
更新日期:2013-11-01 00:00:00
abstract::Detection of mild hypertension by a small number of casual blood pressures may be inaccurate for the determination of average blood pressure. Nonetheless, casual pressures remain the basis for the diagnosis and treatment of hypertensive patients. We compared casual and noninvasive ambulatory blood pressure monitoring ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90180-9
更新日期:1988-10-01 00:00:00
abstract::This case report presents a young adult with asymmetric septal hypertrophy (ASH) and syncope. Infranodal complete heart block was demonstrated as his cause for syncope. Therapy consisted of implantation of a A-V sequential pacemaker. Cardiac output determinations and systolic time intervals demonstrated the beneficial...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80177-4
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Diastolic dysfunction induced by ischemia may alter transmitral blood flow, but this reflects global ventricular function, and pseudonormalization may occur with increased preload. Tissue Doppler may assess regional diastolic function and is relatively load-independent, but limited data exist regarding its a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.123836
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Plasma levels of brain natriuretic peptide (BNP) are increased in patients with left heart failure. In patients with severe pulmonary embolism (PE), primary right ventricular (RV) dysfunction is frequent. Little is known about BNP secretion in acute RV failure. METHODS:We prospectively studied 50 consecutiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00528-3
更新日期:2004-01-01 00:00:00
abstract::Out of 160 prospectively followed patients with aortic regurgitation, the clinical courses of 53 patients with pure, severe, and chronic aortic regurgitation and without coronary artery disease who were selected for surgery on the basis of predefined criteria is discussed. Surgical criteria were either unequivocal sym...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90023-q
更新日期:1990-09-01 00:00:00
abstract::The associations between socioeconomic status, ethnic origin, and risk factors for CHD were studied in 2,591 white and black children from two socioeconomically dissimilar populations in the New York City area. The study subjects were selected from all fourth graders in 44 elementary schools. Blood pressure, plasma li...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90724-1
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Recently revised American College of Cardiology/American Heart Association guidelines for exercise electrocardiography (ExECG) have suggested that ExECG scores be used to assist in management decisions in patients with suspected coronary artery disease (CAD). METHODS:We used 442 women who underwent both ExE...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.125835
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:We sought to determine the relationship of adverse diastolic remodeling (ie, worsening diastolic or persistent restrictive filling) with infarct scar characteristics, and to evaluate its prognostic value after ST-segment elevation myocardial infarction (STEMI). BACKGROUND:Severe diastolic dysfunction (restr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2016.05.020
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well defined. We sought to determine the relationship between bleeding, bloo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.014
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national,...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2017.03.024
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Inflammation is an important feature of atherosclerotic lesions, and the vulnerability of coronary lesions in acute myocardial infarction (AMI) at the time of onset may be related to blood levels of C-reactive protein (CRP) on admission, before CRP levels are affected by myocardial damage. METHODS:A total o...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.108244
更新日期:2000-08-01 00:00:00