Azza Farrag

The association between extracoronary calcification and coronary artery disease in patients with type 2 diabetes mellitus

Cardiovascular complications are the major cause of diabetes-associated morbidity and mortality. However, not all patients with diabetes are at increased risk for cardiovascular disease (CVD). Coronary artery calcification was found to be a powerful predictor of coronary artery disease (CAD). The presence of extracoronary cardiac calcification as a useful predictor of CAD is not yet established, especially in type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the relation between extracoronary calcification and extent of CAD in a group of T2DM patients who were scheduled for computed tomographic coronary angiography (CTCA). We prospectively studied 380 patients (151 had T2DM) under the age of 60 years who were scheduled for CTCA because of suspected CAD. Severity of CAD was assessed by Gensini score. Coronary artery calcium score (CACS) as well as calcium score in the aortic valve, mitral annulus, ascending aorta, and descending aorta were measured by a 256-row multidetector computed tomography scanner with dedicated software for calcium calculation. Patients with known CAD were excluded. Diabetic and nondiabetic patients had comparable age and gender distribution. However, the diabetic group had higher Gensini score, CACS, and extracoronary calcium score (ECCS). Logistic regression analyses identified male gender and ECCS as significant predictors for the presence of CAD in diabetic patients. Age, smoking, and ECCS were the significant predictors of CAD in nondiabetic patients. Type 2 diabetic patients had increased coronary and extracoronary calcification. ECCS was found to be a significant predictor of CAD in diabetic and nondiabetic patients only when CACS was not taken into account.

Obesity and Other Cardiovascular Risk Factors in Egyptian University Students: Magnitude of the Problem

Background: Cardiovascular risk factors can lead to excessive morbidity and mortality from cardiovascular events. Metabolic syndrome in young adults is considered a predictor of increased cardiovascular risk in adulthood. Obesity in specific is rising among adolescents and young adults worldwide including populations living in developing countries. The aim of this study was to evaluate the prevalence of obesity and other cardiovascular risk factors in a group of university students representing large sector of young adults in Egypt. Methods: This is a cross-sectional observational study on 2895 students from 10 public universities in 10 Egyptian governorates that represent different geographic areas in Egypt. Students were recruited for selfadministered questionnaire, anthropometric and blood pressure measurements as well as laboratory analyses for random blood sugar and total cholesterol level. Results: The majority of students were non-smokers, and the minority performed regular physical exercise.Obesity was encountered in 10.7% of participants, while abdominal obesity was shown in 43.4%. Abdominal obesity was more prevalent in South Upper Egypt female students. 2% of students were shown to be hypertensive and 15% were pre-hypertensive. Conclusion: Pre-hypertension and Obesity, particularly the abdominal type was prevalent in Egyptian adolescents and young adults.

Prevalence and severity of pulmonary hypertension in asymptomatic rural residents with schistosomal infection in the Nile Delta

Objectives  Millions of people in the developing world may suffer from pulmonary hypertension (PHTN) because of preexisting infectious conditions. Schistosomiasis can cause pulmonary lesions that eventually lead to PHTN. The aim of this study was to assess the prevalence of PHTN together with assessment of right ventricular (RV) function in asymptomatic rural residents previously infected with schistosomiasis.

Haemoglobin A1c as a marker predicting extent and severity of coronary artery disease in non-diabetic patients.

Objective Lowering haemoglobin A1c (HbA1c) was shown to be associated with reduction of microvascular, neuropathic and possibly macrovascular complications in diabetic patients. However, in non-diabetic patients, few reports have examined the relation between HbA1c and extent of coronary artery disease. The aim of this study was to examine the relationship between HbA1c level and severity of coronary artery disease (CAD) in non-diabetic patients scheduled for elective coronary angiography. Methods We prospectively studied 408 consecutive non-diabetic patients with or without history of previous myocardial infarction who were scheduled for conventional coronary angiography. HbA1c was measured in all patients at the time of admission. Severity of CAD was assessed by the Gensini score. Gensini score > 30 was considered severe coronary atherosclerosis. Patients were divided into two groups: the high-risk group (HbA1c, 5.7-6.4%) and the low-risk group (HbA1c, < 5.7%). Results Patients in the high-risk group had a higher Gensini score (45.1 ± 36.7 vs 26.8 ± 26.0, P< 0.001). Patients with a Gensini score > 30 had higher values of HbA1c (6.0 ± 0.48 vs 5.75 ± 0.54, P< 0.001). HbA1c showed a positive correlation with the Gensini score. HbA1c value of 5.85% showed a sensitivity and specificity of 70 and 50%, respectively, for prediction of severe coronary atherosclerosis. Conclusion HbA1c is significantly associated with severe coronary atherosclerosis in non-diabetic patients.