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- Cetin, S., et al.
(author)
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Increased coronary intervention rate among diabetic patients with poor glycaemic control: A cross-sectional study
- 2014
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In: Bosnian Journal of Basic Medical Sciences. - 1512-8601. ; 14:1, s. 16-20
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Journal article (peer-reviewed)abstract
- The relationship between glycaemic control and coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) is controversial. In the current cross-sectional study, we addressed the relationship between Hemoglobin A1c (HbAlc) values and the need for revascularization among diabetic patients undergoing coronary angiography. A total of 301 consecutive patients with known T2DM (age 61.8 +/- 10.1 years, 46.2 % women) requiring coronary angiography due to CAD symptoms were included. T2DM patients were categorized into two groups based on their HbAlc values: 93 (30.9%) diabetics with good glycaemid control (HbA1c <= 7 %), and 208 (69.1%) diabetics with poor glycaemic control (HbA1c>7 %). A total of 123 patients (40.9%) required revascularization. The revascularization rate was 28.0% among T2DM patients with good glycaemic control and 46.6% among T2DM patients with poor glycaemic control, respectively (p=0.002). In a logistic regression analysis, the need for revascularization was predicted by poor glycaemic control (Odds Ratio [OR] 2.26, 95% Confidence Interval [Cl] 1.32-3.82; p=0.003) adjusted for age, gender, Body-Mass-Index and diabetes duration. Moreover, there was a linear relationship between HbA1c values and number of affected coronary arteries (r= 0.169;p=0.003). Our data suggest that there is a close association between poor glycaemic control and increased revascularization rate in T2DM, which should be considered in primary and secondary prevention models. (c) 2014 Association of Basic Medical Sciences of FB&H. All rights reserved
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- Chen, B., et al.
(author)
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Effect of Continuous Positive Airway Pressure on Lipid Profiles in Obstructive Sleep Apnea: A Meta-Analysis
- 2022
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In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 11:3
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Journal article (peer-reviewed)abstract
- Background: Obstructive sleep apnea (OSA) is associated with dyslipidemia. However, the effects of continuous positive airway pressure (CPAP) treatment on lipid profiles are unclear. Methods: PubMed/Medline, Embase and Cochrane were searched up to July 2021. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment and reported pre-and post-intervention lipid profiles were included. Weighted mean difference (WMD) was used to assess the effect size. Meta-regression was used to explore the potential moderators of post-CPAP treatment changes in lipid profiles. Results: A total of 14 RCTs with 1792 subjects were included. CPAP treatment was associated with a significant decrease in total cholesterol compared to controls (WMD = −0.098 mmol/L, 95% CI = −0.169 to −0.027, p = 0.007, I2 = 0.0%). No significant changes in triglyceride, high-density lipoprotein nor low-density lipoprotein were observed after CPAP treatment (all p > 0.2). Furthermore, meta-regression models showed that age, gender, body mass index, daytime sleepiness, OSA severity, follow-up study duration, CPAP compliance nor patients with cardiometabolic disease did not moderate the effects of CPAP treatment on lipid profiles (all p > 0.05). Conclusions: CPAP treatment decreases total cholesterol at a small magnitude but has no effect on other markers of dyslipidemia in OSA patients. Future studies of CPAP therapy should target combined treatment strategies with lifestyle modifications and/or anti-hyperlipidemic medications in the primary as well as secondary cardiovascular prevention models. © 2022 by the authorsLicensee MDPI, Basel, Switzerland.
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- Chen, B. X., et al.
(author)
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Effect of Continuous Positive Airway Pressure on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea A Meta-Analysis
- 2021
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In: Annals of the American Thoracic Society. - 1546-3222 .- 2329-6933. ; 18:10, s. 1717-1727
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Journal article (peer-reviewed)abstract
- Rationale: Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes weight gain in patients with obstructive sleep apnea (OSA). It is unclear whether weight gain is influenced by CPAP adherence or comorbid disorders. Objectives: To examine the CPAP effects on body mass index (BMI) and local adiposity and the potential moderators of CPAP effects on BMI in patients with OSA. Methods: We searched PubMed/Medline, Embase, and Cochrane through December 2019. Randomized controlled trials of CPAP versus control treatment with >4 weeks' treatment were included. Results: A total of 39 randomized controlled trials with 6,954 subjects were included. In intention-to-treat analysis, the BMI increased significantly after CPAP treatment compared with control treatment (weighted mean difference [WMD], 0.148 kg/m(2); 95% confidence interval, 0.04-0.26; P = 0.001). In studies demonstrating an increase in the BMI, waist and neck circumferences were also significantly increased. Subgroup analyses revealed that an increased BMI was attributable to CPAP use of <5 h/night (WMD, 0.231) but was not attributable to CPAP use of.5 h/night (WMD, 0.001; between-group P value = 0.049). Furthermore, the BMI increased significantly in patients without cardiovascular disease (CVD; WMD, 0.200), whereas it decreased significantly in those with CVD at baseline (WMD, 20.188; between-group P value, 0.001). Moreover, the BMI increased significantly in patients with dysglycemia (WMD, 0.499) but did not increase in those without dysglycemia at baseline (WMD, 0.100; between-group P value = 0.032). Meta-regression confirmed the subgroup findings. Conclusions: The BMI increased significantly in patients with OSA after CPAP treatment, especially in those with CPAP use of <5 h/night, without CVD and/or with dysglycemia at baseline. CPAP use of at least 5 h/night seems to be necessary in mitigating the risk for weight gain in patients with OSA.
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- Peker, Yüksel, 1961, et al.
(author)
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Reliability of the Turkish version of the European Obstructive Sleep Apnea Screening (EUROSAS) questionnaire for drivers
- 2021
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In: Sleep and Breathing. - : Springer Science and Business Media LLC. - 1520-9512 .- 1522-1709. ; 25:2, s. 907-913
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Journal article (peer-reviewed)abstract
- Purpose The European Union Driver License Committee recently developed a questionnaire as a screening tool for obstructive sleep apnea (OSA) named the European Obstructive Sleep Apnea Screening (EUROSAS) questionnaire for drivers. We sought to address the reliability of the Turkish version of this questionnaire. Methods The EUROSAS was translated into Turkish. Using a "test-retest approach", data were collected twice with a 15-day interval among 150 participants (50 professional male drivers [PMD], 50 non-professional male drivers [NPMD], and 50 non-professional female drivers [NPFD]). The EUROSAS score ranges between 2 and 25, with scores >= 10 suggesting the presence of OSA. Results The median EUROSAS scores in the first test were 8.0 (interquartile range [IQR] 6.8-12.0) in PMD, 8.0 (IQR 6.0-11.0) in NPMD, and 5.0 (IQR 4.0-8.0) in NPFD (p< 0.001). Corresponding values in the retest were 9.5 (IQR 7.0-13.0), 8.0 (IQR 6.0-10.0), and 5.0 (IQR 4.0-8.0), respectively (p< 0.001). The EUROSAS score >= 10 was found among 34% in the first test and 50% in the retest in PMD (ns), 34% vs 24% in NPMD (ns), and 8% vs 16% in NPFD (ns). There was a positive correlation between the tests (r= 0.864,p< 0.001), and Cronbach's alpha value for the whole group was 0.477 (0.514 for PMD, 0.512 for NPMD, and 0.543 NPFD, respectively). Conclusions The EUROSAS-Turkish version is easy to understand and is reproducible. However, the test-retest reliability level is poor among the Turkish drivers. Further validation of the questionnaire by objective sleep studies and fitness-to-drive testing is necessary.
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- Rogers, Simon N., et al.
(author)
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Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world
- 2020
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In: Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 42:3, s. 498-512
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Journal article (peer-reviewed)abstract
- Background The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL). Methods Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias. Results There were 2136 patients with a median total number of PCI items selected of 5 (2-10). "Fear of the cancer returning" (39%) and "dry mouth" (37%) were most common. Twenty-five percent (524) reported less than good QOL. Conclusion There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL.
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- Zinchuk, A. V., et al.
(author)
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Physiological Traits and Adherence to Sleep Apnea Therapy in Individuals with Coronary Artery Disease
- 2021
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In: American Journal of Respiratory and Critical Care Medicine. - 1073-449X. ; 204:6, s. 703-712
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Journal article (peer-reviewed)abstract
- Rationale: Untreated obstructive sleep apnea (OSA) is associated with adverse outcomes in patients with coronary artery disease (CAD). Continuous positive airway pressure (CPAP) is the most common treatment, but despite interventions addressing established adherence determinants, CPAP use remains poor. Objectives: To determine whether physiological traits that cause OSA are associated with long-termCPAP adherence in patients with CAD. Methods: Participants in the RICCADSA (Randomized Intervention with CPAP in CAD and OSA) trial with objective CPAP adherence (h/night) over 2 years and analyzable raw polysomnography data were included (N= 249). The physiological traits-loop gain, arousal threshold (ArTH), pharyngeal collapsibility (<(V)over dot> passive), and pharyngeal muscle compensation (<(V)over dot>comp)-were measured by using polysomnography. Linear mixed models were used to assess the relationship between the traits and adherence. We also compared actual CPAP adherence between those with physiologically predicted "poor" adherence (lowest quartile of predicted adherence) and those with physiologically predicted "good" adherence (all others). Measurements and Main Results: The median (interquartile range) CPAP use declined from 3.2 (1.0-5.8) h/night to 3.0 (0.0-5.6) h/night over 24 months (P, 0.001). In analyses adjusted for demographics, anthropometrics, OSA characteristics, and clinical comorbidities, a lower ArTH was associated with worse CPAP adherence (0.7 h/SD of the ArTH; P = 0.021). Both high and low <(V)over dot> comp were associated with lower adherence (P = 0.008). Those with predicted poor adherence exhibited markedly lower CPAP use than those with predicted good adherence for up to 2 years of follow-up (group differences of 2.0-3.2 h/night; P, 0.003 for all). Conclusions: A low ArTH, as well as a very low and high <(V)over dot> comp, are associated with worse long-term CPAP adherence in patients with CAD and OSA. Physiological traits-alongside established determinants-may help predict and improve CPAP adherence.
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