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Huang HY, Lin SY, Katz AJ, Sheu JJ, Lin FJ, Wang CC, Wu CH. Effectiveness and Safety of Clopidogrel vs Aspirin in Elderly Patients With Ischemic Stroke. Mayo Clin Proc 2022; 97:1483-1492. [PMID: 35933134 DOI: 10.1016/j.mayocp.2022.01.033] [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: 08/19/2021] [Revised: 12/06/2021] [Accepted: 01/12/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To evaluate the risks of recurrent stroke and major bleeding events with clopidogrel and aspirin use among patients aged 80 years or older. PATIENTS AND METHODS This retrospective cohort study was conducted using the Full Population Data of the Health and Welfare Database in Taiwan. Patients aged 80 years or older who received monotherapy with clopidogrel or aspirin following hospitalization for primary acute ischemic stroke between January 1, 2009, and December 31, 2018, were included. Inverse probability of treatment weighting was used to balance measured covariates between clopidogrel and aspirin users. Measured outcomes included recurrent acute ischemic stroke, acute myocardial infarction, composite cardiovascular events (recurrent stroke or acute myocardial infarction), intracranial hemorrhage, major gastrointestinal tract bleeding, and composite major bleeding events (intracranial hemorrhage or major gastrointestinal tract bleeding). RESULTS A total of 15,045 patients were included in the study, 1979 of whom used clopidogrel and 13,066 who used aspirin following hospitalization for primary acute ischemic stroke. Clopidogrel use was associated with significantly lower risk of recurrent acute ischemic stroke (hazard ratio [HR], 0.89; 95% CI, 0.83 to 0.96; P=.002), composite cardiovascular events (HR, 0.88; 95% CI, 0.82 to 0.95; P<.001), intracranial hemorrhage (HR, 0.71; 95% CI, 0.56 to 0.90; P=.005), and composite major bleeding events (HR, 0.89; 95% CI, 0.80 to 0.99; P=.04) compared with aspirin use. CONCLUSION In patients aged 80 years or older with primary acute ischemic stroke, clopidogrel users had lower risks of recurrent stroke and the composite cardiovascular events compared with aspirin users. Clopidogrel users also had lower risks of intracranial hemorrhage and the composite major bleeding events compared with aspirin users.
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Affiliation(s)
- Hsin-Yi Huang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | - Shin-Yi Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Aaron J Katz
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS USA; Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS USA
| | - Jau-Jiuan Sheu
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Fang-Ju Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Chuan Wang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-Hsuen Wu
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
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Katsi V, Antoniou CK, Manolakou P, Toutouzas K, Tousoulis D. What's in a prick? Vaccines and the cardiovascular system. Hellenic J Cardiol 2020; 61:233-240. [PMID: 31740362 DOI: 10.1016/j.hjc.2019.09.002] [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: 06/16/2019] [Revised: 07/22/2019] [Accepted: 09/28/2019] [Indexed: 12/24/2022] Open
Abstract
Evidence suggests a crucial role for vaccines in cardiovascular disease, mediated not only by disease prevention but also by immunomodulatory effects. This review attempts to briefly present the effects of pathogens and vaccines on the cardiovascular system and potential mechanisms for the development of vaccines against cardiovascular diseases per se. Current epidemiological evidence regarding vaccine effectiveness in different categories of heart disease is discussed, as well as current international guidelines' recommendations. In summary, cardiologists should strive to promote vaccination against specific pathogens with proven beneficial effects on cardiovascular diseases.
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Affiliation(s)
- Vasiliki Katsi
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokrateion Hospital, Athens, Greece
| | | | - Panagiota Manolakou
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokrateion Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokrateion Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokrateion Hospital, Athens, Greece
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Dendale P, Scherrenberg M, Sivakova O, Frederix I. Prevention: From the cradle to the grave and beyond. Eur J Prev Cardiol 2019; 26:507-511. [DOI: 10.1177/2047487318821772] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Present cardiac prevention mainly focuses on risk reduction later in life, and focuses also mainly on reducing risk factors for coronary heart disease. However, multiple studies have gathered evidence that the development risk of cardiovascular disease starts early in life and that even preconceptional influences play an important role in lifetime risk. Therefore, the importance of well-timed prevention strategies to reduce cardiovascular disease is well established. In this article, we discuss different risk factors for future cardiac disease, and how we can respond to lesser known cardiac risk factors in the different stages of life.
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Affiliation(s)
- Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
| | - Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
- Mobile Health Unit, Hasselt University, Belgium
| | - Oksana Sivakova
- National Research Center for Preventive Medicine, Russian Federation
| | - Ines Frederix
- Faculty of Medicine and Life Sciences, Antwerp University, Belgium
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Yıldırım Dİ, Hayıroğlu Mİ, Ünal N, Eryılmaz MA. Evaluation of varenicline usage on ventricular repolarization after smoking cessation. Ann Noninvasive Electrocardiol 2018; 24:e12609. [PMID: 30417951 DOI: 10.1111/anec.12609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Varenicline, which is a selective partial agonist of the alpha4-beta2 nicotinic acetylcholine receptor, is used for the smoking cessation pharmacotherapy. Cardiovascular adverse effects have been reported after varenicline usage in patients who stop smoking. We investigated the effect of varenicline usage on ventricular repolarization after smoking cessation. METHODS In this prospective cohort study, we evaluated the cardiac arrhythmic effects of varenicline by comparing smoking patients (n = 214) before and after varenicline usage. Varenicline administered patients were also compared to ex-smoker individuals (n = 50) who quit smoking without varenicline usage in terms of ventricular repolarization parameters. RESULTS After calculated according to Fridericia's and Framingham's formulas, QTc intervals were significantly increased when patients compared before and after smoking cessation with varenicline (402.9 ± 24.5 ms vs. 409.1 ± 25.0 ms p < 0.001 and 376.5 ± 15.2 ms, vs. 380.6 ± 13.5 ms; p < 0.001, respectively). There was no arrhythmic event during the follow-up. The change in Tp-e and QTc following varenicline usage was negatively correlated with the smoking packet/year. (ρ: -0.443, p < 0.001 and ρ = -0.601, p < 0.001) CONCLUSION: Varenicline usage was demonstrated to prolong ventricular repolarization parameters similar to animal studies. Varenicline may have a role to predispose cardiac dysrhythmias after utilization in smoking cessation.
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Affiliation(s)
- Duygu İlke Yıldırım
- Department of Family Medicine, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Mert İlker Hayıroğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Neriman Ünal
- Department of Family Medicine, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Mehmet Ali Eryılmaz
- Department of General Surgery, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
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Burke MV, Hays JT, Ebbert JO. Varenicline for smoking cessation: a narrative review of efficacy, adverse effects, use in at-risk populations, and adherence. Patient Prefer Adherence 2016; 10:435-41. [PMID: 27099479 PMCID: PMC4824380 DOI: 10.2147/ppa.s83469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Treating tobacco dependence is the most effective way to reduce tobacco-related death and disability. Counseling and pharmacotherapy have been shown to increase tobacco abstinence rates among smokers. Varenicline is the most effective monotherapy treatment for tobacco dependence; however, it is prescribed less often than indicated, and adherence is less than optimal. We conducted a literature review of the development, efficacy, safety, contraindications, and adverse effects of varenicline; including reviewing data regarding combination therapy, extended duration, and patient adherence. Varenicline was developed to work specifically on the factors that underlie nicotine addiction. Phase II and Phase III trials established dosing, safety profiles, and efficacy. Postmarketing research raised concerns about neuropsychiatric and cardiac effects, resulting in warning labels being added and modified to encourage discussions with patients weighing the risks and benefits. While more research is needed, evidence is strong that varenicline is safe and effective in treating tobacco dependence among people who are at higher risk for neuropsychiatric symptoms and cardiovascular disease. The effectiveness of varenicline can be improved by taking it in combination with other medications, enhancing patient adherence and extending the duration of treatment.
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Jankovic N, Geelen A, Streppel MT, de Groot LC, Kiefte-de Jong JC, Orfanos P, Bamia C, Trichopoulou A, Boffetta P, Bobak M, Pikhart H, Kee F, O'Doherty MG, Buckland G, Woodside J, Franco OH, Ikram MA, Struijk EA, Pajak A, Malyutina S, Kubinova R, Wennberg M, Park Y, Bueno-de-Mesquita HB, Kampman E, Feskens EJ. WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project. Am J Clin Nutr 2015; 102:745-56. [PMID: 26354545 PMCID: PMC4588736 DOI: 10.3945/ajcn.114.095117] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/23/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. OBJECTIVE The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y. DESIGN We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. RESULTS During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable). CONCLUSION Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.
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Affiliation(s)
- Nicole Jankovic
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands; Centre of Clinical Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | | | | | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands; Global Public Health, Leiden University College, the Hague, Netherlands
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Christina Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Antonia Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Paolo Boffetta
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Mark G O'Doherty
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Genevieve Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - Jayne Woodside
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Ellen A Struijk
- Department of Epidemiology, Julius Centre, Utrecht, Netherlands
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University, Krakow, Poland
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | | | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Yikyung Park
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - H Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; and Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Edith J Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;
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Vlachopoulos CV, Terentes-Printzios DG, Aznaouridis KA, Pietri PG, Stefanadis CI. Association between pneumococcal vaccination and cardiovascular outcomes: a systematic review and meta-analysis of cohort studies. Eur J Prev Cardiol 2014; 22:1185-99. [PMID: 25252595 DOI: 10.1177/2047487314549512] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
AIMS Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP) and CAP-related mortality in adults. Pneumococcal vaccination (PV) could protect subjects from cardiovascular events by reducing pneumonia severity or even preventing it. We sought to determine the ability of PV to protect from the risk of cardiovascular events. METHODS AND RESULTS A comprehensive search of electronic databases was conducted up to March 2014. Cohort studies that reported relative risk (RR) estimates with 95% confidence intervals (CI) were included. Eleven studies were included (332,267 participants, mean follow-up 20.1 months). The pooled RRs for cardiovascular events and cardiovascular mortality were 0.86 (95% CI: 0.76-0.97) and 0.92 (95% CI: 0.86-0.98; fixed-effects), respectively, for subjects with PV versus without PV. Protective ability was more prominent in high cardiovascular risk populations and with older age. The protective role of PV was attenuated after 1 year (RR: 0.72; 95% CI: 0.59-0.88 vs RR: 1.03; 95% CI: 0.93-1.14; p = 0.002, for follow-up >1 year vs ≤1 year, respectively). It also increased as the presence of cardiovascular and pulmonary disease increased. Regarding myocardial infarction (MI) and cerebrovascular events, the protective role of PV was statistically significant only in the elderly (RR: 0.90; 95% CI: 0.817-0.999; fixed-effects and RR: 0.86; 95% CI: 0.75-0.99, respectively). CONCLUSION PV is associated with decreased risk of cardiovascular events and mortality. This protective effect increases at older age and in high cardiovascular risk subjects and decreases as the time elapses from PV. PV decreases the risk of MI and cerebrovascular events in the elderly.
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Affiliation(s)
- Charalambos V Vlachopoulos
- Peripheral Vessels Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | | | - Konstantinos A Aznaouridis
- Peripheral Vessels Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Panagiota G Pietri
- Peripheral Vessels Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Christodoulos I Stefanadis
- Peripheral Vessels Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece
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Boggon R, Timmis A, Hemingway H, Raju S, Malvestiti FM, Van Staa TP. Smoking cessation interventions following acute coronary syndrome: a missed opportunity? Eur J Prev Cardiol 2014; 21:767-73. [PMID: 22952289 PMCID: PMC4475793 DOI: 10.1177/2047487312460517] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is recommended that general practitioners (GPs) offer cessation advice and pharmacological interventions to smokers with acute coronary syndrome (ACS). The study objective was to describe the extent to which this is done, and to describe outcomes by smoking status. DESIGN Patients aged 30+ hospitalised for troponin-positive ACS from 2002 to 2009, discharged home alive, were identified in the Myocardial Ischaemia National Audit Project registry. Patient data were linked to the General Practice Research Database, Hospital Episode Statistics, and Office of National Statistics mortality data, enabling a unique perspective of longitudinal smoking data. Patients who smoked prior to the hospitalisation had GP interventions and quitting status established in the 3 months following discharge, and were followed up for major clinical outcomes. METHODS The outcomes evaluated included death, repeat ACS, stroke, heart failure, and major adverse cardiac events (MACE). RESULTS Of the 4834 patients included, 965 (20%) were smokers at the time of their ACS. After the ACS event, only 225 (24%) received any GP smoking intervention within 3 months, with 82 (9%) receiving advice only, and 143 (15%) receiving a pharmacological intervention. Patients who quit (320; 33%) were at a decreased risk of mortality (relative risk (RR) 0.49; 95% confidence interval (CI) 0.35-0.69) and MACE (RR 0.61; 0.46-0.80) compared with patients who did not. CONCLUSIONS Whilst a high proportion of patients with ACS are smokers, there is a low level of GP cessation intervention following hospital discharge. This missed opportunity of patient care is important given the decreased risk of mortality and MACE found amongst those who quit.
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Affiliation(s)
| | - Adam Timmis
- Barts and the London School of Medicine and Dentistry, London, UK
| | - Harry Hemingway
- Department of Epidemiology & Public Health, University College London, UK
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Cabrera MAS, de Andrade SM, Mesas AE. A prospective study of risk factors for cardiovascular events among the elderly. Clin Interv Aging 2012; 7:463-8. [PMID: 23152676 PMCID: PMC3496195 DOI: 10.2147/cia.s37211] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To analyze the impact of cardiovascular (CV) risk factors on the occurrence of fatal and non-fatal CV events in elderly individuals. Methods The present research was a prospective cohort study of 800 elderly Brazilian outpatients (60 to 85 years old) with a 12-year follow-up period (baseline: 1997–1998). The outcome variable was CV mortality or non-fatal CV events (stroke, infarction, angina, heart failure). Hypertension, diabetes, global and abdominal obesity, dyslipidemias, and metabolic syndrome were analyzed as independent variables. The analyses were based on Cox proportional hazard models and adjusted for gender, age range, smoking, regular physical activity, and previous cardiovascular disease. Results A total of 233 fatal and non-fatal CV events were observed (29.1%). In the adjusted analysis, the following variables were associated with CV risk: hypertension hazard ratio (HR): 1.69; confidence interval (CI) 95%: 1.28–2.24, diabetes (HR: 2.67; CI 95%: 1.98–3.61), metabolic syndrome (HR: 1.61; CI 95%: 1.24–2.09), abdominal obesity (HR: 1.36; CI 95%: 1.03–1.79), hypertriglyceridemia (HR: 1.67; CI 95%: 1.22–2.30) and high triglyceride/HDL-c ratio (HR: 1.73; CI 95%: 1.31–2.84). Hypertension, diabetes, and dyslipidemia remained associated with CV risk regardless of abdominal obesity. Conclusion In this prospective study, hypertension, diabetes, metabolic syndrome, abdominal obesity, and hypertriglyceridemia were predictors of CV risk in elderly individuals. These results confirm the relevance of controlling these CV risk factors in this age group.
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