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The role of some drugs, Glycemic control and renal function test in patient with coronary artery calcification

Author: 
Noor N Nafie
Subject Area: 
Health Sciences
Abstract: 

Background: Coronary Computed Tomography Angiography (CCTA) is a rapidly growing, noninvasive imaging modality that developed quickly over the last decade, and its role for evaluation of Coronary Artery Disease (CAD) becomes of great promise with high diagnostic accuracy. The presence and extent of Coronary Artery Calcification (CAC) correlates with the overall magnitude of coronary atherosclerotic plaque burden and with the development of subsequent coronary events. Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also HbA1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also HbA1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. This serves as a marker for average blood glucose levels over the previous 3 months prior to the measurement as this is the half life of red blood cells. It represents a reliable and moving average of blood glucose over preceding three months, Glycated haemoglobin has been the key measure of glycaemic control in diabetic patients for last two decades. It is considered to be the gold standard test, and most widely accepted test of glycaemia among clinicians and patients. Subjects and Methods: This study was conducted at the Department of Biochemistry, College of Pharmacy, University of AL-Rasheed and at the Cardiologic Clinics of Ibn-Al-Bitar Hospital, Baghdad, Iraq, during the period from January 2015 to March 2015. The included 40 patients with ischemic heart disease were classified according to their obtained values of coronary artery Ca score into two groups: Group I (GII) involved 20 patients with coronary artery Ca score equal to 1- 399 (ASU), aged mean( 54.95±1.764) with range (37-70 year), Group II (GI) included 20 subjects who have coronary artery Ca score=0.0 Agatston Score Unit (ASU), aged mean (45.80±2.163) range (31-65 year). These subjects were considered as control group. HbA1c, fasting serum glucose, lipid profile parameters and renal function test (Urea, Creatinine & uric Acid) were also measured by using spectrophotometric methods. All investigations were performed in patients of the two groups (GI and GII). Results: The results of this study revealed significant increase in HbA1c significantly increased in GI compared with GII (P=0.019), with significant increased of (Urea, Creatinine & uric Acid) (P=0.001, p=0.004, p= 0.002) between groups. There was no significant differences in glucose & lipid profile between GI and GII in the these parameters. All patients of GII (with Ca Score =zero) taking statin & Aspirin as protective therapy compare to GI (13/20), (7/20) & which represent (65%) (35%) of this group, (p=0.004#, p=0.0001), these drugs play statically a significant role in treatment of Coronary Artery Calcification(CAC). There is non significant correlation between parameters of (lipid profile, glycemic control & renal function test) with ca- score in GI II(patients with mild to moderate degree of calcification). Conclusion: (CAC) consider to be surrogate marker of atherosclerosis which has been associate with increase value of Hb A1c%, serum level of (Urea, Creatinine & uric Acid) in patients with mild to severe degree of calcification ,combine with high serum level of both glucose & VLDL. All these parameters may play important role in pathogenesis of atherosclerosis in patients with CAD, Statin, Aspirin have protective role in patients with CAD while B-blocker to increase of the survival in and improved QoL of these patients with mild to moderate degree of calcification in patients with Ca score =0.0 Agatston.

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