Measurement of waist circumference has substantial variability and some limitations, while neck circumference is a simple and reliable anthropometric measure. This study aimed to assess the association between neck circumference and waist circumference and to identify the best cutoff of neck circumference that could predict central obesity in prediabetic patients. This cross-sectional study included adult patients with prediabetes, defined as having fasting plasma glucose levels ranging from 100 to 125 mg/dL or HbA1c ranging from 5.7 to 6.49%, who visited the outpatient clinic of Family Medicine Department, Ramathibodi Hospital, Thailand, during October 2014 and March 2016. Neck circumference was measured from the level just below the laryngeal prominence perpendicular to the long axis of the neck. Central obesity was defined as having waist circumference measurements greater than 90 and 80 cm for males and females, respectively. The correlation between neck circumference and waist circumference was explored by applying pairwise correlation coefficient. Receiver operating characteristic (ROC) curve analysis was performed and Youden index equal to “sensitivity – (1-specificity)” was calculated. Neck circumference that yielded the maximum Youden index was determined as the optimal cutoff point for prediction of central obesity. There were 1,534 patients eligible for this study. After adjusting for covariables, neck circumference was found to be significantly associated with waist circumference in both females and males, with β-coefficients of 1.01 (95% CI: 0.83, 1.20) and 0.65 (95% CI: 0.46, 0.85), respectively. After applying the ROC analysis, neck circumferences ≥ 32 cm in females and ≥ 38 cm in males were determined as the best cutoff values to predict central obesity. Neck circumference is strongly correlated with waist circumference in prediabetics and should be considered as an alternative to the waist circumference measurement in screening for central obesity.

Background. Percutaneous coronary intervention (PCI) practice and outcomes vary substantially in different parts of the world. The contemporary data of PCI in Asia are limited and only available from developed Asian countries. Objectives. To explore the pattern of practice and results of PCI procedures in Thailand as well as a temporal change of PCI practice over time compared with the registry from other countries. Methods. Thai PCI Registry is a prospective nationwide registry that was an initiative of the Cardiac Intervention Association of Thailand (CIAT). All cardiac catheterization laboratories in Thailand were invited to participate during 2018-2019, and consecutive PCI patients were enrolled and followed up for 1year. Patient baseline characteristics, procedural details, equipment and medication use, outcomes, and complications were recorded. Results. Among the 39 hospitals participated, there were 22,741 patients included in this registry. Their mean age (standard deviation) was 64.2 (11.7) years and about 70 were males. The most common presentation was acute coronary syndrome (57) with a high proportion of ST-elevation myocardial infarction (28). Nearly two-thirds of patients had multivessel disease and significant left main stenosis was reported in 11. The transradial approach was used in 44.2. The procedural success rate was very high (95.2) despite the high complexity of the lesions (56.9 type C lesion). The incidence of procedural complications was 5.3 and in-hospital mortality was 2.8. Conclusion. Thai PCI Registry provides further insights into the current practice and outcomes of PCI in Southeast Asia. The success rate was very high, and the complications were very low despite the high complexity of the treated lesions.

The impact of the adherence to the adjunctive use criteria (AUC) for intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) and clinical outcomes in low IVUS volume countries are limited. The current study compared the procedural success and complication rates between used and not used IVUS catheter in the patients who were met (C +) and were not met (C−) the AUC for IVUS-guided PCI. From June 2018 through June 2019, a total of 21,066 patients were included in the Thai PCI registry. Among the study population, 15,966 patients (75.8%) have met the IVUS-AUC. The IVUS-guided PCI rates were 14.5% and 11.3% in the C + and C − groups, respectively. After adjusting for covariables by propensity model, IVUS-guided PCI was identified as an independent predictor of the procedural success rate regardless of whether the AUC were met with the relative risk [RR (95% confidence interval (CI)] of 1.033(1.026–1.040) and 1.012(1.002–1.021) in C + and C− groups, respectively. IVUS-guided PCI increased the procedural complication risks in both groups but were not significant with corresponding RRs of 1.171(0.915–1.426) and 1.693(0.959–2.426). Procedural success was achieved with IVUS-guided PCI regardless of whether the AUC were met. IVUS-guided PCI did not lead to an increase in procedural complications.

Background: Timely reperfusion therapy is recommended for patients with ST-segment elevation myocardial infarction (STEMI), and system delay <90 minutes and door-to-device (D2D) time <60 minutes are recommended by the 2017 ESC Guidelines for the management of STEMI patients and have been proposed as a performance measure for triaging patients for primary percutaneous coronary intervention (PCI). However, previous research produced contradictory results regarding the association between D2D time and mortality. Therefore, this study aimed to examine the associations between D2D time and mortality in Thailand. Methods: This cohort study included STEMI patients treated with primary PCI in 39 PCI centres in Thailand from February 27, 2018, to August 1, 2019. Patients were eligible if they met the following criteria: primary STEMI diagnosis, symptom onset within 12 hours, and ST-segment elevation of at least 0.1 mV in 2 or more contiguous leads (at least 0.2 mV in V1–V3) or a new left bundle branch block. Results: Within 12 hours of symptom onset, 3,874 patients underwent primary PCI. The median D2D time was 54 minutes [interquartile range (IQR) 29–90], and there was a significant difference between patients transferred from other hospitals (44 minutes, IQR 25–77, n=2,871) and patients presented directly to PCI centres (81 minutes, IQR 56–129, n=1,003) (P<0.001). Overall, in-hospital mortality was 7.8%. In a multivariable analysis, adjusting for other predictors of mortality and stratifying according to intervals of D2D time, cumulative in-hospital mortality was significantly higher in patients with a D2D time greater than 90 minutes [hazard ratio (HR) 1.5, 95% confidence interval (CI): 1.0–2.1, P=0.046] but not associated with D2D time shorter than 60 minutes (HR 1.2, 95% CI: 0.8–1.8, P=0.319). Conclusions: A D2D time greater than 90 minutes was related to in-hospital mortality in patients with STEMI treated with primary PCI, but a D2D time less than 60 minutes was not consistently associated with D2D time-improved survival in real-world, contemporary practice in Thailand.