Design,Synthesis and Enzymatic Inhibition of Novel Unusual Amino Acids as a Transition State Analogue of Amyloid Precursor Protein Peptide

International Journal of Peptide Research and Therapeutics - β-secretase 1 (BACE1) plays a pivotal role in the pathology of Alzheimer?s disease via accumulation beta amyloid in the...     

2-h postchallenge plasma glucose predicts cardiovascular events in patients with myocardial infarction without known diabetes mellitus

ABSTRACT: Background and Purpose: The incidence of cardiovascular events remains high in patients with myocardial infarction (MI) despite advances in current therapies. New and better methods for identifying patients at high risk of recurrent cardiovascular (CV) events are needed. This study aimed to analyze the predictive value of an oral glucose tolerance test (OGTT) in patients with acute myocardial infarction without known diabetes mellitus (DM). METHODS: The prospective cohort study consisted of 123 men and women aged between 31-80 years who had suffered a previous MI 3-12 months before the examinations. The exclusion criteria were known diabetes mellitus. Patients were followed up over 6.03 +/- 1.36 years for CV death, recurrent MI, stroke and unstable angina pectoris. A standard OGTT was performed at baseline. RESULTS: 2-h plasma glucose (RR, 1.27, 95% CI, 1.00 to 1.62; P<0.05) and smoking (RR, 3.56, 95% CI, 1.02 to 12.38; P<0.05) proved to be independent predictors of CV events in multivariate statistical analysis after adjustments for age, sex, total cholesterol, and other baseline characteristics. CONCLUSIONS: In this study population, with previous MI and without known DM, 2-h PG and smoking were significant predictors of CV death, recurrent MI, stroke and unstable angina pectoris, independent of baseline characteristics and medical treatment.     

2-h postchallenge plasma glucose predicts cardiovascular events in patients with myocardial infarction without known diabetes mellitus

Background

Non-enzymatic glycation increases hemoglobin-oxygen affinity and reduces oxygen delivery to tissues by altering the structure and function of hemoglobin.

Objectives

We investigated whether an elevated blood concentration of glycosylated hemoglobin (HbA1c) could induce falsely high pulse oximeter oxygen saturation (SpO₂) in type 2 diabetic patients during mechanical ventilation or oxygen therapy.

Methods

Arterial oxygen saturation (SaO₂) and partial pressure of oxygen (PO₂) were determined with simultaneous monitoring of SpO₂ in 261 type 2 diabetic patients during ventilation or oxygen inhalation.

Results

Blood concentration of HbA1c was >7% in 114 patients and????7% in 147 patients. Both SaO₂ (96.2?±?2.9%, 95% confidence interval [CI] 95.7-96.7% vs. 95.1?±?2.8%, 95% CI 94.7-95.6%) and SpO₂ (98.0?±?2.6%, 95% CI 97.6-98.5% vs. 95.3?±?2.8%, 95% CI 94.9-95.8%) were significantly higher in patients with HbA1c >7% than in those with HbA1c????7% (Data are mean?±?SD, all p?<?0.01), but PO₂ did not significantly differ between the two groups. Bland-Altman analysis demonstrated a significant bias between SpO₂ and SaO₂ (1.83 ±0.55%, 95% CI 1.73% -1.94%) and limits of agreement (0.76% and 2.92%) in patients with HbA1c >7%. The differences between SpO₂ and SaO₂ correlated closely with blood HbA1c levels (Pearson??s r?=?0.307, p?<?0.01).

Conclusions

Elevated blood HbA1c levels lead to an overestimation of SaO₂ by SpO₂, suggesting that arterial blood gas analysis may be needed for type 2 diabetic patients with poor glycemic control during the treatment of hypoxemia.