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Chu Z, Zhang Y, Guo B, Zhang X, Cao Y, Ji H, Sun B, Schikowski T, Zhao Q, Wang J, Chen Y. Long-term PM 2.5 exposure associated with severity of angina pectoris and related health status in patients admitted with acute coronary syndrome: Modification effect of genetic susceptibility and disease history. ENVIRONMENTAL RESEARCH 2024; 257:119232. [PMID: 38810823 DOI: 10.1016/j.envres.2024.119232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/08/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
Long-term particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5) exposure has been associated with the occurrence of acute coronary syndrome (ACS). However, the impact of PM2.5 exposure and its components on the severity of angina pectoris and disease-related health status in patients hospitalized for ACS is understudied. To assess the association between long-term exposure to PM2.5 components and the angina pectoris severity in ACS patients, as well as the modification effects of genetic factors and disease history in north China. During 2017-2019, 6729 ACS patients were collected in Shandong Province and Beijing, with their angina pectoris severity evaluated using Seattle Angina Questionnaire (SAQ). The 0-3 years' average concentrations of PM2.5 and its five major components were assigned to each patient's residential address. Linear mixed-effects model, weighted quantile regression, and quantile g-computation were used to estimate the effects of both single and joint associations between PM2.5 components and SAQ scores. The interactive effect was estimated by polygenic risk scores and disease history. For each interquartile range increase in PM2.5, the overall SAQ score changed by -3.71% (95%CI: -4.54% to -2.88%), with score of angina stability more affected than angina frequency and other dimensions of angina pectoris severity. Sulfate and ammonium were major contributors to the effect of PM2.5 exposure. Significant modification effect was only observed for disease history, especially for the dimension of physical limitation. Among a series of pre-existing diseases, patients with a family history of coronary artery disease, previous percutaneous coronary intervention or coronary artery bypass grafting, and stroke were more susceptible to PM2.5 exposure than others. Greater exposure to PM2.5 is associated with more serious angina pectoris and worse disease-related health status in ACS patients. Public health and clinical priority should be given to cutting down key effective components and protecting highly vulnerable individuals.
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Affiliation(s)
- Zunyan Chu
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yan Zhang
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Bangjie Guo
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiao Zhang
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Yingying Cao
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Hongmei Ji
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Bo Sun
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, 40225, Germany
| | - Tamara Schikowski
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, 40225, Germany
| | - Qi Zhao
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| | - Jiali Wang
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
| | - Yuguo Chen
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
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Guo S, Wijesuriya R, O'Connor M, Moreno-Betancur M, Goldfeld S, Burgner D, Liu R, Priest N. The effects of adverse and positive experiences on cardiovascular health in Australian children. Int J Cardiol 2024; 411:132262. [PMID: 38878872 DOI: 10.1016/j.ijcard.2024.132262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/01/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Limited evidence suggests that positive experiences in childhood may promote cardiovascular health, providing additional opportunities for prevention and early intervention. This study aimed to examine the effects of adverse and positive experiences on cardiovascular health in late childhood. METHODS Data sources: Longitudinal Study of Australian Children (N = 1874). EXPOSURES Adverse and positive experiences assessed repeatedly (age 0-11 years). OUTCOMES Cardiovascular health (high versus low or moderate) quantified by four health behaviors (diet, physical activity, cigarette smoking, and sleep) and four health factors (body mass index, non-high-density lipoprotein, blood pressure, and blood glucose) (age 11-12 years) as per the American Heart Association's Life's Essential 8 metrics. ANALYSES Separate generalized linear models with log-Poisson links were used to estimate the effects of adverse and positive experiences on cardiovascular health, adjusting for confounders. RESULTS Children exposed to multiple adverse experiences (≥ 2) were less likely to have high cardiovascular health (RR = 0.82, 95% CI = 0.67 to 1.02) than those not exposed. Children exposed to multiple positive experiences (≥ 2) were more likely to have high cardiovascular health (RR = 1.14, 95% CI = 0.94 to 1.38) than those not exposed. Stratified analyses suggested that exposure to multiple positive experiences might buffer the detrimental effects of multiple adverse experiences on cardiovascular health. CONCLUSIONS Both adverse and positive experiences were found to be modestly associated with cardiovascular health in Australian children. Future research and practice should not only consider addressing childhood adversity but also use a strengths-based approach to promoting positive experiences to improve cardiovascular health.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.
| | - Rushani Wijesuriya
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Meredith O'Connor
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Melbourne Children's LifeCourse Initiative, Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Education, University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - David Burgner
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Inflammatory Origins Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of General Medicine, Royal Children's Hospital, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, Australia
| | - Richard Liu
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Naomi Priest
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia; The Centre for Social Policy Research, Australian National University, Canberra, Australia; Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Dos Anjos Souza VR, Vivan L, Seffrin A, Vallini L, de Paula Domingos F, de Lira CAB, Vancini RL, Weiss K, Rosemann T, Knechtle B, Andrade MS. Impact of aging on maximal oxygen uptake in female runners and sedentary controls. Exp Gerontol 2024; 193:112476. [PMID: 38830478 DOI: 10.1016/j.exger.2024.112476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/09/2024] [Accepted: 05/31/2024] [Indexed: 06/05/2024]
Abstract
The present study aimed to compare V̇O2max (absolute, adjusted to total body mass, and adjusted to lean mass) in recreational runners and sedentary women < and > 50 yr and verify the effect of aging and physical activity level on the three types of V̇O2 max expression. The study included 147 women:85 runners (45.7 ± 14.1 yr) and 62 sedentary controls (48.8 ± 9.8 yr). They were subjected to cardiopulmonary exercise testing for V̇O2 max measurement and a body composition test by dual-emission X-ray absorptiometry system. V̇O2max were expressed as absolute values (L/min), relative to total body mass values (mL/kg/min), and relative to lean mass values (mL/kgLM/min). The two-way analysis of variance revealed a significant interaction [F(2,131) = 4.43, p < 0.001] and effects of age group [F(2,131) = 32.79, p < 0.001] and physical activity group [F(2,131) = 55.64, p < 0.001] on V̇O2max (mL/min). V̇O2max (mL/kg/min) and V̇O2 max (mL/kgLM/min) were significantly influenced by age and physical activity levels. The multiple regression model explains 76.2 % of the dependent variable V̇O2max (mL/kg/min), age (β = -0.335, t = -7.841, p < 0.001), and physical activity group (β = -0.784, t = -18.351, p < 0.001). In conclusion, female runners had higher V̇O2 max values than sedentary women at all ages, even though aging has a greater impact on V̇O2 max in the runners group. In addition to cardiorespiratory fitness, women's metabolic lean mass function, as measured by V̇O2max adjusted by lean mass, is significantly influenced by aging. Finally, physical activity has a greater impact on V̇O2 max levels than aging.
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Affiliation(s)
| | - Lavínia Vivan
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Aldo Seffrin
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Lucca Vallini
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Fabio de Paula Domingos
- Postgraduate Program in Translation Medicine, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
| | - Claudio Andre Barbosa de Lira
- Human and Exercise Physiology Division, Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland.
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland; Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.
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Burden SJ, Alshehri R, Lamata P, Poston L, Taylor PD. Maternal obesity and offspring cardiovascular remodelling - the effect of preconception and antenatal lifestyle interventions: a systematic review. Int J Obes (Lond) 2024; 48:1045-1064. [PMID: 38898228 PMCID: PMC11281905 DOI: 10.1038/s41366-024-01536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Preconception or antenatal lifestyle interventions in women with obesity may prevent adverse cardiovascular outcomes in the child, including cardiac remodelling. We undertook a systematic review of the existing data to examine the impact of randomised controlled trials of lifestyle interventions in pregnant women with obesity on offspring cardiac remodelling and related parameters of cardiovascular health. METHODS This review was registered with PROSPERO (CRD42023454762) and aligns with PRISMA guidelines. PubMed, Embase, and previous reviews were systematically searched. Follow-up studies from randomised trials of lifestyle interventions in pregnant women with obesity, which included offspring cardiac remodelling or related cardiovascular parameters as outcome measures, were included based on pre-defined inclusion criteria. RESULTS Eight studies from five randomised controlled trials were included after screening 3252 articles. Interventions included antenatal exercise (n = 2), diet and physical activity (n = 2), and preconception diet and physical activity (n = 1). Children were <2-months to 3-7-years-old, with sample sizes ranging between n = 18-404. Reduced cardiac remodelling, with reduced interventricular septal wall thickness, was consistently reported. Some studies identified improved systolic and diastolic function and a reduced resting heart rate. Risk of bias analyses rated all studies as 'fair' (some risk of bias). A high loss-to-follow-up was a common limitation. CONCLUSION Although there is some evidence to suggest that lifestyle interventions in women with obesity may limit offspring cardiac remodelling, further high-quality longitudinal studies with larger sample sizes are required to confirm these observations and to determine whether these changes persist to adulthood. Child offspring cardiovascular health benefits of preconception and antenatal lifestyle interventions in women with obesity.
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Affiliation(s)
- Samuel J Burden
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK.
| | - Rahaf Alshehri
- Cardiovascular Medicine and Science Research, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Pablo Lamata
- Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
| | - Paul D Taylor
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
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Lokkesmoe R, Hamilton L. The Role of Reverse Cascade Screening in Children with Familial Hypercholesterolemia: A Literature Review and Analysis. Curr Atheroscler Rep 2024; 26:427-433. [PMID: 38888696 DOI: 10.1007/s11883-024-01211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE OF REVIEW Familial Hypercholesterolemia (FH) is a common genetic disorder characterized by lifelong elevation of severely elevated plasma low-density lipoprotein cholesterol. Atherosclerotic cardiovascular disease (ASCVD) risk accelerates after age 20. Early diagnosis allows for treatment of children with FH and creates an opportunity to identify affected relatives through reverse cascade screening (RCS). Historically, cascade screening has had little impact on identifying individuals with FH. RECENT FINDINGS Universal cholesterol screening (UCS) to identify youth with FH, beginning at 9-11 years-of-age, is currently recommended in the U.S. The European Atherosclerosis Society has called for UCS worldwide, emphasizing the need for educational programs to increase awareness amongst healthcare professions. Underdiagnoses and undertreatment of FH remain high. Improved rates of UCS and a systematic approach to RCS are needed. The absence of a coordinated RCS program limits the benefits of UCS. Further research is needed to identify barriers to cholesterol screening in youth.
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Affiliation(s)
- Ryan Lokkesmoe
- Cook Children's Medical Center, Department of Endocrinology, 801 7th Ave, Fort Worth, TX, 76104, USA.
| | - Luke Hamilton
- Cook Children's Medical Center, Department of Research and Endocrinology, Fort Worth, TX, USA
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Chiou A, Hermel M, Chai Z, Eiseman A, Jeschke S, Mehta S, Khan U, Hoodbhoy Z, Safdar N, Khoja A, Junaid V, Vaughan E, Merchant AT, Iqbal J, Almas A, Virani SS, Sheikh S. Going from Primary to Primordial Prevention: Is the Juice Worth the Squeeze? Curr Cardiol Rep 2024:10.1007/s11886-024-02109-3. [PMID: 39073507 DOI: 10.1007/s11886-024-02109-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE OF REVIEW While primary prevention strategies target individuals who are at high risk of cardiovascular disease, there is rising interest towards primordial prevention that focuses on preventing the development of risk factors upstream of disease detection. Therefore, we review the advantages of primordial prevention interventions on minimizing future cardiovascular events. RECENT FINDINGS Primordial prevention of atherosclerotic cardiovascular disease involves behavioral, genetic, and environmental strategies, starting from fetal/infant health and continuing throughout childhood and young adulthood. Early interventions focusing on modifiable risk factors such as physical inactivity, non-ideal body weight, smoking, and environmental pollutants are important towards preventing the initial occurrence of risk factors such as hypertension, dyslipidemia, and diabetes to ultimately reduce cardiovascular disease. Implementing primordial prevention strategies early on in life can minimize cardiovascular events and lead to healthy aging in the population. Future studies can further evaluate the effectiveness of various primordial prevention strategies.
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Affiliation(s)
- Andrew Chiou
- Department of Cardiology, Scripps Clinic, La Jolla, San Diego, CA, USA
| | - Melody Hermel
- Department of Cardiology, United Medical Doctors, La Jolla, San Diego, CA, USA
| | - Zohar Chai
- Department of Biological Sciences, University of California, San Diego, San Diego, CA, USA
| | - Ariana Eiseman
- Northeastern University Bouvé College of Health Science, Boston, MA, USA
| | - Sheila Jeschke
- Department of Cardiology, Scripps Clinic, La Jolla, San Diego, CA, USA
| | - Sandeep Mehta
- Department of Cardiology, Loyola University Medical Center, Chicago, IL, USA
| | - Unab Khan
- Department of Family Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zahra Hoodbhoy
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Nilofer Safdar
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Adeel Khoja
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | | | | | - Anwar T Merchant
- Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Junaid Iqbal
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | - Aysha Almas
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan
| | | | - Sana Sheikh
- Department of Medicine, The Aga Khan University, Stadium Road, Karachi, Pakistan.
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Demissie GD, Birungi J, Haregu T, Thirunavukkarasu S, Oldenburg B. Effects of Lifestyle Interventions on Cardiovascular Disease Risk and Risk Factors Among Individuals at High Risk for Type 2 Diabetes: Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Res Protoc 2024; 13:e53517. [PMID: 38935416 PMCID: PMC11240064 DOI: 10.2196/53517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/02/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Individuals at high risk for type 2 diabetes are also at an increased risk for developing cardiovascular disease (CVD). Although there are separate trials examining the effects of lifestyle interventions on absolute CVD risk among people at high risk for type 2 diabetes, a comprehensive evidence synthesis of these trials is lacking. OBJECTIVE We will systematically synthesize the evidence on the effects of lifestyle interventions in reducing absolute CVD risk and CVD risk factors among people at high risk for type 2 diabetes. METHODS We adhered to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement in reporting the details of this protocol. Randomized controlled trials of diabetes prevention that examined the effects of lifestyle interventions for at least 6 months on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes will be eligible. We will systematically search the MEDLINE, Embase, PsycINFO, CENTRAL, and Scopus databases and ClinicalTrials.gov using a mix of Medical Subject Headings and text words. Two authors will independently screen the abstract and title of the articles retrieved from the search, followed by full-text reviews using the inclusion and exclusion criteria and data extraction from the eligible studies. Article screening and data extraction will be performed in the Covidence software. The primary outcome will be the changes in absolute 10-year CVD risk, as estimated by risk prediction models. The secondary outcomes are the changes in CVD risk factors, including behavioral, clinical, biochemical, and psychosocial risk factors, and incidence of type 2 diabetes. RESULTS An initial database search was conducted in July 2023. After screening 1935 articles identified through the database search, 42 articles were considered eligible for inclusion. It is anticipated that the study findings will be submitted for publication in a peer-reviewed journal by the end of 2024. CONCLUSIONS This study will provide up-to-date, systematically synthesized evidence on the effects of lifestyle interventions on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes. TRIAL REGISTRATION PROSPERO CRD42023429869; https://tinyurl.com/59ajy7rw. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53517.
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Affiliation(s)
- Getu Debalkie Demissie
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Josephine Birungi
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Tilahun Haregu
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sathish Thirunavukkarasu
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, United States
| | - Brian Oldenburg
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Staff AC, Costa ML, Dechend R, Jacobsen DP, Sugulle M. Hypertensive disorders of pregnancy and long-term maternal cardiovascular risk: Bridging epidemiological knowledge into personalized postpartum care and follow-up. Pregnancy Hypertens 2024; 36:101127. [PMID: 38643570 DOI: 10.1016/j.preghy.2024.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/31/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024]
Abstract
Cardiovascular disease (CVD) is globally the leading cause of death and disability. Sex-specific causes of female CVD are under-investigated. Pregnancy remains an underinvestigated sex-specific stress test for future CVD and a hitherto missed opportunity to initiate prevention of CVD at a young age. Population-based studies show a strong association between female CVD and hypertensive disorders of pregnancy. This association is also present after other pregnancy complications that are associated with placental dysfunction, including fetal growth restriction, preterm delivery and gestational diabetes mellitus. Few women are, however, offered systematic cardio-preventive follow-up after such pregnancy complications. These women typically seek help from the health system at first clinical symptom of CVD, which may be decades later. By this time, morbidity is established and years of preventive opportunities have been missed out. Early identification of modifiable risk factors starting postpartum followed by systematic preventive measures could improve maternal cardiovascular health trajectories, promoting healthier societies. In this non-systematic review we briefly summarize the epidemiological associations and pathophysiological hypotheses for the associations. We summarize current clinical follow-up strategies, including some proposed by international and national guidelines as well as user support groups. We address modifiable factors that may be underexploited in the postpartum period, including breastfeeding and blood pressure management. We suggest a way forward and discuss the remaining knowledge gaps and barriers for securing the best evidence-based follow-up, relative to available resources after a hypertensive pregnancy complication in order to prevent or delay onset of premature CVD.
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Affiliation(s)
- Anne Cathrine Staff
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway.
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Campinas/SP, Brazil
| | - Ralf Dechend
- HELIOS Clinic, Berlin, Germany; Experimental and Clinical Research Center, Charité Medical Faculty and Max-Delbrueck Center for Molecular Medicine, and HELIOS Clinic Berlin, Germany
| | - Daniel P Jacobsen
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway
| | - Meryam Sugulle
- Faculty of Medicine, University of Oslo, PB 1171, Blindern, 0381 Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, PB 4956 Nydalen, 0424 Oslo, Norway
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Jois A, Zannino D, Catto‐Smith AG, Kaegi M, Mynard JP, Rosenbaum J, Oliver M, Hardikar W, Alex G, Burgner D. Arterial structure and function in children with inflammatory bowel disease. JGH Open 2024; 8:e13100. [PMID: 38832138 PMCID: PMC11145743 DOI: 10.1002/jgh3.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/12/2024] [Accepted: 05/18/2024] [Indexed: 06/05/2024]
Abstract
Background and Aim People with inflammatory bowel disease (IBD) have an increased risk of cardiovascular disease, including in younger adulthood. This may arise in part from chronic, systemic low-grade inflammation. The process of atherosclerosis may begin in childhood. We sought to determine whether pediatric IBD is associated with adverse changes in arterial structure and function as a marker of early increased cardiovascular risk. Methods We performed a case-control study comparing children with IBD for a median disease duration of 2.49 (interquartile range 1.23, 4.38) years with healthy children. In a single visit, we collected baseline clinical and anthropometric data, and measured blood pressure, pulse wave velocity, carotid artery distensibility, and aortic and carotid intima-media thickness. High-sensitivity C-reactive protein and fasting lipids were measured. Results We enrolled 81 children with IBD (40 with Crohn's disease, 40 with ulcerative colitis, and 1 with unspecified IBD) and 82 control participants. After adjusting for age, sex, body mass index z-score, blood pressure, and low-density lipoprotein cholesterol, there was no difference in measures of arterial structure and function in children with IBD compared with controls, nor between those with Crohn's disease or ulcerative colitis. Conclusion We did not show any differences in arterial structure and function in children with a history of IBD for less than 5 years compared with healthy controls. IBD diagnosed in childhood may provide a window of opportunity to actively reduce standard cardiovascular risk factors and improve future cardiovascular outcomes.
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Affiliation(s)
- Asha Jois
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics UnitMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Anthony G Catto‐Smith
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- School of Humanities, Arts and Social Sciences, University of New EnglandArmidaleNew South WalesAustralia
| | - Meg Kaegi
- Inflammatory Origins Group, Infection, Immunity and Global Health ThemeMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Jonathan P Mynard
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Heart Research GroupMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Biomedical Engineering, University of Melbourne Faculty of Engineering and Information TechnologyParkvilleVictoriaAustralia
| | - Jeremy Rosenbaum
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
| | - Mark Oliver
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
| | - Winita Hardikar
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
| | - George Alex
- Department of Gastroenterology and Clinical NutritionThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
| | - David Burgner
- Department of PaediatricsUniversity of MelbourneParkvilleVictoriaAustralia
- Inflammatory Origins Group, Infection, Immunity and Global Health ThemeMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Infectious Diseases Unit, Department of General MedicineThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
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Hernández-Martínez A, Duarte-Junior MA, Sotos-Prieto M, Ortolá R, Banegas JR, Rodríguez-Artalejo F, Soriano-Maldonado A, Martínez-Gómez D. Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:372-380. [PMID: 37783370 DOI: 10.1016/j.rec.2023.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. METHODS We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression. RESULTS In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89). CONCLUSIONS A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.
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Affiliation(s)
- Alba Hernández-Martínez
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - Miguel Angelo Duarte-Junior
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Rosario Ortolá
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
| | - Alberto Soriano-Maldonado
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - David Martínez-Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
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Cai D, Xiao T, Chen Q, Gu Q, Wang Y, Ji Y, Sun L, Wei J, Wang Q. Association between triglyceride glucose and acute kidney injury in patients with acute myocardial infarction: a propensity score‑matched analysis. BMC Cardiovasc Disord 2024; 24:216. [PMID: 38643093 PMCID: PMC11031878 DOI: 10.1186/s12872-024-03864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/28/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) in patients with acute myocardial infarction (AMI) often indicates a poor prognosis. OBJECTIVE This study aimed to investigate the association between the TyG index and the risk of AKI in patients with AMI. METHODS Data were taken from the Medical Information Mart for Intensive Care (MIMIC) database. A 1:3 propensity score (PS) was set to match patients in the AKI and non-AKI groups. Multivariate logistic regression analysis, restricted cubic spline (RCS) regression and subgroup analysis were performed to assess the association between TyG index and AKI. RESULTS Totally, 1831 AMI patients were included, of which 302 (15.6%) had AKI. The TyG level was higher in AKI patients than in non-AKI patients (9.30 ± 0.71 mg/mL vs. 9.03 ± 0.73 mg/mL, P < 0.001). Compared to the lowest quartile of TyG levels, quartiles 3 or 4 had a higher risk of AKI, respectively (Odds Ratiomodel 4 = 2.139, 95% Confidence Interval: 1.382-3.310, for quartile 4 vs. quartile 1, Ptrend < 0.001). The risk of AKI increased by 34.4% when the TyG level increased by 1 S.D. (OR: 1.344, 95% CI: 1.150-1.570, P < 0.001). The TyG level was non-linearly associated with the risk of AKI in the population within a specified range. After 1:3 propensity score matching, the results were similar and the TyG level remained a risk factor for AKI in patients with AMI. CONCLUSION High levels of TyG increase the risk of AKI in AMI patients. The TyG level is a predictor of AKI risk in AMI patients, and can be used for clinical management.
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Affiliation(s)
- Dabei Cai
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
- Graduate School of Dalian Medical University, Dalian Medical University, Dalian, Liaoning, 116000, China
| | - Tingting Xiao
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
| | - Qianwen Chen
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
| | - Qingqing Gu
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
| | - Yu Wang
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
| | - Yuan Ji
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China
| | - Ling Sun
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China.
- Graduate School of Dalian Medical University, Dalian Medical University, Dalian, Liaoning, 116000, China.
| | - Jun Wei
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, 241000, China.
- Department of Cardiovascular Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 220005, China.
| | - Qingjie Wang
- Department of Cardiology, the Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, China.
- Graduate School of Dalian Medical University, Dalian Medical University, Dalian, Liaoning, 116000, China.
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12
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Gallacher PJ, Yeung D, Bell S, Shah ASV, Mills NL, Dhaun N. Kidney replacement therapy: trends in incidence, treatment, and outcomes of myocardial infarction and stroke in a nationwide Scottish study. Eur Heart J 2024; 45:1339-1351. [PMID: 38426727 PMCID: PMC11015953 DOI: 10.1093/eurheartj/ehae080] [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: 05/26/2023] [Revised: 12/21/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND AND AIMS Patients with kidney failure have a higher risk of cardiovascular disease compared with the general population. Whilst temporal trends of myocardial infarction and stroke are declining in the general population, these have not been evaluated in patients with kidney failure. This study aimed to describe national trends in the incidence, treatment, and outcomes of myocardial infarction and stroke in patients with kidney failure (i.e. on dialysis or with a kidney transplant) over a 20-year period, stratified by age and sex. METHODS In this retrospective national data linkage study, all patients with kidney failure in Scotland (UK) receiving kidney replacement therapy between January 1996 and December 2016 were linked to national hospitalization, prescribing, and death records. The primary outcomes were the incidence of myocardial infarction and stroke, and subsequent cardiovascular death. Generalized additive models were constructed to estimate age-standardized, sex-stratified incidence rates and trends in cardiovascular and all-cause death. RESULTS Amongst 16 050 patients with kidney failure [52 (SD 15) years; 41.5% women], there were 1992 [66 (SD 12) years; 34.8% women] and 996 [65 (SD 13) years; 45.1% women] incident myocardial infarctions and strokes, respectively, between January 1996 and December 2016. During this period, the age-standardized incidence of myocardial infarction per 100 000 decreased in men {from 4376 [95% confidence interval (CI) 3998-4785] to 1835 (95% CI 1692-1988)} and women [from 3268 (95% CI 2982-3593) to 1369 (95% CI 1257-1491)]. Similarly, the age-standardized incidence of stroke per 100 000 also decreased in men [from 1978 (95% CI 1795-2175) to 799 (95% CI 729-875)] and women [from 2234 (95% CI 2031-2468) to 903 (95% CI 824-990)]. Compared with the general population, the incidence of myocardial infarction was four- to eight-fold higher in patients with kidney failure, whilst for stroke it was two- to four-fold higher. The use of evidence-based cardioprotective treatment increased over the study period, and the predicted probability of cardiovascular death within 1 year of myocardial infarction for a 66-year-old patient with kidney failure (mean age of the cohort) fell in men (76.6% to 38.6%) and women (76.8% to 38.8%), and also decreased in both sexes following stroke (men, from 63.5% to 41.4%; women, from 67.6% to 45.8%). CONCLUSIONS The incidence of myocardial infarction and stroke has halved in patients with kidney failure over the past 20 years but remains significantly higher than in the general population. Despite improvements in treatment and outcomes, the prognosis of these patients following myocardial infarction and stroke remains poor.
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Affiliation(s)
- Peter J Gallacher
- BHF/University Centre for Cardiovascular Science, Little France Crescent, University of Edinburgh, Edinburgh EH16 4SA, UK
| | - David Yeung
- BHF/University Centre for Cardiovascular Science, Little France Crescent, University of Edinburgh, Edinburgh EH16 4SA, UK
| | - Samira Bell
- Division of Population Health and Genomics, University of Dundee, Dundee, UK
- Scottish Renal Registry, Scottish Health Audits, Public Health Scotland, Glasgow, UK
| | - Anoop S V Shah
- Department of Non-Communicable Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicholas L Mills
- BHF/University Centre for Cardiovascular Science, Little France Crescent, University of Edinburgh, Edinburgh EH16 4SA, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Neeraj Dhaun
- BHF/University Centre for Cardiovascular Science, Little France Crescent, University of Edinburgh, Edinburgh EH16 4SA, UK
- Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
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Krause I, Manigk R, Lopez EA, Douroumis D. Personalised oral dosage forms using an ultra-compact tablet press at the point of care. Eur J Pharm Biopharm 2024; 197:114220. [PMID: 38360119 DOI: 10.1016/j.ejpb.2024.114220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Over the last 10 years there is an increasing need for the design of personalised medicines at the point of care (PoC) that meet the specific needs of individual patients. A plethora of technologies has been introduced for making affordable personalised pharmaceutical products, which however, do not address manufacturing and regulatory challenges. Here we introduce a novel ultra-compact tablet press which was used for the design and compression of rosuvastatin-aspirin and amiloride-lysonipril bilayer tablets respectively. By applying precision dosing, it was feasible to manufacture tablets of different dose strengths and control features such as hardness, friability and disintegration times. The compaction of on-demand personalised multidrug pills that meet quality standards could revolutionised the treatment of patients at the point of care.
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Affiliation(s)
- Ingo Krause
- PrivMed® X AB, Björnholmsvägen 4, SE-184 92 Åkersberga, Sweden
| | - Rene Manigk
- PrivMed® X AB, Björnholmsvägen 4, SE-184 92 Åkersberga, Sweden
| | - Elena Arribas Lopez
- Centre for Research Innovation, University of Greenwich, Medway Campus, Kent ME4 4TB, UK
| | - Dennis Douroumis
- Centre for Research Innovation, University of Greenwich, Medway Campus, Kent ME4 4TB, UK; Delta Pharmaceutics Ltd. Chatham, Kent ME4 5NG, UK.
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14
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Jackowska B, Wiśniewski P, Noiński T, Bandosz P. Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality from noncommunicable diseases. PLoS One 2024; 19:e0298696. [PMID: 38483876 PMCID: PMC10939220 DOI: 10.1371/journal.pone.0298696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
Morbidity and premature mortality from noncommunicable diseases can be largely prevented by adopting a healthy lifestyle at the earliest possible age. However, tools designed for the early identification of those at risk among young adults are lacking. We developed and validated a multivariable model for the prediction of life expectancy, allowing the early identification of apparently healthy adults at risk of lifestyle-related diseases. We used a cross-sectional approach to calculate life expectancy using data from 38,481 participants of the National Health and Nutrition Examination Survey (1999-2014), aged ≥20 years. A multivariable logistic model was used to quantify the impact of risk factors on mortality. The model included the following lifestyle-related mortality risk factors as predictors: smoking, diet, physical activity, and body mass index. The presence of the following chronic diseases was considered: diabetes, arrhythmia, coronary artery disease, myocardial infarction, stroke, and malignant neoplasms. The model showed a good predictive ability; the area under the receiver operating characteristic curve measure was 0.846 (95% uncertainty interval 0.838-0.859). Life expectancy was determined using the life table method and the period life tables for the US population as the baseline. The results of this model underscore the importance of lifestyle-related risk factors in life expectancy. The difference between life expectancy for 30-year-old individuals with lifestyle characteristics ranked in 90% and 10% of their gender and age groups was 23 years for males and 18 years for females, whereas in 75% and 25%, it was 14 years for males and 10 years for females. In addition to early risk identification, the model estimates the deferred effect of lifestyle and the impact of lifestyle changes on life expectancy. Thus, it can be used in early prevention to demonstrate the potential risks and benefits of complex lifestyle modifications for educational purposes or to motivate behavioral changes.
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Affiliation(s)
- Beata Jackowska
- Department of Statistics, Faculty of Management, University of Gdańsk, Sopot, Poland
| | - Piotr Wiśniewski
- Chair and Department of Endocrinology and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
- Lab4Life Sp. z o.o., Gdynia, Poland
| | | | - Piotr Bandosz
- Lab4Life Sp. z o.o., Gdynia, Poland
- Division of Preventive Medicine & Education, Medical University of Gdańsk, Gdańsk, Poland
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15
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Ding W, Ding L, Lu Y, Sun W, Wang Y, Wang J, Gao Y, Li M. Circular RNA-circLRP6 protects cardiomyocyte from hypoxia-induced apoptosis by facilitating hnRNPM-mediated expression of FGF-9. FEBS J 2024; 291:1246-1263. [PMID: 38105623 DOI: 10.1111/febs.17038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/30/2023] [Accepted: 12/15/2023] [Indexed: 12/19/2023]
Abstract
Coronary atherosclerosis-induced myocardial ischemia leads to cardiomyocyte apoptosis. The regulatory mechanisms for cardiomyocyte apoptosis have not been fully understood. Circular RNAs are non-coding RNAs which play important roles in heart function maintenance and progression of heart diseases by regulating gene transcription and protein translation. Here, we reported a conserved cardiac circular RNA, which is generated from the second exon of LRP6 and named circLRP62-2 . CircLRP62-2 can protect cardiomyocyte from hypoxia-induced apoptosis. The expression of circLRP62-2 in cardiomyocytes was down-regulated under hypoxia, while forced expression of circLRP62-2 inhibited cell apoptosis. Normally, circLRP62-2 was mainly localized in the nucleus. Under hypoxia, circLRP62-2 is associated with heterogeneous nuclear ribonucleoprotein M (hnRNPM) to be translocated into the cytoplasm. It recruited hnRNPM to fibroblast growth factor 9 (FGF9) mRNA to enhance the expression of FGF9 protein, promoting hypoxia-adaption and viability of cardiomyocytes. In summary, this study uncovers a new inhibitor of apoptosis and reveals a novel anti-apoptotic pathway composed of circLRP62-2 , hnRNPM, and FGF9, which may provide therapeutic targets for coronary heart disease and ischemic myocardial injury.
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Affiliation(s)
- Wei Ding
- The Affiliated Hospital of Qingdao University, Qingdao Medical College, Qingdao University, China
| | - Lin Ding
- School of Basic Medical Sciences, Qingdao University, China
| | - Yijian Lu
- School of Basic Medical Sciences, Qingdao University, China
| | - Weihan Sun
- School of Basic Medical Sciences, Qingdao University, China
| | - Yu Wang
- School of Basic Medical Sciences, Qingdao University, China
| | - Jianxun Wang
- School of Basic Medical Sciences, Qingdao University, China
| | - Yufang Gao
- The Affiliated Hospital of Qingdao University, Qingdao Medical College, Qingdao University, China
| | - Mengyang Li
- School of Basic Medical Sciences, Qingdao University, China
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Lu Y, Lan T. Spatiotemporal trends of cardiovascular disease burden attributable to low physical activity during 1990-2019: an analysis of the Global Burden of Disease Study 2019. Public Health 2024; 228:137-146. [PMID: 38354583 DOI: 10.1016/j.puhe.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/01/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES The epidemiological trends of cardiovascular disease (CVD) burden attributed to low physical activity (LPA) across various regions and countries are poorly understood. Hence, we assessed the global, regional, and national spatiotemporal trends of LPA-related CVD from 1990 to 2019. STUDY DESIGN We conducted a secondary analysis of the Global Burden of Disease Study 2019. The data on LPA-related CVD were examined with regard to sex, age, year, and Socio-Demographic Index (SDI). METHODS We assessed the temporal changes in age-standardized mortality rate (ASMR) and age-standardized death rate (ASDR) using the estimated annual percentage change (EAPC) over a 30-year period. RESULTS There were a staggering 0.64 million deaths and 9.99 million disability-adjusted life-years globally attributed to LPA-related CVD in 2019. The majority of the LPA-related CVD burden was observed in the population aged ≥80 years. It also indicated a high disease burden of LPA-related CVD in Central Asia, Arabian Peninsula, and North Africa. Although there has been a decline in ASMR and ASDR associated with LPA-related CVD on a global scale, the countries experiencing the most substantial increase in LPA-related CVD burden are Uzbekistan, Tajikistan, and Azerbaijan. The ASMR and ASDR remained stable in regions with low, low-middle, and middle SDI levels. The EAPCs of ASMR and ASDR were negatively linked with SDI in 2019. CONCLUSIONS From 1990 to 2019, LPA led to a significant and escalating burden of CVD in certain regions, namely, Uzbekistan, Tajikistan, and Azerbaijan. It is imperative for governments and policymakers to implement regulatory measures and strategic interventions aimed at mitigating this burden.
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Affiliation(s)
- Yunyan Lu
- Department of Cardiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, People's Republic of China
| | - Tian Lan
- Department of Breast Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310007, People's Republic of China.
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Zheng D, Cao L. Association Between Myocardial Infarction and Triglyceride-Glucose Index: A Study Based on NHANES Database. Glob Heart 2024; 19:23. [PMID: 38404616 PMCID: PMC10885828 DOI: 10.5334/gh.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024] Open
Abstract
Objective To investigate differences in levels of the triglyceride-glucose (TyG) index between individuals with myocardial infarction (MI) and those without MI, as well as the association between TyG index and risk of MI. Methods Data from the National Health and Nutrition Examination Survey (NHANES) for US adults from 2013 to 2018 were included in this study. Using MI as an outcome variable and TyG index as an exposure variable, logistic regression models were employed to analyze relationship between MI and TyG index. Results The study included 6,695 participants. Compared to the non-MI group, patients with MI had significantly higher TyG index (8.89 vs. 8.63, P = 0.003). Higher TyG index was significantly associated with an increased risk of MI in US adults (OR: 1.69, 95% CI: 1.26-2.26, P < 0.001). Race, smoking status, and history of chronic obstructive pulmonary disease (COPD) had significant impacts on the association between TyG index and risk of MI (P for interaction < 0.05). Subgroup analysis demonstrated a significant positive correlation between TyG index and MI risk in non-Hispanic Black individuals, non-smokers, and individuals without COPD across multiple models (OR > 1.0, P < 0.05). Conclusion US adults with higher TyG index were more susceptible to MI, and TyG index may be used to identify individuals at high risk of MI in the US population.
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Affiliation(s)
- Dandan Zheng
- The Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang City, Hubei Province, China
| | - Ligong Cao
- The Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang City, Hubei Province, China
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Ding L, Ponzano M, Grotta A, Adami HO, Xue F, Lagerros YT, Bellocco R, Ye W. Ideal cardiovascular health and risk of death in a large Swedish cohort. BMC Public Health 2024; 24:358. [PMID: 38308327 PMCID: PMC10837860 DOI: 10.1186/s12889-024-17885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) can be assessed by 7 metrics: smoking, body mass index, physical activity, diet, hypertension, dyslipidemia and diabetes, proposed by the American Heart Association. We examined the association of ideal CVH metrics with risk of all-cause, CVD and non-CVD death in a large cohort. METHODS A total of 29,557 participants in the Swedish National March Cohort were included in this study. We ascertained 3,799 deaths during a median follow-up of 19 years. Cox regression models were used to estimate hazard ratios with 95% confidence intervals (95% CIs) of the association between CVH metrics with risk of death. Laplace regression was used to estimate 25th, 50th and 75th percentiles of age at death. RESULTS Compared with those having 6-7 ideal CVH metrics, participants with 0-2 ideal metrics had 107% (95% CI = 46-192%) excess risk of all-cause, 224% (95% CI = 72-509%) excess risk of CVD and 108% (31-231%) excess risk of non-CVD death. The median age at death among those with 6-7 vs. 0-2 ideal metrics was extended by 4.2 years for all-causes, 5.8 years for CVD and 2.9 years for non-CVD, respectively. The observed associations were stronger among females than males. CONCLUSIONS The strong inverse association between number of ideal CVH metrics and risk of death supports the application of the proposed seven metrics for individual risk assessment and general health promotion.
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Affiliation(s)
- Lijie Ding
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Department of Health Management, Shandong Sports University, Jinan, China
| | - Marta Ponzano
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Department of Statistics and Quantitative Methods, University of Milano, Bicocca, Italy
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Ylva Trolle Lagerros
- Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden.
- Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
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Meng Y, Sharman JE, Koskinen JS, Juonala M, Viikari JSA, Buscot MJ, Wu F, Fraser BJ, Rovio SP, Kähönen M, Rönnemaa T, Jula A, Niinikoski H, Raitakari OT, Pahkala K, Magnussen CG. Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness. JAMA Pediatr 2024; 178:133-141. [PMID: 38048127 PMCID: PMC10696511 DOI: 10.1001/jamapediatrics.2023.5351] [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: 05/25/2023] [Accepted: 09/17/2023] [Indexed: 12/05/2023]
Abstract
Importance Although cardiovascular disease (CVD) begins in early life, the extent to which blood pressure (BP) at different life stages contributes to CVD is unclear. Objective To determine the relative contribution of BP at different life stages across the early-life course from infancy to young adulthood with carotid intima-media thickness (IMT). Design, setting, and participants The analyses were performed in 2022 using data gathered from July 1989 through January 2018 within the Special Turku Coronary Risk Factor Intervention Project, a randomized, infancy-onset cohort of 534 participants coupled with annual BP (from age 7 months to 20 years), biennial IMT measurements (from ages 13 to 19 years), who were followed up with again at age 26 years. Exposures BP measured from infancy (aged 7 to 13 months), preschool (2 to 5 years), childhood (6 to 12 years), adolescence (13 to 17 years), and young adulthood (18 to 26 years). Main outcomes and measures Primary outcomes were carotid IMT measured in young adulthood at age 26 years. Bayesian relevant life-course exposure models assessed the relative contribution of BP at each life stage. Results Systolic BP at each life stage contributed to the association with young adulthood carotid IMT (infancy: relative weight, 25.3%; 95% credible interval [CrI], 3.6-45.8; preschool childhood: relative weight, 27.0%; 95% CrI, 3.3-57.1; childhood: relative weight, 18.0%; 95% CrI, 0.5-40.0; adolescence: relative weight, 13.5%; 95% CrI, 0.4-37.1; and young adulthood: relative weight, 16.2%; 95% CrI, 1.6-46.1). A 1-SD (at single life-stage) higher systolic BP accumulated across the life course was associated with a higher carotid IMT (0.02 mm; 95% CrI, 0.01-0.03). The findings for carotid IMT were replicated in the Cardiovascular Risk in Young Finns Study that assessed systolic BP from childhood and carotid IMT in adulthood (33 to 45 years). Conclusion and relevance In this cohort study, a life-course approach indicated that accumulation of risk exposure to BP levels at all life stages contributed to adulthood carotid IMT. Of those, the contribution attributed to each observed life stage was approximately equal. These results support prevention efforts that achieve and maintain normal BP levels across the life course, starting in infancy.
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Affiliation(s)
- Yaxing Meng
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Juhani S. Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, Satakunta Central Hospital, Pori, Finland
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Jorma S. A. Viikari
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Feitong Wu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Brooklyn J. Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Suvi P. Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tapani Rönnemaa
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Harri Niinikoski
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Costan G. Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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20
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Martino F, Niglio T, Barillà F, Martino E, Paravati V, Bassareo PP. The Association between Mid-Upper Arm Circumference and Blood Pressure in an Italian Population of School-Aged Children and Adolescents with Lipid Disorders. J Clin Med 2024; 13:663. [PMID: 38337357 PMCID: PMC10856649 DOI: 10.3390/jcm13030663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Many anthropometric measurements have been investigated concerning their association with blood pressure (BP) in paediatric age groups. This study aims to find a relationship between mid-upper arm circumference (MUAC) and BP in a population of children and adolescents aged 1-18 years. Methods: 5853 subjects (2977 females and 2876 males) were studied. MUAC, body mass index (BMI), and BP were measured. The individuals in the study were subdivided and grouped by gender and type of school attended in Italy: 1-5 years (pre-school), 6-10 years (primary school), 11-13 years (secondary school), 14-18 years (high school). Results: In the age range of 6-13 years, all the subjects with MUAC > 50th percentile had systolic and diastolic BP significantly higher than children with MUAC below 50th percentile (p < 0.0001). In the age range 14-18 years, the relationship persisted only in females (p < 0.001 and p < 0.05 for diastolic and systolic BP, respectively). A linear relationship was found between MUAC and BMI. Conclusions: In Italian children of both genders aged 6-13, arm distribution of body fat is strongly associated with increased systolic and diastolic BP. As such, a simple anthropometric measurement like MUAC might represent a tool to identify young subjects who are at risk for HTN.
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Affiliation(s)
- Francesco Martino
- Department of Internal Medicine, Anaesthesiology, and Cardiovascular Science, La Sapienza University, 00161 Rome, Italy; (E.M.); (V.P.)
| | | | - Francesco Barillà
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Eliana Martino
- Department of Internal Medicine, Anaesthesiology, and Cardiovascular Science, La Sapienza University, 00161 Rome, Italy; (E.M.); (V.P.)
| | - Vincenzo Paravati
- Department of Internal Medicine, Anaesthesiology, and Cardiovascular Science, La Sapienza University, 00161 Rome, Italy; (E.M.); (V.P.)
| | - Pier Paolo Bassareo
- School of Medicine, University College of Dublin, DO4 W6F6 Dublin, Ireland;
- Department of Cardiology, Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland
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21
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Williams KJ. Eradicating Atherosclerotic Events by Targeting Early Subclinical Disease: It Is Time to Retire the Therapeutic Paradigm of Too Much, Too Late. Arterioscler Thromb Vasc Biol 2024; 44:48-64. [PMID: 37970716 DOI: 10.1161/atvbaha.123.320065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Recent decades have seen spectacular advances in understanding and managing atherosclerotic cardiovascular disease, but paradoxically, clinical progress has stalled. Residual risk of atherosclerotic cardiovascular disease events is particularly vexing, given recognized lifestyle interventions and powerful modern medications. Why? Atherosclerosis begins early in life, yet clinical trials and mechanistic studies often emphasize terminal, end-stage plaques, meaning on the verge of causing heart attacks and strokes. Thus, current clinical evidence drives us to emphasize aggressive treatments that are delayed until patients already have advanced arterial disease. I call this paradigm "too much, too late." This brief review covers exciting efforts that focus on preventing, or finding and treating, arterial disease before its end-stage. Also included are specific proposals to establish a new evidence base that could justify intensive short-term interventions (induction-phase therapy) to treat subclinical plaques that are early enough perhaps to heal. If we can establish that such plaques are actionable, then broad screening to find them in early midlife individuals would become imperative-and achievable. You have a lump in your coronaries! can motivate patients and clinicians. We must stop thinking of a heart attack as a disease. The real disease is atherosclerosis. In my opinion, an atherosclerotic heart attack is a medical failure. It is a manifestation of longstanding arterial disease that we had allowed to progress to its end-stage, despite knowing that atherosclerosis begins early in life and despite the availability of remarkably safe and highly effective therapies. The field needs a transformational advance to shift the paradigm out of end-stage management and into early interventions that hold the possibility of eradicating the clinical burden of atherosclerotic cardiovascular disease, currently the biggest killer in the world. We urgently need a new evidence base to redirect our main focus from terminal, end-stage atherosclerosis to earlier, and likely reversible, human arterial disease.
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Affiliation(s)
- Kevin Jon Williams
- Department of Cardiovascular Sciences, Department of Medicine, Lewis Katz School of Medicine at Temple University, PA
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22
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Kline NS, Webb NJ, Griner SB. Transgender Incarceration and Law Enforcement as a Source of Harm: Upstream and Primordial Prevention Perspectives. VIOLENCE AND VICTIMS 2023; 38:897-909. [PMID: 37989527 DOI: 10.1891/vv-2022-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
In the United States (US), transgender individuals are more likely to experience violence and sexual assault in jails and prisons compared with cisgender peers. Harms of incarceration on transgender individuals include limited access to medical care and hormone therapy, as well as being housed in facilities based on biological sex instead of gender identity. However, there has been insufficient research on addressing factors that lead to transgender individuals being incarcerated in the first place. In this article, we argue the need to focus on law enforcement interactions with transgender individuals in the US to reduce incarceration-related harms. Using the perspectives of primordial prevention and focusing on upstream factors that create health-related harms, we assert that focusing on law enforcement is a necessary component in addressing how the criminal justice system harms transgender individuals.
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Affiliation(s)
- Nolan S Kline
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Nathaniel J Webb
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
| | - Stacey B Griner
- University of North Texas Health Science Center School of Public Health, Fort Worth, TX, USA
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23
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Doehner W, Böhm M, Boriani G, Christersson C, Coats AJS, Haeusler KG, Jones ID, Lip GYH, Metra M, Ntaios G, Savarese G, Shantsila E, Vilahur G, Rosano G. Interaction of heart failure and stroke: A clinical consensus statement of the ESC Council on Stroke, the Heart Failure Association (HFA) and the ESC Working Group on Thrombosis. Eur J Heart Fail 2023; 25:2107-2129. [PMID: 37905380 DOI: 10.1002/ejhf.3071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
Heart failure (HF) is a major disease in our society that often presents with multiple comorbidities with mutual interaction and aggravation. The comorbidity of HF and stroke is a high risk condition that requires particular attention to ensure early detection of complications, efficient diagnostic workup, close monitoring, and consequent treatment of the patient. The bi-directional interaction between the heart and the brain is inherent in the pathophysiology of HF where HF may be causal for acute cerebral injury, and - in turn - acute cerebral injury may induce or aggravate HF via imbalanced neural and neurovegetative control of cardiovascular regulation. The present document represents the consensus view of the ESC Council on Stroke, the Heart Failure Association and the ESC Working Group on Thrombosis to summarize current insights on pathophysiological interactions of the heart and the brain in the comorbidity of HF and stroke. Principal aspects of diagnostic workup, pathophysiological mechanisms, complications, clinical management in acute conditions and in long-term care of patients with the comorbidity are presented and state-of-the-art clinical management and current evidence from clinical trials is discussed. Beside the physicians perspective, also the patients values and preferences are taken into account. Interdisciplinary cooperation of cardiologists, stroke specialists, other specialists and primary care physicians is pivotal to ensure optimal treatment in acute events and in continued long-term treatment of these patients. Key consensus statements are presented in a concise overview on mechanistic insights, diagnostic workup, prevention and treatment to inform clinical acute and continued care of patients with the comorbidity of HF and stroke.
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Affiliation(s)
- Wolfram Doehner
- Berlin Institute of Health Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Deutsches Herzzentrum der Charité, Department of Cardiology (Campus Virchow) and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Böhm
- Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Saarland University (Kardiologie, Angiologie und Internistische Intensivmedizin), Homburg, Germany
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | | | | | - Karl Georg Haeusler
- Department of Neurology, Universitätsklinikum Würzburg (UKW), Würzburg, Germany
| | - Ian D Jones
- Liverpool Centre for Cardiovascular Science, School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marco Metra
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - George Ntaios
- Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Heart and Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Eduard Shantsila
- Department of Primary Care, University of Liverpool, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Gemma Vilahur
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau and CIBERCV, Barcelona, Spain
| | - Giuseppe Rosano
- St George's University Hospital, London, UK, San Raffaele Cassino, Rome, Italy
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24
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Weintraub WS. High costs of cardiovascular disease in the European Union. Eur Heart J 2023; 44:4768-4770. [PMID: 37632364 DOI: 10.1093/eurheartj/ehad587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/24/2023] [Indexed: 08/28/2023] Open
Affiliation(s)
- William S Weintraub
- MedStar Health Research Institute and Department of Medicine, Georgetown University, Washington, DC, USA
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25
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Weintraub WS. Editorial: Incidence, disparities and outcome of acute coronary syndromes: Implications for health care systems. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 56:73-74. [PMID: 37380505 DOI: 10.1016/j.carrev.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023]
Affiliation(s)
- William S Weintraub
- MedStar Health Research Institute and Department of Medicine, Georgetown University, Washington, DC, United States of America.
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26
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Wahid A, Wen J, Yang Q, Zhang Z, Zhao X, Tang X. Serum HMGB1 is a biomarker for acute myocardial infarction with or without heart failure. Clin Transl Sci 2023; 16:2299-2309. [PMID: 37775976 PMCID: PMC10651663 DOI: 10.1111/cts.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 10/01/2023] Open
Abstract
This study measured serum high mobility group box 1 (HMGB1) levels in patients with acute myocardial infarction (AMI) and/or heart failure (HF) and evaluated their relationship with peripheral inflammatory biomarkers and cardiac biomarkers, which have not been reported before. Of the patients, 55 had AMI without HF (AMI-HF ), 42 had AMI with HF (AMI+HF ), and 60 had HF without AMI (HF-AMI ) compared with 50 healthy controls. Blood samples were collected to assess serum HMGB1 levels and blood test-related inflammatory biomarkers (e.g., erythrocyte sedimentation rate [ESR], hs-CRP, uric acid, and white blood cell count) and cardiac biomarkers (e.g., MYO, cTnI, CKMB, CK, NT-proBNP, LDH, aspartate aminotransferase [AST], and alanine aminotransferase [ALT]). Compared to healthy controls, three groups of patients, especially those with AMI+HF , had significantly higher levels of serum HMGB1. All tested inflammatory biomarkers (except uric acid) were significantly positively correlated with HMGB1 in patients with AMI patients but not in patients with non-AMI. In addition, all tested cardiac biomarkers (except NT-proBNP in AMI-HF ) were significantly higher in patients with AMI than in control individuals. The levels of MYO, cTnI, CKMB, CK, AST, and ALT were not significantly changed in patients with HF-AMI compared to control individuals, but were still much lower than those in patients with AMI (except ALT). In all patients, the levels of NT-proBNP, and cTnI were significantly correlated with HMGB1 levels. Except for MYO, LDH, AST, and ALT, all cardiac biomarkers in AMI-HF and AMI+HF showed a significant correlation with HMGB1. Among risk factors, hypertension, diabetes, previous heart disease, and reduced left ventricular ejection fraction showed a significant correlation with HMGB1 in all disease groups.
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Affiliation(s)
- Abdul Wahid
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Juan Wen
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Qiong Yang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Zhihui Zhang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Xiexiong Zhao
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Xiaohong Tang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
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27
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Mallaiah J, Leon RD, Williams O, Allegrante JP. Cardiovascular Disease and Stroke-Focused Competency Assessment Tools for Community Health Workers in the United States: A Scoping Review. Health Promot Pract 2023; 24:1183-1195. [PMID: 36062599 DOI: 10.1177/15248399221120809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease (CVD) and stroke are major contributors to chronic disease burden in the United States. Despite the high prevalence of stroke, 90% of all stroke events are preventable and can be attributed to seven key modifiable risk factors (MRFs)-high blood pressure (BP), high cholesterol, diabetes mellitus (DM), smoking, obesity, unhealthy diet, and physical inactivity. In the United States, stroke prevention interventions led by community health workers (CHWs) have been proven to be highly effective in preventing the onset of MRFs. We conducted a scoping review of the competency assessment methods used in CVD and stroke-focused CHW training programs. We searched six online databases: PubMed, Cochrane, CINAHL, Embase, Web of Science, and HaPI, from all available years until January 2021. Of the 1,774 initial articles found, we identified 30 eligible articles to be included in the review. Nine of these studies used previously validated instruments, whereas the remaining 21 studies used tools from the training curriculum or independently developed instruments. Only five of these validated tools reported psychometric properties; none of them were designed for the CHW population. Our scoping review of literature revealed that CHW-specific competency assessment methods were limited, with few or no domain-referenced tools on CVD or stroke risk factors that complied with established measurement standards. We conclude that there is an urgent need for the development of a comprehensive and valid assessment instrument in CVD and stroke prevention to evaluate CHW performance and optimize their credibility, representing important first steps toward integrating CHWs into health care systems.
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28
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Prugger C, Perier MC, Gonzalez-Izquierdo A, Hemingway H, Denaxas S, Empana JP. Incidence of 12 common cardiovascular diseases and subsequent mortality risk in the general population. Eur J Prev Cardiol 2023; 30:1715-1722. [PMID: 37294923 DOI: 10.1093/eurjpc/zwad192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/25/2023] [Accepted: 06/03/2023] [Indexed: 06/11/2023]
Abstract
BACKGROUND Incident events of cardiovascular diseases (CVDs) are heterogenous and may result in different mortality risks. Such evidence may help inform patient and physician decisions in CVD prevention and risk factor management. AIMS This study aimed to determine the extent to which incident events of common CVD show heterogeneous associations with subsequent mortality risk in the general population. METHODS AND RESULTS Based on England-wide linked electronic health records, we established a cohort of 1 310 518 people ≥30 years of age initially free of CVD and followed up for non-fatal events of 12 common CVD and cause-specific mortality. The 12 CVDs were considered as time-varying exposures in Cox's proportional hazards models to estimate hazard rate ratios (HRRs) with 95% confidence intervals (CIs). Over the median follow-up of 4.2 years (2010-16), 81 516 non-fatal CVD, 10 906 cardiovascular deaths, and 40 843 non-cardiovascular deaths occurred. All 12 CVDs were associated with increased risk of cardiovascular mortality, with HRR (95% CI) ranging from 1.67 (1.47-1.89) for stable angina to 7.85 (6.62-9.31) for haemorrhagic stroke. All 12 CVDs were also associated with increased non-cardiovascular and all-cause mortality risk but to a lesser extent: HRR (95% CI) ranged from 1.10 (1.00-1.22) to 4.55 (4.03-5.13) and from 1.24 (1.13-1.35) to 4.92 (4.44-5.46) for transient ischaemic attack and sudden cardiac arrest, respectively. CONCLUSION Incident events of 12 common CVD show significant adverse and markedly differential associations with subsequent cardiovascular, non-cardiovascular, and all-cause mortality risk in the general population.
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Affiliation(s)
- Christof Prugger
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marie-Cécile Perier
- INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Diseases, Université Paris Cité, 56 rue Leblanc, 75015 Paris, France
| | - Arturo Gonzalez-Izquierdo
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
| | - Harry Hemingway
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
| | - Spiros Denaxas
- Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA London, UK
- Health Data Research UK, 215 Euston Road, NW1 2DA London, UK
- UCL Hospitals Biomedical Research Centers (BRC), 270 Tottenham Court Road, 215 Euston Road, NW1 2BE London, UK
- British Heart Foundation Data Science Center, 215 Euston Road, NW1 2BE London, UK
| | - Jean-Philippe Empana
- INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Diseases, Université Paris Cité, 56 rue Leblanc, 75015 Paris, France
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29
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Hooijschuur MCE, Janssen EBNJ, Mulder EG, Kroon AA, Meijers JMJ, Brugts JJ, Van Bussel BCT, Van Kuijk SMJ, Spaanderman MEA, Ghossein-Doha C. Prediction model for hypertension in first decade after pre-eclampsia in initially normotensive women. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:531-539. [PMID: 37289947 DOI: 10.1002/uog.26284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/04/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To develop a prediction model for the development of hypertension in the decade following pre-eclampsia in women who were normotensive shortly after pregnancy. METHODS This was a longitudinal cohort study of formerly pre-eclamptic women attending a university hospital in The Netherlands between 1996 and 2019. We developed a prediction model for incident hypertension using multivariable logistic regression analysis. The model was validated internally using bootstrapping techniques. RESULTS Of 259 women, 185 (71%) were normotensive at the first cardiovascular assessment, at a median of 10 (interquartile range (IQR), 6-24) months after a pre-eclamptic pregnancy, of whom 49 (26%) had developed hypertension by the second visit, at a median of 11 (IQR, 6-14) years postpartum. The prediction model, based on birth-weight centile, mean arterial pressure, total cholesterol, left ventricular mass index and left ventricular ejection fraction, had good-to-excellent discriminative ability, with an area under the receiver-operating-characteristics curve (AUC) of 0.82 (95% CI, 0.75-0.89) and an optimism-corrected AUC of 0.80. The sensitivity and specificity of our model to predict hypertension were 98% and 34%, respectively, and positive and negative predictive values were 35% and 98%, respectively. CONCLUSIONS Based on five variables, we developed a good-to-excellent predictive tool to identify incident hypertension following pre-eclampsia in women who were normotensive shortly after pregnancy. After external validation, this model could have considerable clinical utility in tackling the cardiovascular legacy of pre-eclampsia. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M C E Hooijschuur
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - E B N J Janssen
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E G Mulder
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
| | - A A Kroon
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - J M J Meijers
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
| | - J J Brugts
- Department of Cardiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - B C T Van Bussel
- Department of Intensive Care Medicine and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - S M J Van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M E A Spaanderman
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
| | - C Ghossein-Doha
- Department of Obstetrics and Gynecology, Maastricht University Medical Centre and GROW, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Brandt EJ, Garfein J, Pai CW, Bryant J, Kline-Rogers E, Fink S, Rubenfire M. Identifying Factors for Low-Risk Participation in Alternative Cardiac Rehabilitation Models for Patients with Coronary Heart Disease Using MI'S SCOREPAD. Cardiovasc Ther 2023; 2023:7230325. [PMID: 37719172 PMCID: PMC10504043 DOI: 10.1155/2023/7230325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/16/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Although a recent joint society scientific statement (the American Association of Cardiovascular Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology) suggests home-based cardiac rehab (CR) is appropriate for low- and moderate-risk patients, there are no paradigms to define such individuals with coronary heart disease. Methods We reviewed a decade of data from all patients with coronary heart disease enrolled in a single CR center (University of Michigan) to identify the prevalence of low-risk factors, which may inform on consideration for participation in alternative models of CR. Low-risk factors included not having any of the following: metabolic syndrome, presence of implantable cardioverter defibrillator or permanent pacemaker, active smoking, prior stroke, congestive heart failure, obesity, advanced renal disease, poor exercise capacity, peripheral arterial disease, angina, or clinical depression (MI'S SCOREPAD). We report on the proportion of participants with these risk factors and the proportion with all of these low-risk factors. Results The mean age of CR participants (n = 1984) was 63 years; 25% were women, and 82% were non-Hispanic White. The mean number of low-risk factors was 8.5, which was similar in the 2011-2012 and 2018-2019 cohorts (8.5 vs. 8.3, respectively, P = 0.08). Additionally, 9.3% of the 2011-2012 cohort and 7.6% of the 2018-2019 cohort had all 11 of the low-risk factors. Conclusion In this observational study, we provide a first paradigm of identifying factors among coronary heart disease patients that may be considered low-risk and likely high-gain for participation in alternative models of CR. Further work is needed to track clinical outcomes in patients with these factors to determine thresholds for enrolling participants in alternative forms of CR.
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Affiliation(s)
- Eric J. Brandt
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Joshua Garfein
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Chih-Wen Pai
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Joseph Bryant
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Eva Kline-Rogers
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Samantha Fink
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Melvyn Rubenfire
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, Shohaimi S, Mohammadi M. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:206. [PMID: 37087452 PMCID: PMC10122825 DOI: 10.1186/s12872-023-03231-w] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/08/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary. METHODS Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of "Prevalence", "Outbreak", "Burden", "Myocardial Infarction", "Myocardial Infarct", and "Heart Attack" were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication. RESULTS Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%. CONCLUSION Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Amir Abdolmaleki
- Department of Operating Room, Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shabnam Rasoulpoor
- Department of Psychiatric Nursing, Miandoab School of Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Asghar Khaleghi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Leila Afshar Hezarkhani
- Neuroscience Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Zhu W, Luo L, Ye G, Ou J. Potential diagnostic value of N1LR and SNHG1 in acute myocardial infarction. BMC Med Genomics 2023; 16:71. [PMID: 37013574 PMCID: PMC10071696 DOI: 10.1186/s12920-023-01501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/25/2023] [Indexed: 04/05/2023] Open
Abstract
INTRODUCTION Acute myocardial infarction (AMI) is a common cardiovascular disease that can lead to myocardial necrosis and a poor prognosis. Clinical practice requires an accurate and quick diagnosis of AMI due to the inherent limitations of current biomarkers. Therefore, research into novel biomarkers is necessary. We aimed to explore the diagnostic potency of the long non-coding RNA (lncRNA) N1LR and SNHG1 in patients diagnosed with AMI. METHOD We measured lncRNA levels in 148 AMI patients and 50 healthy volunteers with quantitative RT-PCR method. Receiver operating characteristic (ROC) analysis was administered to detect the diagnostic power of selected lncRNAs. Correlation analysis was performed to explore the relationship between N1LR as well as SNHG1 and the conventional myocardial biomarkers (LDH, CK, CKMB and cTnI). RESULTS ROC analysis reveals the possibility of N1LR and SNHG1 as biomarkers in AMI diagnosis (AUC of N1LR: 0.873; AUC of SNHG1: 0.890). Correlation analysis revealed that N1LR was negatively correlated with the conventional biomarkers and SNHG1 was positively correlated with the conventional biomarkers. CONCLUSION For the first time, we investigated the potential predictive diagnostic value of N1LR and SNHG1 in AMI diagnosis and substantial outcomes were obtained. Also, they may be capable of reflecting the progress of the disease during clinical practice from the correlation analysis.
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Affiliation(s)
- Wei Zhu
- Internal Medicine, Cardiovascular Center, Yangjiang People's Hospital, Guangdong, China
| | - Li Luo
- Internal Medicine, Cardiovascular Center, Yangjiang People's Hospital, Guangdong, China
| | - Guangning Ye
- Internal Medicine, Cardiovascular Center, Yangjiang People's Hospital, Guangdong, China
| | - Jiaman Ou
- Internal Medicine, Cardiovascular Center, Yangjiang People's Hospital, Guangdong, China.
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Chan YK, Cheng CY, Sabanayagam C. Eyes as the windows into cardiovascular disease in the era of big data. Taiwan J Ophthalmol 2023; 13:151-167. [PMID: 37484607 PMCID: PMC10361436 DOI: 10.4103/tjo.tjo-d-23-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/11/2023] [Indexed: 07/25/2023] Open
Abstract
Cardiovascular disease (CVD) is a major cause of mortality and morbidity worldwide and imposes significant socioeconomic burdens, especially with late diagnoses. There is growing evidence of strong correlations between ocular images, which are information-dense, and CVD progression. The accelerating development of deep learning algorithms (DLAs) is a promising avenue for research into CVD biomarker discovery, early CVD diagnosis, and CVD prognostication. We review a selection of 17 recent DLAs on the less-explored realm of DL as applied to ocular images to produce CVD outcomes, potential challenges in their clinical deployment, and the path forward. The evidence for CVD manifestations in ocular images is well documented. Most of the reviewed DLAs analyze retinal fundus photographs to predict CV risk factors, in particular hypertension. DLAs can predict age, sex, smoking status, alcohol status, body mass index, mortality, myocardial infarction, stroke, chronic kidney disease, and hematological disease with significant accuracy. While the cardio-oculomics intersection is now burgeoning, very much remain to be explored. The increasing availability of big data, computational power, technological literacy, and acceptance all prime this subfield for rapid growth. We pinpoint the specific areas of improvement toward ubiquitous clinical deployment: increased generalizability, external validation, and universal benchmarking. DLAs capable of predicting CVD outcomes from ocular inputs are of great interest and promise to individualized precision medicine and efficiency in the provision of health care with yet undetermined real-world efficacy with impactful initial results.
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Affiliation(s)
- Yarn Kit Chan
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Center for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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Deraz O, Van Sloten T, Climie R, Debras C, Fezeu LK, Deschasaux-Tanguy M, Jouven X, Kesse-Guyot E, Galan P, Hercberg S, Touvier M, Empana JP. Person-centered and measured life's simple 7 cardiovascular health concordance and association with incident cardiovascular disease. Sci Rep 2023; 13:5247. [PMID: 37002422 PMCID: PMC10066211 DOI: 10.1038/s41598-023-32219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Person-centered cardiovascular health (CVH) may facilitate cardiovascular disease primordial prevention in low resources settings. The study aims to assess the validity of person-centered CVH compared to gold standard measured CVH by examining the concordance between person-centered vs. measured CVH together with their respective association with incident cardiovascular disease events (CVD). Life's Simple 7 (LS7) CVH metrics, including non-smoking, Body Mass Index, diet, physical activity, blood glycemia, blood pressure, and blood cholesterol were collected from 19,473 adults participating in the e-cohort NutriNet-Santé study from 2011 to 2014 and were followed until September 2020. Clinical examinations and blood analyses defined the measured biological metrics, while diagnoses, medication, or treatment for type 2 diabetes, hypertension, and hypercholesterolemia defined person-centered biological metrics. Declared behavioral metrics were common for both measured and person-centered CVH. The study included 18,714 CVD-free participants (mean age 51 years, 73% women), among whom 16.52% and 38.75% had 5-7 ideal LS7 metrics according to measured and person-centered CVH, respectively. Weighted concordance of person-centered and measured CVH was 0.87 [0.86; 0.88]. Over median follow-up of 8.05 years, 749 CVD events occurred. There was a 7% (HR 0.93 [0.88; 0.99]) and 13% (HR 0.87 [0.83; 0.92]) risk reduction of CVD risk by additional measured and person-centered ideal metrics, respectively. In conclusion, person-centered CVH may represent a reliable alternative to measured CVH.
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Affiliation(s)
- Omar Deraz
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Thomas Van Sloten
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rachel Climie
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Charlotte Debras
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Xavier Jouven
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Jean-Philippe Empana
- Université Paris Cité, UMR-S970, Paris Cardiovascular Research Center, INSERM, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France.
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Ulloa-Gomez AM, Agredo A, Lucas A, Somvanshi SB, Stanciu L. Smartphone-based colorimetric detection of cardiac troponin T via label-free aptasensing. Biosens Bioelectron 2023; 222:114938. [PMID: 36462432 DOI: 10.1016/j.bios.2022.114938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022]
Abstract
We report an aptasensing platform for the detection of cardiac troponin T (cTnT) in the immediate and early phases of acute myocardial infarction (AMI). High-flow filter paper was used to fabricate a microfluidic paper-based analytical device (μ-PAD), which was further modified with gold-decorated polystyrene microparticles functionalized with a highly specific cTnT aptamer. Herein, cTnT detection is presented in two linear ranges (0.01-0.8 μg/ml and 6.25-50 μg/ml) with an LoD of 3.9X10-4 μg/ml, which is in agreement with reference values determined by the American Heart Association. The proposed platform showed remarkable selectivity against AMI-associated cardiac biomarkers such as TNF-alpha, interleukin-6, cardiac troponin I, and reactive protein-C. This aptasensor is a label-free assay that relies only on smartphone-based image analysis and takes less processing time in comparison with traditional methods like ELISA. Furthermore, it exhibits outstanding stability over 23 days when devices are stored at 4 °C. The reported platform is a stable and cost-effective method for the on-site and user-friendly detection of cTnT in normal saline buffer and diluted human serum.
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Affiliation(s)
- Ana M Ulloa-Gomez
- Department of Materials Engineering, Purdue University, West Lafayette, IN, 7907, USA
| | - Alejandra Agredo
- Department of Biological Sciences, West Lafayette, IN, 47907, USA; Purdue Life Sciences Interdisciplinary Program (PULSe), West Lafayette, IN, 47907, USA
| | - Alec Lucas
- Department of Materials Engineering, Purdue University, West Lafayette, IN, 7907, USA
| | - Sandeep B Somvanshi
- Department of Materials Engineering, Purdue University, West Lafayette, IN, 7907, USA
| | - Lia Stanciu
- Department of Materials Engineering, Purdue University, West Lafayette, IN, 7907, USA; Birck Nanotechnology Center, Purdue University, West Lafayette, IN, 47907, USA.
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Weintraub WS, Mancini GBJ, Boden WE. Percutaneous coronary intervention from COURAGE to ISCHEMIA and beyond. Int J Cardiol 2023; 373:39-43. [PMID: 36427605 DOI: 10.1016/j.ijcard.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
Multiple randomized clinical trials and observational studies in patients with chronic coronary artery disease have evaluated whether revascularization, in particular PCI, can reduce the incidence of future cardiovascular events and relieve angina. Perhaps the two most widely quoted trials are COURAGE and ISCHEMIA. In both trials revascularization did not reduce the incidence of cardiovascular death or non-fatal events. In both, revascularization did relieve angina, particularly in patients with severe pain. From the time of COURAGE to ISCHEMIA there were also multiple developments. In particular improved stent technology with second and third generation drug eluting stents in ISCHEMIA compared to bare metal stents in COURAGE. There was also the development of new methods to evaluate ischemia, in particular the potential surrogate fractional flow reserve. This period also saw improvement and maturation of coronary computed tomography angiography to assess coronary anatomy non-invasively. There was also greater emphasis on more intensive, guideline directed medical therapy to treat dyslipidemia and hypertension. There has also been greater recognition that not all angina is due to epicardial obstructive disease. Microvascular disease and coronary spasm are responsible for much of the symptom burden of ischemia. These data have led to a paradigm shift toward a more nuanced approach to treating stable ischemic heart disease, with less need for revascularization except in cases of particularly severe anatomic disease or unremitting symptoms while on optimal medial therapy. In recognition of the importance of disparities in cardiovascular health, it is crucial to implement preventive strategies with optimal medical therapy in the community.
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Affiliation(s)
- William S Weintraub
- MedStar Health Research Institute and Georgetown University, Washington, DC, USA.
| | - G B John Mancini
- Centre for Cardiovascular Innovation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - William E Boden
- VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA
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Percutaneous Coronary Intervention Is Not Superior to Optimal Medical Therapy in Chronic Coronary Syndrome: A Meta-Analysis. J Clin Med 2023; 12:jcm12041395. [PMID: 36835935 PMCID: PMC9968177 DOI: 10.3390/jcm12041395] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
(1) Background and Aim: Conflicting evidence exists regarding the benefits of percutaneous coronary intervention (PCI) on survival and symptomatic relief of patients with chronic coronary syndrome (CCS) compared with optimal medical therapy (OMT). This meta-analysis is to evaluate the short- and long-term clinical benefit of PCI over and above OMT in CCS. (2) Methods: Main endpoints were major adverse cardiac events (MACEs), all-cause mortality, cardiovascular (CV) mortality, myocardial infarction (MI), urgent revascularization, stroke hospitalization, and quality of life (QoL). Clinical endpoints at very short (≤3 months), short- (<12 months), and long-term (≥ 12 months) follow-up were evaluated. (3) Results: Fifteen RCTs with a total of 16,443 patients with CCS (PCI n = 8307 and OMT n = 8136) were included in the meta-analysis. At mean follow-up of 27.7 months, the PCI group had similar risk of MACE (18.2 vs. 19.2 %; p < 0.32), all-cause mortality (7.09 vs. 7.88%; p = 0.56), CV mortality (8.74 vs. 9.87%; p = 0.30), MI (7.69 vs. 8.29%; p = 0.32), revascularization (11.2 vs. 18.3%; p = 0.08), stroke (2.18 vs. 1.41%; p = 0.10), and hospitalization for anginal symptoms (13.5 vs. 13.9%; p = 0.69) compared with OMT. These results were similar at short- and long-term follow-up. At the very short-term follow-up, PCI patients had greater improvement in the QoL including physical limitation, angina frequency, stability, and treatment satisfaction (p < 0.05 for all) but such benefits disappeared at the long-term follow-up. (4) Conclusions: PCI treatment of CCS does not provide any long-term clinical benefit compared with OMT. These results should have significant clinical implications in optimizing patient's selection for PCI treatment.
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Boden WE, Marzilli M, Crea F, Mancini GBJ, Weintraub WS, Taqueti VR, Pepine CJ, Escaned J, Al-Lamee R, Gowdak LHW, Berry C, Kaski JC. Evolving Management Paradigm for Stable Ischemic Heart Disease Patients: JACC Review Topic of the Week. J Am Coll Cardiol 2023; 81:505-514. [PMID: 36725179 PMCID: PMC10561495 DOI: 10.1016/j.jacc.2022.08.814] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 02/01/2023]
Abstract
Management of stable coronary artery disease (CAD) has been based on the assumption that flow-limiting atherosclerotic obstructions are the proximate cause of angina and myocardial ischemia in most patients and represent an important target for revascularization. However, the role of revascularization in reducing long-term cardiac events in these patients has been limited mainly to those with left main disease, 3-vessel disease with diabetes, or decreased ejection fraction. Mounting evidence indicates that nonepicardial coronary causes of angina and ischemia, including coronary microvascular dysfunction, vasospastic disorders, and derangements of myocardial metabolism, are more prevalent than flow-limiting stenoses, raising concerns that many important causes other than epicardial CAD are neither considered nor probed diagnostically. There is a need for a more inclusive management paradigm that uncouples the singular association between epicardial CAD and revascularization and better aligns diagnostic approaches that tailor treatment to the underlying mechanisms and precipitants of angina and ischemia in contemporary clinical practice.
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Affiliation(s)
- William E Boden
- VA Boston Healthcare System, Boston, Massachusetts, USA; Boston University School of Medicine, Boston, Massachusetts, USA.
| | | | - Filippo Crea
- Department of Cardiology, Catholic University, Rome, Italy
| | - G B John Mancini
- Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - William S Weintraub
- MedStar Health Research Institute, Georgetown University, Washington, DC, USA
| | - Viviany R Taqueti
- Division of Cardiovascular Medicine and Imaging, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Carl J Pepine
- Division of Cardiovascular Medicine, University of Florida School of Medicine, Gainesville, Florida, USA
| | - Javier Escaned
- Hospital Clinico San Carlos IDISSC, Complutense University, Madrid, Spain
| | | | | | - Colin Berry
- University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Juan Carlos Kaski
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
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Galvis Y, Pineda K, Zapata J, Aristizabal J, Estrada A, Fernandez ML, Barona-Acevedo J. Consumption of Eggs Alone or Enriched with Annatto ( Bixa orellana L.) Does Not Increase Cardiovascular Risk in Healthy Adults-A Randomized Clinical Trial, the Eggant Study. Nutrients 2023; 15:nu15020369. [PMID: 36678239 PMCID: PMC9865189 DOI: 10.3390/nu15020369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
Most atherosclerotic cardiovascular diseases can be prevented by modifying lifestyles, including unhealthy diets. Eggs contain important carotenoids that may impact cardiovascular risk. The lipid nature of eggs can improve the bioavailability of other carotenoids, such as Annatto (Bixa orellana L.), with reported antioxidant properties. Although numerous studies have shown that there is no association between egg consumption and cardiovascular risk, there is still controversy. In addition, there is limited information about Annatto's effects on human health. This study evaluated the association between egg consumption and its enrichment with Annatto in lipid biomarkers of cardiovascular disease. In a parallel clinical trial, one hundred and five (n = 105) men and women were randomized by age, sex, and body mass index (BMI), and distributed into three groups. Subjects consumed daily, for 8 weeks, either two eggs, two eggs with Annatto, or two egg whites. Plasma lipids were measured by enzymatic colorimetric methods, plasma apolipoproteins and lipoprotein subfractions and size by nuclear magnetic resonance. There were no differences between groups in age, sex, and BMI. No significant changes were found over time or between groups in plasma triglycerides, LDL cholesterol, HDL cholesterol, apolipoprotein (apo) A1, apo B, or lipoprotein subfraction concentrations. In healthy adults, the intake of two eggs a day, or two eggs with Annatto for eight weeks, did not generate adverse changes in cardiovascular risk markers.
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Affiliation(s)
- Yeisson Galvis
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Keilly Pineda
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juliana Zapata
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juan Aristizabal
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- Physiology and Biochemistry Research Group-PHYSIS, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Alejandro Estrada
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - María Luz Fernandez
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ 85721, USA
| | - Jacqueline Barona-Acevedo
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- Correspondence:
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Exploring Myocardial Ischemia-Reperfusion Injury Mechanism of Cinnamon by Network Pharmacology, Molecular Docking, and Experiment Validation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:1066057. [PMID: 36873789 PMCID: PMC9981296 DOI: 10.1155/2023/1066057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/13/2023] [Accepted: 02/01/2023] [Indexed: 02/25/2023]
Abstract
Myocardial ischemia-reperfusion injury (MIRI) is a common complication of acute myocardial infarction that seriously endangers human health. Cinnamon, a traditional Chinese medicine, has been used to counteract MIRI as it has been shown to possess anti-inflammatory and antioxidant properties. To investigate the mechanisms of action of cinnamon in the treatment of MIRI, a deep learning-based network pharmacology method was established to predict potential active compounds and targets. The results of the network pharmacology showed that oleic acid, palmitic acid, beta-sitosterol, eugenol, taxifolin, and cinnamaldehyde were the main active compounds, and phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt), mitogen-activated protein kinase (MAPK), interleukin (IL)-7, and hypoxia-inducible factor 1 (HIF-1) are promising signaling pathways. Further molecular docking tests revealed that these active compounds and targets exhibited good binding abilities. Finally, experimental validation using a zebrafish model demonstrated that taxifolin, the active compound of cinnamon, has a potential protective effect against MIRI.
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Abou-ElWafa H, El-Gilany AH. Acute diseases: An epidemiologic perspective. JOURNAL OF ACUTE DISEASE 2023. [DOI: 10.4103/2221-6189.369072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Salazar MR. Hypertension, a linchpin between environmental noise exposure and the development of cardiovascular disease? J Clin Hypertens (Greenwich) 2022; 25:165-167. [PMID: 36585817 PMCID: PMC9903190 DOI: 10.1111/jch.14618] [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: 11/20/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 01/01/2023]
Abstract
Environmental noise exposure has been considered one of the most common hazards worldwide, especially in the workplace environment, and could produce a variety of health issues. Some epidemiological evidence supports the association between occupational noise exposition and a high risk for hypertension and cardiovascular diseases. Wang et al. has conducted an observational cross-sectional study using occupational data of 4746 workers, 32.4% were exposed to high occupational noise. These exposed individuals had a moderate increase in the risk for hypertension (adjusted odds ratio [OR], 1.30; 95% confidence interval [CI], 1.05-1.62). The subgroup analyses showed that the relationship between noise and hypertension prevalence was stronger in young participants (OR, 1.70; 95% CI, 1.21-2.40). Noise exposure activates the sympathetic and endocrine systems producing an increase in blood pressure and the changes in other biological risk factors. Moreover, a recently published study showed that oxidative stress and DNA damage were significantly higher in subjects exposed to noise. Emotional stress reactions and unconscious physiological stress could also be potential mechanisms for hypertension. Finally, physiological stress caused by noise exposure may also increase indulgence in unhealthy behaviors, such as smoking and alcohol consumption, and indirectly result in an increased risk of hypertension and cardiovascular diseases. Previously published studies showed relationships between environmental noise exposure (including road traffic, railway, and aircraft noises) and the development of hypertension and cardiovascular diseases. Thus, the study by Wang et al. emphasizes the importance of environmental control in the prevention of cardiovascular diseases, not only in the workplace but also outside it.
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Affiliation(s)
- Martin R. Salazar
- Facultad de Ciencias MédicasUniversidad Nacional de La PlataLa PlataArgentina,Sociedad Argentina de Hipertensión Arterial (SAHA)Argentina
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Ren J, Xiao H, Wang P. Acute Effects of the Interval and Duration of Intermittent Exercise on Arterial Stiffness in Young Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16847. [PMID: 36554739 PMCID: PMC9779233 DOI: 10.3390/ijerph192416847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
We proved the hypothesis that intermittent exercise would have a better effect on arterial stiffness by shortening the duration of intervals and increasing the number of bouts. Twenty healthy male college students (20.4 ± 0.4 years) were randomly assigned to a quiet control (CON), 30 min continuous exercise (CE), long-interval intermittent exercise with long intervals (IELL), long-interval intermittent exercise with short intervals (IELS), and short-interval intermittent exercise with short intervals (IESS). The intensity was set to 45% of the heart rate reserve. The brachial-ankle pulse wave (baPWV) was measured at baseline (BL), 0 min post-exercise, 20 min post-exercise, 40 min post-exercise, and 60 min post-exercise. BaPWV changes (⊿baPWV) from the BL in the same tests were used for the analysis. ⊿baPWV did not change significantly in the CON. ⊿baPWV decreased significantly at 0, 20, and 40 min in all exercise tests. ⊿baPWV decreased significantly at 60 min in IELS and IESS. At 60 min, the ⊿baPWV of IELS and IESS was still significantly lower than that of CON and CE, and the ⊿baPWV of IESS was still significantly lower than that of IELS. Hence, shortening the intervals of intermittent exercise and increasing the number of repetitions may enhance the effect of improving arterial stiffness.
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German CA, Baum SJ, Ferdinand KC, Gulati M, Polonsky TS, Toth PP, Shapiro MD. Defining Preventive Cardiology: A Clinical Practice Statement from the American Society for Preventive Cardiology. Am J Prev Cardiol 2022; 12:100432. [DOI: 10.1016/j.ajpc.2022.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
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Ramírez J, van Duijvenboden S, Young WJ, Tinker A, Lambiase PD, Orini M, Munroe PB. Prediction of Coronary Artery Disease and Major Adverse Cardiovascular Events Using Clinical and Genetic Risk Scores for Cardiovascular Risk Factors. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2022; 15:e003441. [PMID: 35861959 PMCID: PMC9584057 DOI: 10.1161/circgen.121.003441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) and major adverse cardiovascular events (MACE) are the leading causes of death in the general population, but risk stratification remains suboptimal. CAD genetic risk scores (GRSs) predict risk independently from clinical tools, like QRISK3. We assessed the added value of GRSs for a variety of cardiovascular traits (CV GRSs) for predicting CAD and MACE and tested their early-life screening potential by comparing against the CAD GRS only. METHODS We used data from 379 581 participants in the UK Biobank without known cardiovascular conditions (follow-up, 11.3 years; 3.3% CAD cases and 5.2% MACE cases). In a training subset (50%) we built 3 scores: QRISK3; QRISK3 and an established CAD GRS; and QRISK3, the CAD GRS and the CV GRSs. In an independent subset (50%), we evaluated each score's performance using the concordance index, odds ratio and net reclassification index. We then repeated the analyses without considering QRISK3. RESULTS For CAD, the combination of QRISK3 and the CAD GRS had a better performance than QRISK3 alone (concordance index, 0.766 versus 0.753; odds ratio, 5.47 versus 4.82; net reclassification index, 7.7%). Adding the CV GRSs did not significantly improve risk stratification. When only looking at genetic information, the combination of CV GRSs and the CAD GRS had a better performance than the CAD GRS alone (concordance index, 0.637 versus 0.625; odds ratio, 2.17 versus 2.07; net reclassification index, 3.3%). Similar results were obtained for MACE. CONCLUSIONS In individuals without known cardiovascular disease, the inclusion of CV GRSs to a clinical tool and an established CAD GRS does not improve CAD or MACE risk stratification. However, their combination only with the CAD GRS increases prediction performance indicating potential use in early-life screening before the advanced development of conventional cardiovascular risk factors.
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Affiliation(s)
- Julia Ramírez
- Clinical Pharmacology and Precision Medicine Deparment, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (J.R., S.v.D., W.J.Y., A.T., P.B.M.).,Electronic Engineering and Communications Department, Aragon Institute of Engineering Research, University of Zaragoza, Spain and CIBER's Bioengineering, Biomaterials and Nanomedicine, Spain. (J.R.)
| | - Stefan van Duijvenboden
- Clinical Pharmacology and Precision Medicine Deparment, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (J.R., S.v.D., W.J.Y., A.T., P.B.M.).,Institute of Cardiovascular Science, University College London, London, United Kingdom (S.v.D., P.D.L., M.O.)
| | - William J Young
- Clinical Pharmacology and Precision Medicine Deparment, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (J.R., S.v.D., W.J.Y., A.T., P.B.M.).,Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (W.J.Y., P.D.L., M.O.)
| | - Andrew Tinker
- Clinical Pharmacology and Precision Medicine Deparment, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (J.R., S.v.D., W.J.Y., A.T., P.B.M.).,NIHR Barts Cardiovascular Biomedical Research Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (A.T., P.B.M.)
| | - Pier D Lambiase
- Institute of Cardiovascular Science, University College London, London, United Kingdom (S.v.D., P.D.L., M.O.).,Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (W.J.Y., P.D.L., M.O.)
| | - Michele Orini
- Institute of Cardiovascular Science, University College London, London, United Kingdom (S.v.D., P.D.L., M.O.).,Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (W.J.Y., P.D.L., M.O.)
| | - Patricia B Munroe
- Clinical Pharmacology and Precision Medicine Deparment, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (J.R., S.v.D., W.J.Y., A.T., P.B.M.).,NIHR Barts Cardiovascular Biomedical Research Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (A.T., P.B.M.)
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Song SR, Kim KH, Park JH, Song KJ, Shin SD. Association between prehospital recognition of acute myocardial infarction and length of stay in the emergency department. Clin Exp Emerg Med 2022; 9:323-332. [PMID: 36111415 PMCID: PMC9834821 DOI: 10.15441/ceem.22.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the association between prehospital recognition of acute myocardial infarction (AMI) and length of stay (LOS) in the emergency department (ED) of emergency medical service (EMS)-transported AMI patients. METHODS A multicenter retrospective observational study was conducted using prehospital and hospital data from three tertiary emergency departments. Patients diagnosed with AMI between January 2015 and December 2018 were enrolled. Study groups were categorized according to prehospital recognition and prehospital 12-lead electrocardiography (ECG) into three groups based on an EMS cardiovascular registry: group A, no prehospital recognition (reference group); group B, prehospital recognition without 12-lead ECG; and group C, prehospital recognition with 12-lead ECG. The primary outcome was an ED LOS of less than 4 hours. RESULTS Among 1,237 study participants, 722 (58.4%) were in group A, 325 (26.3%) were in group B, and 190 (15.4%) were in group C. Multivariable logistic regression showed that groups B and C had a higher likelihood of a short ED LOS (adjusted odds ratio [95% confidence interval]: group B, 1.64 [1.21-2.22] and group C, 1.88 [1.30-2.71]) than group A. There was no significant difference in ED LOS according to whether prehospital 12-lead ECG was conducted. CONCLUSION Prehospital recognition of AMI by EMS personnel, with or without 12-lead ECG, was associated with a short ED LOS.
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Affiliation(s)
- So Ra Song
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ki Hong Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea,Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea,Correspondence to: Ki Hong Kim Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea E-mail:
| | - Jeong Ho Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea,Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea,Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea,Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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Lloyd-Jones DM, Ning H, Labarthe D, Brewer L, Sharma G, Rosamond W, Foraker RE, Black T, Grandner MA, Allen NB, Anderson C, Lavretsky H, Perak AM. Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates From the National Health and Nutrition Examination Survey (NHANES), 2013 Through 2018. Circulation 2022; 146:822-835. [PMID: 35766033 DOI: 10.1161/circulationaha.122.060911] [Citation(s) in RCA: 133] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/22/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score. METHODS We included individuals ages 2 through 79 years (not pregnant or institutionalized) who were free of cardiovascular disease from the National Health and Nutrition Examination Surveys in 2013 through 2018. For all participants, we calculated the overall CVH score (range, 0 [lowest] to 100 [highest]), as well as the score for each component of diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure, using published American Heart Association definitions. Sample weights and design were incorporated in calculating prevalence estimates and standard errors using standard survey procedures. CVH scores were assessed across strata of age, sex, race and ethnicity, family income, and depression. RESULTS There were 23 409 participants, representing 201 728 000 adults and 74 435 000 children. The overall mean CVH score was 64.7 (95% CI, 63.9-65.6) among adults using all 8 metrics and 65.5 (95% CI, 64.4-66.6) for the 3 metrics available (diet, physical activity, and body mass index) among children and adolescents ages 2 through 19 years. For adults, there were significant differences in mean overall CVH scores by sex (women, 67.0; men, 62.5), age (range of mean values, 62.2-68.7), and racial and ethnic group (range, 59.7-68.5). Mean scores were lowest for diet, physical activity, and body mass index metrics. There were large differences in mean scores across demographic groups for diet (range, 23.8-47.7), nicotine exposure (range, 63.1-85.0), blood glucose (range, 65.7-88.1), and blood pressure (range, 49.5-84.0). In children, diet scores were low (mean 40.6) and were progressively lower in higher age groups (from 61.1 at ages 2 through 5 to 28.5 at ages 12 through 19); large differences were also noted in mean physical activity (range, 63.1-88.3) and body mass index (range, 74.4-89.4) scores by sociodemographic group. CONCLUSIONS The new Life's Essential 8 score helps identify large group and individual differences in CVH. Overall CVH in the US population remains well below optimal levels and there are both broad and targeted opportunities to monitor, preserve, and improve CVH across the life course in individuals and the population.
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Affiliation(s)
- Donald M Lloyd-Jones
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Hongyan Ning
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Darwin Labarthe
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | | | - Garima Sharma
- Johns Hopkins University School of Medicine, Baltimore, MD (G.S.)
| | - Wayne Rosamond
- University of North Carolina Gillings School of Public Health, Chapel Hill (W.R.)
| | - Randi E Foraker
- Washington University School of Medicine, St Louis, MO (R.E.F.)
| | - Terrie Black
- University of Massachusetts Amherst College of Nursing (T.B.)
| | | | - Norrina B Allen
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
| | - Cheryl Anderson
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla (C.A.)
| | | | - Amanda M Perak
- Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J., H.N., D.L., N.B.A., A.M.P.)
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Sang CJ, Song X, de Visser RSF, Krallman R, Montgomery D, Pai CW, Kline-Rogers E, DuRussel-Weston J, Eagle KA, Jackson EA. Lifestyle Behaviors and Cardiometabolic Health in Middle-School Children. Child Obes 2022; 18:361-368. [PMID: 34871088 DOI: 10.1089/chi.2021.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Lifestyle behaviors (LB), defined by diet and physical activity, are associated with cardiometabolic health among adults. The association of LB with cardiometabolic health among middle-school children is uncertain. Methods: An abbreviated version of the School Physical Activity and Nutrition survey was used to examine LB among students participating in a wellness program between 2004 and 2018. Students were incorporated into three groups determined by self-reported healthy LB (≥6, 4-5, ≤3 behaviors), including; ≤1 serving/day sugary foods/beverages; ≤1 serving/day fried/fatty foods; ≥1 serving/day fruits and vegetables; ≤2 hours of screen time/day; ≥1 day/week of physical education; ≥1 team sport/year; and ≥1 session/week of moderate to vigorous activity. Baseline cardiometabolic parameters [BMI, lipids, glucose, and blood pressure (BP)], resting heart rate (HR), and HR recovery were examined in association with LB groups. Results: Of 2538 children, 488 (19.2%) reported ≥6, 1219 (48.0%) reported 4-5, and 831 (32.7%) reported ≤3 LB. White or Asian race and higher socioeconomic status were associated with ≥6 LB (p < 0.001). Students performing ≤3 LB exhibited higher BMI (p < 0.001), BP (p = 0.001), resting HR (p < 0.001), and HR recovery (p < 0.001). Students performing ≥6 LB were less likely to be overweight (p < 0.001), obese (p < 0.001), or have low high-density lipoprotein (p = 0.05); however, more likely to have elevated triglycerides (p < 0.01). Conclusions: Among middle-school students, baseline BMI, BP, resting, and recovery HR were higher among children reporting fewer healthy LB. Students performing more healthy LB were less likely to be overweight or obese. Efforts to improve LB among middle-school children may be important for primordial cardiovascular prevention efforts.
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Affiliation(s)
- Charlie J Sang
- Department of Internal Medicine and Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ximou Song
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Rosa S F de Visser
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Rachel Krallman
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Daniel Montgomery
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Chih-Wen Pai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Eva Kline-Rogers
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | | | - Kim A Eagle
- Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Elizabeth A Jackson
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Wong DYL, Lam MC, Ran A, Cheung CY. Artificial intelligence in retinal imaging for cardiovascular disease prediction: current trends and future directions. Curr Opin Ophthalmol 2022; 33:440-446. [PMID: 35916571 DOI: 10.1097/icu.0000000000000886] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Retinal microvasculature assessment has shown promise to enhance cardiovascular disease (CVD) risk stratification. Integrating artificial intelligence into retinal microvasculature analysis may increase the screening capacity of CVD risks compared with risk score calculation through blood-taking. This review summarizes recent advancements in artificial intelligence based retinal photograph analysis for CVD prediction, and suggests challenges and future prospects for translation into a clinical setting. RECENT FINDINGS Artificial intelligence based retinal microvasculature analyses potentially predict CVD risk factors (e.g. blood pressure, diabetes), direct CVD events (e.g. CVD mortality), retinal features (e.g. retinal vessel calibre) and CVD biomarkers (e.g. coronary artery calcium score). However, challenges such as handling photographs with concurrent retinal diseases, limited diverse data from other populations or clinical settings, insufficient interpretability and generalizability, concerns on cost-effectiveness and social acceptance may impede the dissemination of these artificial intelligence algorithms into clinical practice. SUMMARY Artificial intelligence based retinal microvasculature analysis may supplement existing CVD risk stratification approach. Although technical and socioeconomic challenges remain, we envision artificial intelligence based microvasculature analysis to have major clinical and research impacts in the future, through screening for high-risk individuals especially in less-developed areas and identifying new retinal biomarkers for CVD research.
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Affiliation(s)
- Dragon Y L Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
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Berkowitz J, Khetpal V, Echouffo-Tcheugui JB, Bambs CE, Aiyer A, Kip KE, Reis SE, Erqou S. Associations between cumulative social risk, psychosocial risk, and ideal cardiovascular health: Insights from the HeartSCORE study. Am J Prev Cardiol 2022; 11:100367. [PMID: 35923764 PMCID: PMC9340530 DOI: 10.1016/j.ajpc.2022.100367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/16/2022] [Accepted: 07/16/2022] [Indexed: 11/21/2022] Open
Abstract
Higher social risk is associated with achievement of fewer ideal cardiovascular health factors. The association was modestly attenuated after adjusting for depression, stress, and perceived discrimination. Psychosocial factors may mediate part of the association between social risk and achievement of ideal cardiovascular health.
Background Limited studies have assessed the effects of psychosocial risk factors on achievement of ideal cardiovascular health (CVH). Methods Using the Heart Strategies Concentrating on Risk Evaluation (HeartSCORE) cohort, we examined the cross-sectional associations of cumulative social risk (CSR) and three psychosocial factors (depression, stress, perceived discrimination) with ideal CVH. CSR was calculated by assigning one point for each of: low family income, low education level, minority race (Black), and single-living status. Ideal CVH was calculated by assigning one point for ideal levels of each factor in American Heart Association's Life's Simple 7. Ideal CVH was dichotomized into fewer versus higher by combining participants achieving <3 versus ≥3 factors. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of having fewer ideal CVH factors. Psychosocial factors were assessed as mediators of the association between CSR and ideal CVH. Results We included 2000 participants (mean age 59.1 [7.5] years, 34.6% male, 42.7% Black, and 29.1% with low income), among whom 60.6% had <3 ideal CVH factors. The odds of having fewer ideal CVH factors increased significantly with increasing CSR scores from 1 to 2, to ≥3 compared to individuals with CSR score of zero, after adjusting for age and sex (OR [95% CIs]: 1.77 [1.41 - 2.22]; 2.09 [1.62 - 2.69] 2.67 [1.97 - 3.62], respectively). Taking the components of ideal CVH separately, higher CSR was directly associated with odds of being in ‘non-ideal’ category for six of the seven factors, but was inversely associated with probability of being in ‘non-ideal’ category for cholesterol. The association was modestly attenuated after adjusting for depression, stress, and perceived discrimination (corresponding OR [95% CI]: 1.69 [1.34 - 2.12], 1.96 [1.51 - 2.55], 2.34 [1.71 - 3.20]). The psychosocial factors appeared to mediate between 10% and 20% of relationship between CSR and ideal CVH. Conclusions Increased CSR was associated with lower probability of achieving ideal CVH factors. A modest amount of the effect of CSR on ideal CVH appeared to be mediated by depression, stress and perceived discrimination. Public health strategies aimed at improving ideal cardiovascular health may benefit from including interventions targeting social and psychosocial risk factors.
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Affiliation(s)
- Julia Berkowitz
- Department of Medicine, the Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Vishal Khetpal
- Department of Medicine, the Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Justin B Echouffo-Tcheugui
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Claudia E Bambs
- Department of Public Health, and Advanced Center for Chronic Diseases-ACCDiS, School of Medicine, Pontificia Universidad Católica de Chile, United States
| | - Aryan Aiyer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kevin E. Kip
- UPMC Health Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Steven E. Reis
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sebhat Erqou
- Department of Medicine, the Warren Alpert Medical School of Brown University, Providence, RI, United States
- Division of Cardiology, Department of Medicine, Providence VA Medical Center, Providence, RI, United States
- Corresponding author at: Providence VA Medical Center, 830 Chalkstone Avenue, Providence, RI 02908, United States.
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