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Alkali NH, Uloko AE, Chiroma I, Mugana A, Garba MA, Okpe IO, Gargah ET, Abdullahi UF, Shadrach L, Haladu IA. Cardiovascular Risk Awareness, Exercise Practices and Metabolic Outcomes among Patients with Diabetes Mellitus in Northern Nigeria: A Cross-sectional, Multicentre Study. Niger Postgrad Med J 2024; 31:139-146. [PMID: 38826017 DOI: 10.4103/npmj.npmj_54_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Physical exercise helps to mitigate cardiovascular risks in people with diabetes mellitus (DM), but there are limited data in Nigeria. This study aimed to assess cardiovascular risk awareness, exercise practices and metabolic outcomes among Nigerians with diabetes. MATERIALS AND METHODS We conducted a cross-sectional study at five tertiary hospitals using questionnaire interviews and clinical assessments. Participants' knowledge of cardiovascular risk factors and knowledge of exercise were assessed on 12- and 5-item scores, while exercise practices were classed as adequate if performed regularly on 3 or more days weekly for a total of 150 min or more based on the American Diabetes Association recommendations. Mean body mass index (BMI), blood pressure (BP), fasting blood glucose, serum haemoglobin A1C (HbA1c), lipid profile, urea, creatinine and uric acid were then compared among participant groups. RESULTS We studied 426 participants with DM, 58.7% females. The mean age was 52.9 ± 13.1 years, with males significantly older than females (54.6 ± 12.2 vs. 51.8 ± 13.5 years; 95% confidence interval: 0.27-5.28, P = 0.03). The mean age at diabetes diagnosis was 44.8 ± 11.7 years, and the median duration of diabetes was 84 months. There was low knowledge of cardiovascular risk factors and low knowledge of exercise (mean scores of 2.94 and 2.31, respectively). Forty-three per cent of participants reported adequate exercise, which was significantly associated with younger age (P = 0.007), male gender (P = 0.001) and formal education (P = 0.021). Participants with adequate exercise had lower systolic BP and serum urea compared to those with inadequate exercise, but there were no significant differences in BMI, fasting glucose, HbA1c, serum lipids, creatinine or uric acid. CONCLUSION Participants had low knowledge of cardiovascular risks and the appropriate exercise practices for diabetes patients. There is a need for better patient education on diabetes self-care and exercise at clinic visits.
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Affiliation(s)
- Nura Hamidu Alkali
- Department of Medicine, Abubakar Tafawa Balewa University, Bauchi, Nigeria
| | - Andrew E Uloko
- Department of Medicine, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ijuptil Chiroma
- Department of Medicine, University of Maiduguri, Maiduguri, Borno, Nigeria
| | - Ayuba Mugana
- Department of Medicine, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | | | | | | | | | - Lumsami Shadrach
- Department of Medicine, Modibbo Adama University Teaching Hospital, Yola, Adamawa, Nigeria
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Rakic JM, Pullinger CR, Van Blarigan EL, Movsesyan I, Stock EO, Malloy MJ, Kane JP. APOL1 Risk Variants Associate With the Prevalence of Stroke in African American Current and Past Smokers. J Am Heart Assoc 2023; 12:e030796. [PMID: 38084718 PMCID: PMC10863786 DOI: 10.1161/jaha.123.030796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND African American smokers have 2.5 times higher risk for stroke compared with nonsmokers (higher than other races). About 50% of the African American population carry 1 or 2 genetic variants (G1 and G2; rare in other races) of the apolipoprotein L1 gene (APOL1). Studies showed these variants may be associated with stroke. However, the role of the APOL1 risk variants in tobacco-related stroke is unknown. METHODS AND RESULTS In a cross-sectional study, we examined whether APOL1 risk variants modified the relationship between tobacco smoking and stroke prevalence in 513 African American adults recruited at University of California, San Francisco. Using DNA, plasma, and questionnaires we determined APOL1 variants, smoking status, and stroke prevalence. Using logistic regression models, we examined the association between smoking (ever versus never smokers) and stroke overall, and among carriers of APOL1 risk variants (1 or 2 risk alleles), and noncarriers, separately. Among participants, 41% were ever (current and past) smokers, 54% were carriers of the APOL1 risk variants, and 41 had a history of stroke. The association between smoking and stroke differed by APOL1 genotype (Pinteraction term=0.014). Among carriers, ever versus never smokers had odds ratio (OR) 2.46 (95% CI, 1.08-5.59) for stroke (P=0.034); OR 2.00 (95% CI, 0.81-4.96) among carriers of 1 risk allele, and OR 4.72 (95% CI, 0.62-36.02) for 2 risk alleles. Among noncarriers, smoking was not associated with a stroke. CONCLUSIONS Current and past smokers who carry APOL1 G1 and/or G2 risk variants may be more susceptible to stroke among the African American population.
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Affiliation(s)
- Jelena Mustra Rakic
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Center for Tobacco Control Research and EducationUniversity of California, San FranciscoCAUSA
| | - Clive R. Pullinger
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of Physiological NursingUniversity of California, San FranciscoCAUSA
| | - Erin L. Van Blarigan
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoCAUSA
| | - Irina Movsesyan
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
| | - Eveline Oestreicher Stock
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
| | - Mary J. Malloy
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
| | - John P. Kane
- Cardiovascular Research InstituteUniversity of California, San FranciscoCAUSA
- Department of MedicineUniversity of California, San FranciscoCAUSA
- Department of Biochemistry and BiophysicsUniversity of California, San FranciscoCAUSA
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Yubero-Serrano EM, Gutiérrez-Mariscal FM, Gómez-Luna P, Alcalá-Diaz JF, Pérez-Martinez P, López-Miranda J. Dietary modulation of advanced glycation end products metabolism on carotid intima-media thickness in type 2 diabetes patients: From the CORDIOPREV study. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:105-114. [PMID: 36184301 DOI: 10.1016/j.arteri.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Advanced glycation end products (AGEs) are pro-oxidant and cytotoxic compounds involved in the progression of chronic diseases as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). The total body burden of AGEs also depend of those consume through the diet. Our aim was to analyze whether the reduction of AGE levels, after the consumption of two-healthy diets were associated with a greater decrease of intima-media thickness of both common carotid arteries (IMT-CC) in patients with T2DM and coronary heart disease (CHD). METHODS 540 CHD patients with T2DM, at baseline, from the CORDIOPREV study, were divided into two groups: (1) Responders, patients whose IMT-CC was reduced or not changed after dietary intervention and (2) Non-responders, patients whose IMT-CC was increased after dietary intervention. A total of 423 completed baseline and the 5-year follow-up carotid ultrasounds were analyzed in this study. RESULTS Our data showed that Responders, despite had a higher baseline IMT-CC and serum methylglyoxal (MG) levels than Non-responders, showed a reduction of serum levels of this glycotoxin after dietary intervention. Conversely, in patients whose IMT-CC was increased after dietary intervention (Non-responders), serum MG levels were increased. Moreover, an increase of circulating level of AGEs (and in particular, MG), after dietary intervention, could be considered a risk factor for the progression of atherosclerosis in patients with T2DM and CHD. CONCLUSION These results support the importance of identifying underlying mechanisms in the context of secondary prevention of CVD that would provide therapeutic targets to reduce the high risk of cardiovascular events of these patients. CLINICAL TRIAL REGISTRATION-URL https://clinicaltrials.gov/ct2/show/NCT00924937. Unique Identifier: NCT00924937.
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Affiliation(s)
- Elena M Yubero-Serrano
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
| | - Francisco M Gutiérrez-Mariscal
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Purificación Gómez-Luna
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Juan F Alcalá-Diaz
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Pablo Pérez-Martinez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - José López-Miranda
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
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4
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Zhang Y, Zhai Y, Niu B, Liu X, Zhang X, Wu S, Zhu C. Association between Depression and Clinical Outcomes following Percutaneous Coronary Intervention: A Meta-Analysis. Psychopathology 2022; 55:251-257. [PMID: 35421863 DOI: 10.1159/000524228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several studies suggested that depression was associated with poor prognosis following percutaneous coronary intervention (PCI) in coronary heart disease (CHD), whereas other studies showed that there were no associations between depression and poor outcomes. OBJECTIVES Considering these problems, this meta-analysis was conducted to evaluate the relationship between depression and clinical outcomes after PCI. METHODS Articles published before July 2021 were analyzed from the databases: PubMed, Web of Science, EMBASE, Medline, and Google Scholar. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed to generate a pooled effect size and 95% CI with a random or fixed effects model. Q test and I2 were used to assess heterogeneities between studies. RESULTS The meta-analysis indicated that depression was associated with a higher risk of major adverse cardiac events (MACE) after PCI with a random effects model (HR = 1.89, 95% CI: 1.33-2.68, I2 = 57.0%, p = 0.023). The study indicated that depression was associated with a higher risk of all-cause mortality after PCI with a fixed effects model (HR = 1.71, 95% CI: 1.43-2.05, I2 = 0.0%, p = 0.756). The study indicated no significant association between depression and risk of repeat revascularization after PCI with a random effects model (HR = 2.10, 95% CI: 0.96-4.58, I2 = 68.9%, p = 0.022). CONCLUSION Results indicated that depression is associated with adverse clinical outcomes in CHD patients' post-PCI. Appropriate mental health check and psychological treatment may be necessary for the prognosis of CHD patients who receive PCI.
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Affiliation(s)
- Yifan Zhang
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - You Zhai
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Bohan Niu
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaolu Liu
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoxiao Zhang
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shangwen Wu
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Cuiling Zhu
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
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5
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Song C, Wu G, Chang S, Bie L. Plasma P-selectin level is associated with severity of coronary heart disease in Chinese Han population. J Int Med Res 2021; 48:300060519896437. [PMID: 32588673 PMCID: PMC7432984 DOI: 10.1177/0300060519896437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective This study aimed to evaluate the association between plasma P-selectin levels
and the severity of coronary heart disease (CHD) in a Chinese Han
population. Methods We enrolled 219 patients with CHD and 168 healthy individuals without CHD as
a control group. Coronary stenosis was evaluated based on the number of
diseased coronary arteries and the Gensini scoring system. P-selectin levels
were quantified by enzyme-linked immunosorbent assay and the association
between CHD and plasma P-selectin level was analyzed. Results P-selectin levels were significantly higher in CHD patients compared with
controls. Levels were highest in patients with three-vessel disease and
lowest in those with one-vessel disease, with significant differences among
the groups. P-selectin levels were also highest in the high-score and lowest
in the low-score group according to Gensini score, with significant
differences among the groups. P-selectin level was significantly positively
correlated with Gensini score and C-reactive protein level. Elevated
P-selectin was identified as an independent risk factor for CHD. Conclusion P-selectin levels were increased in Chinese Han patients with CHD. P-selectin
level is an independent risk factor for CHD and may serve as a biomarker
reflecting the severity of CHD in the Chinese Han population.
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Affiliation(s)
- Chunhui Song
- Department of Cardiology, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Cardiology, the People's Hospital of Funing, Funing, Jiangsu, China
| | - Guohai Wu
- Department of Cardiology, the People's Hospital of Funing, Funing, Jiangsu, China
| | - Sheng Chang
- Department of Cardiology, the People's Hospital of Funing, Funing, Jiangsu, China
| | - Lizhan Bie
- National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
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6
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Hou Y, Zhang D, Zhu J, Zhao X, Lu M, Wu Q, Ojo O, Wang X, Zhang Y. Short report: depression and anxiety symptoms as predictors of adverse cardiovascular events in Chinese patients after percutaneous coronary intervention. PSYCHOL HEALTH MED 2020; 26:1126-1133. [PMID: 33073611 DOI: 10.1080/13548506.2020.1837388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression and anxiety often co-occur in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). This study was conducted to examine the predictive value of depression, anxiety, and their combination on the prognosis of Chinese PCI patients. A multicenter prospective study was undertaken with a sample of 309 primary PCI patients. The Hospital Anxiety and Depression Scale (HADS) was completed at baseline to assess anxiety and depression symptoms. Major adverse cardiovascular events (MACEs) were recorded for 12 months after PCI . Days from baseline to the first MACE was the outcome variable. MACEs occurred in 26 (8.4%) patients. After adjustments for socio-demographic and clinical characteristics, a Cox proportional hazards regression model revealed that depression (HR = 2.70, 95% confidence interval [CI] 1.22-5.95; p =.014) and anxiety (HR = 2.56, 95% CI 1.18-5.54; p =.017) symptoms were independent predictors of MACEs. A subanalysis showed that the cumulative event-free survival curves did not differ among depressed and anxious patients and depressed but non-anxious patients (Log Rank p =.52). In conclusion, depression is associated with an increased risk for MACEs post-PCI, independent of anxiety. Although anxiety is associated with MACEs, it has no additional predictive value when co-occurring with depression.
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Affiliation(s)
- Yunying Hou
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,School of Nursing, Soochow University, Suzhou, China
| | - Dandan Zhang
- School of Nursing, Soochow University, Suzhou, China
| | - Jifang Zhu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Zhao
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Minxia Lu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qing Wu
- School of Nursing, Soochow University, Suzhou, China
| | - Omorogieva Ojo
- Faculty of Education and Health, University of Greenwich Avery Hill Campus, London, UK
| | - Xiaohua Wang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,School of Nursing, Soochow University, Suzhou, China
| | - Yonghong Zhang
- School of Public Health, Soochow University, Suzhou, China
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Almarzooq ZI, Colantonio LD, Okin PM, Richman JS, Brown TM, Levitan EB, Bryan J, Safford MM. Risk factors for 'microsize' vs. usual myocardial infarctions in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 5:343-351. [PMID: 30843051 DOI: 10.1093/ehjqcco/qcz007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/27/2019] [Accepted: 03/01/2019] [Indexed: 12/29/2022]
Abstract
AIMS A recently described phenomenon is that of myocardial infarction (MI) events that meet criteria for MI, but that have very low peak troponin elevations, so-called 'microsize MI'. These events are very common and associated with increased risk of all-cause mortality. Our aim is to compare risk factors for microsize MI vs. usual MI events. METHODS AND RESULTS Among 24 470 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort free of coronary heart disease at baseline, heart-related hospitalizations were expert adjudicated for MI using published guidelines. Myocardial infarctions were classified as microsize MI (peak troponin <0.5 ng/mL) or usual MI (peak troponin ≥0.5 ng/mL). Competing risk analyses assessed associations between baseline risk factors and incident microsize vs. usual MI. Between 2003 and 2013 there were 891 MIs; 279 were microsize MI and 612 were usual MI. Risk factors for both usual MI and microsize MI include age, gender, diabetes, and urinary albumin to creatinine ratio. Risk factors for only usual MI include Residence in the Stroke Belt and Buckle regions and current smoking. Black race was associated with a uniquely lower risk of usual MI. CONCLUSION The similarities in risk profiles suggest a possible common aetiology and should encourage clinicians to both treat reversible risk factors for microsize MI and to initiate secondary prevention strategies following these events until this emerging clinical entity is better understood. Future studies should further assess the clinical outcomes of these two entities and their effect on future management.
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Affiliation(s)
- Zaid I Almarzooq
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
| | - Lisandro D Colantonio
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter M Okin
- Division of Cardiology, 525 East 68th Street, F-2006, New York, NY, USA
| | - Joshua S Richman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Todd M Brown
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joanna Bryan
- Division of General Internal Medicine, Weill Cornell Medicine, 525 East 68th Street, F-2006, New York, NY, USA
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medicine, 525 East 68th Street, F-2006, New York, NY, USA
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Lin HC, Lin JR, Tsai WC, Lu CH, Chang WN, Huang CC, Wang HC, Kung CT, Su CM, Su YJ, Lin WC, Cheng BC, Hsu CW, Lai YR, Tsai NW. The outcomes of statin therapy in patients with acute ischemic stroke in Taiwan: a nationwide epidemiologic study. QJM 2019; 112:891-899. [PMID: 31350560 DOI: 10.1093/qjmed/hcz189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/01/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Acute stroke is the third leading cause of death in Taiwan. Although statin therapy is widely recommended for stroke prevention, little is known about the epidemiology of statin therapy after acute ischemic stroke (AIS) in Taiwan. To investigate the effects of statin therapy on recurrent stroke, intracranial hemorrhage (ICH), coronary artery disease (CAD), cost of hospitalization and mortality, we conducted a nationwide population-based epidemiologic study. METHODS Cases of AIS were identified from the annual hospitalization discharge diagnoses of the National Health Insurance Research Database with the corresponding International Classification of Diseases, ninth revision codes from January 2001 to December 2010. We divided the AIS patients into three groups: non-statin, pre-stroke statin and post-stroke statin. RESULTS A total of 422 671 patients with AIS (including 365 419 cases in the non-statin group, 22 716 cases in the pre-stroke statin group and 34 536 cases in the post-stroke statin group) were identified. When compared to the non-statin group, both statin groups had a lower recurrent stroke risk [pre-stroke statin: odds ratio (OR) = 0.84; 95% confidence interval (CI) = 0.82-0.87; P < 0.0001; post-stroke statin: OR = 0.89; 95% CI = 0.86-0.91; P < 0.0001], lower ICH risk (pre-statin: OR = 0.75; 95% CI = 0.69-0.82; P < 0.0001; post-stroke statin: OR = 0.75; 95% CI = 0.71-0.81; P < 0.0001), and a lower mortality rate (pre-stroke statin: OR = 0.56; 95% CI = 0.53-0.59; P < 0.0001; post-stroke statin: OR = 0.51; 95% CI = 0.48-0.53; P < 0.0001). In terms of CAD, only the post-statin group had a lower risk (OR = 0.81; 95% CI = 0.79-0.84; P < 0.0001) than the non-statin group. The post-statin group had the lowest 1-year medical costs after index discharge among the three groups. CONCLUSIONS Statin therapy reduced the risks of recurrent stroke, CAD, ICH and the first year mortality in patients after AIS. Treatment with statin therapy after AIS is a cost-effective strategy in Taiwan.
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Affiliation(s)
- H-C Lin
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - J-R Lin
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, Taiwan
- Research Services Center for Health Information, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, Taiwan
| | - W-C Tsai
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - C-H Lu
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, No. 70, Lianhai Rd., Gushan Dist., Kaohsiung City, Taiwan
| | - W-N Chang
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - C-C Huang
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - H-C Wang
- Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - C-T Kung
- Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - C-M Su
- Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - Y-J Su
- Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - W-C Lin
- Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - B-C Cheng
- Department of Biological Science, National Sun Yat-Sen University, No. 70, Lianhai Rd., Gushan Dist., Kaohsiung City, Taiwan
- Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
| | - C-W Hsu
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, No. 70, Lianhai Rd., Gushan Dist., Kaohsiung City, Taiwan
| | - Y-R Lai
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, No. 70, Lianhai Rd., Gushan Dist., Kaohsiung City, Taiwan
| | - N-W Tsai
- Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City, Taiwan
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9
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Long DL, Howard G, Long DM, Judd S, Manly JJ, McClure LA, Wadley VG, Safford MM, Katz R, Glymour MM. An Investigation of Selection Bias in Estimating Racial Disparity in Stroke Risk Factors. Am J Epidemiol 2019; 188:587-597. [PMID: 30452548 DOI: 10.1093/aje/kwy253] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 01/01/2023] Open
Abstract
Selection due to survival or attrition might bias estimates of racial disparities in health, but few studies quantify the likely magnitude of such bias. In a large national cohort with moderate loss to follow-up, we contrasted racial differences in 2 stroke risk factors, incident hypertension and incident left ventricular hypertrophy, estimated by complete-case analyses, inverse probability of attrition weighting, and the survivor average causal effect. We used data on 12,497 black and 17,660 white participants enrolled in the United States (2003-2007) and collected incident risk factor data approximately 10 years after baseline. At follow-up, 21.0% of white participants and 23.0% of black participants had died; additionally 22.0% of white participants and 28.4% of black participants had withdrawn. Individual probabilities of completing the follow-up visit were estimated using baseline demographic and health characteristics. Adjusted risk ratio estimates of racial disparities from complete-case analyses in both incident hypertension (1.11, 95% confidence interval: 1.02, 1.21) and incident left ventricular hypertrophy (1.02, 95% confidence interval: 0.84, 1.24) were virtually identical to estimates from inverse probability of attrition weighting and survivor average causal effect. Despite racial differences in mortality and attrition, we found little evidence of selection bias in the estimation of racial differences for these incident risk factors.
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Affiliation(s)
- D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dustin M Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Virginia G Wadley
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monika M Safford
- Division of General Internal Medicine, Cornell School of Medicine, New York, New York
| | - Ronit Katz
- Kidney Research Institute, University of Washington, Seattle, Washington
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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Handforth A, Parker GA. Conditions Associated with Essential Tremor in Veterans: A Potential Role for Chronic Stress. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2018; 8:517. [PMID: 29971194 PMCID: PMC6026277 DOI: 10.7916/d8vd8ff5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/06/2018] [Indexed: 02/06/2023]
Abstract
Background Increased depression, hearing loss, dementia, alcoholism, and mortality in essential tremor patients remain unexplained. We investigated whether conditions associated with tremor are linked to chronic stress. Methods The FY2013 Veterans Affairs database was queried for 38 selected dual diagnosis combinations in 5,854,223 veterans aged 21–95 years. Results Post-traumatic stress disorder, anxiety, and depression were the most common psychiatric diagnoses in tremor patients, with the odds ratio exceeding 2 in all 15-year cohorts. Depending on age, patients with essential tremor were more likely than those without to have obsessive–compulsive disorder, bipolar illness, schizophrenia, use tobacco and abuse alcohol, have hypertension, obesity, hyperlipidemia, diabetes, vitamin D deficiency, coronary and cerebrovascular diseases, congestive heart failure, stroke, asthma, hypothyroidism, irritable bowel syndrome, renal insufficiency, alcoholic liver disease, hearing loss, glaucoma, macular degeneration, migraine, epilepsy, idiopathic polyneuropathy, history of head trauma, and ‘Alzheimer’s dementia. In contrast, lung and colorectal cancer, amyotrophic lateral sclerosis, psychostimulant abuse, and rheumatoid arthritis were not more common. Discussion Post-traumatic stress disorder, anxiety, and depression, strongly associated with essential tremor, are known risk factors for poor health habits, tobacco use and alcohol abuse; collectively these are risk factors for vascular disease, with further negative health consequences for multiple organ systems. As essential tremor is associated with all these conditions, we propose that chronic stress is not only responsible for the conditions associated with tremor but in some cases itself directly and indirectly induces essential tremor, so that tremor and poor health share a common cause.
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Affiliation(s)
- Adrian Handforth
- Neurology Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Gail A Parker
- Knowledge Management, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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11
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Yu F, Li J, Huang Q, Cai H. Increased Peripheral Blood Visfatin Concentrations May Be a Risk Marker of Coronary Artery Disease: A Meta-Analysis of Observational Studies. Angiology 2018; 69:825-834. [PMID: 29706084 DOI: 10.1177/0003319718771125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A comprehensive quantitative evaluation of the relationship between peripheral blood visfatin concentrations and coronary artery disease (CAD) is lacking. This study is the first attempt to quantify this relationship via a meta-analysis of published observational studies in terms of weighted mean difference (WMD). Literature retrieval, article selection, and data extraction were conducted. Heterogeneity was inspected using both subgroup and meta-regression analyses. In total, 15 articles involving 1053 CAD cases and 714 controls were included. Overall, peripheral blood visfatin concentrations were significantly higher in CAD cases than in controls (WMD: 4.72 ng/mL; 95% confidence interval [CI]: 2.97-6.47; P < .001), with significant heterogeneity and publication bias. Six studies were theoretically missing based on filled funnel plot, and considering the impact of these missing studies still detected a significant overall mean difference in visfatin (WMD: 2.82 ng/mL; 95% CI: 2.22-3.58; P < .001; number of studies: 21). Subgroup and meta-regression analyses indicated age, body mass index, race, diabetes, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were identified as possible causes of heterogeneity. In conclusion, our findings suggest that increased peripheral blood visfatin concentrations may be a risk marker of CAD.
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Affiliation(s)
- Fuling Yu
- 1 Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jianwei Li
- 2 Department of Cardiology, Xi'an No 4 Hospital, Xi'an, Shaanxi, China
| | - Qilei Huang
- 3 Department of Cardiology, Affiliated Nanping First Hospital, Fujian Medical University, Nanping, Fujian, China
| | - Hongbin Cai
- 1 Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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12
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Sterling MR, Durant RW, Bryan J, Levitan EB, Brown TM, Khodneva Y, Glasser SP, Richman JS, Howard G, Cushman M, Safford MM. N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study. BMC Cardiovasc Disord 2018; 18:66. [PMID: 29661151 PMCID: PMC5902876 DOI: 10.1186/s12872-018-0806-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 04/11/2018] [Indexed: 01/28/2023] Open
Abstract
Background N-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern troponin assays and are emerging as a large proportion of all MI. Here, we sought to compare the association of NT-proBNP with risk of incident typical MI and microsize MI in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Methods The REGARDS Study is a national cohort of 30,239 US community-dwelling black and white adults aged ≥ 45 years recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MI (definite/probable MI with peak troponin ≥ 0.5 μg/L), incident microsize MI (definite/probable MI with peak troponin < 0.5 μg/L), and incident fatal CHD. Using a case-cohort design, we estimated the hazard ratio of the outcomes as a function of baseline NT-proBNP. Competing risk analyses tested whether the associations of NT-proBNP differed between the risk of incident microsize MI and incident typical MI as well as if the association of NT-proBNP differed between incident non-fatal microsize MI and incident non-fatal typical MI, while accounting for incident fatal coronary heart disease (CHD) as well as heart failure (HF). Results Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal CHD. NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI, even after removing individuals with suspected HF prior to or coincident with their incident CHD event. Conclusion NT-proBNP is associated with all MIs, but is a more powerful risk factor for microsize than typical MI. Electronic supplementary material The online version of this article (10.1186/s12872-018-0806-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA.
| | - Raegan W Durant
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Joanna Bryan
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Todd M Brown
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Yulia Khodneva
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Stephen P Glasser
- Department of Internal Medicine, University of Kentucky College of Medicine, Louisville, KY, USA
| | - Joshua S Richman
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Mary Cushman
- Departments of Medicine and Pathology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA
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13
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Frisbee SJ, Singh SS, Jackson DN, Lemaster KA, Milde SA, Shoemaker JK, Frisbee JC. Beneficial Pleiotropic Antidepressive Effects of Cardiovascular Disease Risk Factor Interventions in the Metabolic Syndrome. J Am Heart Assoc 2018; 7:e008185. [PMID: 29581223 PMCID: PMC5907597 DOI: 10.1161/jaha.117.008185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the increased prevalence and severity of clinical depression and elevated cardiovascular disease risk represent 2 vexing public health issues, the growing awareness of their combined presentation compounds the challenge. The obese Zucker rat, a model of the metabolic syndrome, spontaneously develops significant depressive symptoms in parallel with the progression of the metabolic syndrome and, thus, represents a compelling model for study. The primary objective was to assess the impact on both cardiovascular outcomes, specifically vascular structure and function, and depressive symptoms in obese Zucker rats after aggressive treatment for cardiovascular disease risk factors with long-term exercise or targeted pharmacological interventions. METHODS AND RESULTS We chronically treated obese Zucker rats with clinically relevant interventions against cardiovascular disease risk factors to determine impacts on vascular outcomes and depressive symptom severity. While most of the interventions (chronic exercise, anti-hypertensive, the interventions (long-term exercise, antihypertensive, antidyslipidemia, and antidiabetic) were differentially effective at improving vascular outcomes, only those that also resulted in a significant improvement to oxidant stress, inflammation, arachidonic acid metabolism (prostacyclin versus thromboxane A2), and their associated sequelae were effective at also blunting depressive symptom severity. Using multivariable analyses, discrimination between the effectiveness of treatment groups to maintain behavioral outcomes appeared to be dependent on breaking the cycle of inflammation and oxidant stress, with the associated outcomes of improving endothelial metabolism and both cerebral and peripheral vascular structure and function. CONCLUSIONS This initial study provides a compelling framework from which to further interrogate the links between cardiovascular disease risk factors and depressive symptoms and suggests mechanistic links and potentially effective avenues for intervention.
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Affiliation(s)
- Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Sarah S Singh
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Dwayne N Jackson
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Kent A Lemaster
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Samantha A Milde
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - J Kevin Shoemaker
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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14
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Heeres RHM, Hoogeveen EK, Geleijnse JM, de Goede J, Kromhout D, Giltay EJ. Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients. BMC Psychol 2017; 5:1. [PMID: 28081723 PMCID: PMC5228176 DOI: 10.1186/s40359-016-0170-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/20/2016] [Indexed: 01/01/2023] Open
Abstract
Background The aim was to investigate whether mild kidney dysfunction and low-grade inflammation in post-myocardial infarction patients are independently associated with markers of mental well-being (i.e. depressive and apathy symptoms, and dispositional optimism). Methods In post-myocardial infarction patients, kidney function was assessed by estimated glomerular filtration rate (eGFR) calculated from the combined CKD-EPI formula based on serum levels of both creatinine and cystatine C. Systemic inflammation was assessed using high sensitivity C-reactive protein (hs-CRP) levels. The 15-item Geriatric Depression Scale (GDS-15), the 3-item apathy subscale and the 4-item optimism questionnaire (4Q) were used to measure mental well-being and were analyzed using linear multivariable regression analysis. Results Of the 2355 patients, mean age was 72.3 (range 63–84) years and 80.1% were men. After multivariable adjustment, a poorer kidney function was associated with more depressive symptoms (β = -0.084, p < 0.001), more apathy symptoms (β = -0.101, p < 0.001), and less dispositional optimism (β = 0.072, p = 0.002). Moreover, higher levels of hs-CRP were associated with more depressive symptoms (β = 0.051, p = 0.013), more apathy symptoms (β = 0.083, p < 0.001) and less dispositional optimism (β = -0.047 p = 0.024). Apathy showed the strongest independent relation with both low eGFR and high hs-CRP. Conclusions In post-myocardial infarction patients, impaired kidney function and systemic inflammation showed a stronger association with apathy than with depressive symptoms and dispositional optimism.
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Affiliation(s)
- Rick H M Heeres
- Department of Psychiatry, Leiden University Medical Center, Postbus 9600, 2300, RC, Leiden, Netherlands.
| | - Ellen K Hoogeveen
- Departments of Internal Medicine and Nephrology, Jeroen Bosch Hospital, Den Bosch, Netherlands
| | | | - Janette de Goede
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Daan Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Postbus 9600, 2300, RC, Leiden, Netherlands
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Walker SO, Mao G, Caruso D, Hong X, Pongracic JA, Wang X. Cardiovascular Risk Factors in Parents of Food-Allergic Children. Medicine (Baltimore) 2016; 95:e3156. [PMID: 27082554 PMCID: PMC4839798 DOI: 10.1097/md.0000000000003156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Previous studies suggest that chronic stress may induce immune system malfunction and a broad range of adverse health outcomes; however, the underlying pathways for this relationship are unclear. Our study aimed to elucidate this question by examining the relationship between parental cardiovascular risk factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist-to-hip ratio (WHR) and maternal psychological stress score (MPSS) relative to the severity of the child's food allergy (FA) and number of affected children. SBP, DBP, BMI, and WHR were measured and calculated at the time of recruitment by trained nurses. MPSS was obtained based on self-report questionnaires covering lifestyle adjustments, perceived chronic stress, and quality of life. General linear models examined whether caregiver chronic stress was associated with FA. For mothers with children under age 5 years, SBP, DBP and number of affected children had strong and graded relationships with severity of the child's FA. MPSS was also significantly and positively associated with child FA severity (P < 0.001). However, no relationships were found between FA severity, BMI, or WHR for either parent. This was also the case for paternal SBP, DBP, and number of affected children of any age. There is a strong and graded link between cardiovascular risk and perceived stress in mothers of food-allergic children under age 5. Findings may have important implications for family-centered care of FA, may generalize to caregivers of children with chronic conditions, and extend the literature on allostatic load.
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Affiliation(s)
- Sheila Ohlsson Walker
- From the Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University, Bloomberg School of Public Health (SOW, GM, DC, XH, XW), Johns Hopkins University School of Education, Baltimore, MD (SOW), Institute for Interdisciplinary Salivary Bioscience Research, Arizona State University, Tempe, AZ (SOW), Department of Preventive Medicine, School of Environmental Science & Public Health, Wenzhou Medical University (GM), Center on Clinical and Epidemiological Eye Research, the Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China (GM), and Division of Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL (JAP)
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Barbalho SM, Bechara MD, Quesada K, Gabaldi MR, Goulart RDA, Tofano RJ, Gasparini RG. Síndrome metabólica, aterosclerose e inflamação: tríade indissociável? J Vasc Bras 2015. [DOI: 10.1590/1677-5449.04315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Observa-se, nas populações mundiais, aumento do sedentarismo e aumento do consumo de gorduras e açúcares, sendo estes vinculados normalmente aos alimentos industrializados. A consequência disso rapidamente se manifestou no aumento do sobrepeso/obesidade e na instalação de alterações fisiológicas e metabólicas, como a Síndrome Metabólica, que é representada por alterações na glicemia, nos lipídeos e na pressão arterial. Há evidências de ligação estreita entre estas alterações e os processos inflamatórios, que também podem estar associados ao estresse oxidativo. Estas condições levam à patogênese das alterações vasculares ou intensificam os processos metabólicos que acompanham a Síndrome Metabólica. O objetivo desta revisão foi comparar as inúmeras referências literárias que mostram correlação entre os componentes da Síndrome Metabólica e o aumento dos mediadores de inflamação. Para isso, utilizou-se Pubmed, Scopus, Lilacs e Scielo como base de dados, sendo que os artigos selecionados dataram principalmente dos últimos cinco anos.
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Affiliation(s)
- Sandra Maria Barbalho
- Universidade de Marília, Brasil; Faculdade de Tecnologia de Alimentos de Marília, Brasil
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Hu ST, Shen YF, Gong JM, Yang YJ. Effect of sophoridine on Ca²⁺ induced Ca²⁺ release during heart failure. Physiol Res 2015; 65:43-52. [PMID: 26596316 DOI: 10.33549/physiolres.933052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sophoridine is a type of alkaloid extract derived from the Chinese herb Sophora flavescens Ait (kushen) and possess a variety of pharmacological effects including anti-inflammation, anti-anaphylaxis, anti-cancer, anti-arrhythmic and so on. However, the effect of sophoridine on heart failure has not been known yet. In this study, the effect of sophoridine on heart failure was investigated using Sprague-Dawley (SD) rat model of chronic heart failure. Morphological results showed that in medium and high dose group, myofilaments were arranged orderly and closely, intermyofibrillar lysis disappeared and mitochondria contained tightly packed cristae compared with heart failure group. We investigated the Ca(2+) induced Ca(2+) transients and assessed the expression of ryanodine receptor (RyR2) and L-type Ca(2+) channel (dihydropyridine receptor, DHPR). We found that the cytosolic Ca(2+) transients were markedly increased in amplitude in medium (deltaF/F(0)=43.33+/-1.92) and high dose groups (deltaF/F(0)=47.21+/-1.25) compared with heart failure group (deltaF/F(0)=16.7+/-1.29, P<0.01), Moreover, we demonstrated that the expression of cardiac DHPR was significantly increased in medium- and high dose-group compared with heart failure rats. Our results suggest that sophoridine could improve heart failure by ameliorating cardiac Ca(2+) induced Ca(2+) transients, and that this amelioration is associated with upregulation of DHPR.
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Affiliation(s)
- S-T Hu
- Department of Physiology, Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China, Department of Biophysics, Second Military Medical University, Shanghai, People's Republic of China.
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