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1、China Heart survey - Call for Action,Dayi Hu Peoples Hospital of Peking University 2008-4-11,2,The Primary Cause of Death: Cardio-Cerebral Vascular Diseases,World Health Organization. Atlas of Heart Disease and Stroke. 2005,3,Major Risk Factors for CAD: Hypertension, Hyperlipidemia, Hyperglycemia,Al
2、though the emergence of new drugs and the release of many evidence-based research outcomes recently, are the mortality of cardio-cerebral vascular events fully reduced?,5,Although the use of intervention therapy and drugs dramatically increased, the mortality of cardio-cerebral vascular diseases is
3、still going up,Source:Death and risk factors, epidemiology, trend and distribution in Chinese. Peking Union Medical College Press. Sep. 2005.,6,Cause:“The therapy is separated”,7,Cause: Hyperglycemia a neglected risk factor of CVD,8,China Heart Survey: Content,Background Diabetes is as dangerous as
4、CAD Patients with CAD are at the high risk for hyperglycemia Design Result Meaning,9,Diabetes is as dangerous as CAD,Haffner SM et al. N Engl J Med. 1998;339:229-234.,Events/100 person-yr,10,American Heart Association: Diabetes is cardiovascular disease,Steven Haffner: Concern each diabetic patient
5、as important as patients with MI,Circulation. 1999; 100: 1134-46.,11,EHS(EURO Heart Survey),ESC report in Sep.2004: The survey involved 110 centres in 25 countries recruiting 4961 patients with CAD 2107 were admitted on an acute basis and 2854 had an elective consultation. At enrolment, 1524 of thes
6、e patients was known to have type 2 diabetes, a FPG was measured in the remaining patients, and an OGTT in 1920 of these patients.,The Euro Heart Survey on diabetes and the heart,European Heart Journal (2004) 25, 18801890,12,Euro Heart Survey: classification of glucometabolic state(n= 4,961),29%,22%
7、,31%,3%,15%,34%,22%,30%,4%,10%,NGT,IFG(6.1mmol/L),IGT,Diagnosed DM,Newly diagnosed DM,The Euro Heart Survey on diabetes and the heart,European Heart Journal (2004) 25, 18801890,13,Euro Heart Survey: the myth,What is the epidemic about hyperglycemia in Chinese patients with CAD? Is the strategy for h
8、yperglycemia diagnosis suitable to such patients?,14,China Heart Survey: content,Background Diabetes is as dangerous as CAD Patients with CAD are at the high risk for hyperglycemia Design Result Meaning,15,China Heart Survey: design,Subjects 52 hospitals in 7 cities in China participated in the surv
9、ey Time From Jun. 1st to Aug. 31th 2005 3513 patients hospitalized for CAD was recruited Inclusion criteria Coronary heart disease Chronic Stable Angina Healed myocardial infraction Acute coronary syndrome Arrhythmia and heart failure was excluded,16,Method,OGTT was measured in all patients, except
10、for the patients with known diabetes OGTT was unnecessary for the patients whose FPG 8 mmol/L in two testing,17,China Heart Survey: flow chart,Previously known diabetes,Newly diagnosed diabetes (FPG),Newly diagnosed diabetes (FPG),773 OGTT,420,Previously known diabetes,41,1,234,Acute admission,2,279
11、,Elective admission,3,513,random,3,687,screened,733,56,1,490 OGTT,Da-Yi Hu, et al. European Heart Journal 2006;27:2573-2579.,18,China Heart Survey: content,Background Diabetes is as dangerous as CAD Patients with CAD are at the high risk for hyperglycemia Design Result Meaning,19,China Heart Survey:
12、 77% of patients with CAD had hyperglycemia,n=3,513,20,Without the use of OGTT, over 80% of newly diagnosed diabetes and pre-diabetes will remain undiagnosed,21,Conclusion,In the enrolled patients (n=3,513), the percentage of hyperglycemia (included diabetes and pre-diabetes) was about 80% The preva
13、lence of diabetes was 52.92% (n=1,859),of which 20.1%(n=706)was newly diagnosed diabetes The prevalence of pre-diabetes was 26.38%(n=927), all was newly diagnosed excepted one patient,22,If FPG was measured alone, without the use of OGTT 80% of 609 newly diagnosed diabetic patients will remain undia
14、gnosed 70 of 926 newly diagnosed pre-diabetic patients will remain undiagnosed 75 of newly diagnosed diabetic and pre-diabetic patients will remain undiagnosed if FPG is measured alone.,Conclusion,23,China Heart Survey: content,Background Diabetes is as dangerous as CAD Patients with CAD are at the
15、high risk for hyperglycemia Design Result Meaning,24,China Heart Survey: meaning,CHS sound the alert for our cardiologists, neurologists and cardio-vascular surgeons, indicating that we should concern whether dysglycaemia exist in the admitted patients. As far as dysglycaemia concerned, no matter what is diabetes, IFG or IGT, early diagnosis and early intervention help to reduce its harm to cardiovascular system. Therefore, the screening of dysglycaemia should be advocated.,Cardiologist should prevent and treat diabetes in the first line.,25,THANK YOU!,
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