Piyamitr Sritara, MD, FRCP, FACP
Dean, Faculty of Medicine Ramathibodi Hospital,Mahidol University, Thailand
Professor Piyamitr Sritara received his Medical Degree from Faculty of Medicine Ramathibodi Hospital, Mahidol University, in 1982, and completed his internship training in 1983 at Ramathibodi Hospital where he was the Chief Intern. Following his education and training, he worked as a General Practitioner for two years until 1985.
Prof. Sritara was an Honorary Registrar in Cardiology to Dr. Greenbaum of Edgware General Hospital in Middlesex and Dr. Ilsley of Harefield Hospital. In October 1992, he was certified by the Thai Board of Cardiology and became a member of the Committee of the Thai Cardiology Board of Examination in 1994. He has been a Professor of Medicine since 2006. He was appointed as the Dean of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University since December 2015.
Over the course of his career, he has authored and co-authored of research manuscripts published in peer-reviewed medical journals more than 145 articles, h-index 34, Citation 11,614 times, FWCI 14.11 (Updated 21 Apr, 2022), as well as chapters of Cardiology textbooks. His publications were mainly focused on thrombolysis and thrombin inhibition for the management of myocardial infarction, PCSK9 in acute coronary syndrome and arterial stiffness. His recent research includes Cardiovascular Epidemiology in Thailand and Asia Pacific Cohort Studies Collaboration.
Cardio-ankle vascular index as a predictor of major adverse cardiovascular events in metabolic syndrome patients
Thosaphol Limpijankit1, Prin Vathesatogkit1, Dujrudee Matchariyakul2, Teerapat Yingchoncharoen1, Sukanya Siriyotha3, Ammarin Thakkinstian3, Piyamitr Sritara1
1 Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
2 Medical and Health Office, Electricity Generating Authority of Thailand, Bangkruay, Thailand.
3 Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Background: Arterial stiffness, as reflected in the cardio-ankle vascular index (CAVI), is a risk factor for major adverse cardiovascular events (MACEs).
Hypothesis: Combining CAVI and metabolic syndrome (MetS) may enhance prediction of MACEs in a general adult population.
Methods: A total of 3807 employees of the Electricity Generating Authority of Thailand were enrolled in a longitudinal health study during 2007-2008. Baseline characteristics were collected and CAVI determined. Subjects with previous coronary artery disease or stroke were excluded from analysis. MetS was defined using the modified NCEP-ATP III for Asians. The primary study endpoint was occurrence of a MACE (myocardial infarction, stroke, or
Results: MetS was present in 39.2% at study baseline. The prevalence of CAVI > 9 was higher in subjects with MetS compared to those without (33.7% vs. 28.5%, P = 0.001). During the 12.4 ± 0.6 years follow-up, 227 participants developed MACEs and 350 died. MetS was more common in patients who developed a MACE (8.2% vs. 5.0%, p < 0.001) than was non-MetS, but it was not a significant risk after adjusting covariables. Participants with CAVI > 9 had greater risk for MACEs 1.34 (95% CI: 1.01, 1.79) relative to those with CAVI < 9. Participants with both MetS and CAVI > 9 had the worst outcomes, with the highest frequency of MACEs, among the four groups.
Conclusion: Arterial stiffness assessed by CAVI may enhance prediction of future MACEs, adding to the null predictive power of MetS. This index can be used to motivate MetS patients to modify their life-styles for prevention.
Source: Limpijankit T, Sritara P et al. Clin Cardiol. 2021; 44: 1628-1635.