- 著者
- Gyung-Min Park Hyonggin An Seung-Whan Lee Young-Rak Cho Eun Ha Gil Sung Ho Her Hyun Woo Park Jung-Min Ahn Duk-Woo Park Soo-Jin Kang Young-Hak Kim Cheol Whan Lee Dong Hyun Yang Joon-Won Kang Tae-Hwan Lim Hong-Kyu Kim Jaewon Choe Seong-Wook Park Seung-Jung Park
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-14-1197, (Released:2015-05-08)
- 参考文献数
- 29
- 被引用文献数
- 1 8
Background:Little is known about subclinical atherosclerosis on coronary computed tomographic angiography (CCTA) in asymptomatic individuals with metabolic syndrome (MetS).Methods and Results:We analyzed 5,213 asymptomatic individuals who underwent CCTA. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Of the study participants, 2,042 (39.2%) had MetS. MetS was an independent predictor of significant coronary artery disease (CAD) in at least 1 coronary artery (odds ratio [OR]=1.992, 95% confidence interval [CI]=1.623–2.445, P<0.001) and significant CAD in the left main (LM) or proximal left anterior descending (LAD) artery (OR=2.151, 95% CI=1.523–3.037, P<0.001). During the follow-up period (median 28.1 [interquartile range, 19.2–36.5] months), 111 individuals had 114 cardiac events. Individuals with MetS were significantly associated with more cardiac events than those without (RR [rate ratio]=1.67, 95% CI=1.15–2.43, P=0.007). In the MetS group, individuals with significant CAD had the majority of cardiac events (RR=64.33, 95% CI=29.17–141.88, P<0.001). Furthermore, in the MetS with significant CAD group, those with significant CAD in the LM or proximal LAD had more cardiac events (RR=2.63, 95% CI=1.51–4.59, P=0.001).Conclusions:MetS was associated with subclinical atherosclerosis on CCTA with subsequent high risk for cardiac events. These findings suggest the importance of reducing unfavorable metabolic conditions in asymptomatic individuals.
- 著者
- Jae-Sik Jang Han-Young Jin Jeong-Sook Seo Tae-Hyun Yang Dae-Kyeong Kim Tae Hee Kim Sang-Hwa Urm Dong-Soo Kim Dong-Kie Kim Sang-Hoon Seol Doo-Il Kim Kyoung-Im Cho Bo-Hyun Kim Yong Hyun Park Hyung-Gon Je Jung-Min Ahn Won-Jang Kim Jong-Young Lee Seung-Whan Lee
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.76, no.9, pp.2255-2265, 2012 (Released:2012-08-24)
- 参考文献数
- 65
- 被引用文献数
- 39 74
Background: Sodium bicarbonate has been postulated to prevent contrast-induced acute kidney injury (CI-AKI) by various mechanisms, although the reports are conflicting. Methods and Results: We searched MEDLINE, EMBASE, and the Cochrane databases for randomized controlled trials that compared a sodium chloride with a sodium bicarbonate hydration regimen with regard to CI-AKI. Data across 19 clinical trials consisting of 3,609 patients were combined. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of CI-AKI (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.36–0.86; P=0.008). Stratified analyses by the type of contrast medium suggested lower odds of CI-AKI with sodium bicarbonate in studies using low-osmolar contrast media (OR 0.40; 95% CI 0.23–0.71, P=0.002) compared with those using the iso-osmolar agents (OR 0.76; 95% CI 0.41–1.43; P=0.40). No significant difference in the rates of postprocedural death (OR 0.49; 95% CI 0.23–1.04; P=0.06) and the requirement for renal replacement therapy (OR 0.94; 95% CI 0.46–1.91; P=0.86) was observed. However, we found significant changes in serum bicarbonate and potassium levels after sodium bicarbonate infusion. Conclusions: This updated meta-analysis demonstrates that sodium bicarbonate-based hydration is superior to sodium chloride in preventing CI-AKI of patients undergoing exposure to iodinated contrast media. (Circ J 2012; 76: 2255–2265)