SA Journal of Diabetes & Vascular Disease: Vol 21, Issue 1, November 2024

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SAJDVD: VOLUME 21, ISSUE 1, November 2024

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From the Editor’s Desk
Authors: Mahomed, FA
From: South African Journal of Diabetes and Vascular Disease, Vol 21, Issue 1, November 2024
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Correlation between carotid intima–media thickness and patient outcomes in coronary artery disease in central South Africa
Authors: V MOKOENA, L BOTES, SC BROWN, FE SMIT
From: South African Journal of Diabetes and Vascular Disease, Vol 21, Issue 1, November 2024
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Objectives: Carotid intima–medial thickness (CIMT) is a non-invasive tool used to detect atherosclerosis and diagnose cardiovascular disease. This study aimed to determine whether pre-operative CIMT measurements correlated with intraand postoperative outcomes in patients with acute coronary syndrome (ACS) undergoing coronary artery bypass graft (CABG) surgery.
Methods: This retrospective, analytical cohort included 89 patients diagnosed with ACS who received CABG surgery. Patients were divided into two cohorts: group 1: normal CIMT < 0.07 cm and group 2: abnormal CIMT ≥ 0.07 cm. B-mode ultrasound was used to measure the CIMT in all patients. Pre-, intra- and postoperative data and complications were recorded for each patient.
Results: The study included 77 (86.5%) males and 12 (13.5%) females. Pre-operative mean body mass index was significantly higher (p = 0.03) in group 2 than in group 1. Group 2 had a significantly increased incidence of diabetes (p = 0.008) and hypertension (p = 0.009), and increased NT-proBNP levels (p = 0.02). Intra- and postoperative outcomes between the groups were comparable, with no significant differences.
Conclusion: The study showed no correlation between abnormal CIMT and increased adverse intra- and postoperative patient outcomes. Therefore, the results of this study show CIMT should not be considered a tool to predict adverse events in patients undergoing CABG surgery.
Ultrasonographic assessment and clinical outcomes after deployment of a suture-mediated femoral vascular closure device
Authors: DIMITRIOS PAPOUTSIS, KONSTANTINOS MOUROUZIS, NIKOLETA BOZINI, KONSTANTINOS AZNAOURIDIS, EVANGELOS OIKONOMOU, KATERINA CHATZIMICHAEL, ELIAS BROUNTZOS, MANOLIS VAVURANAKIS, COSTAS TSIOUFIS, JOHN LEKAKIS, GERASIMOS SIASOS, DIMITRIS TOUSOULIS
From: South African Journal of Diabetes and Vascular Disease, Vol 21, Issue 1, November 2024
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Introduction: Data regarding changes in the arterial vascular wall after the deployment of suture-mediated vascular closure devices (VCD) at the femoral site in patients undergoing percutaneous coronary angiography (CAG) or percutaneous coronary intervention (PCI) are sparse. This study investigated the occurrence of structural vascular changes or adverse vascular complications at the access site in the short term after the deployment of a suture-mediated intravascular VCD.
Methods: Ninety-three patients (72% males) with a mean age of 62 ± 11 years were enrolled. Duplex sonography was conducted at the access site at baseline, 24 hours and 30 days after femoral puncture in patients with successful VCD deployment. Vessel diameter, flow velocities, the severity of atherosclerosis, and the intravascular or perivascular tissue alterations in both the right common femoral artery (RCFA) and right external iliac artery (REILA) were assessed. Vascular complications were documented.
Results: There were no significant changes regarding the diameter of the RCFA in the transverse and longitudinal view, peak systolic velocity (PSV) of the RCFA, PSV ratio of the RCFA to REILA, the resistive index of the RFCA and the severity of arterial wall abnormalities before femoral puncture, the day following VCD deployment and 30 days after (p = NS for all) in the general population and in patients with diabetes mellitus, on oral anticoagulants or with mild peripheral artery disease (p = NS for all markers). Device failure was observed in four cases. Few (4.4%) patients had vascular complications, which included exclusively major or minor haematomas, most of which did not persist at the 30-day follow up.
Conclusion: The use of a suture-mediated VCD was safe and was not associated with adverse vascular wall changes at the femoral access site 30 days after deployment in patients undergoing CAG and/or PCI.
The predictive value of triglyceride–glucose index for assessing the severity and MACE of premature coronary artery disease
Authors: LING YANG, YU PENG, ZHENG ZHANG
From: South African Journal of Diabetes and Vascular Disease, Vol 21, Issue 1, November 2024
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Objective: The aim of this study was to investigate the predictive value of the triglyceride–glucose (TyG) index to assess the severity and major adverse cardiovascular events (MACE) of patients in hospital with premature coronary artery disease (PCAD).
Methods: A total of 300 patients with PCAD, diagnosed by coronary angiography (CAG), were enrolled in this study. According to the tertiles of TyG index, the 300 patients were divided into a T1 (n = 100), T2 (n = 100) and T3 group (n = 100). According to the presence or absence of MACE, the 300 patients were divided into a MACE (n = 80) and a non-MACE group (n = 220). The patients’ clinical data were compared between the groups, the relationship between TyG index and the severity of PCAD and MACE were analysed through multivariable logistic regression analysis, and their predictive value was detected using receiver operating characteristic (ROC) curves.
Results: Multivariable logistic regression analysis showed that the TyG index was an independent risk factor for the severity of PCAD and MACE. The area under the ROC curve was 0.833 and 0.807, respectively (all p < 0.05).
Conclusion: The TyG index was independently associated with the severity of PCAD and MACE, and had a good predictive value.
Comprehensive ABC (HbA1c, blood pressure, LDL-C) control and cardiovascular disease risk in patients with type 2 diabetes mellitus and major depressive disorder in a South African managed healthcare organisation
Authors: LOVINA A NAIDOO, NEIL BUTKOW, PAULA BARNARD-ASHTON, ELENA LIBHABER
From: South African Journal of Diabetes and Vascular Disease, Vol 21, Issue 1, November 2024
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Aim: Patients with type 2 diabetes mellitus (T2DM) who have suboptimal control of the triad of glucose (A), blood pressure (B) and lipid profile (C) have an increased risk of cardiovascular disease (CVD). Additionally, the presence of major depressive disorder (MDD) can lead to poor outcomes. Therefore, the aim of this study was to assess the role of MDD with ABC control in patients with T2DM in a South African private healthcare setting.
Methods: Healthcare medical claims and electronic health records of 1 211 adult patients with T2DM and/or MDD were analysed for 2019.
Results: Only 24% of the T2DM +/– MDD patients reached a low-density lipoprotein cholesterol (LDL-C) target < 1.8 mmol/l, and only 13% of the T2DM + MDD and 7.1% of T2DM – MDD patients achieved simultaneous ABC targets. The proportion of patients admitted due to macrovascular complications was higher in the T2DM + MDD group (22.8%) compared to the T2DM – MDD (13.1%) and MDD group (9.9%) (p = 0.012). Multivariate logistic regression analysis showed that older patients with T2DM + MDD achieved better glycated haemoglobin and LDL-C control. Significantly more patients with T2DM + MDD (12%) had repeat macrovascular admissions in 2019 compared to the T2DM – MDD patients (2.9%) (p = 0.005).
Conclusion: Despite a managed-care environment, the comprehensive ABC control among patients with T2DM was suboptimal, particularly in those with MDD, placing them at greater risk for CVD events.

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