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hydrochlorothiazide plus atorvastatin on glycemic profile in patients with hypertension and dyslipidemia
Abstracts / Atherosclerosis 241 (2015) e72ee148
laga, Spain; Hospital Virgen de la Victoria, Ma Sanitarios, Ibermutuamur, Madrid, Spain
2
Departamento de Proyectos
* Corresponding author. Aims: To analyse the association between Atherogenic Dislipidaemia (AD) the incidence of cardiovascular diseases (CVD), among working population. Methods: A cohort of 639,198 workers without prior coronary heart disease or cerebrovascular disease, and participating in the Ibermutuamur Cardiovascular Risk Assessment Study were selected. Baseline medical assessment included anthropometric characteristics, two blood pressure measurements (OMRON M4I) and serum tests. DA was defined as triglycerides 150 mg/dl and HDL-Cholesterol <40 mg/dl (Males) /<50 mg/dl (Females). Logistic regression analyses were carried out to test the association of DA with CVD (ICD-9-CM 401-414, 426-443), during 1-year follow-up. Results: 71.4% (95% CI: 71.3-71.5) of participants were men. Median age was 34 years-old (P25¼27; P75¼43). The percentage of workers with AD was 5.0% (95% CI: 4,9 -5,1). During 1-year follow-up, 564 workers showed a sickness absence episode due to CVD. The incidence rate for all CVD was 88.2/100,000 workers (95% IC: 81.0-95.5), 34.3/100,000 (95% CI: 29.7-38.8) for coronary heart diseases, and 14.7/100,000 (95% CI: 11.7-17.7) for cerebrovascular diseases. After adjusting for baseline CVR level, AD remained associated to CVD (OR¼1.73; 95% CI: 1.31-2.28); to coronary heart disease (OR¼1.78; 95% CI: 1.15-2.75), and to cerebrovascular diseases (OR¼2.33; 95% CI: 1.27-4.29), during this 1-year follow-up. Conclusions: AD is associated with the incidence of CVD, coronary heart disease and cerebrovascular diseases. This association is partially independent of global CVR as estimated by the SCORE charts. EAS-0122. PREMATURE MYOCARDIAL INFARCTION AND SHORT-TERM RESULTS IN TURKEY *
S. Yilmaz , H. Gunduz, P. Varim, S. Demirtas, M. Vatan, M. Çakar, E. Aydin, L. Edis, H. Kiliç. Cardiology, Sakarya University Medicine Faculty Research and Education Hospital, Sakarya, Turkey
e127
EAS-0205. THE GENDER DIFFERENCE OF BACKGROUND AND RISK FACTORS IN ACUTE CORONARY SYNDROME Y. Sudo*, N. Amioka, M. Ueeda, S. Kobashi, T. Yamaji, Y. Koide, Y. Nakano, D. Yamada, N. Ohnishi, A. Takaishi. Cardiology, Mitoyo General Hospital, Kanonji, Japan
* Corresponding author. Aim: The risk factors of coronary artery disease are well known, but the difference of them between male and female is still unclear. The aim of this study is to reveal the gender differences of background and risk factors in patients with acute coronary syndrome (ACS). Methods: Consecutive 1623 ACS patients (male; 1186, female; 437) were enrolled. We examined the differences of background and risk factors between male and female, including malondialdehyde-modified lowdensity lipoprotein (MDA-LDL) and polyunsaturated fatty acids (PUFAs) by analysis of variance. Results: The onset age of ACS was younger in male (P<0.001). Typical biomarkers of lipid like T.Cho, HDL-C and LDL-C were higher in female (P¼0.001, P<0.001, P¼0.02). PUFA and MDA-LDL did not show significant differences, on the other hand, MDA-LDL/LDL-C ratio, which indicates levels of oxidative stress, was higher in male (P ¼0.02). HbA1c and ratio of hypertension were not different significantly between each gender. Uric acid (UA) was higher, and eGFR was lower in male patients (P<0.001, P<0.001). The smoking rate was also higher in male patients (P<0.001). Conclusions: Stronger oxidative stress, elevated UA, decreased renal function and higher smoking rate were remarkable characters of male patients with ACS. It was suggested that these complex factors contributed to the younger onset of ACS in male. EAS-0208. EFFECT OF NEBIVOLOL OR NEBIVOLOL/HYDROCHLOROTHIAZIDE PLUS ATORVASTATIN ON GLYCEMIC PROFILE IN PATIENTS WITH HYPERTENSION AND DYSLIPIDEMIA
* Corresponding author.
A. Kei, E. Liberopoulos, M. Elisaf*. Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
Aim: To investigate the clinical features and in-hospital outcomes of young adults with ACS in Turkey.
* Corresponding author.
Methods: We identified 627 patients aged 45 years old who had undergone coronary angiography from 2011 to 2014 and 412 patients of them have ACS. Clinical data was collected retrospectively. Results: In ACS group, the mean age was 41.74±4.1 years with male predominance (84.7%). Most of patients (98%) admitted with chest pain. Patients often presented with STEMI, predominantly of the anterior wall. The most common risk factor was dyslipidemia (hypertriglyceridemia, lowHDL-C) (81.1%), smoking (80.8%), family history (34.2%), hypertension (29.6%) and DM (27.2%). Past history of CAD was documented in 16.5%. The mean BMI was 28.15±3.7 kg/m2 with 83.8% of patients considered overweight in ACS. Serum glucose levels (138.36 ±70.8 mg/dl and 107.981±40.2mg/dl; P<0.00) was higher in primary admission compared patients with normal coronary artery. The majority of patients had single vessel disease (55.3%) and 46 patients with ACS had normal coronary arteries (11.2%). PCI was the main myocardial reperfusion therapy (37.6%) and had favourable outcomes (success 94.84%). The most frequent complications were arrhythmias, mainly ventricular (5.82%).Overall in-hospital mortality was low with 5 deaths (1.21%). The incidence of heart failure was 2.91% and cardiogenic shock was observed only 3 patients. Recurrent angina and acute stent thrombosis occurred in 5 patients (1.21%). Conclusions: As expected, ACS in young adults had a higher incidence in males. Earlier risk assessment and primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in young patients.
Introduction: A potentially diabetogenic role for statins has been suggested. Similarly, first and second generation beta-blockers and hydrochlorothiazide (HCTZ) have negative effects on glucose homeostasis. Nebivolol is a third generation beta-blocker which may beneficially affect carbohydrate metabolism. The effect of combined treatment with nebivolol, HCTZ and atorvastatin is unknown. Patient and methods: This is a prospective, randomized, open-label, blinded endpoint (PROBE) study. Drug-naive patients with hypertension and dyslipidemia were recruited. All patients received atorvastatin (10 mg). In addition, patients with stage 1 hypertension received nebivolol (5 mg, AN group), while patients with stage 2 hypertension received nebivolol/HCTZ (5/12.5 mg, AN/H-12.5 group or 5/25 mg, AN/H-25 group). The primary efficacy endpoint was the between group mean change from baseline in homeostasis model assessment of insulin resistance (HOMAIR) index at 12 weeks. Results: Seventy-eight patients completed the study. In both AN and AN/ H-12.5 group HOMA-IR levels did not significantly change [from 1.6 (1.42.1) to 1.5 (1.4-2.0, p¼NS) compared with baseline and from 1.6 (1.3-2.2) to 1.7 (1.7-2.4), p¼0.07 compared with baseline), respectively]. In contrast, the HOMA-IR significantly increased by 10% in the AN/H-25 group [from 1.7 (1.3-2.3) to 1.9 (1.4-2.4), p¼0.02 compared with baseline and p<0.01 for the comparison with the other 2 groups]. Conclusions: Administration of nebivolol may counterbalance the negative effects on HOMA-IR of atorvastatin with or without HCTZ 12.5 mg but not that of atorvastatin plus HCTZ 25 mg.
laga, Spain; Hospital Virgen de la Victoria, Ma Sanitarios, Ibermutuamur, Madrid, Spain
2
Departamento de Proyectos
* Corresponding author. Aims: To analyse the association between Atherogenic Dislipidaemia (AD) the incidence of cardiovascular diseases (CVD), among working population. Methods: A cohort of 639,198 workers without prior coronary heart disease or cerebrovascular disease, and participating in the Ibermutuamur Cardiovascular Risk Assessment Study were selected. Baseline medical assessment included anthropometric characteristics, two blood pressure measurements (OMRON M4I) and serum tests. DA was defined as triglycerides 150 mg/dl and HDL-Cholesterol <40 mg/dl (Males) /<50 mg/dl (Females). Logistic regression analyses were carried out to test the association of DA with CVD (ICD-9-CM 401-414, 426-443), during 1-year follow-up. Results: 71.4% (95% CI: 71.3-71.5) of participants were men. Median age was 34 years-old (P25¼27; P75¼43). The percentage of workers with AD was 5.0% (95% CI: 4,9 -5,1). During 1-year follow-up, 564 workers showed a sickness absence episode due to CVD. The incidence rate for all CVD was 88.2/100,000 workers (95% IC: 81.0-95.5), 34.3/100,000 (95% CI: 29.7-38.8) for coronary heart diseases, and 14.7/100,000 (95% CI: 11.7-17.7) for cerebrovascular diseases. After adjusting for baseline CVR level, AD remained associated to CVD (OR¼1.73; 95% CI: 1.31-2.28); to coronary heart disease (OR¼1.78; 95% CI: 1.15-2.75), and to cerebrovascular diseases (OR¼2.33; 95% CI: 1.27-4.29), during this 1-year follow-up. Conclusions: AD is associated with the incidence of CVD, coronary heart disease and cerebrovascular diseases. This association is partially independent of global CVR as estimated by the SCORE charts. EAS-0122. PREMATURE MYOCARDIAL INFARCTION AND SHORT-TERM RESULTS IN TURKEY *
S. Yilmaz , H. Gunduz, P. Varim, S. Demirtas, M. Vatan, M. Çakar, E. Aydin, L. Edis, H. Kiliç. Cardiology, Sakarya University Medicine Faculty Research and Education Hospital, Sakarya, Turkey
e127
EAS-0205. THE GENDER DIFFERENCE OF BACKGROUND AND RISK FACTORS IN ACUTE CORONARY SYNDROME Y. Sudo*, N. Amioka, M. Ueeda, S. Kobashi, T. Yamaji, Y. Koide, Y. Nakano, D. Yamada, N. Ohnishi, A. Takaishi. Cardiology, Mitoyo General Hospital, Kanonji, Japan
* Corresponding author. Aim: The risk factors of coronary artery disease are well known, but the difference of them between male and female is still unclear. The aim of this study is to reveal the gender differences of background and risk factors in patients with acute coronary syndrome (ACS). Methods: Consecutive 1623 ACS patients (male; 1186, female; 437) were enrolled. We examined the differences of background and risk factors between male and female, including malondialdehyde-modified lowdensity lipoprotein (MDA-LDL) and polyunsaturated fatty acids (PUFAs) by analysis of variance. Results: The onset age of ACS was younger in male (P<0.001). Typical biomarkers of lipid like T.Cho, HDL-C and LDL-C were higher in female (P¼0.001, P<0.001, P¼0.02). PUFA and MDA-LDL did not show significant differences, on the other hand, MDA-LDL/LDL-C ratio, which indicates levels of oxidative stress, was higher in male (P ¼0.02). HbA1c and ratio of hypertension were not different significantly between each gender. Uric acid (UA) was higher, and eGFR was lower in male patients (P<0.001, P<0.001). The smoking rate was also higher in male patients (P<0.001). Conclusions: Stronger oxidative stress, elevated UA, decreased renal function and higher smoking rate were remarkable characters of male patients with ACS. It was suggested that these complex factors contributed to the younger onset of ACS in male. EAS-0208. EFFECT OF NEBIVOLOL OR NEBIVOLOL/HYDROCHLOROTHIAZIDE PLUS ATORVASTATIN ON GLYCEMIC PROFILE IN PATIENTS WITH HYPERTENSION AND DYSLIPIDEMIA
* Corresponding author.
A. Kei, E. Liberopoulos, M. Elisaf*. Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
Aim: To investigate the clinical features and in-hospital outcomes of young adults with ACS in Turkey.
* Corresponding author.
Methods: We identified 627 patients aged 45 years old who had undergone coronary angiography from 2011 to 2014 and 412 patients of them have ACS. Clinical data was collected retrospectively. Results: In ACS group, the mean age was 41.74±4.1 years with male predominance (84.7%). Most of patients (98%) admitted with chest pain. Patients often presented with STEMI, predominantly of the anterior wall. The most common risk factor was dyslipidemia (hypertriglyceridemia, lowHDL-C) (81.1%), smoking (80.8%), family history (34.2%), hypertension (29.6%) and DM (27.2%). Past history of CAD was documented in 16.5%. The mean BMI was 28.15±3.7 kg/m2 with 83.8% of patients considered overweight in ACS. Serum glucose levels (138.36 ±70.8 mg/dl and 107.981±40.2mg/dl; P<0.00) was higher in primary admission compared patients with normal coronary artery. The majority of patients had single vessel disease (55.3%) and 46 patients with ACS had normal coronary arteries (11.2%). PCI was the main myocardial reperfusion therapy (37.6%) and had favourable outcomes (success 94.84%). The most frequent complications were arrhythmias, mainly ventricular (5.82%).Overall in-hospital mortality was low with 5 deaths (1.21%). The incidence of heart failure was 2.91% and cardiogenic shock was observed only 3 patients. Recurrent angina and acute stent thrombosis occurred in 5 patients (1.21%). Conclusions: As expected, ACS in young adults had a higher incidence in males. Earlier risk assessment and primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in young patients.
Introduction: A potentially diabetogenic role for statins has been suggested. Similarly, first and second generation beta-blockers and hydrochlorothiazide (HCTZ) have negative effects on glucose homeostasis. Nebivolol is a third generation beta-blocker which may beneficially affect carbohydrate metabolism. The effect of combined treatment with nebivolol, HCTZ and atorvastatin is unknown. Patient and methods: This is a prospective, randomized, open-label, blinded endpoint (PROBE) study. Drug-naive patients with hypertension and dyslipidemia were recruited. All patients received atorvastatin (10 mg). In addition, patients with stage 1 hypertension received nebivolol (5 mg, AN group), while patients with stage 2 hypertension received nebivolol/HCTZ (5/12.5 mg, AN/H-12.5 group or 5/25 mg, AN/H-25 group). The primary efficacy endpoint was the between group mean change from baseline in homeostasis model assessment of insulin resistance (HOMAIR) index at 12 weeks. Results: Seventy-eight patients completed the study. In both AN and AN/ H-12.5 group HOMA-IR levels did not significantly change [from 1.6 (1.42.1) to 1.5 (1.4-2.0, p¼NS) compared with baseline and from 1.6 (1.3-2.2) to 1.7 (1.7-2.4), p¼0.07 compared with baseline), respectively]. In contrast, the HOMA-IR significantly increased by 10% in the AN/H-25 group [from 1.7 (1.3-2.3) to 1.9 (1.4-2.4), p¼0.02 compared with baseline and p<0.01 for the comparison with the other 2 groups]. Conclusions: Administration of nebivolol may counterbalance the negative effects on HOMA-IR of atorvastatin with or without HCTZ 12.5 mg but not that of atorvastatin plus HCTZ 25 mg.