الفهرس 
`Diabetes as a risk factor for Vascular diseaseOnly 14 pages are availabe for public view
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Abstract
Increased common carotid intima–media thickness has been associated with unfavorable levels of established cardiovascular risk factors, prevalent cardiovascular disease and atherosclerosis elsewhere in the arterial system (Bots ML, et al., 2002, Witteman JC, et al., 2002).
Mauro Amato, et al. (2007) have shown that carotid IMT correlates much better with coronary atherosclerosis when both vascular beds are investigated by the same technique (ultrasound) and using the same parameter (IMT).
Multiple studies proved that carotid intima-media thickness was significantly greater in diabetic patients than in non-diabetic patients (Naomi Mitsuhashi, et al., 2002, Andreas Melidonis et al., 2003, Wagenknecht LE, et al., 2003, Karen C. Johnston, et al., 2003).
Another study showed that not only diabetes is a risk factor for cardiovascular disease but even impaired glucose tolerance (IGT) also shows importance as a risk factor (Deirdre, et al., 2004).
Risk Factors for vascular disease include:
- Diabetes mellitus (Deirdre, et al., 2004)
- Hypertension (Naomi M, et al., 2002)
- Hyperlipidemia (Naomi M, et al., 2002)
- Smoking (Pyorala K, et al., 1987)
Diagnosing acute first myocardial infarction:
- History and clinical picture.
- Electrocardiogram showing criteria of current myocardial infarction (ST segment elevation and or T wave inversion) and excluding previous myocardial infarction (Q waves).
- Cardiac enzymes (CK, CK-MB, Troponine T)
- Echocardiographic study.
Diagnosing carotid artery disease:
- Radiography
- Ct scan
- Magnetic resonance imaging
- Nuclear medicine
- Angiography
- Ultrasonography
Management of carotid artery disease:
- If asymptomatic and lesion < 70% then medical treatment in the form of aspirin.
- If lesion < 70% and symptomatic then cerebral arteriogram is required
• If no other problems then medical treatment in the form of aspirin.
• If other problems are seen or carotid lesion is rough and irregular then proceed to carotid angioplasty or carotid endarterectomy.
- If lesion > 70% then carotid angioplasty or carotid endarterctomy should be done.
(Lancet et al., 1998)
Patients and methods:
- Our study estimates the prevalence of carotid artery stenosis in diabetics versus non diabetics with first acute myocardial infarction. It enrolled 100 patients admitted to Mabaret El-Maadi Hospital presenting with acute myocardial infarction.
- Each patient enrolled in the current study was subjected to:
1- Full history and examination.
2- 12 leads Electrocardiogram.
3- Serial Cardiac enzymes.
4- Laboratory examinations in the form of CBC, serum creatinine, serum urea and SGOT.
5- Transthoracic Echocardiographic study.
6- Carotid duplex study.
Results:
- The prevalence of carotid artery disease in patients presenting by first acute myocardial infarction in our study was 51 patients from 100 patients in percent of 51%.
- The prevalence of carotid artery disease in diabetic patients was 64.29% patients as opposed to 20% in non-diabetic patients.
- The prevalence of carotid artery disease in hypertensive patients in our study was 81.63% patients as opposed to 21.57% in patients without hypertension.
- The prevalence of carotid artery disease in dyslipidemic patients was 68.38% patients as opposed to 25% in patients without dyslipidemia.
- The prevalence of carotid artery disease in smoking patients was 73.08% as opposed to 27.09% in non-smokers.