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Chen CC, Wu PW, Tsay PK, Wang CC, Toh CH, Wan YL. Subtracted Computed Tomography Angiography in the Evaluation of Coronary Arteries With Severe Calcification or Stents Using a 320-Row Computed Tomography Scanner. J Thorac Imaging 2020; 35:317-325. [PMID: 32073538 DOI: 10.1097/rti.0000000000000480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Coronary computed tomography angiography (CCTA) has its limitations in evaluating arteries with stents or heavy calcification. This study compares the diagnostic performance of subtracted coronary computed tomography angiography (SCCTA) and nonsubtracted coronary computed tomography angiography (NSCCTA) in evaluating coronary artery disease (CAD) and in-stent restenosis (ISR). MATERIALS AND METHODS Twelve patients with stents and 20 patients with heavy coronary calcifications (total Agatston's score >400) underwent both SCCTA and invasive coronary angiography (ICA) with an interval of <3 months. Four subjects in the stented group also had heavy calcifications. Overall, 30 stented segments and 202 calcified segments were assessed to compare the diagnostic performance of SCCTA and NSCCTA in detecting ISR and CAD. RESULTS For the 30 stented segments, SCCTA/NSCCTA had a sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) (shown in %) of 66.7/100, 100/55.6, 96.7/60, 100/20, and 96.4/100 in diagnosing ISR, respectively. For the 202 calcified segments, SCCTA/NSCCTA had a sensitivity, specificity, accuracy, PPV, and NPV of 68.8/84.4, 97.6/76.5, 93.1/77.7, 84.6/40.3, and 94.3/96.3 in diagnosing CAD, respectively. For both stented and calcified segments, SCCTA was significantly superior to NSCCTA in specificity and accuracy. For the calcified segments, SCCTA was significantly superior to NSCCTA in PPV. There was no significant difference in the diagnostic performance of SCCTA between the stented and calcified segments. CONCLUSIONS The diagnostic accuracy and specificity of SCCTA are significantly superior to those of NSCCTA in evaluating CAD and ISR. SCCTA shows no statistical difference in its diagnostic performance between the stented and calcified segments.
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Affiliation(s)
- Chun-Chi Chen
- Section of Cardiology, Department of Internal Medicine
| | - Patricia Wanping Wu
- Department of Medical Imaging and Intervention, Linkou and Taoyuan Chang Gung Memorial Hospital
| | - Pei-Kwei Tsay
- Department of Public Health and Center of Biostatistics, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Cheng-Hong Toh
- Department of Medical Imaging and Intervention, Linkou and Taoyuan Chang Gung Memorial Hospital
| | - Yung-Liang Wan
- Department of Medical Imaging and Intervention, Linkou and Taoyuan Chang Gung Memorial Hospital
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Ajtahed SS, Rezapour T, Etemadi S, Moradi H, Habibi Asgarabad M, Ekhtiari H. Efficacy of Neurocognitive Rehabilitation After Coronary Artery Bypass Graft Surgery in Improving Quality of Life: An Interventional Trial. Front Psychol 2019; 10:1759. [PMID: 31440180 PMCID: PMC6694840 DOI: 10.3389/fpsyg.2019.01759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/15/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction Cognitive deficits are frequent after coronary artery bypass graft (CABG) surgery and consequently could lead to a decrease in quality of life. This is the first study that has been conducted with the aim of examining the efficacy of a computerized cognitive rehabilitation therapy (CCRT) in improving quality of life in patients after CABG surgery. Methods In this study, an interventional trial with pre-, post-, and follow-up assessments in active (CCRT), active control and control groups was conducted. Seventy-five patients after CABG surgery were selected and assigned to the groups (n = 25 for each group). CCRT consists of four modules of attention, working memory, response inhibition and processing speed training with graded schedule in 20-min sessions three times per week within 8 weeks. Cognitive functions (attention and working memory) were assessed by the tests of continuous performance, Flanker, useful field of view and digit span at three time points: pre- and post-intervention (T0 and T1) and 6-month follow-up (T2). Quality of life was assessed by the SF-36 questionnaire at the same time points. The CCRT group received the cognitive rehabilitation for 2 months, active control group received a sham version of CCRT in an equal time duration and control group did not receive any cognitive intervention. Results Repeated measures analysis of variance (ANOVA) revealed a time by group interaction on cognitive functions, with CCRT producing a significant improvement at T1 (p < 0.01) and these improvements were maintained at T2. Moreover, in CCRT and active control groups, quality of life (QoL) improved at T1 and these improvements remained stable throughout follow-up (T2). However, improvement of QoL in CCRT group was greater than improvement of QoL in the other two groups at T1. Pearson’s correlation analysis shows a positive correlation between QoL improvement and sustained attention and working memory enhancement (p < 0.05). Conclusion Cognitive rehabilitation can lead to a significant improvement in the cognitive functions that have been trained in patients receiving CABG. Interestingly enough, cognitive rehabilitation can also improve quality of life in patients after CABG surgery and this improvement is maintained for at least 6 months.
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Affiliation(s)
| | - Tara Rezapour
- Department of Psychology, University of Tehran, Tehran, Iran
| | | | - Hadi Moradi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Mojtaba Habibi Asgarabad
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Ekhtiari
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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53
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Inflammation and coronary artery disease: from pathophysiology to Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). Coron Artery Dis 2019; 29:429-437. [PMID: 29652673 DOI: 10.1097/mca.0000000000000625] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The worldwide prevalence of cardiovascular disease in general and atherosclerotic coronary artery disease in particular is a health and economic concern of unparalleled proportion. Despite a long history of astute observations beginning in 1575 made by Fallopius, followed by those of von Rokatansky, Virchow, Osler, and Ross, and incremental knowledge of the pathobiology of atherosclerosis to include varying stages of inflammation, response to internally and externally mediated vascular injury, and impaired homeostasis, gaps in the field's understanding persist. Here, we summarize the current scope of the problem for coronary artery disease, emerging constructs in its pathobiology and common clinical phenotypes, potentially useful biomarkers, clinical trials designed specifically to test the 'inflammation hypothesis' of disease, and the interface of pathobiology and precision medicine as a foundation for diagnosis, management, and future advances in the diagnosis, prognosis, natural history, prevention, and optimal management.
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Poorzand H, Tsarouhas K, Hozhabrossadati SA, Khorrampazhouh N, Bondarsahebi Y, Bacopoulou F, Rezaee R, Jafarzadeh Esfehani R, Morovatdar N. Risk factors of premature coronary artery disease in Iran: A systematic review and meta-analysis. Eur J Clin Invest 2019; 49:e13124. [PMID: 31038733 DOI: 10.1111/eci.13124] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/25/2019] [Accepted: 04/26/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this study was to determine the mean age at which coronary artery disease (CAD) hase decreased in recent years in Iran. This systematic review and meta-analysis compares the prevalence of different risk factors of premature CAD (PCAD) in patients vs healthy individuals. METHODS Medline, Web of Science, Embase and Scientific Information Database were searched for studies about PCAD risk factors in Iran until 28 October 2017. Observational studies of Iranians, comparing risk factors between patients with PCAD and age- and sex-matched healthy subjects, were included. Fixed-effects and random-effects model were used for pooling data. Odds ratio (OR) with 95% CI and mean difference were used for effect size estimation among studies. RESULTS Twelve studies were eligible for meta-analysis. Diabetes mellitus (OR: 2.4, 95% CI: 1.9-3.03; P = 0.0001, I2 = 25.5%; P = 0.2), family history of CAD (OR: 2.09, 95% CI: 1.22-3.6; P = 0.007, I2 = 86%; P = 0.0001), dyslipidaemia (OR: 2.05, 95% CI: 1.15-3.64; P = 0.01, I2 = 54%; P = 0.08), smoking (OR: 1.65, 95% CI: 1.11-2.46; P = 0.01, I2 = 77.2%; P = 0.000) and hypertension (OR: 1.35, 95% CI: 1.21 to-1.50; P < 0.001, I2 = 31%, P = 0.1) associated with PCAD. Sensitivity analysis demonstrated that patients with PCAD had significantly lower levels of high-density lipoprotein (HDL) cholesterol and significantly higher levels of triglycerides compared to healthy subjects (MD: -2.56, 95% CI: -3.54 to -1.58, P < 0.001, I2 = 42%, P = 0.01 and MD: 21.17, 95% CI: 14.73-27.62, P < 0.001, I2 = 80.12%, P < 0.001, respectively). It should be noted that although high levels of heterogeneity in LDL and HDL values among the studies were observed, when dyslipidaemia was studied as a binary variable, no significant heterogeneity among studies was observed. CONCLUSION Diabetes mellitus, family history of CAD, dyslipidaemia, smoking, and hypertension were significantly and positively associated with CAD in young adults compared to healthy age- and sex-matched population in Iran.
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Affiliation(s)
- Hoorak Poorzand
- Atherosclerosis Prevention Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Konstantinos Tsarouhas
- Department of Cardiology, University Hospital of Larissa, Larissa, Greece.,Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | | | - Nastaran Khorrampazhouh
- Students Research Committee, Faculty of Medicine, Mashhad University of medical sciences, Mashhad, Iran
| | - Yones Bondarsahebi
- Students Research Committee, Faculty of Medicine, Mashhad University of medical sciences, Mashhad, Iran
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ramin Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Chemical Engineering, Aristotle University of Thessaloniki, Environmental Engineering Laboratory, University Campus, Thessaloniki, Greece.,HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Thessaloniki, Greece
| | - Reza Jafarzadeh Esfehani
- Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Morovatdar
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Prevalence and Risk Factors of Hypertension in the Vietnamese Elderly. High Blood Press Cardiovasc Prev 2019; 26:239-246. [PMID: 31020550 DOI: 10.1007/s40292-019-00314-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/02/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Hypertension (HT) is considered as a major determinant of cardiovascular complications. However, few studies have addressed HT prevalence among adults aged 60 years and older in the northern mountainous region of Vietnam. AIM To determine the prevalence of HT and its risk factors in the elderly in that area. METHODS A cross-sectional study was conducted in a study area in the northern of Vietnam. We interviewed 354 adults aged 60 years or over who were randomly selected, and then measured their blood pressure. RESULTS The overall HT prevalence was 62.15%. The isolated systolic hypertension (ISH) prevalence was 22.88%. There was a slight decrease in the proportion of HT by stage 1, stage 2 and stage 3 respectively. The univariate and multivariate logistic regression analysis indicated some risk factors for HT including age groups, body mass index (BMI) and waist-hip ratio (WHR) (p < 0.05). Furthermore, we also found that the risk factors of ISH was obesity status classified by BMI category and WHR (p < 0.05). In particularly, the ethnicity was statistically significantly associated with ISH. CONCLUSION Our data showed a high prevalence of hypertension in the elderly in studied area. The risk factors for HT and ISH among studied subjects included age groups, ethnic groups, BMI and WHR. Hence, these findings are important for policy-making related to launch public health prevention and control campaigns for hypertension among older adults in the northern mountainous region of Vietnam.
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Severino P, D'Amato A, Netti L, Pucci M, Infusino F, Maestrini V, Mancone M, Fedele F. Myocardial Ischemia and Diabetes Mellitus: Role of Oxidative Stress in the Connection between Cardiac Metabolism and Coronary Blood Flow. J Diabetes Res 2019; 2019:9489826. [PMID: 31089475 PMCID: PMC6476021 DOI: 10.1155/2019/9489826] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/23/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022] Open
Abstract
Ischemic heart disease (IHD) has several risk factors, among which diabetes mellitus represents one of the most important. In diabetic patients, the pathophysiology of myocardial ischemia remains unclear yet: some have atherosclerotic plaque which obstructs coronary blood flow, others show myocardial ischemia due to coronary microvascular dysfunction in the absence of plaques in epicardial vessels. In the cross-talk between myocardial metabolism and coronary blood flow (CBF), ion channels have a main role, and, in diabetic patients, they are involved in the pathophysiology of IHD. The exposition to the different cardiovascular risk factors and the ischemic condition determine an imbalance of the redox state, defined as oxidative stress, which shows itself with oxidant accumulation and antioxidant deficiency. In particular, several products of myocardial metabolism, belonging to oxidative stress, may influence ion channel function, altering their capacity to modulate CBF, in response to myocardial metabolism, and predisposing to myocardial ischemia. For this reason, considering the role of oxidative and ion channels in the pathophysiology of myocardial ischemia, it is allowed to consider new therapeutic perspectives in the treatment of IHD.
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Affiliation(s)
- Paolo Severino
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea D'Amato
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Lucrezia Netti
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Mariateresa Pucci
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Fabio Infusino
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Viviana Maestrini
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Zaribaf F, Mohammadifard N, Sarrafzadegan N, Karimi G, Gholampour A, Azadbakht L. Dietary patterns in relation to lipid profiles among Iranian adults. J Cardiovasc Thorac Res 2019; 11:19-27. [PMID: 31024668 DOI: 10.15171/jcvtr.2019.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/01/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: Lipid metabolism is one of the main concerns of cardiovascular disease and atherosclerosis. Little is known about the association between dietary patterns and dyslipidemia. Therefore, the present study aimed to determine such association among Iranian adults. Methods: This cross-sectional study was conducted on 1433 Iranian adults in Isfahan Healthy Heart Program (IHHP). Usual dietary intakes were assessed with the use of a 48 items food frequency questionnaire (FFQ). Factor analysis was used to identify dietary patterns. Three major dietary patterns were identified: western, semi healthy and healthy fat patterns. Results: After adjustment, subjects in the upper quartiles of western dietary pattern were more likely to have high total cholesterol concentrations than those in the first quartile (odds ratio [OR]: 2.07; 95% CI: 1.25-3.42). Individuals with greater adherence to western dietary pattern had greater odds of having high low-density lipoprotein-cholesterol (LDL-C) levels compared with those in the lowest quartiles (2.53; 1.45-4.40). Conclusion: Semi healthy dietary pattern was not associated with cardiovascular disease (CVD) risk factors. Same trend was observed for healthy fat dietary pattern. Significant association was found between western dietary pattern and dyslipidemia among Iranian adults.
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Affiliation(s)
- Fatemeh Zaribaf
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golgis Karimi
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abdolali Gholampour
- Isfahan Health Center (No.2), Isfahan Provincial Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Sharif Nia H, Sivarajan-Froelicher E, Haghdoost AA, Moosazadeh M, Huak-Chan Y, Farsavian AA, Nazari R, Yaghoobzadeh A, Goudarzian AH. The estimate of average age at the onset of acute myocardial infarction in Iran: A systematic review and meta-analysis study. ARYA ATHEROSCLEROSIS 2019; 14:225-232. [PMID: 30783413 PMCID: PMC6368197 DOI: 10.22122/arya.v14i5.1739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Research indicates that the age of onset of first acute myocardial infarction (AMI) is an essential element in the life expectancy that has been decreasing in developing countries. There are various studies performed in Iran reporting a range of ages at time of AMI. Thus, this meta-analysis study is designed to determine the mean age at first AMI in the Iranian population. METHODS All studies that met the inclusion and exclusion criteria were reviewed using standard keywords in the databases from 2000 to 2016. Two raters verified a total of 658 articles. Sixteen studies met the inclusion criteria of this study for meta-analysis. Cochran test and I-squared (I2) were used for samples’ homogeneity. Pooled estimates of mean were calculated using the random effects inverse-variance model. RESULTS The mean age of AMI varied between 55.9 to 62.9 years among the primary studies. The pooled mean age of first AMI with a 95% confidence interval (CI) for the total sample, men, and women were 59 (58.9, 60.4), 58.7 (58.3, 59.2), and 64.2 (63.5, 64.8), respectively. CONCLUSION Our meta-analysis shows that the mean age of first onset of AMI in Iranian people is slightly lower than that reported elsewhere; and it is lower for men than for women.
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Affiliation(s)
- Hamid Sharif Nia
- Assistant Professor, Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erika Sivarajan-Froelicher
- Professor, Department of Physiological Nursing, School of Nursing AND Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Ali Akbar Haghdoost
- Professor, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Moosazadeh
- Assistant Professor, Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yiong Huak-Chan
- Head of Biostatistics Unit, Department of Biostatistics, School of Medicine, National University Health System, Singapore, Singapore
| | - Ali Asghar Farsavian
- Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghieh Nazari
- Assistant Professor, Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ameneh Yaghoobzadeh
- PhD Candidate, Department of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Goudarzian
- MSc Student, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Rahmani Vasokolaei Z, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Saatchi K, Poshtchaman Z, Sieloff C, Vaismoradi M. Comparison of the Effects of Hand Reflexology versus Acupressure on Anxiety and Vital Signs in Female Patients with Coronary Artery Diseases. Healthcare (Basel) 2019; 7:E26. [PMID: 30754687 PMCID: PMC6473738 DOI: 10.3390/healthcare7010026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 01/27/2023] Open
Abstract
Hospitalization in the cardiac care unit can increase anxiety in patients. This study aimed to compare hand reflexology versus acupressure on anxiety and vital signs in female patients with coronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre- and post-intervention design was conducted on 135 female patients with coronary artery diseases. Female patients hospitalized in a cardiac care unit were randomly divided into three groups of hand reflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of random numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs were measured before, immediately after and half an hour after the intervention. Data analysis was performed using descriptive and analytical statistics. Before the intervention, there was no statistically significant difference in anxiety levels between the groups (p > 0.05). Also, the effects of hand reflexology and acupressure immediately and half an hour later on the reduction of anxiety and vital signs were equal (p < 0.05). Implementation of hand reflexology and acupressure can have positive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce patients' anxiety with an equal effectiveness.
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Affiliation(s)
- Zohre Rahmani Vasokolaei
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran 3319118651, Iran.
| | - Nahid Rejeh
- Elderly Care Research Center, Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran 3319118651, Iran.
| | - Majideh Heravi-Karimooi
- Elderly Care Research Center, Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran 3319118651, Iran.
| | - Seyed Davood Tadrisi
- Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran 1435915371, Iran.
| | - Kiarash Saatchi
- Iranian Scientific Acupuncture Association, Tehran 1414734117, Iran.
| | - Zahra Poshtchaman
- Department of Nursing, Sabzevar University of Medical Sciences, Sabzevar 9617913114, Iran.
| | - Christina Sieloff
- College of Nursing, Montana State University, Bozeman, MT 59715, USA.
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø 8049, Norway.
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Ul Amin R, Ahmedani MAM, Karim M, Raheem A. Correlation between Gensini Score and Duration of Diabetes in Patients Undergoing Coronary Angiography. Cureus 2019; 11:e4010. [PMID: 31001464 PMCID: PMC6450596 DOI: 10.7759/cureus.4010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 11/05/2022] Open
Abstract
Introduction The relationship between the duration of diabetes mellitus and coronary artery disease (CAD) is well established. Moreover, the Gensini score system is a reliable assessment tool for the severity of coronary artery disease (CAD). After an extensive literature search, we found that there is a knowledge gap about the relationship between the Gensini score and the duration of diabetes in our population. Therefore, the aim of this study was to find the relationship between the Gensini score and the duration of diabetes in patients undergoing a coronary angiography. Methods A cross-sectional study was conducted among 321 consecutively selected diabetic patients. Clinically diagnosed cases of diabetes on proper anti-diabetic treatment were included in this study. Patients with known severe CAD or history of coronary artery bypass grafting (CABG) surgery or primary coronary intervention (PCI) were excluded from the study. Coronary angiography was performed on all the patients and their Gensini score was calculated using the modified scoring schema. Duration of diabetes and other baseline risk factors were recorded for all patients. The relationship between the Gensini score and the duration of diabetes was assessed by calculating Pearson's correlation coefficient. Results A total of 321 diabetic patients were included in this study, out of which 67.9% (218) were men and mean ± standard deviation age was 56.13 ± 7.67 years ranging between 40 to 70 years with a majority of the patients, 63.9% (205), being under 60 years of age. Along with diabetes, the most commonly observed risk factor was hypertension, which was observed in 77.6% (249) of the patients. Smoking and obesity were also observed in 18.7% (60) and 17.4% (56) of the patients, respectively. A significant positive correlation, 0.55 (p<0.001), was observed between the duration of diabetes and the Gensini scores. The correlation was found to be stronger in older patients (more than 60 years of age) with a correlation coefficient of 0.52 vs. 0.38, and male patients with correlation coefficients of 0.66 vs. 0.34. Conclusion A significant positive correlation between the Gensini score and the duration of diabetes mellitus was observed. This correlation is relatively stronger among male and older patients (more than 60 years of age).
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Affiliation(s)
- Razi Ul Amin
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | | | - Musa Karim
- Miscellaneous, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Ahmed Raheem
- Pathology, Aga Khan University Hospital, Karachi, PAK
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Adegoke O, Awolola NA, Ajuluchukwu JN. Prevalence and pattern of cardiovascular-related causes of out-of- hospital deaths in Lagos, Nigeria. Afr Health Sci 2018; 18:942-949. [PMID: 30766558 PMCID: PMC6354864 DOI: 10.4314/ahs.v18i4.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background In developed countries 50% – 75% of deaths from cardiovascular-diseases occurs out-of-hospital. In Nigeria where patronage of orthodox health facilities is low, the impact of cardiovascular-related diseases on out-of-hospital mortality has been sparsely studied. Objectives To determine the prevalence and pattern of cardiovascular-related causes of out-of-hospital deaths in Lagos, Nigeria. Methods A 5-year retrospective review of all autopsied medical decedents brought-in-dead (BID) to a Nigerian tertiary health facility to identify cardiovascular-related causes of death. Results A total of 90 cardiovascular-related deaths out of 176 medical BID cases were identified, giving a prevalence of 51.1%. Mean age was 65.2 ± 15.6 years. Male: Female ratio was 1.4: 1, the females were older (68.29 ± 14.89) vs (61.63 ± 15.55) years. Age group > 60 years accounted for 63.3% of deaths. Commonest primary diseases were hypertensive heart disease (48.9%) and cerebrovascular accident (24.4%). Myocardial infarction occurred in 8.9%. Heart failure, cerebral dysfunction and unspecified circulatory collapse were the causes of death in 54.4%, 23.3% and 14.4% respectively. Conclusion Cardiovascular-related diseases are major contributors to out-of-hospital medical deaths occurring chiefly in those >60 years. Hypertensive heart disease and heart failure are the greatest contributors to this cardiovascular-related disease mortality.
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Affiliation(s)
- Oluseyi Adegoke
- College of Medicine, University of Lagos, Nigeria, Department of Medicine
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Lepik D, Tõnisson M, Kuudeberg A, Väli M. Glycated haemoglobin (HbA 1c) for postmortem diagnosis of diabetes. Forensic Sci Res 2018; 3:170-177. [PMID: 30483666 PMCID: PMC6197130 DOI: 10.1080/20961790.2018.1452354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 03/12/2018] [Indexed: 11/24/2022] Open
Abstract
The study was conducted at the Estonian Forensic Science Institute in 2008–2014 as continuous part of our previous study of alcohol and premature death in Estonian men. Autopsy data from 504 cases of male deaths (ages 19–79) were collected and blood and urine samples for glycated haemoglobin (HbA1c), liver enzymes and alcohol concentration were analysed. The aim of our research was to find undiagnosed diabetes and diabetes risk cases postmortem on the basis of increased values of HbA1c. HbA1c was within the reference value 4.8%–5.9% (29–42 mmol/mol), in 88.1% (n = 444) of cases, below reference value in 2.4% (n = 12), in the risk group of diabetes, HbA1c 6.0%–6.4% (42–46 mmol/mol) was within 5.8% (n = 29), and HbA1c result of ≥6.5% (48 mmol/mol) manifested in 3.8% (n = 19) of cases. The higher the age, the more cases with HbA1c value ≥6.0% (42 mmol/mol) occurred. In the group of external causes of death (n = 348), the HbA1c value of ≥6.5% (48 mmol/mol) HbA1c occurred in four cases. The HbA1c value was ≥6.5% (48 mmol/mol) in 78.9% of 156 cases when the cause of death was disease, of which 58% were cardiovascular diseases. The prevalence of diabetes and diabetes risk was found lower compared to population-based study, as majority of the deceased were young and middle-aged males and no females were included. In the case of poisoning with narcotic substances, HbA1c was within the reference range. A negative correlation occurred between alcohol intoxication and HbA1c value. A positive correlation between ALT and HbA1c was found – the higher stage of liver damage correlated with the higher HbA1c level.
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Affiliation(s)
- Delia Lepik
- Department of Pathological Anatomy and Forensic Medicine, Faculty of Medicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu,Estonia
| | - Mailis Tõnisson
- Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Southern Estonian Forensic Medical Examination Department, Estonian Forensic Science Institute, Tallinn, Estonia
| | - Anne Kuudeberg
- Department of Pathological Anatomy and Forensic Medicine, Faculty of Medicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu,Estonia
| | - Marika Väli
- Department of Pathological Anatomy and Forensic Medicine, Faculty of Medicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu,Estonia.,Management Board, Estonian Forensic Science Institute, Tallinn, Estonia
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Automated determination of cardiac rest period on whole-heart coronary magnetic resonance angiography by extracting high-speed motion of coronary arteries. Clin Imaging 2018; 52:183-188. [PMID: 30098491 DOI: 10.1016/j.clinimag.2018.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/04/2018] [Accepted: 07/05/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of the present study was to develop an automated system for determining the cardiac rest period during whole-heart coronary magnetic resonance angiography (CMRA) examination. MATERIALS AND METHODS Ten healthy male volunteers (25-51 years old, 50-77 beats/min heart rate) were enrolled in this prospective study. A motion area map was generated from a cine image set by extracting high-speed component of cardiac motion, and it was used to specify the rest period in the proposed CMRA. In conventional CMRA, the rest period was determined based on the visual inspection of cine images. Agreement of the start time, end time, and trigger time between the two methods was assessed by the Bland-Altman plot analysis. Two observers visually evaluated the quality of the curved planar reformation (CPR) image of the coronary arteries. RESULTS The proposed method significantly prolonged the start time (mean systematic difference 37.7 ms, P < 0.05) compared with the conventional method. Good agreement was observed for the end time (mean systematic difference 8.9 ms) and trigger time (mean systematic difference -28.8 ms) between the two methods. A significantly higher image quality (P < 0.05) was provided for the left circumflex artery in the proposed CMRA (mean grading score 3.88) than in conventional CMRA (mean grading score 3.68). CONCLUSION Our system enabled detection of the rest period automatically without operator intervention and demonstrated somewhat higher image quality compared with conventional CMRA. Its use may be useful to improve the imaging workflow for CMRA in clinical practice.
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Heart-type fatty acid binding protein (H-FABP) as a biomarker for acute myocardial injury and long-term post-ischemic prognosis. Acta Pharmacol Sin 2018; 39:1155-1163. [PMID: 29770799 DOI: 10.1038/aps.2018.37] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 02/28/2018] [Indexed: 12/11/2022] Open
Abstract
Acute myocardial infarction (AMI) is a life-threatening event. Even with timely treatment, acute ischemic myocardial injury and ensuing ischemia reperfusion injury (IRI) can still be difficult issues to tackle. Apart from radiological and other auxiliary examinations, laboratory tests of applicable cardiac biomarkers are also necessary for early diagnosis and close monitoring of this disorder. Heart-type fatty acid binding protein (H-FABP), which mainly exists inside cardiomyocytes, has recently emerged as a potentially promising biomarker for myocardial injury. In this review we discuss the sensitivity and specificity of H-FABP in the assessment of myocardial injury and IRI, especially in the early stage, and its long-term prognostic value in comparison with other commonly used cardiac biomarkers, including myoglobin (Mb), cardiac troponin I (cTnI), creatine kinase MB (CK-MB), C-reactive protein (CRP), glycogen phosphorylase isoenzyme BB (GPBB), and high-sensitivity cardiac troponin T (hs-cTnT). The potential and value of combined application of H-FABP with other biomarkers are also discussed. Finally, the prospect of H-FABP is summarized; several technical issues are discussed to facilitate wider application of H-FABP in clinical practice.
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Bonny A, Tibazarwa K, Mbouh S, Wa J, Fonga R, Saka C, Ngantcha M. Epidemiology of sudden cardiac death in Cameroon: the first population-based cohort survey in sub-Saharan Africa. Int J Epidemiol 2018; 46:1230-1238. [PMID: 28453817 PMCID: PMC5837681 DOI: 10.1093/ije/dyx043] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 11/18/2022] Open
Abstract
Background Incidence estimates of sudden cardiac death (SCD) in sub-Saharan Africa (SSA) are unknown. Method Over 12 months, the household administrative office and health community committee within neighbourhoods in two health areas of Douala, Cameroon, registered all deaths among 86 188 inhabitants aged >18 years. As part of an extended multi-source surveillance system, the Emergency Medical Service (EMS), local medical examiners and district hospital mortuaries were also surveyed. Whereas two physicians investigated every natural death, two cardiologists reviewed all unexpected natural deaths. Results There were 288 all-cause deaths and 27 (9.4%) were SCD. The crude incidence rate was 31.3 [95% confidence interval (CI): 20.3–40.6]/100 000 person-years. The age-standardized rate by the African standard population was 33.6 (95% CI: 22.4–44.9)/100 000 person-years. Death occurred at night in 37% of cases, including 11% of patients who died while asleep. Out-of-hospital sudden cardiac arrest occurred in 63% of cases, 55.5% of which occurred at home. Of the 88.9% cases of witnessed cardiac arrest, 63% occurred in the presence of a family member and cardiopulmonary resuscitation was attempted only in 3.7%. Conclusion The burden of SCD in this African population is heavy with distinct characteristics, whereas awareness of SCD and prompt resuscitation efforts appear suboptimal. Larger epidemiological studies are required in SSA in order to implement preventive measures, especially in women and young people.
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Affiliation(s)
- Aimé Bonny
- Cameroon Cardiovascular Research Network, Douala, Cameroon.,University of Douala, Department of Clinical Sciences, Douala, Cameroon.,Cardiovascular Research Unit, Department of Cardiology, Clinique Paul Picquet, Sens, France
| | - Kemi Tibazarwa
- The Jakaya Kikwete Cardiac Institute, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Samuel Mbouh
- Institut national de la jeunesse et sport (INJS), Yaoundé, Cameroon
| | - Jonas Wa
- Hôpital de District de Bonassama, Douala, Cameroon
| | - Réné Fonga
- Hôpital de District de New-Bell, Douala, Cameroon
| | - Cecile Saka
- Service de cardiologie, hôpital Laquintinie de Douala, Cameroon
| | - Marcus Ngantcha
- Cameroon Cardiovascular Research Network, Douala, Cameroon.,Cardiovascular Research Unit, Department of Cardiology, Clinique Paul Picquet, Sens, France
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Rahimi R, Singh MKC, Noor NM, Omar E, Noor SM, Mahmood MS, Abdullah N, Nawawi HM. Manifestation of Coronary Atherosclerosis in Klang Valley, Malaysia: An Autopsy Study. J Atheroscler Thromb 2018; 25:405-409. [PMID: 29118310 PMCID: PMC5945553 DOI: 10.5551/jat.39107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aims: The present study aimed to determine the epidemiological aspects of medico-legal autopsies and manifestation of coronary atherosclerosis. Methods: This was a cross sectional study involving 222 cases recruited from National Institute of Forensic Medicine (NIFM) Hospital Kuala Lumpur (HKL) and Department of Forensic Medicine Hospital Sungai Buloh (HSgB) for a period of 15 months, from December 2012 to April 2014. Sociodemographic and autopsy findings, including the cause and manner of death were documented. Results: Male and female subjects aged 18–70 years were recruited. Males contributed to 86% of the total subjects and comprised 61% of young adults. Road traffic accidents were the primary cause of death, contributing almost 50% of the subjects. One third of the cases comprised of death due to natural causes, wherein almost 75% of the subjects within this category succumbed to sudden cardiac death. Coronary artery disease (CAD) contributed to 60% of the sudden cardiac death (SCD). Single and double-vessel diseases were the most common pattern of atherosclerosis. In almost 80% of CAD cases, atherosclerosis affected the left anterior descending artery (LAD). Conclusion: Cardiovascular diseases were the most significant natural cause of sudden death with a staggering figure of 75%. CAD was the single most commonly encountered pathology within the SCD. Most cases presented with single and double-vessel diseases, observed in all subjects, as well as the young adult population.
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Affiliation(s)
- Razuin Rahimi
- The Centre for Pathology Diagnostic and Research Laboratories (CPDRL), Faculty of Medicine, Universiti Teknologi MARA.,Department of Forensic Medicine, Hospital Sungai Buloh
| | - Mansharan Kaur Chainchel Singh
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA.,National Institute of Forensic Medicine, Hospital Kuala Lumpur
| | - Norizal Mohd Noor
- The Centre for Pathology Diagnostic and Research Laboratories (CPDRL), Faculty of Medicine, Universiti Teknologi MARA
| | - Effat Omar
- The Centre for Pathology Diagnostic and Research Laboratories (CPDRL), Faculty of Medicine, Universiti Teknologi MARA
| | | | | | | | - Hapizah Mohd Nawawi
- The Centre for Pathology Diagnostic and Research Laboratories (CPDRL), Faculty of Medicine, Universiti Teknologi MARA.,Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA
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Wang Y, Huang Q, Liu J, Wang Y, Zheng G, Lin L, Yu H, Tang W, Huang Z. Vascular endothelial growth factor A polymorphisms are associated with increased risk of coronary heart disease: a meta-analysis. Oncotarget 2018; 8:30539-30551. [PMID: 28430629 PMCID: PMC5444763 DOI: 10.18632/oncotarget.15546] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 02/08/2017] [Indexed: 02/06/2023] Open
Abstract
Coronary heart disease (CHD) is a common complex disease resulting from the interaction of multiple environmental and genetic factors. To assess the potential relationship of vascular endothelial growth factor (VEGFA) rs699947 C>A, rs3025039 C>T and rs2010963 G>C polymorphisms with CHD risk, a comprehensive meta-analysis was conducted. A systematic search of EMBASE and PubMed online database for publications on VEGFA polymorphisms and risk of CHD was carried out. Crude Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated to determine the association. A total of ten publications including 22 trails involving 2097 cases and 2867 controls were included in our pooled analysis. Overall, results of the present meta-analysis demonstrated a significant association between VEGFA rs699947 C>A polymorphism and an increased risk of CHD. After stratifying by ethnicity and CHD type, the association was also obtained. A significant association between VEGFA rs3025039 C>T polymorphism and risk of CHD was also found. For VEGFA rs2010963 G>C polymorphism, the polymorphism was associated with MI risk. In conclusion, our findings suggest that VEGFA rs699947 C>A, rs3025039 C>T and rs2010963 G>C polymorphisms are risk factors for CHD. In the future, large sample size and well-designed epidemiologic studies are needed to confirm these conclusions.
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Affiliation(s)
- Yafeng Wang
- Cardiovascular Department, The Second Clinical Medical College of Fujian Medical University, Quanzhou, Fujian, China
| | - Qiuyu Huang
- Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Jianchao Liu
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Fujian, China
| | - Yanan Wang
- Department of Function, Agribusiness Hospital of Xishuangbanna, Jinghong, Yunnan, China
| | - Gongfeng Zheng
- Cardiovascular Department, The Second Clinical Medical College of Fujian Medical University, Quanzhou, Fujian, China
| | - Ling Lin
- Rheumatism Department, The Second Clinical Medical College of Fujian Medical University, Quanzhou, Fujian, China
| | - Hui Yu
- Department of Abdominal Surgery, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Weifeng Tang
- Department of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Fujian, China
| | - Ziyang Huang
- Cardiovascular Department, The Second Clinical Medical College of Fujian Medical University, Quanzhou, Fujian, China
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Bekendam MT, Kop WJ, Barzilay S, Widdershoven JW, Aarnoudse W, Denollet J, Mommersteeg PMC. The predictive value of positive affect and Type D personality for adverse cardiovascular clinical outcomes in patients with non-obstructive coronary artery disease. J Psychosom Res 2018; 104:108-114. [PMID: 29275779 DOI: 10.1016/j.jpsychores.2017.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/25/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with non-obstructive coronary artery disease (NOCAD) continue to experience disabling symptoms. Positive affect (PA) has shown a cardioprotective potential. Type D personality has previously been shown to have a deleterious effect on adverse outcomes in diverse cardiac populations. Little is known about the predictive value of PA and Type D personality for long-term outcomes in NOCAD patients. The aim was to investigate the effect of PA and Type D personality on clinical outcomes. METHODS 547 patients (mean age 61 years±9, 48% male) who underwent a coronary angiography or CT-scan between January 2009 and February 2013 answered questionnaires concerning PA (GMS) and Type D personality (DS14). Cox proportional hazards analyses were performed. RESULTS When analyzed dichotomously, PA was a significant predictor of need for repeat cardiac testing (HR=0.64, 95% CI: 0.41-0.99), but not emergency department (ED) admissions (HR=0.83, 95% CI: 0.52-1.32) after adjustment for age, sex, education, diagnosis by group, BMI and hypertension. Analyzed continuously, the predictive value of PA was non-significant for both repeat testing (HR=0.85, 95% CI: 0.69-1.06) and ED admissions (HR=0.98, 95% CI: 0.77-1.23). Type D personality, both continuously and dichotomously, was not significantly associated with the outcomes. Findings were also examined for men and women separately. CONCLUSION Although Type D personality was not predictive of adverse events in this sample, PA is an interesting and important variable to take into account in NOCAD patients. Research on psychosocial factors in NOCAD patients should consider the importance of choices of endpoint, given the heterogeneity of NOCAD patients.
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Affiliation(s)
- Maria T Bekendam
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Willem J Kop
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Simone Barzilay
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jos W Widdershoven
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; The Department of Cardiology, TweeSteden Hospital, Tilburg, The Netherlands
| | - Wilbert Aarnoudse
- The Department of Cardiology, TweeSteden Hospital, Tilburg, The Netherlands
| | - Johan Denollet
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Paula M C Mommersteeg
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
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Desabandhu V, Sulaiman S, Bastian C, Goyal KK. Combined percutaneous intervention of coronary artery disease and atrial septal defect. IHJ CARDIOVASCULAR CASE REPORTS (CVCR) 2018; 2:24-26. [DOI: 10.1016/j.ihjccr.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Qaderdan K, Vos GJA, McAndrew T, Steg PG, Hamm CW, van‘t Hof A, Mehran R, Deliargyris EN, Bernstein D, Stone GW, ten Berg JM. Outcomes in elderly and young patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with bivalirudin versus heparin: Pooled analysis from the EUROMAX and HORIZONS-AMI trials. Am Heart J 2017; 194:73-82. [PMID: 29223437 DOI: 10.1016/j.ahj.2017.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 08/07/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Since older age is a strong predictor of not only bleeding but also of ischemic events, understanding the risk:benefit profile of bivalirudin in the elderly undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation (STEMI) is important. For this, we aim to compare elderly with young patients, who all underwent pPCI for STEMI and randomly received either bivalirudin or heparin. METHODS We performed a patient-level pooled analysis (n=5800) of two large randomized trials. A total of 2149 (37.1%) elderly patients (>65 years of age) with STEMI were enrolled and randomly assigned to either bivalirudin or heparin with or without a GPI (control group) before pPCI. Clinical outcomes at 30 days were analyzed. RESULTS In elderly patients, bivalirudin significantly reduced non-CABG major bleeding (7.1% vs 10.4%; P<.01), subacute ST (0.4% vs 1.5%; P<.01), and net adverse clinical events (NACE; composite of all-cause mortality, reinfarction, IDR, stroke or protocol-defined non-CABG major bleeding [13.7% vs 17.2%; P=.03]) with comparable rates of stroke, MI, acute ST, or all-cause death, when compared with heparin with or without GPI. CONCLUSIONS In a large group of elderly patients enrolled in the EUROMAX and HORIZONS-AMI trials, bivalirudin was associated with lower 30-day rates of non-CABG major bleeding, subacute ST and NACE, with similar 30-day rates of acute ST and mortality.
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71
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Appiah D, Capistrant BD. Cardiovascular Disease Risk Assessment in the United States and Low- and Middle-Income Countries Using Predicted Heart/Vascular Age. Sci Rep 2017; 7:16673. [PMID: 29192146 PMCID: PMC5709399 DOI: 10.1038/s41598-017-16901-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/15/2017] [Indexed: 12/27/2022] Open
Abstract
Almost 80% of the global burden of cardiovascular disease (CVD) occurs in low- and middle-income countries (LMICs). However, LMICs do not have well-established, low-technology ways to quantify and communicate CVD risk at population or individual levels. We examined predicted heart/vascular age (PHA) in six LMICs and the United States. Data were from CVD-free adults in World Health Organization Study on Global Aging and Adult Health (n = 29094) and US National Health and Nutritional Examination Survey (n = 6726). PHA was calculated using the non-laboratory Framingham CVD risk equation. High excess PHA (HEPHA) was defined as the differences between PHA and chronological age >5 years. Logistic regression models were used to identify factors associated with HEPHA. Age-standardized prevalence of HEPHA was higher in Russia 52%; China 56%; Mexico 59%; and South Africa 65% compared to the US 45%, Ghana 36%; and India 38%. In LMICs, higher income, being divorced/widowed, alcohol intake and abdominal obesity had higher odds of HEPHA; higher education, fruit intake and physical activity had lower odds of HEPHA. The use of PHA may offer a useful avenue to communicate CVD risk. Interventions tailored at socioeconomic and cultural factors that influence CVD risk factors may be necessary to prevent CVD in LMICs.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Abilene, TX, USA.
| | - Beatrix D. Capistrant
- Statistical & Data Sciences, Smith College, Northampton, MA, USA
- Division of Epidemiology and Community Health, University of Minnesota Minneapolis, Minneapolis, MN, USA
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Chinese Herbal Cardiotonic Pill Stabilizes Vulnerable Plaques in Rabbits by Decreasing the Expression of Adhesion Molecules. J Cardiovasc Pharmacol 2017; 68:215-22. [PMID: 27110743 PMCID: PMC5049970 DOI: 10.1097/fjc.0000000000000403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The cardiotonic pill (CP), consisting of a mixture of Radix Salviae Miltiorrhizae, Radix Notoginseng, and Borneolum Syntheticum, has been widely used in the prevention and treatment of cardiovascular disease. Adhesion molecules, including intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1, are involved in the development of vulnerable plaque. We investigated the effect of the CP in a rabbit model of vulnerable plaque established by local transfection with p53 gene. Compared with the control group, rabbits with vulnerable plaque showed a significantly lower intima-media thickness and plaque burden after CP treatment for 12 weeks. Moreover, the reduction in rate of plaque rupture and vulnerability index was similar. On enzyme-linked immunosorbent assay, real-time polymerase chain reaction, and immunohistochemistry analysis, the expression of intercellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 was inhibited with CP treatment. CP treatment could postpone atherosclerotic plaque development and stabilize vulnerable plaque by inhibiting the expression of adhesion molecules in treatment of cardiovascular disease.
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The role of biomarkers in the diagnosis and risk stratification of acute coronary syndrome. Future Sci OA 2017; 4:FSO251. [PMID: 29255623 PMCID: PMC5729601 DOI: 10.4155/fsoa-2017-0036] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/11/2017] [Indexed: 11/30/2022] Open
Abstract
Coronary artery disease is a growing concern. Although traditional biomarkers, such as troponins and creatine kinase, play a central role in the diagnosis, risk stratification and management of coronary artery disease, they are unable to detect myocardial ischemia in the absence of necrosis. Therefore, early detection of ischemia in patients presenting with acute coronary syndrome still remains a burning question. High-sensitivity troponin is evolving as a reliable biomarker in this regard and has been absorbed into clinical practice. Biomarkers are currently the focus of immense interest as it not only helps with diagnosis and management but also helps to understand the pathophysiology of the disease process. In addition, analysis using a multimarker strategy has also proven to be a very useful tool in risk stratification. This review will focus on the biomarkers and its application in the diagnosis and risk stratification of acute coronary syndrome. Cardiovascular diseases are a common group of diseases that affect a large population and account for a significant number of deaths worldwide. Acute coronary syndrome (ACS) is a growing public health concern, where inadequate blood flow to the heart muscle results in reversible or irreversible damage to the cardiomyocyte. Early detection of ACS is crucial to deliver appropriate timely therapy to prevent myocardial necrosis and heart failure. Biomarkers are measurable and quantifiable biological substances that are used as indicators in the early diagnosis and management of patients with ACS. This article provides an overview of this topic and provides suggestions for the future.
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Kilinc MF, Yasar E, Aydin HI, Yildiz Y, Doluoglu OG. Association between coronary artery disease severity and overactive bladder in geriatric patients. World J Urol 2017; 36:35-40. [DOI: 10.1007/s00345-017-2098-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022] Open
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Forrester JD, Cai LZ, Zeigler S, Weiser TG. Surgical Site Infection after Sternotomy in Low- and Middle-Human Development Index Countries: A Systematic Review. Surg Infect (Larchmt) 2017; 18:774-779. [DOI: 10.1089/sur.2017.149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Lawrence Z. Cai
- School of Medicine, Stanford University, Stanford, California
| | - Sanford Zeigler
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Thomas G. Weiser
- Department of General Surgery, Stanford University, Stanford, California
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76
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Masud R, Baqai HZ. The communal relation ofMTHFR,MTR,ACEgene polymorphisms and hyperhomocysteinemia as conceivable risk of coronary artery disease. Appl Physiol Nutr Metab 2017; 42:1009-1014. [DOI: 10.1139/apnm-2017-0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Homocysteine and its modulating genes have strongly emerged as novel biomarkers for coronary artery disease (CAD). In the present study, we investigated whether polymorphisms in homocysteine pathway genes and the plasma levels of homocysteine, folate, and vitamin B12, independently or in combination, are associated with CAD risk. A total of 504 participants were recruited (cases, n = 254; controls, n = 250, respectively). Tetra primer allele refractory mutation system polymerase chain reaction (PCR) was used for resolving the genotypes of 5′10′ methylenetetrahydrofolate reductase ‘MTHFR’ polymorphisms (rs1801133, rs1801131), 5′ methyl tetrahydrofolate homocysteine methyltransferase ‘MTR’ polymorphism (rs1805087), paroxanse1 ‘PON1’ polymorphism (rs662), and cystathionine beta synthase ‘CBS’ polymorphism (rs5742905). Conventional PCR amplification was carried out for resolving angiotensin converting enzyme ‘ACE’ insertion/deletion (I/D) polymorphism (rs4646994). ANOVA analysis, adjusted for the covariates, revealed that rs1801133, rs1805087 polymorphisms and homocysteine levels were associated with CAD. Logistic regression analysis (adjusted) revealed similar findings. Logistic regression analysis after applying factorial design to the studied single nucleotide polymorphisms (SNPs) revealed that homocysteine levels and heterozygous and mutant alleles at rs1801133, rs1805087, along with mutant alleles at rs1801131, rs4646994, conferred higher risk for CAD. Our results provide insight into the multifactorial nature of coronary artery disease. We highlight that SNPs in folate pathway genes and homocysteine have role in disease causation and can be used in disease prediction strategies.
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Affiliation(s)
- Rizwan Masud
- Division of Physiology, Department of Biomedical Sciences, College of Medicine, King Faisal University, Al Ahsa, 31982, Saudi Arabia
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78
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Traina MI, Almahmeed W, Edris A, Murat Tuzcu E. Coronary Heart Disease in the Middle East and North Africa: Current Status and Future Goals. Curr Atheroscler Rep 2017; 19:24. [PMID: 28378303 DOI: 10.1007/s11883-017-0659-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The Middle East and North Africa has witnessed a dramatic transformation over the last 30 years caused by rapid urbanization and modernization and significant changes to diet and lifestyle. This review attempts to highlight recent data in regards to ischemic heart disease and its risk factors from the region. RECENT FINDINGS Ischemic heart disease is now the leading cause of death in the region. Age at presentation with myocardial infarction and acute coronary syndrome appears to be significantly younger than global averages. Increased rates of all major risk factors including diabetes, hypertension, hyperlipidemia, smoking, obesity, and sedentary lifestyle have been noted. Specifically, significant changes to dietary habits and growing epidemic of use of alternative tobacco products are noted. This review article highlights the growing epidemic of ischemic heart disease in the region led by dramatic increases in incidence of its risk factors. This epidemic will require a multipronged approach to address the varied issues and mitigate the growing prevalence of the disease.
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Affiliation(s)
- Mahmoud I Traina
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates
| | - Ahmad Edris
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates
| | - E Murat Tuzcu
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates.
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79
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Chiadak JD, Perret J, Womeni HM, Kuiaté JR, Cullus P, Senterre C, Delporte C. Pilot study of risk factors associated with cardiovascular disease in northern and southern Cameroonians. Cardiovasc J Afr 2017; 28:235-241. [PMID: 28556848 PMCID: PMC5642027 DOI: 10.5830/cvja-2016-094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/16/2016] [Indexed: 12/14/2022] Open
Abstract
Aim: The aim of the study was to evaluate whether the risk factors for cardiovascular disease (CVD) are similar in the northern and southern regions of Cameroon. Methods: The participants answered a questionnaire concerning their lifestyle. Anthropometric and blood pressure measurements were evaluated in 192 individuals and biochemical parameters in 50 randomly selected volunteers. Results: Northerners displayed low alcohol and tobacco consumption, little practice of sport but physically demanding professions, and consumption of soybean, refined palm and other polyunsaturated oils. Southerners consumed alcohol, practiced sport, had intellectually based professions, and consumed crude and refined palm oils. Waist circumference and body mass index were higher in the southerners compared to the northerners. Blood glucose levels, and systolic and diastolic blood pressures were higher among the northerners than the southerners. Among the southerners, there were positive correlations between total cholesterol levels and systolic or diastolic blood pressure, low-density lipoprotein cholesterol and blood glucose levels or diastolic blood pressure, triglyceride levels and systolic blood pressure. Conclusion: Providing region-adapted, health-related advice for northern and southern Cameroonians would contribute to reducing risk factors for CVD.
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Affiliation(s)
- Jeanne Durendale Chiadak
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium; Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon
| | - Jason Perret
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jules Roger Kuiaté
- Department of Biochemistry, Faculty of Sciences, University of Dschang, Cameroon
| | - Pierre Cullus
- Biostatistics and Medical Informatics Service, Faculty of Medicine, Université Libre de Bruxelles, Belgium
| | - Christelle Senterre
- Research Centre of Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Christine Delporte
- Laboratory of Pathophysiological and Nutritional Biochemistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
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Vora A, Naik A, Lokhandwala Y, Chopra A, Varma J, Wander GS, Jaswal A, Srikanthan V, Singh B, Kahali D, Gupta A, Mantri RR, Mishra A, Pandurangi U, Ghosh D, Makkar JS, Sahu S, Radhakrishnan R. Profiling cardiac arrhythmia and heart failure patients in India: The Pan-arrhythmia and Heart Failure Observational Study. Indian Heart J 2017; 69:226-239. [PMID: 28460772 PMCID: PMC5414953 DOI: 10.1016/j.ihj.2016.11.329] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 11/29/2016] [Indexed: 12/04/2022] Open
Abstract
Background The PANARrhythMia and Heart Failure Registry (PANARM HF) characterized demographic, clinical and interventional therapy indication profiles of cardiac arrhythmia (CA) and heart failure (HF) patients in India. Methods Consulting Physicians (CP) who medically manage CA and HF patients enrolled patients with one or more of the following: syncope, pre-syncope, dyspnea, palpitation, fatigue and LV dysfunction. The CPs were trained by interventional cardiologists (IC) to identify CA/HF patients indicated for implantable device/radiofrequency ablation (RFA). 59 CP’s, 16 IC’s & 2205 patients from 12 cities participated. Demographic, clinical, device/RFA indication and referral-consultation profiles were created. IC’s provided device/RFA recommendations based on these profiles. Results The CA/HF distribution of patients was: HF – 58%, bradyarrhythmia – 15%, atrial fibrillation – 15%, other supraventricular tachyarrhythmia – 10% and ventricular tachycardia/fibrillation – 4.5%. 62% of the CA/HF population was male and 45% were below age 60. Coronary artery disease (52%), hypertension (44%), diabetes (30%) & myocardial infarction (20%) were prominent. 1011 (46%) of the CA/HF population were potential device/RFA candidates according to the IC’s. However, only 700 (69%) of these patients were referred to the IC by the CP. Of referred patients, only 177 (25%) consulted the IC and were recommended therapy. Thus, 824 (83%) of patients indicated for interventional therapy were not advised therapy or did not opt for it. Conclusion The India PANARM HF study provides new information and insights into the demographic, clinical, interventional therapy, referral and consultation pattern profiles of CA/HF patients in India.
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Affiliation(s)
- Amit Vora
- Glenmark Cardiac Centre, Mumbai, India
| | - Ajay Naik
- Care Institute of Medical Sciences, Ahmedabad, India
| | | | | | | | | | - Aparna Jaswal
- Escorts Heart Institute and Research Centre, New Delhi, India
| | | | | | | | | | - R R Mantri
- Sir Ganga Ram Hospital, New Delhi, India
| | - Anil Mishra
- B.M. Birla Heart Research Centre, Kolkata, India
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81
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Aginsky KD, Constantinou D, Delport M, Watson ED. Cardiovascular Disease Risk Profile and Readiness to Change in Blue- and White-Collar Workers. FAMILY & COMMUNITY HEALTH 2017; 40:236-244. [PMID: 28525444 DOI: 10.1097/fch.0000000000000148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study provides a health and risk profile of blue- (BCWs) and white-collar workers (WCWs). Health screening data (n = 603; age 38.2 ± 9.7 years) included cholesterol and glucose finger-prick test, blood pressure, body mass index, and self-reported stress levels and readiness to change. Blue-collar workers were significantly older and had higher blood pressure readings and were more likely to develop hypertension (odds ratio [OR]: 1.72; 95% confidence interval [CI]: 1.05-2.81; P = .03), but less likely to present with hypercholesterolemia (OR: 0.50; 95% CI: 0.31-0.81; P = .01) and overweight/obesity (OR: 0.65; 95% CI: 0.42-0.99; P = .047). White-collar workers showed significantly higher cholesterol and stress levels. This study highlights the importance of occupation type in workplace health screening and intervention planning.
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Affiliation(s)
- Kerith D Aginsky
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand (Dr Aginsky, Mr Constantinou, and Dr Watson), and EOH Workplace Health and Wellness (Ms Delport), Johannesburg, South Africa
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82
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Padur AA, Hamdan AB, Abdullah TTBIP, Gunalan C, Kumar N. Evaluation of cardiovascular disease in patients with systemic arterial hypertension in relation to age and sex: a retrospective study in a south Indian population. J Vasc Bras 2017; 16:11-15. [PMID: 29930617 PMCID: PMC5829686 DOI: 10.1590/1677-5449.010516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Systemic arterial hypertension manifests as constant elevation of blood pressure and is considered to be an important cardiovascular risk factor. Systemic evaluation of cardiovascular diseases in patients with systemic arterial hypertension is imperative for prevention. OBJECTIVES The objective of the present study was to investigate and inter-relate sex and age with systemic arterial hypertension and cardiovascular diseases. METHODS Medical records of patients with systemic arterial hypertension and cardiovascular disease were evaluated. Data from the medical records were recorded in a prescribed protocol and the data were analyzed and correlated to the patients' age and sex. RESULTS A total of 170 medical records for patients who visited the cardiology department were reviewed. Of these, 50 patients had systemic arterial hypertension and 19 of this subset had cardiovascular diseases. When we correlated systemic arterial hypertension with age, we observed that patients in the 51-60 years age group were more prone to systemic arterial hypertension (36%). Most of the patients with both systemic arterial hypertension and cardiovascular disease were female and in the 61-70 years age group, while among males the highest rate of occurrence was seen in the 51-60 years age group. The correlation coefficient (r) was 0.62, indicating a moderate, positive, linear relationship between systemic arterial hypertension and cardiovascular disease. CONCLUSIONS A majority of patients with systemic arterial hypertension may develop cardiovascular disease and, as age increases, the tendency to develop hypertension also increases.
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Affiliation(s)
- Ashwini Aithal Padur
- Manipal University, Melaka Manipal Medical College, Department of Anatomy, Manipal Campus, Manipal, Karnataka, India
| | - Aisyah Binti Hamdan
- Manipal University, Melaka Manipal Medical College, Manipal Campus, Manipal, Karnataka, India
| | | | - Chandrigga Gunalan
- Manipal University, Melaka Manipal Medical College, Manipal Campus, Manipal, Karnataka, India
| | - Naveen Kumar
- Manipal University, Melaka Manipal Medical College, Department of Anatomy, Manipal Campus, Manipal, Karnataka, India
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83
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Mirhafez SR, Avan A, Tajfard M, Mohammadi S, Moohebati M, Fallah A, Ghazavi H, Savadi H, Ghayour Mobarhan M. Relationship between serum cytokines receptors and matrix metalloproteinase 9 levels and coronary artery disease. J Clin Lab Anal 2016; 31. [PMID: 27910999 DOI: 10.1002/jcla.22100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 10/29/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The prevalence of coronary artery disease (CAD) is increasing globally, supporting the need for the identification of novel biomarkers. Therefore in the present study, we have explored the association of SIL2A, SIL6R, STNFRI, STNFRII, and MMP9 in CAD patients. METHODS Twenty one patients with angiographically defined CAD with more than 50% occlusion, at least, in one coronary artery and twenty healthy subjects (n=20) without the history of cardiovascular symptoms were enrolled. Demographic and biochemical analysis (e.g. Total Cholesterol (TC), Triglyceride (TG), and HDL-C) were measured in all the subjects. The level of cytokines receptor (SIL2A, SIL6R, SIL6R, STNFRI, STNFRII, and matrix metallopeptidase 9 (MMP9) were evaluated. RESULTS Our results showed the higher level of MMP9 in patients group compared to the control subjects, while no significant differences were detected for other cytokines. In particular the level of MMP9 was significantly (P=.015) increased from 181.16 ng/mL (95%CI: 112.1-199.2) to 192.0 ng/mL (95%CI: 181.5-265.2). Moreover, the sensitivity and specificity of MMP9 were 95.45% and 45%, respectively, as detected by receiver operating characteristic (ROC) curves. CONCLUSION We demonstrate the significant correlation of MMP-9 with CAD with sensitivity of 95.45%, suggesting its role as a biomarker in CAD patients. Further studies in larger population - preferably multicenter setting - are warranted to explore the functional role of this marker in coronary artery disease.
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Affiliation(s)
- Seyed Reza Mirhafez
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Tajfard
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Science, Mashhad, Iran.,Management and Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Science, Mashhad, Iran
| | - Shabnam Mohammadi
- Department of Basic Sciences, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.,Neurogenic Inflammation Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arash Fallah
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Ghazavi
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Savadi
- Department of Medicine, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran
| | - Majid Ghayour Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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84
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Guo JJ, Chen Y, Du W, Peng H, Wang R, Xia Y, Xin P, Wigle PR, Papadimitropoulos EA. Antithrombotic Therapy and Direct Medical Costs in Patients with Acute Coronary Syndrome in Shanghai, China. Value Health Reg Issues 2016; 9:93-98. [PMID: 27881268 DOI: 10.1016/j.vhri.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 12/16/2015] [Accepted: 01/16/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide. OBJECTIVES To describe patient profile, treatment patterns, and disease burden for patients with ACS. METHODS A retrospective descriptive cohort study was conducted. Data were obtained from electronic medical records from seven Shanghai medical centers. Patients with at least one primary diagnosis of ACS from 2006 to 2012 were included. Patient ACS-related antithrombotic medication use, laboratory tests, key comorbidities, health care utilization, and direct medical costs were examined. Log-linear regression was conducted to explore factors associated with total direct medical costs. RESULTS The mean age for the 6601 patients included was 69.7 ± 12.5 years, and most of the patients (73%) were men. Comorbidities included diabetes (18.2%), hypertension (21.2%), and hyperlipidemia (8.6%). Out of these, 6466 (98%) patients had been hospitalized for ACS with an average length of stay of 14.0 ± 16.4 days per hospitalization. A total of 914 (13.8%) patients had emergency room visits. Of these, 93.5% received any antithrombotic therapy, including antiplatelet agents (92.7%) and anticoagulants (20.8%). ACS-related direct medical costs (in yuan renminbi [¥]) were ¥18,421 ± ¥24,741 per hospitalization, including costs for medications (¥6,776) and laboratory tests (¥1,355), and ¥2,894 ± ¥7,060 per outpatient visit, including costs for medications (¥620) and laboratory tests (¥464). The higher direct medical cost was associated significantly (P < 0.05) with age, being male, antiplatelet and anticoagulant use, and several comorbid disease states (diabetes, hyperlipidemia, hypertension, and chronic kidney disease). CONCLUSIONS Antithrombotic therapeutic treatments were commonly used among patients with ACS in Shanghai, China. Higher treatment costs for patients with ACS in Shanghai, China, involved their antithrombotic medication use and key comorbidities.
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Affiliation(s)
- Jeff J Guo
- Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
| | - Yun Chen
- Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai, China
| | - Wenmin Du
- Adverse Drug Reaction Reporting Center, Shanghai Food and Drug Administration, Shanghai, China
| | - Hongying Peng
- Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Rui Wang
- Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Ying Xia
- Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Ping Xin
- Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai, China
| | - Patricia R Wigle
- Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Emmanuel A Papadimitropoulos
- Global Patient Outcomes and Real World Evidence, Eli Lilly & Company, Indianapolis, IN, USA; Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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85
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Rai V, Agrawal DK. Role of risk stratification and genetics in sudden cardiac death. Can J Physiol Pharmacol 2016; 95:225-238. [PMID: 27875062 DOI: 10.1139/cjpp-2016-0457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sudden cardiac death (SCD) is a major public health issue due to its increasing incidence in the general population and the difficulty in identifying high-risk individuals. Nearly 300 000 - 350 000 patients in the United States and 4-5 million patients in the world die annually from SCD. Coronary artery disease and advanced heart failure are the main etiology for SCD. Ischemia of any cause precipitates lethal arrhythmias, and ventricular tachycardia and ventricular fibrillation are the most common lethal arrhythmias precipitating SCD. Pulseless electrical activity, bradyarrhythmia, and electromechanical dissociation also result in SCD. Most SCDs occur outside of the hospital setting, so it is difficult to estimate the public burden, which results in overestimating the incidence of SCD. The insufficiency and limited predictive value of various indicators and criteria for SCD result in the increasing incidence. As a result, there is a need to develop better risk stratification criteria and find modifiable variables to decrease the incidence. Primary and secondary prevention and treatment of SCD need further research. This critical review is focused on the etiology, risk factors, prognostic factors, and importance of risk stratification of SCD.
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Affiliation(s)
- Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA.,Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA
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Yayla Ç, Okyay K, Yılmaz A, Şahinarslan A, Yar Sağlam AS, Eyiol A, Bolayır HA, Sezenöz B, Menevşe S, Çengel A. Association of rs10757274 and rs2383206 Polymorphisms on 9p21 locus with Coronary Artery Disease in Turkish Population. Korean Circ J 2016; 46:615-621. [PMID: 27721851 PMCID: PMC5054172 DOI: 10.4070/kcj.2016.46.5.615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/02/2015] [Accepted: 12/11/2015] [Indexed: 12/29/2022] Open
Abstract
Background and Objectives Genetic predisposition is an important risk factor for coronary artery disease (CAD). In this study, we aimed to evaluate the impact of rs10757274 and rs2383206 polymorphisms in chromosome 9p21 on presence and severity of CAD in a Turkish population. Subjects and Methods A total of 646 patients who underwent coronary angiography were included in this study. Coronary vessel score and Gensini score were calculated to assess the angiographic severity of CAD. Alleles of AA, AG, and GG were determined for rs10757274 (polymorphism-1) and rs2383206 (polymorphism-2) polymorphisms located in chromosome 9p21 from the blood samples. Results There was a significant difference between the alleles in polymorphism-1 in the presence of coronary artery disease (38.9% in AA, 48.0% in GG and 56.4% in AG, p=0.017). However, there was no difference between the alleles in polymorphism-2. According to vessel scores, there was a significant difference between the alleles in polymorphism-1 (AA 0.71±1.04, GG 0.88±1.07, AG 1.06±1.12, p=0.018). In polymorphism-2, vessel scores did not show a difference between the alleles. In polymorphism-1, there was a significant difference in Gensini score (p=0.041). Gensini scores did not differ between the alleles in polymorphism-2 (p>0.05 for all). In multivariate analyses, none of the alleles was an independent factor for presence of CAD. Conclusion The presence of rs10757274 polymorphism including AG allele in chromosome 9p21 was related to CAD. However, this relationship was not independent of other cardiovascular risk factors.
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Affiliation(s)
- Çağrı Yayla
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
| | - Kaan Okyay
- Department of Cardiology, School of Medicine, Baskent University, Ankara, Turkey
| | - Akın Yılmaz
- Department of Medical Biology and Genetic, School of Medicine, Gazi University, Ankara, Turkey
| | - Asife Şahinarslan
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
| | - Atiye Seda Yar Sağlam
- Department of Medical Biology and Genetic, School of Medicine, Gazi University, Ankara, Turkey
| | - Azmi Eyiol
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
| | - Hasan Ata Bolayır
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
| | - Burak Sezenöz
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sevda Menevşe
- Department of Medical Biology and Genetic, School of Medicine, Gazi University, Ankara, Turkey
| | - Atiye Çengel
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey
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Chinnaiyan KM, Raff GL. Coronary CT Angiography in the Emergency Department: Current Status. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:62. [DOI: 10.1007/s11936-016-0484-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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88
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Fornai F, Carrizzo A, Forte M, Ambrosio M, Damato A, Ferrucci M, Biagioni F, Busceti C, Puca AA, Vecchione C. The inflammatory protein Pentraxin 3 in cardiovascular disease. IMMUNITY & AGEING 2016; 13:25. [PMID: 27559355 PMCID: PMC4995820 DOI: 10.1186/s12979-016-0080-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/15/2016] [Indexed: 12/12/2022]
Abstract
The acute phase protein Pentraxin 3 (PTX3) plays a non-redundant role as a soluble pattern recognition receptor for selected pathogens and it represents a rapid biomarker for primary local activation of innate immunity and inflammation. Recent evidence indicates that PTX3 exerts an important role in modulating the cardiovascular system in humans and experimental models. In particular, there are conflicting points concerning the effects of PTX3 in cardiovascular diseases (CVD) since several observations indicate a cardiovascular protective effect of PTX3 while others speculate that the increased plasma levels of PTX3 in subjects with CVD correlate with disease severity and with poor prognosis in elderly patients. In the present review, we discuss the multifaceted effects of PTX3 on the cardiovascular system focusing on its involvement in atherosclerosis, endothelial function, hypertension, myocardial infarction and angiogenesis. This may help to explain how the specific modulation of PTX3 such as the use of different dosing, time, and target organs could help to contain different vascular diseases. These opposite actions of PTX3 will be emphasized concerning the modulation of cardiovascular system where potential therapeutic implications of PTX3 in humans are discussed.
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Affiliation(s)
- Francesco Fornai
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy ; I.R.C.C.S. Neuromed, Pozzilli, IS Italy
| | | | | | | | | | - Michela Ferrucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | | | - Annibale A Puca
- Vascular Physiopathology Unit, I.R.C.C.S. Multimedica, Milan, Italy ; Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, SA 84081 Italy
| | - Carmine Vecchione
- I.R.C.C.S. Neuromed, Pozzilli, IS Italy ; Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, SA 84081 Italy
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Wojda TR, Cornejo K, Valenza PL, Carolan G, Sharpe RP, Mira AEA, Galwankar SC, Stawicki SP. Medical demographics in sub-Saharan Africa: Does the proportion of elderly patients in accident and emergency units mirror life expectancy trends? J Emerg Trauma Shock 2016; 9:122-5. [PMID: 27512334 PMCID: PMC4960779 DOI: 10.4103/0974-2700.185278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Thomas R Wojda
- Department of Surgery, St. Luke's University Health Network, Bethlehem, PA, USA. E-mail:
| | - Kristine Cornejo
- Department of Family Medicine-Warren, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Pamela L Valenza
- Department of Family Medicine-Warren, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Gregory Carolan
- Department of Orthopedics, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Richard P Sharpe
- Department of Surgery, St. Luke's University Health Network, Bethlehem, PA, USA. E-mail:
| | - Alaa-Eldin A Mira
- Department of Geriatrics, St. Luke's University Health Network, Bethlehem, PA, USA
| | - Sagar C Galwankar
- Department of Emergency Medicine, University of Florida, Jacksonville, Florida, USA
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90
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Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:256. [PMID: 27500157 DOI: 10.21037/atm.2016.06.33] [Citation(s) in RCA: 651] [Impact Index Per Article: 81.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.
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Affiliation(s)
| | - Carme Perez-Quilis
- Research Institute of the Hospital 12 de Octubre ('i+12'), Madrid, Spain
| | - Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany
| | - Alejandro Lucia
- Research Institute of the Hospital 12 de Octubre ('i+12'), Madrid, Spain;; European University of Madrid, Madrid, Spain
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91
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Al-Ganmi AH, Perry L, Gholizadeh L, Alotaibi AM. Cardiovascular medication adherence among patients with cardiac disease: a systematic review. J Adv Nurs 2016; 72:3001-3014. [PMID: 27377689 DOI: 10.1111/jan.13062] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 12/20/2022]
Abstract
AIMS The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications. BACKGROUND Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal. DESIGN A systematic quantitative review of intervention effects. DATA SOURCES We conducted systematic searches for English-language, peer-reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004-December 2014. REVIEW METHODS According to pre-determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers; 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool; and included in the review. RESULTS Study findings were presented descriptively; due to the heterogeneity of studies meta-analysis was not possible. Included papers described interventions categorized as: (1) multifaceted; and (2) behavioural and educational, comprising: (a) text message and mail message; (b) telephone calls; (c) motivational interviewing and (d) nurse-led counselling and education. CONCLUSIONS Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target individual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review.
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Affiliation(s)
- Ali Hussein Al-Ganmi
- University of Technology Sydney, Faculty of Nursing, Midwifery and Health, Sydney, New South Wales, Australia.,University of Baghdad, College of Nursing, Iraq
| | - Lin Perry
- University of Technology Sydney, Faculty of Nursing, Midwifery and Health, Sydney, New South Wales, Australia.,Health Services and Practice Research Strength, South Eastern Sydney Local Health District, Randwick, New South Wales, Australia.,Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Leila Gholizadeh
- Faculty University of Technology Sydney, Faculty of Nursing, Midwifery and Health, Sydney, New South Wales, Australia
| | - Abdulellah Modhi Alotaibi
- University of Technology Sydney, Faculty of Nursing, Midwifery and Health, Sydney, New South Wales, Australia.,Shqra University, Faculty of Applied Health Sciences, Saudi Arabia
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92
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Sarraju A, Kim SH, Knowles JW. Cardiometabolic Effects of Glucagon-Like Peptide-1 Agonists. Curr Atheroscler Rep 2016; 18:7. [PMID: 26782825 DOI: 10.1007/s11883-016-0558-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cardiovascular disease is the leading cause of death among adults in the USA. Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) are known risk factors for cardiovascular disease. Despite the development of numerous effective anti-glycemic therapies, we have been unable to completely mitigate cardiovascular risk with glucose lowering alone, and prevention of cardiovascular disease in patients with diabetes is primarily achieved with the use of medications that address other risk factors such as anti-hypertensives or statins. Glucagon-like peptide-1 (GLP-1) is a key hormone in the pathophysiology of diabetes. GLP-1 agonists have been recently approved for the treatment of T2DM as well as for chronic weight management. In this review, we aim to explore the effects of GLP-1 agonists on cardiovascular health with a focus on cardiometabolic variables and cardiac function.
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Affiliation(s)
- Ashish Sarraju
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Sun H Kim
- Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Joshua W Knowles
- Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University School of Medicine, Falk CVRC, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA, 94305, USA.
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93
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Aboul-Enein F, Aljuaid MO, Alharthi HT, Almudhhi AM, Alzahrani MA. The Concordance between Myocardial Perfusion Imaging and Coronary Angiography in Detecting Coronary Artery Disease: A Retrospective Study in a Tertiary Cardiac Center at King Abdullah Medical City. Cardiol Res Pract 2016; 2016:9847575. [PMID: 27429833 PMCID: PMC4939340 DOI: 10.1155/2016/9847575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/06/2016] [Accepted: 05/29/2016] [Indexed: 11/17/2022] Open
Abstract
Background. Coronary artery disease (CAD) is considered as the leading cause of the cardiovascular fatalities worldwide. CAD is diagnosed by many modalities of imaging such as myocardial perfusion imaging (MPI) and coronary angiography (CAG). Methods. A retrospective cross-sectional study was conducted that included all patients referred to the KAMC (King Abdullah Medical City) nuclear cardiology lab from its opening until the end of May 2014 (a period of 17 months). A total of 228 patient reports with a history of conducting either CAG or MPI or both were used in this study and statistically analyzed. Results. An analysis of the MPI results revealed that 78.5% of the samples were abnormal. On the other hand, 26.75% of the samples revealed that they were subjected to CAG and MPI. There was a significant and fair agreement between MPI and CAG by using all the agreement coefficients (kappa = 0.237, phi = 0.310, and P value = 0.043). The sensitivity, specificity, and accuracy of MPI with reference to CAG were 97.8%, 20%, and 78.69%, respectively. In addition, positive predictive and negative predictive values were 78.95% and 75%, respectively. Conclusion. In a tertiary referral center, there was a significant agreement between MPI and CAG and a high accuracy of MPI. MPI was a noninvasive diagnostic test that could be used as a gatekeeper for CAG.
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94
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Abstract
Acute coronary artery syndrome in the leading cause of morbidity and mortality in Western countries, and its epidemiological burden is also constantly increasing worldwide, including Asia. Due to social and economic consequences, a number of experimental and epidemiological studies have analyzed its etiology so far, in order to develop effective preventive and treatment measures. Thanks to these studies, it is now clear that coronary artery disease (CAD) is a complex multifactorial disorder, resulting from close interaction between acquired and inherited risk factors. In particular, considerable advances were made in the last decade about our understanding of the genetic causes of CAD, mainly propelled by the progresses in whole genome scanning and the development of genome wide association studies. This narrative review is hence dedicated to explore the role of genetic factors in the risk of developing acute CAD.
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Affiliation(s)
- Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy
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95
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Pourafkari N, Pourafkari L, Nader ND. Electroconvulsive therapy for depression following acute coronary syndromes: a concern for the anesthesiologist. J Clin Anesth 2016; 31:223-8. [DOI: 10.1016/j.jclinane.2016.01.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/28/2016] [Indexed: 01/28/2023]
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96
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Sogomonian R, Alkhawam H, Jolly J, Vyas N, Ahmad S, Moradoghli Haftevani E, Al-Khazraji A, Finkielstein D, Vittorio TJ. Serum vitamin D levels correlate to coronary artery disease severity: a retrospective chart analysis. Expert Rev Cardiovasc Ther 2016; 14:977-82. [PMID: 27187061 DOI: 10.1080/14779072.2016.1190273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The pro-atherosclerotic nature of vitamin D deficiency has been shown to increase cardiovascular events. We further emphasized and evaluated the severity of coronary artery disease (CAD) with varying levels of vitamin D in relation to age, gender, ethnicity and baseline confounders. METHODS A retrospective, single-center study of 9,399 patients admitted between 2005 and 2014 for chest pain who underwent coronary angiography. Patients without a vitamin D level, measured as 25-dihydroxyvitamin D (25[OH]D) were excluded from our study. 25(OH)D deficiency and insufficiency were defined by having serum concentration levels of less than 20 ng/ml and 20 to 29.9 ng/ml, respectively, while normal levels were defined as greater than or equal to 30 ng/ml. We assessed levels of 25(OH)D and extent of coronary disease with coronary angiography as obstructive CAD (left main stenosis of ≥50% or any stenosis of ≥70%), non-obstructive CAD (≥1 stenosis ≥20% but no stenosis ≥70%) and normal coronaries (no stenosis >20%). RESULTS Among 9,399 patients, 1,311 qualified, of which 308 patients (23%) had normal 25(OH)D levels, 552 patients (42%) had 25(OH)D deficiency and 451 patients (35%) had 25(OH)D insufficiency. In an analysis of the extent of coronary disease, we identified 20% of patients having normal coronaries, 55% having obstructive CAD and 25% having non-obstructive CAD. Baseline clinical risk factors and co-morbidities did not differ between the groups. Patients with normal 25(OH)D levels were found to have normal coronaries compared to patients with 25(OH)D deficiency or insufficiency (OR: 7, 95% CI: 5.2 - 9.5, p < 0.0001). Comparing patients with normal 25(OH)D levels, patients with 25(OH)D deficiency or insufficiency (<29 ng/ml), 62% were found to have obstructive CAD (n = 624, OR: 2.9, 95% CI: 2.3-3.7, p < 0.0001) and 25% had non-obstructive CAD (n = 249, OR: 1.5, 95% CI: 1.1-2, p = 0.02). CONCLUSION Normal coronaries and CAD were shown to correlate with normal and low levels of 25(OH)D, respectively. There is an inverse relationship between the percentage of coronary artery occlusion and serum 25(OH)D concentrations. Vitamin D may provide benefits in risk stratification of patients with CAD and serve as a possible risk factor.
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Affiliation(s)
- Robert Sogomonian
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Hassan Alkhawam
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - JoshPaul Jolly
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Neil Vyas
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Sumair Ahmad
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | | | - Ahmed Al-Khazraji
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Dennis Finkielstein
- c Department of Cardiology , Icahn School of Medicine at Mount Sinai Beth Israel Medical Center , New York , NY , USA
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97
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Bastami M, Ghaderian SMH, Omrani MD, Mirfakhraie R, Vakili H, Parsa SA, Nariman-Saleh-Fam Z, Masotti A. MiRNA-Related Polymorphisms in miR-146a and TCF21 Are Associated with Increased Susceptibility to Coronary Artery Disease in an Iranian Population. Genet Test Mol Biomarkers 2016; 20:241-8. [DOI: 10.1089/gtmb.2015.0253] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Milad Bastami
- Medical Genetics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mir Davood Omrani
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Mirfakhraie
- Medical Genetics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Vakili
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Alipour Parsa
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ziba Nariman-Saleh-Fam
- Medical Genetics Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrea Masotti
- Bambino Gesù Children's Hospital-IRCCS, Gene Expression - Microarrays Laboratory, Rome, Italy
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98
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Choudhury AR, Choudhury KN, Islam SMS. Relationship of dental diseases with coronary artery diseases and diabetes in Bangladesh. Cardiovasc Diagn Ther 2016; 6:131-7. [PMID: 27054102 DOI: 10.21037/cdt.2016.02.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Evidence suggests that dental diseases might have a role in the development and progression of coronary artery diseases (CAD) and diabetes mellitus (DM). The objective of this study was to determine the relationship of dental diseases with CAD and DM in Bangladesh. METHODS We conducted a cross-sectional study among 216 consecutive patients admitted in a tertiary hospital between March and July 2011. Data were collected on socio-demographic status, smoking, blood pressure (BP), diet, physical activities, and biochemical measurements of lipid profile, glycated hemoglobin (HbA1c), C-reactive protein (CRP), fibrinogen, creatinine kinase MB (CK-MB), troponin, serum creatinine and serum glutamic-pyruvic transaminase (SGPT). CAD was detected using echocardiographic and coronary angiogram (CAG) reports. All patients underwent oral examination for dental disease. Relationship between dental disease with CAD and DM were explored statistically. RESULTS The mean age of the participants was 57.8±12.5 years and almost two-thirds (67.1%) were male. A great majority of the patients had CAD (90.3%) and type 2 DM (83.8%), and only 44% suffered from dental diseases. Less than one-third patients presented with acute myocardial infarction (MI), 23% with old MI, 11% unstable angina (UA) and 26.4% with non-ST elevation MI. Logistic regression results indicated that patients with DM and CAD had approximately 2.6 and 4.6 times more odds of association with dental diseases than those without DM and CAD (both P value <0.001). CONCLUSIONS This study suggests a relationship of dental diseases with CAD and DM among Bangladeshi patients. Further studies are required to confirm these relationships in large clinical studies. Screening for CAD and DM should be considered among those with dental diseases and vice-versa.
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Affiliation(s)
- Arup Ratan Choudhury
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Kamrun Nahar Choudhury
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Sheikh Mohammed Shariful Islam
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
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99
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Zhao J, Booth H, Dear K, Tu EJC. Cardiovascular mortality sex differentials in selected East Asian and Western populations. J Epidemiol Community Health 2016; 70:983-9. [PMID: 27048151 DOI: 10.1136/jech-2015-206577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 03/16/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Explaining patterns in the sex ratio (male/female) of cardiovascular disease (CVD) mortality would improve understanding of mortality transitions under modernisation. Little research has examined secular trends in this ratio across populations, taking age and cohort into account. We examine cohort effects in the ratios of CVD mortality (including ischaemic heart disease and cerebrovascular disease) among 4 East Asian populations that vary in the timing of their modernisation, and assess the effect of smoking on these patterns in comparison with Western populations. METHODS The sequential method for log-linear models is applied to analyse age, period and cohort effects for sex ratios. Age and cohort effects are fitted first, with population as offset; period effects are fitted in a second model using the fitted values from the first model as the offset. Lung cancer mortality serves as a proxy for smoking. RESULTS Increases in sex ratios of CVD mortality began in earlier cohorts in Western than in East Asian populations. Once begun, increases were more rapid in East Asia. The cohort effect for the sex ratio of CVD mortality differs from that for lung cancer mortality. Trends in sex ratios of CVD mortality by cohort are similar before and after adjustment for lung cancer mortality in East Asia; the increasing trend across 1900-1945 cohorts is maintained in Western populations after adjustment. CONCLUSIONS The sex ratio of CVD mortality has increased across successive cohorts living in increasingly modernised environments. There is scant evidence that this increase is attributable to changing sex-specific rates of smoking.
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Affiliation(s)
- Jiaying Zhao
- The Institute for Asian Demographic Research, School of Sociology and Political Science, Shanghai University, Shanghai, China School of Demography, College of Arts and Social Sciences, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Heather Booth
- School of Demography, College of Arts and Social Sciences, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Keith Dear
- Duke Global Health Institute, Duke University and Duke Kunshan University, Kunshan, China
| | - Edward Jow-Ching Tu
- Division of Social Science, The Hong Kong University of Science and Technology, Hong Kong, Hong Kong
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100
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Verdoia M, Barbieri L, Schaffer A, Bellomo G, Marino P, De Luca G. Impact of renal function on mean platelet volume and its relationship with coronary artery disease: A single-centre cohort study. Thromb Res 2016; 141:139-44. [PMID: 27039166 DOI: 10.1016/j.thromres.2016.03.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) has been proposed as a marker of platelet reactivity and cardiovascular disease. Chronic kidney disease (CKD) significantly favors the occurrence of cardiovascular events, by increasing the circulating levels of a wide spectrum of pro-oxidant and pro-thrombotic mediators. However, opposite alterations of platelet function, both enhanced aggregability and increased bleeding diathesis have been reported in these patients, with contrasting results on the effects of renal function on MPV and coronary artery disease, that were assessed in present study. METHODS In patients undergoing coronary angiography, MPV and renal function (serum creatinine and estimated Glomerular Filtration Rate, eGFR, by MDRD formula) were assessed at admission. Coronary artery disease (CAD) was defined as a stenosis >50% in at least 1 coronary vessel, while severe CAD as left main or trivessel disease. RESULTS Among 3712 patients, 1044 (28.1%) had chronic kidney disease. CKD was related with age, female gender, diabetes and glycemic control, history of myocardial infarction, cerebrovascular accidents, coronary artery bypass grafting and left ventricular dysfunction or arrhythmias as indication to angiography, therapy with angiotensin-receptor blockers, nitrates, diuretics and calcium-antagonists, but lower rate of smoking, lower fibrinogen levels, haemoglobin, total and HDL cholesterol (p<0.001, respectively). CKD patients displayed increased severity and complexity of CAD (p<0.001) and significantly larger platelet volume (p<0.001), with CKD resulting as independent predictor of MPV above the median (≥10.85fl; Adjusted OR[95%CI]=1.56[1.23,1.99], p=0.002). Moreover, in the 1044 patients with renal failure, higher platelet volume (above the median value; ≥10.85fl) was associated with age (p=0.05), haemoglobin levels and platelet count (p<0.001), but not to a higher prevalence or extent of coronary artery disease (CAD: adjusted OR[95%CI]=0.80[0.58-1.09], p=0.16; severe CAD, adjusted OR[95%CI]=1.07[0.81-1.41], p=0.65). CONCLUSIONS Higher values of MPV are observed among patients with chronic kidney disease, inversely relating to eGFR. However, larger platelet size does not contribute to explain the increased severity of coronary artery disease observed among these patients.
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Affiliation(s)
- Monica Verdoia
- Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy
| | - Lucia Barbieri
- Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy
| | - Alon Schaffer
- Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy
| | - Giorgio Bellomo
- Clinical Chemistry, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy; Departement of Translational Medicine, Eastern Piedmont University, Novara, Italy
| | - Paolo Marino
- Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy; Departement of Translational Medicine, Eastern Piedmont University, Novara, Italy
| | - Giuseppe De Luca
- Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara. Italy; Departement of Translational Medicine, Eastern Piedmont University, Novara, Italy; Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy.
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