Background. One of the primary reasons for high mortality in end-stage renal disease (ESRD) is cardiovascular disease in patients with renal replacement therapy (RRT). Left ventricular hypertrophy ...(LVH) significantly predicts mortality and cardiovascular events. Objectives. We assess the left ventricular mass index change in two dialysis methods: hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The factors associated with increased left ventricular mass index (LVMI). Materials and Methods. We recruit more than 50 HD patients and 45 CAPD patients with LVH of similar age, gender, dialysis duration, and LVMI for one-year follow-up. Results. The LVMI in the group of HD patients after one year increased from 180.28 ± 45.32 g/m2 to 212.58 ± 66.22 g/m2 (p = 0.001), while the LVMI in the group of patients with CAPD increased from 190.16 ± 66.01 g/m2 to 197.42 ± 78 g/m2 (p = 0.32). Multivariable logistic regression analysis, we demonstrated that dialysis by HD (β = −1,167, 95% CI: 0.104–0.938, p = 0.036) and anemia treatment lower the goals (β = 1.9566, 95% CI: 1.466–34.094, p = 0.015) were two factors associated with the progression of the LVMI. Conclusion. The LVH of end-stage renal disease patients with HD treatment is worse than CAPD treatment after a follow-up in one year. Dialysis by periodic hemodialysis and anemia treatment that fails to achieve the goal are risk factors associated with increased progression of LVMI in patients with ESRD.
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BFBNIB, FZAB, GIS, IJS, KILJ, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Previous studies have demonstrated that sertraline has a positive impact on improving depression; however, data on the prevalence and treatment outcomes of sertraline among patients with comorbid ...Type 2 diabetes mellitus and depression remain limited.
Determine the prevalence and associated factors of depression, and evaluate the treatment outcomes of sertraline intervention at two dosage levels (50 mg per day and 100 mg per day) in patients with comorbid depression and type 2 diabetes mellitus in Vietnam.
The study included type 2 diabetes mellitus patients receiving outpatient treatment at Bac Lieu General Hospital from March 2023 to March 2024. Following the assessment of depression prevalence and associated factors, a randomized, single-blind clinical trial was conducted. Patients were randomly assigned to two groups: odd-numbered patients received treatment with 50 mg/day sertraline dosage, while even-numbered patients received treatment with 100 mg/day sertraline dosage. The criteria for success included improvement in symptoms and severity of depression after 6 months of treatment.
A total of 225 type 2 diabetes mellitus patients with a mean age of 63.8 ± 10.7 years were included, among whom 72 were diagnosed with depression, accounting for a prevalence rate of 32 %. Among these patients, 51 were female (70.8 %) and 21 were male (29.2 %). Female gender, overweight, obesity, diabetes duration over 36 months, and a history of cardiovascular disease were found to be associated with depression. However, in the multivariate model, only overweight, obesity, HbA1c ≥ 6.5 %, and a history of cardiovascular disease were identified as independent factors contributing to depression in type 2 diabetes mellitus patients, with odds ratios of 4.12 (95 % CI: 1.78–9.56; p = 0.001), 0.37 (95 % CI: 0.15–0.95; p = 0.038) and 25.90 (95 % CI: 9.05–74.12; p < 0.001), respectively. Following 6 months of treatment, in the 50 mg/day dosage group, the proportion of patients with moderate to severe depression decreased from 77.8 % to 33.3 % (p < 0.001). Similarly, in the 100 mg/day dosage group, the proportion of patients with moderate to severe depression decreased from 94.4 % to 52.8 % (p < 0.001).
Depression accounts for approximately one-third of type 2 diabetes mellitus cases. Overweight, obesity, HbA1c levels, and cardiovascular disease are independent factors associated with depression. Intervention with sertraline for depression treatment at both 50 mg/day and 100 mg/day dosages demonstrates significant improvements in depression severity after 6 months of treatment.
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•Depression accounts for approximately one-third of type 2 diabetes mellitus cases.•Overweight, obesity, HbA1c levels, and cardiovascular disease are independent factors associated with depression.•Intervention with sertraline for depression treatment demonstrates significant improvements in depression.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
NGAL serum concentration have predictive value for cardiovascular events and mortality in patients with acute coronary syndrome (ACS).
Assessed the all-cause mortarlity prognosis value of serum ...neutrophil gelatinase-associated lipocalin (NGAL), combination with N-terminal pro B-type natriuretic peptide (NT-proBNP), and hsTnT, and GRACE score in patients with ACS.
We conducted a cross-sectional analysis study used in this study in 58 patients with ACS. Serum NGAL, NT-proBNP, hs-TnT concentration and GRACE score associated with death events (after 3 months of follow-up) were assessed by receiver operating characteristic (ROC) curve.
High performance in predicting mortality of NGAL with a cut-off value of 154.55 ng/mL (AUC, 95% CI = 0.96, 0.90 – 1.0; p = 0.001), GRACE score with 140.50 scores (AUC, 95% CI = 0.76, 0.57 – 0.96; p = 0.051). Combination of NTproBNP plus NGAL indicated with the highest value (AUC, 95% CI = 0.96, 0.91 – 1.0; Se = 80.0; Sp = 92.5; p = 0.001). The relative risk assessment indicated a high value in mortality prediction of NGAL with a cut-off value of 154.55 (OR, 95% CI = 49.0, 4.3 – 549.2; p < 0.001), and GRACE score with 140.50 scores (OR, 95% CI = 11.1, 1.1 – 108.4; p = 0.013).
NGAL can be employed as a biomarker for the early prediction of mortality events in individuals with ACS. The combination of NGAL, NT-proBNP, hsTnT, and GRACE score showed the higher outcome but not worth mentioning.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Very few studies worldwide have assessed the estimated glomerular filtration rate (eGFR) using serum cystatin C (ScysC) in comparison to the gold standard measured glomerular filtration rate (mGFR) ...with a gamma camera technique using 99m-Technetium-Diethylene Triaminepentoacetic Acid (99mTc-DTPA). To determine the eGFR formula with the most accurate estimate of glomerular filtration rate when compared with mGFR in a healthy population in Vietnam. We conducted a cross-sectional descriptive study of more than 100 adults without hypertension. The study subjects were examined for general characteristics and blood biochemistry tests to assess eGFR, and the glomerular filtration rate was measured using 99mTc-DTPA with the Gates technique to record mGFR. The estimated values of the eGFR formula were evaluated and compared with the actual mGFR using 99mTechnetium-DTPA. Serum creatinine (Scr) concentration showed a significant difference between males and females: 0.9 ± 0.1 versus 0.8 ± 0.1 (P < .001), while ScysC concentration did not show this difference. The mGFR in the age groups < 40, 40 to 59, and ≥ 60: 105.0 ± 9.9, 94.8 ± 8.6, and 93.4 ± 10.6, respectively (P < .001). The eGFR-CKD-EPI-cystatin C 2012 formula showed the highest positive correlation with mGFR (ΔGFR = -1.6, R = 0.68, P < .001). eGFR calculated using cystatin C does not require sex adjustment, whereas, for creatinine, sex adjustment is necessary. The eGFR-CKD-Epi-CysC formula showed the lowest difference and a strong correlation with mGFR.
Type 2 Diabetes Mellitus (T2DM) stands as the foremost risk factor for infected foot ulcers, contributing to a myriad of chronic complications including cardiovascular, renal, neuropathic, vascular, ...and podiatric issues. Employing suitable antibiotic therapy becomes imperative in managing Diabetic Foot Infections (DFIs). This study endeavors to assess the efficacy of antibiotic treatment in addressing infected foot ulcers among patients with T2DM in Vietnam.
A descriptive cross-sectional study with analysis was performed on 830 T2DM patients (67 patients with DFIs were treated with antibiotic therapy to evaluate treatment outcomes).
Among T2DM patients, 8.07 % had infected foot ulcers, with an average age of 62.5 ± 11 years and a female-to-male ratio of 2.9:1. Ulcer healing post-antibiotic treatment was 88.06 %, with 35.82 % aligning initial antibiotic treatment with antibiogram results. Bacterial resistance rates were high for Cephalosporin (>60 %), Ampicillin/Sulbactam (91.67 %), and Quinolone groups (>60 %), while Carbapenem group showed high sensitivity (>73 %). Initial empiric antibiotic treatment response was associated with osteomyelitis existence and ulcer healing outcomes (p < 0.005). Wagner grade > 2, elevated CRP levels, and atherosclerotic stenosis were associated with lengthy clinic stays.
Selecting the proper antibiotic regimen is crucial in effectively managing Type 2 Diabetic Foot Infections. Identifying the risk factors associated with treatment outcomes is imperative to mitigate adverse effects on foot infection treatment outcomes among T2DM patients in Vietnam.
•Choosing appropriate antibiotic therapy is essential in the treatment of diabetic foot infections.•Initial empiric antibiotic use is associated with the healing of foot ulcers.•Initial empiric antibiotic therapy response was associated with osteomyelitis presence and ulcer healing outcomes.•Wagner grade, CRP levels, and atherosclerotic stenosis were associated with prolonged hospital stays.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
CYP2C19 gene polymorphism combination with inflammatory cell ratios was significant in the prognosis of coronary heart disease.
A cross-sectional analysis study, with 6 months follow-up on 142 ...patients with acute coronary syndrome. Patients were analyzed for CYP2C19 gene polymorphisms by real-time polymerase chain reaction (PCR) and complete blood count to determine inflammatory cell ratios and recorded cardiovascular events (CEs) after following up to 6 months.
For 90-day CEs, CYP2C19 gene polymorphism (Hazard Ratio (HR): 1.965, 95 % Confidence Interval (CI): 1.012–3.814), the combination of a neutrophil and lymphocyte ratio (NLR) ≥ 2.982 (HR: 13.001, 95 % CI: 1.37–97.304) or a platelet to lymphocyte ratio (PLR) ≥ 162.42 (HR: 2.878, 95 % CI: 1.212–6.835) was independent predictors of CEs. For 180-day CEs, CYP2C19 gene polymorphism combination with NLR ≥3.02 (HR: 13.946, 95 % CI: 1.833–106.121) or PLR ≥160.38 (HR: 5.349, 95 % CI: 1.379–20.745) or monocyte to lymphocyte ratio (MLR) ≥ 0.3 (HR: 4.699, 95 % CI: 1.032–31.393) were independent predictors of CEs.
NLR, PLR or MLR combined with CYP2C19 gene polymorphism were stronger independent predictors of cardiovascular events in patients with acute coronary syndromes compared to CYP2C19 gene polymorphism and inflammatory cell ratios separately. CYP2C19 polymorphism and high NLR was the strongest predictor of both CEs at 90 days and 180 days.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
لتحديد الأداء التشخيصي والعوامل المؤثرة في التصوير الوعائي المقطعي المحوسب للشريان التاجي المكون من 128 شريحة مقارنة بتصوير الأوعية التاجية المجتاحة في مرضى الشريان التاجي.
سجلت دراسة تحليلية مقطعية ...139 مريضا يشتبه في إصابتهم بمرض الشريان التاجي والذين خضعوا لـ 128 شريحة للتصوير المقطعي المحوسب للأوعية وكذلك تصوير الأوعية التاجية المجتاحة.
أظهر النموذج المعتمد على المريض حساسية عالية بنسبة 93.2٪ وقيمة تنبؤية إيجابية بنسبة 95.3٪ للتضيق ≥ 50٪. ومع ذلك ، كانت هذه القيم أقل عند تحليلها من خلال النماذج المستندة إلى الشرايين (حساسية عالية بنسبة 85.6٪ وقيمة تنبؤية إيجابية بنسبة 81.1٪) والقطاعات (حساسية عالية بنسبة 73.9٪ وقيمة تنبؤية إيجابية بنسبة 66.6٪). كانت الخصوصية والقيمة التنبؤية السلبية هي الأعلى في النموذج المعتمد على القطعة ، وانخفضت في النماذج المستندة إلى الأوعية والمرضى بنسبة 96.4٪ و 95.4٪ ؛ 90.5٪ و 90.0٪ ؛ و 36.4٪ و 42.1٪ على التوالي (للتضيق ≥ 70٪). انخفضت جميع القيم التشخيصية عندما كانت درجة الكالسيوم 400 وحدة أغاتستون.
يظهر التصوير الوعائي المقطعي المحوسب للشريان التاجي المكون من 128 شريحة الطريقة المثلى وذات الحد الأدنى من الاجتياح وعالي الأداء لتشخيص تضيق وتشكل آفات الشريان التاجي. كان الأداء التشخيصي لتصوير الأوعية المقطعي المحوسب للشريان التاجي المكون من 128 شريحة مرتفعا جدا. لم يؤثر معدل ضربات القلب ومؤشر كتلة الجسم على دقة التشخيص، بينما تم العثور على درجة الكالسيوم البالغة 400 وحدة أغاتستون كعامل يتسبب في انخفاض الأداء التشخيصي.
To determine the diagnostic performance and influencing factors of 128-slice coronary computed tomography angiography (CCTA) compared with invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD).
A cross-sectional analysis study enrolled 139 patients suspected of having CAD, who underwent and received a 128-slice CCTA and ICA.
The patient-based model showed high sensitivity and a positive predictive value of 93.2% and 95.3%, respectively (for stenosis ≥50%). However, these values were lower when analyzed using vessel-based (85.6% and 81.1%) and segment-based (73.9% and 66.6%) models. Specificity and negative predictive value were highest in the segment-based model, decreasing in vessel- and patient-based models at 96.4% and 95.4%, 90.5% and 90.0%, and 36.4% and 42.1%, respectively (for stenosis ≥70%). All diagnostic values were reduced when the calcium score was ≥400 Agatston units.
128-slice CCTA is an optimal, minimally invasive, and high-performance method to diagnose the stenosis and morphology of coronary artery lesions. The diagnostic performance of 128-slice CCTA is very high. Heart rate and body mass index do not affect diagnostic accuracy, whereas a calcium score ≥400 Agatston units is a factor that causes a decrease in diagnostic performance.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Prognostic assessment of early cardiovascular events in patients with acute coronary syndrome (ACS) can be aided by the HEART, TIMI, and GRACE scores. However, their combined use has not been ...extensively researched.
Determining the prognostic value of in-hospital and 6-month mortality using the GRACE, TIMI, and HEART scores in patients with acute coronary syndrome.
We conducted a cross-sectional descriptive study on 68 patients with acute coronary syndrome, following them longitudinally for 6 months at Can Tho Central General Hospital, Vietnam.
The GRACE score demonstrated good prognostic value for in-hospital mortality, with an area under the curve (AUC) of 0.805. Sensitivity and specificity were 90% and 65.51%. Conversely, the TIMI risk score had a poor prognostic value for in-hospital mortality (AUC = 0.682; sensitivity = 60%, specificity = 63.79%) and 6-month mortality (AUC = 0.692; sensitivity = 60%, specificity = 66.03%). On the other hand, the HEART score had quite good prognostic value for in-hospital mortality (AUC = 0.726; sensitivity = 50%, specificity = 89.74%) and good prognostic value for 6-month mortality (AUC = 0.805; sensitivity = 57.1%, specificity = 97.14%).
The GRACE scores demonstrate greater prognostic value for in-hospital mortality in patients with acute coronary syndrome compared to the TIMI and HEART scores.
Las puntuaciones HEART, TIMI y GRACE son herramientas valiosas en la evaluación pronóstica de eventos cardiovasculares tempranos en pacientes con síndrome coronario agudo (SCA). Sin embargo, su uso combinado no ha sido exhaustivamente investigado.
Determinar el valor pronóstico de la mortalidad intrahospitalaria y a los 6 meses mediante las puntuaciones GRACE, TIMI y HEART en pacientes con SCA.
Realizamos un estudio descriptivo transversal con seguimiento longitudinal de 68 pacientes con SCA durante 6 meses en el Hospital General Central de Can Tho, Vietnam.
La puntuación GRACE demostró un buen valor pronóstico para la mortalidad hospitalaria (AUC = 0.805, sensibilidad = 90%, especificidad = 65.51%). La puntuación TIMI tuvo un valor pronóstico deficiente para la mortalidad hospitalaria (AUC = 0.682, sensibilidad = 60%, especificidad = 63.79%) y la mortalidad a los 6 meses (AUC = 0.692, sensibilidad = 60%, especificidad = 66.03%). En contraste, la puntuación HEART tuvo un buen valor pronóstico para la mortalidad hospitalaria (AUC = 0.726, sensibilidad = 50%, especificidad = 89.74%) y a los 6 meses (AUC = 0.805, sensibilidad = 57.1%, especificidad = 97.14%).
Las puntuaciones GRACE demuestran un mayor valor pronóstico para la mortalidad hospitalaria en pacientes con síndrome coronario agudo en comparación con las puntuaciones TIMI y HEART.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The relationships between glucose abnormalities, insulin resistance (IR) and heart failure (HF) are unclear, especially regarding to the HF type, i.e., HF with reduced (HFrEF) or preserved (HFpEF) ...ejection fraction. Overweight, diabetes and hypertension are potential contributors to IR in persons with HF. This study aimed to evaluate the prevalence of prediabetes and IR in a population of Vietnamese patients with HFrEF or HFpEF but no overweight, diabetes or hypertension, in comparison with healthy controls, and the relation between prediabetes or IR and HF severity.
We conducted a prospective cross-sectional observational study in 190 non-overweight normotensive HF patients (114 with HFrEF and 76 with HFpEF, 92.6% were ischemic HF, mean age was 70.1 years, mean BMI 19.7 kg/m
) without diabetes (neither known diabetes nor newly diagnosed by OGTT) and 95 healthy individuals (controls). Prediabetes was defined using 2006 WHO criteria. Glucose and insulin levels were measured fasting and 2 h after glucose challenge. IR was assessed using HOMA-IR and several other indexes.
Compared to controls, HF patients had a higher prevalence of prediabetes (63.2% vs 22.1%) and IR (according to HOMA-IR, 55.3% vs 26.3%), higher HOMA-IR, insulin/glucose ratio after glucose and FIRI, and lower ISIT0 and ISIT120 (< 0.0001 for all comparisons), with no difference for body weight, waist circumference, blood pressure and lipid parameters. Prediabetes was more prevalent (69.3% vs 53.9%, p = 0.03) and HOMA-IR was higher (p < 0.0001) in patients with HFrEF than with HFpEF. Among both HFrEF and HFpEF patients, those with prediabetes or IR had a more severe HF (higher NYHA functional class and NT-proBNP levels, lower ejection fraction; p = 0.04-< 0.0001) than their normoglycemic or non-insulinresistant counterparts, with no difference for blood pressure and lipid parameters.
In non-diabetic non-overweight normotensive patients with HF, the prevalence of prediabetes is higher with some trend to more severe IR in those with HFrEF than in those with HFpEF. Both prediabetes and IR are associated with a more severe HF. The present data support HF as a culprit for IR. Intervention strategies should be proposed to HF patients with prediabetes aiming to reduce the risk of incident diabetes. Studies should be designed to test whether such strategies may translate into an improvement of further HF-related outcomes.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In 2018, GOLD addressed the issues of genotypes associated with risk factors for COPD. The genome-wide association study (GWAS) demonstrated an association between COPD and several genetic variants ...of single nucleotide polymorphisms (SNPs) of the
gene with the risk of COPD.
To study the single nucleotide polymorphisms rs2869967 and rs17014601 of the
gene in chronic obstructive pulmonary disease. Subjects and research methods: 80 subjects diagnosed with COPD and 80 subjects determined not to have COPD according to GOLD 2020 criteria; the subjects were clinically examined, interviewed, and identified as possessing single nucleotide polymorphisms using the sanger sequencing method on whole blood samples.
The male/female ratio of the patient group and the control group was 79/1 and 39/1, respectively. The percentages of C and T alleles of rs2869967 in COPD patients were 50.6% and 49.4%, respectively. The percentages of C and T alleles of rs17014601 in COPD patients were 31.9% and 68.1%, respectively. At rs17014601, the ratio values of alleles T and C in the disease group and the control group were markedly different, making them statistically reliable (
= 0.031). The rate of CT genotype in the group of patients was considerably higher than that of the control group. The TT homozygous genotype had a lower risk of COPD compared with the other genotypes in the dominant model (ORTT/(CC + CT) = 0.441; CI95% = 0.233-0.833); this difference was statistically significant (
= 0.012).
With rs17014601, it is characteristic that the frequency of the T allele appears more than the C allele, and the CT heterozygous phenotype accounts for the highest proportion in rs17014601 and rs2869967 recorded in COPD patients. There is an association between the genetic variant of the SNP
-rs17014601 and the risk of COPD.
