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Mao B, Qiu J, Zhao N, Shao Y, Dai W, He X, Cui H, Lin X, Lv L, Tang Z, Xu S, Huang H, Zhou M, Xu X, Qiu W, Liu Q, Zhang Y. Maternal folic acid supplementation and dietary folate intake and congenital heart defects. PLoS One 2017; 12:e0187996. [PMID: 29145433 PMCID: PMC5690601 DOI: 10.1371/journal.pone.0187996] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background It has been reported that folic acid supplementation before and/or during pregnancy could reduce the risk of congenital heart defects (CHDs). However, the results from limited epidemiologic studies have been inconclusive. We investigated the associations between maternal folic acid supplementation, dietary folate intake, and the risk of CHDs. Methods A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. After exclusion of stillbirths and multiple births, a total of 94 births were identified with congenital heart defects, and 9,993 births without any birth defects. Unconditional logistic regression was used to estimate the associations. Results Compared to non-users, folic acid supplement users before pregnancy had a reduced risk of overall CHDs (OR: 0.42, 95% CI: 0.21–0.86, Ptrend = 0.025) after adjusted for potential confounders. A protective effect was observed for certain subtypes of CHDs (OR: 0.37, 95% CI: 0.16–0.85 for malformation of great arteries; 0.26, 0.10–0.68 for malformation of cardiac septa; 0.34, 0.13–0.93 for Atrial septal defect). A similar protective effect was also seen for multiple CHDs (OR: 0.49, 95% CI: 0.26–0.93, Ptrend = 0.004). Compared with the middle quartiles of dietary folate intake, lower dietary folate intake (<149.88 μg/day) during pregnancy were associated with increased risk of overall CHDs (OR: 1.63, 95% CI: 1.01–2.62) and patent ductus arteriosus (OR: 1.85, 95% CI: 1.03–3.32). Women who were non-user folic acid supplement and lower dietary folate intake have almost 2-fold increased CHDs risk in their offspring. Conclusions Our study suggested that folic acid supplementation before pregnancy was associated with a reduced risk of CHDs, lower dietary folate intake during pregnancy was associated with increased risk. The observed associations varied by CHD subtypes. A synergistic effect of dietary folate intake and folic acid supplementation was also observed.
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Affiliation(s)
- Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Nan Zhao
- Yale University School of Public Health, New Haven, Connecticut, United States of America
| | - Yawen Shao
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Wei Dai
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Hongmei Cui
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Ling Lv
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Zhongfeng Tang
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Sijuan Xu
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Huang Huang
- Yale University School of Public Health, New Haven, Connecticut, United States of America
| | - Min Zhou
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Weitao Qiu
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, Qilihe District, Lanzhou, Gansu Province, China
- * E-mail: (YZ); (QL)
| | - Yawei Zhang
- Yale University School of Public Health, New Haven, Connecticut, United States of America
- * E-mail: (YZ); (QL)
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Chen Y, Li D, Jing J, Yan H, Liu J, Shen Z, James S, Varenhorst C. Treatment Trends, Effectiveness, and Safety of Statins on Lipid Goal Attainment in Chinese Percutaneous Coronary Intervention Patients: a Multicenter, Retrospective Cohort Study. Clin Ther 2017; 39:1827-1839.e1. [DOI: 10.1016/j.clinthera.2017.07.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/13/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
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53
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Li S, Ning H, Ye Y, Wei W, Guo R, Song Q, Liu L, Liu Y, Na L, Niu Y, Chu X, Feng R, Moustaid-Moussa N, Li Y, Sun C. Increasing extracellular Ca 2+ sensitizes TNF-alpha-induced vascular cell adhesion molecule-1 (VCAM-1) via a TRPC1/ERK1/2/NFκB-dependent pathway in human vascular endothelial cells. BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH 2017; 1864:1566-1577. [PMID: 28583863 DOI: 10.1016/j.bbamcr.2017.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 05/16/2017] [Accepted: 06/01/2017] [Indexed: 12/29/2022]
Abstract
Increasing circulating Ca2+ levels within the normal range has been reported to positively correlate with the incidence of fatal cardiovascular diseases (CVDs). However, limited studies have been able to delineate the potential mechanism(s) linking circulating Ca2+ to CVD. In this study, we exposed primary human umbilical vein endothelial cells (HUVECs) and human umbilical vein cell line (EA.hy926) to different extracellular Ca2+ to mimic the physiological state. Our data revealed that increasing extracellular Ca2+ significantly enhanced susceptibility to tumor necrosis factor (TNF)-alpha-stimulated vascular cell adhesion molecule (VCAM)-1 expression and monocytes adhesion. Knocking-down VCAM-1 by siRNA abolished calcium-induced monocytes adhesion on HUVECs. Follow up mechanistic investigations identified that extracellular Ca2+-increased calcium influx contributed to the activation of VCAM-1. This was mediated via upregulation of transient receptor potential channel (TRPC)1 in a nuclear factor (NF)κB-dependent manner. Most importantly, we found that a novel TRPC1-regulated extracellular signal-regulated kinase 1/2 (ERK1/2) pathway exclusively contributed to calcium-induced NFκB activation. This study provided direct evidence that increasing extracellular Ca2+ enhanced TNF-alpha-induced VCAM-1 activation and monocytes adhesion. Moreover, we identified a novel TRPC1/ERK1/2/NFκB signaling pathway mediating VCAM-1 activation and monocyte adhesion in this pathological process. Our studies indicate that blood calcium levels should be strictly monitored to help prevent CVD, and that TRPC1 might act as a potential target for the treatment and prevention against increased circulating calcium-enhanced CVDs.
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Affiliation(s)
- Songtao Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China; Key Laboratory of Cardiovascular Medicine Research, Harbin Medical University, Ministry of Education, 150081, China
| | - Hua Ning
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Yaxin Ye
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Wei Wei
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Rui Guo
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Qing Song
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Lei Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Yunyun Liu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China
| | - Lixin Na
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Yuchun Niu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Xia Chu
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Rennan Feng
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China
| | - Naima Moustaid-Moussa
- Department of Nutritional Sciences and Obesity Research Cluster, Texas Tech University, Lubbock, TX 79409, USA
| | - Ying Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China.
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin 150081, China; Research Institute of Food, Nutrition and Health, Sino-Russian Medical Research Center, Harbin Medical University, Harbin 150081, China.
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Hu P, Wang S, Lee J. Socioeconomic gradients of cardiovascular risk factors in China and India: results from the China health and retirement longitudinal study and longitudinal aging study in India. Int J Public Health 2017; 62:763-773. [PMID: 28401249 DOI: 10.1007/s00038-017-0968-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/26/2017] [Accepted: 03/22/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Cardiovascular disease has become a major public health challenge in developing countries. The goal of this study is to compare socioeconomic status (SES) gradients of cardiovascular risk factors (CVRF) both within and between China and India. METHODS We used multivariable logistic regression models to examine the associations between SES and CVRF, using data from the China health and retirement longitudinal study and the longitudinal aging study in India. RESULTS The results showed that, compared to illiteracy, the odds ratios of completing junior high school for high-risk waist circumference were 4.99 (95% confidence interval: 1.77-14.06) among Indian men, 3.42 (95% confidence interval: 1.66-7.05) among Indian women, but 0.74 (95% confidence interval: 0.59-0.92) among Chinese women. Similar patterns were observed between educational attainment and high-risk body mass index, and between education and hypertension, based on self-reported physician diagnosis and direct blood pressure measurements. CONCLUSIONS SES is associated with CVRF in both China and India. However, this relationship showed opposite patterns across two countries, suggesting that this association is not fixed, but is subjective to underlying causal pathways, such as patterns of risky health behaviors and different social and health policies.
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Affiliation(s)
- Peifeng Hu
- Division of Geriatric Medicine, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA, 90095-1687, USA.
| | - Serena Wang
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
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Zhao X, Yang X, Gao C, Chu Y, Yang L, Tian L, Li L. Improved Survival of Patients with ST-Segment Elevation Myocardial Infarction 3-6 Hours After Symptom Onset Is Associated with Inter-Hospital Transfer for Primary Percutaneous Coronary Intervention (PCI) at a Large Regional ST-Segment Elevation Myocardial Infarction (STEMI) Program vs. In-Hospital Thrombolysis in a Community Hospital. Med Sci Monit 2017; 23:1055-1063. [PMID: 28240997 PMCID: PMC5341906 DOI: 10.12659/msm.902466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study sought to compare the 30-day and 1-year survival of patients diagnosed with ST-segment elevation myocardial infarction (STEMI), whose symptom onset to in-hospital first medical contact (IHFMC) was 3-6 h, who received either in-hospital thrombolysis (IHT) in the nearest county hospital or direct transfer to a larger hospital in Henan province, China for primary percutaneous coronary intervention (PPCI). MATERIAL AND METHODS Patients were allocated into 2 groups: one group received IHT in the local county hospital, whereas the other group were transferred to the PCI centers to receive PPCI. Patient demographic data, baseline characteristics, and time between different stages of patient contact to the initiation of treatment for IHT or PPCI were recorded for analysis. RESULTS No significant difference was identified between the 2 groups with the baseline characteristics and demographic data. The all-cause mortality was not significantly different between the IHT and PPCI group at 30 days (13.0% vs. 9.9%, p=0.386). However, a significant difference in mortality between the IHT and PPCI group was observed at 1 year (23.4% vs. 14.1%, p=0.035). Inter-hospital transfer time for PPCI tended to be the independent predictor for survival (OR: 4.4 CI 95%: 1.9-14.5, p 0.001). Overall, the patients undergoing PPCI in inter-hospital transfer had a higher survival rates for 1 year compared with patients receiving IHT. CONCLUSIONS Despite the delay associated with inter-hospital transfer for PPCI, patients with STEMI 3-6 h after symptom onset have improved survival with PPCI over patients treated locally with IHT.
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Affiliation(s)
- Xiangmei Zhao
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Xianzhi Yang
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Chuanyu Gao
- Deparment of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Yingjie Chu
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Lei Yang
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Lixiao Tian
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
| | - Lin Li
- Deparment of Emergency, Zhengzhou University People's Hospital, Zhengzhou, Henan, China (mainland)
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Zhang W, Ji F, Yu X, Wang X. Factors associated with unattained LDL-cholesterol goals in Chinese patients with acute coronary syndrome one year after percutaneous coronary intervention. Medicine (Baltimore) 2017; 96:e5469. [PMID: 28072688 PMCID: PMC5228648 DOI: 10.1097/md.0000000000005469] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Reducing low-density lipoprotein cholesterol (LDL-C) to target ≤1.81 mmol/L is a common therapeutic goal after acute coronary syndrome (ACS). This study aimed to examine the factors associated with reaching or not this LDL-C target after 1 year of optimal statin therapy postpercutaneous coronary intervention (PCI). This was a retrospective study of 633 consecutive prospectively enrolled patients with ACS treated between January 2011 and December 2012 at the Beijing Hospital (China). All patients were treated with PCI and statins for 1 year. A multivariate analysis was carried out to identify the factors associated with reaching the LDL-C target of ≤1.81 mmol/L. The rate of unreached LDL-C goal after 1 year was 48%. Compared with those who achieved their LDL-C goal, patients not achieving their LDL-C goal showed a higher proportion of females (37.9% vs 28.7%, P < 0.001), higher LDL-C levels at admission (2.82 ± 0.75 vs 2.08 ± 0.70 mmol/L, P < 0.001), lower proportion of patients with a history of PCI (17.6% vs 24.8%, P = 0.03), and younger age (66.7 ± 10.6 vs 68.9 ± 10.1 years, P = 0.009). A multivariate analysis showed that lower LDL-C levels on admission were predictive of LDL-C goal achievement (odds ratio [OR] = 4.81; 95% confidence interval [CI]: 3.46-6.70; P < 0.001), together with older age (OR: 0.98; 95% CI: 0.96-0.997; P = 0.026), and male gender (OR: 0.64; 95% CI: 0.42-0.98; P = 0.040). Higher LDL-C levels at admission, younger age, and female gender were independently associated with not reaching the LDL-C target after 1 year of optimal statin therapy after PCI.
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Kim YD, Jung YH, Saposnik G. Traditional Risk Factors for Stroke in East Asia. J Stroke 2016; 18:273-285. [PMID: 27733028 PMCID: PMC5066436 DOI: 10.5853/jos.2016.00885] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/21/2016] [Accepted: 08/23/2016] [Indexed: 01/19/2023] Open
Abstract
Stroke is one of the leading causes of death and morbidity worldwide. The occurrence of stroke is strongly dependent on well-known vascular risk factors. After rapid modernization, urbanization, and mechanization, East Asian countries have experienced growth in their aged populations, as well as changes in lifestyle and diet. This phenomenon has increased the prevalence of vascular risk factors among Asian populations, which are susceptible to developing cardiovascular risk factors. However, differing patterns of stroke risk factor profiles have been noted in East Asian countries over the past decades. Even though the prevalence of vascular risk factors has changed, hypertension is still prevalent and the burden of diabetes and hypercholesterolemia will continue to increase. Asia remains a high tobacco-consuming area. Although indicators of awareness and management of vascular risk factors have increased in many East Asian countries, their rates still remain low. Here we review the burdens of traditional risk factors, such as hypertension, diabetes, hypercholesterolemia, and smoking in East Asia. We will also discuss the different associations between these vascular risk factors and stroke in Asian and non-Asian populations.
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Affiliation(s)
- Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yo Han Jung
- Department of Neurology, Changwon Fatima Hospital, Changwon, Korea
| | - Gustavo Saposnik
- Stroke Outcomes Research Unit, Division of Neurology, University of Toronto, Toronto, Canada
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Lippi G, Lo Cascio C, Brocco G, Danese E, Montagnana M, Bassi A, Caruso B, Bovo C, Salvagno GL. High-density lipoprotein cholesterol values independently and inversely predict cardiac troponin T and I concentration. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:188. [PMID: 27294084 DOI: 10.21037/atm.2016.03.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND This retrospective study was planned to establish potential associations between circulating values of cardiac troponins and those of conventional blood lipids. METHODS The study population consisted of patients attending an inpatient clinic of the University Hospital of Verona during the year 2015 as part of routine cardiovascular risk assessment. No exclusion criteria were applied. Serum lipids including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were measured using reference enzymatic techniques, whereas troponin T (TnT) was measured using a high-sensitivity (HS) immunoassay. A second analysis was also performed in the General Hospital of Verona, extracting data from the local laboratory database of all patients in whom troponin I (TnI) and blood lipids were simultaneously measured during the same year. RESULTS In univariate analysis, HS-TnT was found to be associated with age, sex, TC, LDL-C, HDL-C, but not with TG. In multivariate linear regression analysis, age (positive correlation; P<0.001) and HDL-C (negative correlation; P=0.032) remained significantly associated with HS-TnT. The frequency of HS-TnT values >50 ng/L was higher in subjects with HDL-C <1 mmol/L than in those with HDL-C ≥1 mmol/L [odds ratio (OR), 1.84; 95% confidence interval (CI), 1.03-3.32]. The frequency of HS-TnT values >50 ng/L was also higher in elderly subjects than in younger ones (OR, 2.10; 95% CI, 1.15-3.84). The combination of age and HDL-C explained 35% of overall variability of TnT concentration. In the second analysis, HDL-C was also found to be an independent and negative predictor of TnI in multivariate linear regression analysis (P=0.010). The combination of age and HDL-C explained approximately 28% of the overall variability of TnI concentration. CONCLUSIONS Our study suggests that HDL-C values inversely predict cardiac troponins concentration irrespective of age, sex and other blood lipids.
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Affiliation(s)
- Giuseppe Lippi
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Claudia Lo Cascio
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Giorgio Brocco
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Elisa Danese
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Martina Montagnana
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Antonella Bassi
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Beatrice Caruso
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Chiara Bovo
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
| | - Gian Luca Salvagno
- 1 Section of Clinical Biochemistry, University of Verona, Verona, Italy ; 2 Laboratory of Clinical Chemistry and Hematology, General Hospital of Verona, Verona, Italy ; 3 Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy ; 4 Medical Direction, University Hospital of Verona, Verona, Italy
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King-Shier KM, Singh S, Khan NA, LeBlanc P, Lowe JC, Mather CM, Chong E, Quan H. Ethno-Cultural Considerations in Cardiac Patients’ Medication Adherence. Clin Nurs Res 2016; 26:576-591. [DOI: 10.1177/1054773816646078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We aimed to develop an in-depth understanding about factors that influence cardiac medication adherence among South Asian, Chinese, and European White cardiac patients. Sixty-four patients were purposively sampled from an ongoing study cohort. Interviews were audio-recorded and transcribed for analyses. Physicians’ culturally sensitive communication and patients’ motivation to live a symptom-free and longer life enhanced adherence. European Whites were motivated to enhance personal well-being and enjoy family life. South Asians’ medication adherence was influenced by the desire to fulfill the will of God and family responsibilities. The Chinese were motivated to avoid pain, illness, and death, and to obey a health care provider. The South Asians and Chinese wanted to ultimately reduce medication use. Previous positive experiences, family support, and establishing a routine also influenced medication adherence. Deterrents to adherence were essentially the reverse of the motivators/facilitators. This analysis represents an essential first step forward in developing ethno-culturally tailored interventions to optimize adherence.
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Affiliation(s)
| | - S. Singh
- University of Calgary, Alberta, Canada
| | - N. A. Khan
- University of British Columbia, Vancouver, Canada
| | | | | | | | - E. Chong
- University of British Columbia, Vancouver, Canada
| | - H. Quan
- University of Calgary, Alberta, Canada
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Liu L, Tang Z, Li X, Luo Y, Guo J, Li H, Liu X, Tao L, Yan A, Guo X. A Novel Risk Score to the Prediction of 10-year Risk for Coronary Artery Disease Among the Elderly in Beijing Based on Competing Risk Model. Medicine (Baltimore) 2016; 95:e2997. [PMID: 26986112 PMCID: PMC4839893 DOI: 10.1097/md.0000000000002997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The study aimed to construct a risk prediction model for coronary artery disease (CAD) based on competing risk model among the elderly in Beijing and develop a user-friendly CAD risk score tool. We used competing risk model to evaluate the risk of developing a first CAD event. On the basis of the risk factors that were included in the competing risk model, we constructed the CAD risk prediction model with Cox proportional hazard model. Time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) were used to evaluate the discrimination ability of the both methods. Calibration plots were applied to assess the calibration ability and adjusted for the competing risk of non-CAD death. Net reclassification index (NRI) and integrated discrimination improvement (IDI) were applied to quantify the improvement contributed by the new risk factors. Internal validation of predictive accuracy was performed using 1000 times of bootstrap re-sampling. Of the 1775 participants without CAD at baseline, 473 incident cases of CAD were documented for a 20-year follow-up. Time-dependent AUCs for men and women at t = 10 years were 0.841 [95% confidence interval (95% CI): 0.806-0.877], 0.804 (95% CI: 0.768-0.839) in Fine and Gray model, 0.784 (95% CI: 0.738-0.830), 0.733 (95% CI: 0.692-0.775) in Cox proportional hazard model. The competing risk model was significantly superior to Cox proportional hazard model on discrimination and calibration. The cut-off values of the risk score that marked the difference between low-risk and high-risk patients were 34 points for men and 30 points for women, which have good sensitivity and specificity. A sex-specific multivariable risk factor algorithm-based competing risk model has been developed on the basis of an elderly Chinese cohort, which could be applied to predict an individual's risk and provide a useful guide to identify the groups at a high risk for CAD among the Chinese adults over 55 years old.
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Affiliation(s)
- Long Liu
- From the Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China (LL, YL, JG, HL, XL, LT, AY, XG); Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China (LL, YL, JG, HL, XL, LT, XG); Xuan Wu Hospital, Capital Medical University, Beijing, China (ZT); The Graduate Entry Medical School, University of Limerick, Limerick, Ireland (XL); and Beijing Municipal Science and Technology Commission, Beijing, China (AY)
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Gao R, Yang Y, Han Y, Huo Y, Chen J, Yu B, Su X, Li L, Kuo HC, Ying SW, Cheong WF, Zhang Y, Su X, Xu B, Popma JJ, Stone GW. Bioresorbable Vascular Scaffolds Versus Metallic Stents in Patients With Coronary Artery Disease. J Am Coll Cardiol 2015; 66:2298-2309. [DOI: 10.1016/j.jacc.2015.09.054] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/16/2015] [Accepted: 09/25/2015] [Indexed: 11/15/2022]
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