Background: The selection of vascular access is an important determinant of procedural success, safety, vascular complications, patient satisfaction, and hospital length of stay during percutaneous coronary intervention (PCI). Although current international guidelines recommend transradial access (TRA) as the preferred approach, comparative data between transradial and transfemoral access (TFA) in the Mongolian population remain limited. Therefore, this study aimed to compare the clinical and patient reported outcomes of the two vascular access strategies in Mongolia. Aim: To compare the clinical outcomes of transradial and transfemoral access in patients undergoing coronary angiography and percutaneous coronary intervention. Materials and Methods: A hospital-based cohort study was conducted including 200 consecutive patients undergoing coronary angiography or PCI. Participants were equally allocated into the transradial access group (TRA, n=100) and the transfemoral access group (TFA, n=100). Demographic characteristics, post procedural pain assessed using the Visual Analogue Scale (VAS), length of hospital stay, access site complications, early mobility, and patient reported satisfaction were evaluated. Patient satisfaction was assessed using a five point Likert scale based on internationally recognized patient reported outcome domains. Statistical analyses were performed using SPSS version 25.0. Continuous variables were compared using the independent samples t-test or Mann-Whitney U test, whereas categorical variables were analyzed using the Chi-square test or Fisher’s exact test. A p-value <0.05 was considered statistically significant. Result: The mean age of the participants was 60.8±11.56 years, and 75.5% were male. Patients treated via transradial access experienced significantly lower post procedural pain than those treated through transfemoral access (VAS: 2.5±0.29 vs. 3.4±0.21; p=0.031). Early mobility within 24 hours after the procedure was significantly better in the TRA group (p=0.009). Minor vascular complications and hematoma (<10 cm) occurred only in the transfemoral group (1.0% each), while no major vascular complications were observed in either group. Patient-reported assessment of treatment outcomes and symptom improvement (p=0.048) and overall patient satisfaction (p=0.041) were significantly higher in the transradial group. No significant differences were observed between the groups regarding perceived healthcare service quality, accessibility, or physician–patient communication (p>0.05). Conclusion Compared with transfemoral access, transradial access was associated with lower post-procedural pain, better early recovery, fewer access-site complications, and higher patient-reported treatment outcomes and overall satisfaction, supporting its use as the preferred vascular access strategy for coronary angiography and PCI.

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide, accounting for approximately 19.8 million deaths in 2022, or 32% of all deaths. Insulin resistance is an important pathophysiological mechanism not only in the development of type 2 diabetes mellitus (T2DM) but also in the development and progression of cardiovascular disease. Evidence remains limited regarding the simultaneous assessment of associations between selected anthropometric measures and insulin resistance in patients with ischemic heart disease (IHD). Aim: To investigate the association between waist-to-height ratio (WHtR) and insulin resistance indices (TG/HDL and HOMA-IR) in patients with chronic ischemic heart disease. Materials and Methods: This hospital-based cross-sectional study included 274 patients aged 40–75 years. Written informed consent was obtained from all participants. Data were collected using a structured questionnaire, anthropometric measurements were performed, and peripheral blood samples were collected. Laboratory measurements included fasting lipid profile, fasting glucose, and fasting insulin levels. WHtR was calculated as waist circumference (cm) divided by height (cm). Insulin resistance was assessed using the TG/HDL ratio, calculated as TG (mmol/L) divided by HDL (mmol/L), and the HOMA-IR index. Metabolic syndrome was defined according to the Joint Interim Statement (JIS-2009) criteria. Results: Among the 274 participants, 209 (76.3%) were male and 65 (23.7%) were female, with a mean age of 61.1±7.9 years. WHtR was significantly and positively correlated with HOMA-IR, with a weak-to-moderate correlation (Spearman’s ρ=0.303, p<0.001). A weak but statistically significant positive correlation was also observed between WHtR and the TG/HDL ratio (ρ=0.136, p=0.039). The discriminative ability of WHtR for insulin resistance was moderate (AUC=0.645, 95% CI: 0.562–0.729; p=0.001). The optimal cutoff value determined using the Youden index was 0.60, with a sensitivity of 63.2% and specificity of 64.2%. Multivariable logistic regression analysis showed that WHtR ≥0.60 was independently associated with insulin resistance. Conclusion WHtR was significantly and positively associated with HOMA-IR and the TG/HDL ratio, and WHtR ≥0.60 was independently associated with insulin resistance.

Background: Type 2 diabetes has increased risk of heart failure 2-4 times more than those in non-diabetic subjects. The early detection of asymptomatic ventricular dysfunction by using NT-pro BNP test in diabetic patients is the best strategy for decreasing morbidity and mortality of heart failure. Aim: The aims of this study were to detect asymptomatic cardiac ventricular dysfunction by using NT-pro BNP test in subjects with type 2 diabetes and to define the factors associated with elevated NT-proBNP. Materials and Methods: This cross-sectional study was included diabetic and non diabetic subjects aged from 35- to 64 years, who had no clinical symptoms of heart failure. Cardiovascular risk factors were detected by clinical examinations. NT-pro BNP determination was performed on an immunoassay analyzer (FIA1100, Getein Bio Medical Inc, China), which uses reagent strip to obtain quantitative NT-pro BNP results in plasma. The cut-off point for NT-pro BNP was 300 pg/ml. Results: A total of 536 subjects without clinical symptoms of heart failure were included in the study of which, 150 were diabetic and 386 were non diabetic. The mean age was 52.8 ± 7.8 years and 281 (52.4%) were females. Cardiac ventricular dysfunction was detected in 7.3% of diabetic and 5.2% of non diabetic subjects. Cardiac ventricular dysfunction in diabetic subjects was increased with age and non-significantly higher in females than in males (8.3% vs 6.4%, p>0.05). In the logistic regression analysis, uncontrolled hypertension (OR 3.80, 95% CI 1.07–13.44), long duration of disease (OR 5.30, 95% CI 1.36-20.66), and ageing (OR 5.40, 95% CI 1.29–22.88) were significantly correlated cardiac ventricular dysfunction in subjects with type 2 diabetes. Conclusion Cardiac ventricular dysfunction in subjects with type 2 diabetes was detected 1.4 times more than those in non diabetic subjects. The likelihood of positive NT-pro BNP test in subjects with type 2 diabetes was independently (p<0.05) associated with advanced age, uncontrolled hypertension and long duration of diabetes.

Background: Patients with rheumatoid arthritis are at increased risk of developing cardiovascular disease. In Mongolia, the registration of inflammatory diseases is increasing every year, and cardiovascular diseases are the leading cause of death. Aim: We aimed to determine the degree of cardiovascular risk and its correlation in people with rheumatoid arthritis. Materials and Methods: The study was conducted in a cross-sectional study design with 64 patients with rheumatoid arthritis between May and November 2024. Cardiovascular risk was assessed using mSCORE and the World Health Organization (WHO) cardiovascular Risk Table. We received ethical approval to begin the research at the MNUMS meeting on May 17, 2024 (No. 2024/3-05). Results: The average age of the participants was 55.2±9.7 years, and the average duration since being diagnosed with RA was 9.8±8.0 years. Among the participants, 82.8% (n=53) were female, and 17.2% (n=11) were male. The mean WHO risk index was 10.25±11, while the mean mSCORE risk index was 2.9±4 (p=0.001). There was a significant difference in mSCORE scores between the 40-55 and 56-65 age groups (p<0.001). In contrast, the mSCORE risk assessment showed that 15.6% (n=10) had high risk, and 6.3% (n=4) had very high risk. Among the parameters of inflammatory biomarkers, CRP (OR=0.05, r=0.35, 95% CI 0.9-3.2, p=0.004) has a statistically significant difference and positive correlation, and HDL-C (OR=2.3, r=-0.25, 95% CI 2.9- 10.0, p<0.0001) was significantly different and negatively correlated. Conclusion A total of 64 participants participated in our study, and according to the WHO assessment, 17.2% were at high or very high risk of developing cardiovascular disease in the next 10 years, and according to the mSCORE, 21.9% were at high or very high risk of developing cardiovascular disease. Although the degree of disease activity was not significantly associated with cardiovascular risk, the inflammatory biomarker C-reactive protein was statistically significantly different or positively associated with cardiovascular risk assessment.

BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.

BACKGROUND. Heart failure is the leading cause of the death among non-communicable diseases. Heart failure is a fatal disease that once its clinical symptoms appeared, five years of survival rate is 50-75%. Chronic heart failures are the main risk factors arterial hypertension, diabetes, obesity and dyslipidemia Thus, early diagnosis before its symptoms are presented and treatment with close monitoring is the most rational and effective approach for decreasing heart failure diseases and deaths caused by it. OBJECTIVE. To determine the level of NT-pro BNP in people with high risk of chronic heart failure and assess its results. METHODS. We conducted hospital-based descriptive study at State Second Central Hospital and Bayanzurkh District Medical Center. Total of 100 participants aged from 35 to 64 who had no symptom of chronic heart failure however with high risk were recruited in this study. Based on the document entitled “Heart failure prevention 2008” of the American Heart Association, old age, arterial hypertension, diabetes mellitus, heart attack and obesity were considered as higher risks of heart failure. Risk factors of heart failure were estimated by questionnaire and physical examination. The level of NT-pro BNP in plasma was determined using FIA8000 analyzer. According to the guideline produced by the European Society of Cardiology in 2016, result of the testing is considered “positive” when NT-pro BNP is higher than 125 pg/ml. Risk factors of chronic heart failure were studied in comparison with two groups which were NT-pro BNP positive and negative results and their statistically significant difference were determined. RESULTS. Of 87 participants, 51 (51%) were female and 49(49%) were male. Half of the participants (51%) were aged between 55-64. Arterial hypertension was determined in 88% of the participant, 38% were overdose drink of alcohol, therefore 55% were 1,2,3 levels obesity and 36% were diabetic. When determining the NT-pro BNP level, in 34 cases (34%) were positive. Hence, 31% of the people with arterial hypertension, 9% of the people overdose drink with alcohol, 20% of the people with obesity, 12% of the people with diabetes showed positive results of NT-pro BNP. When studying the risk factors of chronic heart failure of the compared two groups of NT-pro BNP positive and negative results, statistically significant difference (p<0.05) was increased of the with arterial hypertension and obesity. CONCLUSION. NT-pro BNP is the arterial hypertension and obesity which is increasing for people compared to the other risking factors