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Zhang X, Du Y, Zhang T, Zhao Z, Guo Q, Ma X, Shi D, Zhou Y. Prognostic significance of triglyceride-glucose index in acute coronary syndrome patients without standard modifiable cardiovascular risk factors. Cardiovasc Diabetol 2024; 23:270. [PMID: 39044255 PMCID: PMC11267681 DOI: 10.1186/s12933-024-02345-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND A significant percentage of patients with acute coronary syndrome (ACS) without standard modifiable cardiovascular risk factors (SMuRFs) are being identified. Nonetheless, the prognostic influence of the TyG index on adverse events in this type of patient remains unexplored. The aim of this study was to assess the prognostic value of the TyG index among ACS patients without SMuRFs for predicting adverse outcomes. METHODS This study involved 1140 consecutive patients who were diagnosed with ACS without SMuRFs at Beijing Anzhen Hospital between May 2018 and December 2020 and underwent coronary angiography. Each patient was followed up for a period of 35 to 66 months after discharge. The objective of this study was to examine major adverse cardiac and cerebrovascular events (MACCE), which included all-cause mortality, non-fatal myocardial infarction, non-fatal ischemic stroke, as well as ischemia-driven revascularization. RESULTS During the median follow-up period of 48.3 months, 220 (19.3%) MACCE events occurred. The average age of the participants was 59.55 ± 10.98 years, and the average TyG index was 8.67 ± 0.53. In the fully adjusted model, when considering the TyG index as either a continuous/categorical variable, significant associations with adverse outcomes were observed. Specifically, for each 1 standard deviation increase in the TyG index within the highest TyG index group, there was a hazard ratio (HR) of 1.245 (95% confidence interval CI 1.030, 1.504) for MACCE and 1.303 (95% CI 1.026, 1.653) for ischemia-driven revascularization (both P < 0.05), when the TyG index was analyzed as a continuous variable. Similarly, when the TyG index was examined as a categorical variable, the HR (95% CI) for MACCE in the highest TyG index group was 1.693 (95% CI 1.051, 2.727) (P < 0.05) in the fully adjusted model, while the HR (95% CI) for ischemia-driven revascularization was 1.855 (95% CI 0.998, 3.449) (P = 0.051). Additionally, the TyG index was found to be associated with a poor prognosis among the subgroup. CONCLUSION The TyG index is correlated with poor prognosis in patients with ACS without SMuRFs, suggesting that it may be an independent predictive factor of adverse events among these individuals.
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Affiliation(s)
- Xiaoming Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yu Du
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Tianhao Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Zehao Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Qianyun Guo
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Xiaoteng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Dongmei Shi
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China.
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Vyas MV, Redditt V, Mohamed S, Abraha M, Sheth J, Shah BR, Ko DT, Ke C. Determinants, Prevention, and Incidence of Cardiovascular Disease Among Immigrant and Refugee Populations. Can J Cardiol 2024; 40:1077-1087. [PMID: 38387721 DOI: 10.1016/j.cjca.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024] Open
Abstract
Immigration policies shape the composition, socioeconomic characteristics, and health of migrant populations. The health of migrants is also influenced by a confluence of social, economic, environmental, and political factors. Immigrants and refugees often face various barriers to accessing health care because of factors such as lack of familiarity with navigating the health care system, language barriers, systemic racism, and gaps in health insurance. Social determinants of health and access to primary care health services likely influence the burden of cardiovascular risk factors among immigrants. The relatively low burden of many cardiovascular risk factors in many immigrant populations likely contributes to the generally lower incidence rates of acute myocardial infarction, heart failure, and stroke in immigrants compared with nonimmigrants, although cardiovascular disease incidence rates vary substantially by country of origin. The "healthy immigrant effect" is the hypothesis that immigrants to high-income countries, such as Canada, are healthier than nonimmigrants in the host population. However, this effect may not apply universally across all immigrants, including recent refugees, immigrants without formal education, and unmarried immigrants. As unfolding sociopolitical events generate new waves of global migration, policymakers and health care providers need to focus on addressing social and structural determinants of health to better manage cardiovascular risk factors and prevent cardiovascular disease, especially among the most marginalized immigrants and refugees.
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Affiliation(s)
- Manav V Vyas
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Division of Neurology, Li Ka Shing Knowledge Institute, St. Michael's Hospital-Unity Health, Toronto, Ontario, Canada
| | - Vanessa Redditt
- Crossroads Clinic, Women's College Hospital, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sebat Mohamed
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mosana Abraha
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Javal Sheth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Dennis T Ko
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Schulich Heart Centre, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Calvin Ke
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Medicine, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
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3
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Song G, Chang H, Mu N. Image testing based on biomedical drug loading in cardiovascular drug care simulation for coronary heart disease. Med Eng Phys 2024; 126:104150. [PMID: 38621849 DOI: 10.1016/j.medengphy.2024.104150] [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: 01/05/2024] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 04/17/2024]
Abstract
Coronary heart disease is a common cardiovascular disease, and its therapeutic effect is affected by the distribution and absorption of drugs in the body. Biomedical drug-carrying image testing technology can provide a quantitative assessment of drug distribution and absorption in the body. This study aims to explore the application of biomedical drug-carrying image testing technology in the simulation of cardiovascular drug care in coronary heart disease, so as to provide reference for the optimization of drug treatment plan and individualized treatment. The study collected clinical data and medication regiments of patients with coronary heart disease. Then, the imaging examination of patients was carried out by selecting appropriate drug loading markers using the biomedical drug loading image examination technology. Then quantitative analysis was used to process the image data to quantitatively evaluate the distribution and absorption of drugs in the cardiovascular system. The quantitative data of drug distribution and absorption in patients with coronary heart disease have been obtained successfully by means of biomedical imaging. These data reveal the dynamic changes of drugs in the cardiovascular system, and help doctors optimize drug therapy, improve treatment effectiveness, and achieve personalized treatment.
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Affiliation(s)
- Guifang Song
- Department of Cardiology, Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Huili Chang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Nv Mu
- Department of Neurology, Yantai Yuhuangding Hospital, Yantai 264000, China.
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Xu X, Li D, Zhang S. Retrospective study for correlation analysis of nutritional status with osteoporosis, sarcopenia and cognitive impairment in elderly patients with coronary heart disease. Front Cardiovasc Med 2024; 10:1335572. [PMID: 38371735 PMCID: PMC10870772 DOI: 10.3389/fcvm.2023.1335572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/26/2023] [Indexed: 02/20/2024] Open
Abstract
Coronary heart disease (CHD) is an abbreviation of coronary atherosclerotic heart disease, which remains challenging for diagnosis and treatment. Current study aims to explore the correlation between geriatric nutritional risk index (GNRI) and osteoporosis, sarcopenia, cognitive dysfunction in elderly patients with CHD, and to analyze the clinical diagnostic value of GNRI in the above complications. A total of 92 elderly patients with CHD treated in Suzhou Ninth People's Hospital from January 2020 to October 2023 were retrospectively collected as the experimental group, and 68 non-CHD subjects matched for sex and age in the same period of physical examination were randomly selected as the control group. Osteoporosis, sarcopenia and cognitive dysfunction were analyzed in all patients, and the correlation between GNRI and these indices in different populations was analyzed by Spearman's rank correlation. The diagnostic efficacy of GNRI in osteoporosis, sarcopenia, and cognitive impairment was analyzed by ROC curves. There was no significant difference in age, sex distribution, body mass index (BMI) and serum biological indexes between the elderly patients with CHD and the control group (all P > 0.05). Correlation analysis showed that GNRI level was positively correlated with bone mineral content (BMC), bone mineral density (BMD) T value and osteocalcin (OCN) (All r > 0, P < 0.05). In addition, GNRI levels were positively correlated with skeletal muscle mass (ASMI), grip strength and calf circumference (CC) (All r > 0, P < 0.05). However, there was no significant correlation between GNRI levels and cognitive dysfunction-related indicators (P > 0.05). In the elderly and elderly with CHD, the diagnostic AUC of GNRI was 0.875 and 0.862 in osteoporosis, and 0.912 and 0.932 in sarcopenia, respectively. The level of GNRI is significantly correlated with osteoporosis and sarcopenia. GNRI level, as an auxiliary diagnostic tool in elderly patients with CHD, exerts important clinical significance for early detection of the risk of complications, such as osteoporosis and sarcopenia.
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Affiliation(s)
| | | | - Shan Zhang
- Department of Geriatric, Suzhou Ninth People’s Hospital, Suzhou, Jiangsu, China
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5
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Li M, Song S, Rong Y, Wu D, Yin Y. Zhishi Xiebai Guizhi Decoction for coronary heart disease: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e36588. [PMID: 38241594 PMCID: PMC10798696 DOI: 10.1097/md.0000000000036588] [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: 08/26/2023] [Accepted: 11/20/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is a type of cardiovascular disease (CVD) caused by coronary atherosclerosis. It is a main cause of medical burden and cardiovascular related death. Zhishi Xiebai Guizhi Decoction (ZXGD) is a representative prescription of traditional Chinese medicine (TCM) in the treatment of CHD, but there is poor systemically evidence-based appraisal. OBJECTIVE To evaluate the efficacy and safety of ZXGD for CHD. METHODS Eight databases were retrieved for randomized controlled trials (RCTs). Data was extracted independently by 2 reviewers. The quality of the included studies was assessed by Cochrane Collaboration risk of bias tool. Clinical efficacy, blood lipid, vascular endothelial function, inflammatory factor and homocysteine (Hcy) were prespecified outcome measures. RESULTS Twenty-four studies (2272 patients) were included. Meta-analysis showed that compared with conventional western medicine (WM) alone, ZXGD was associated with a greater symptom improvement rate with a relative risk (RR) of 1.21 [95% CI (1.16, 1.26), P < .00001] and a greater electrocardiogram (ECG) improvement rate with a RR of 1.27 [95% CI (1.16, 1.40), P < .00001]. In terms of blood lipid, ZXGD reduced total cholesterol (TC) with a mean difference (MD) of -1.15 [95%CI (-1.75, -0.55), P = .0002] and triglyceride (TG) [MD = -0.72, 95%CI (-0.99, -0.45), P < .00001], reduced low-density lipoprotein cholesterol (LDL-C) [MD = -0.93, 95% CI (-1.17, -0.69), P < .00001], and increased high-density lipoprotein cholesterol (HDL-C) [MD = 0.31, 95%CI (0.20, 0.42), P < .00001]. In terms of vascular endothelial function, ZXGD decreased the level of endothelin-1 (ET-1) [MD = -7.81, 95%CI (-9.51, -6.10), P < .00001], and increased nitric oxide (NO) [MD = 8.90, 95%CI (7.86, 9.93), P < .00001]. ZXGD also reduced high-sensitivity C-reactive protein (hs-CRP) [MD = -1.73, 95% CI (-2.63, -0.83), P < .00001] and Hcy [MD = -2.03, 95%CI (-2.78, -1.28), P < .00001]. No significant differences were found in adverse event rate between the 2 groups with a RR of 0.77 [95% CI (0.44, 1.34), P = .36]. CONCLUSION ZXGD is effective and safe in the treatment of CHD. However, more rigorous and high-quality RCTs are needed to verify the conclusion.
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Affiliation(s)
- Ming Li
- Office of Academic Affairs, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shengqiang Song
- Office of Academic Affairs, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuanhang Rong
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Di Wu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongtian Yin
- Office of Academic Affairs, Shandong University of Traditional Chinese Medicine, Jinan, China
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Menotti A, Puddu PE, Kafatos AG, Tolonen H, Adachi H, Jacobs DR. Cardiovascular Mortality in 10 Cohorts of Middle-Aged Men Followed-Up 60 Years until Extinction: The Seven Countries Study. J Cardiovasc Dev Dis 2023; 10:201. [PMID: 37233168 PMCID: PMC10219369 DOI: 10.3390/jcdd10050201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES To investigate mortalities from three major groups of cardiovascular diseases (CVDs) in a pooled cohort and followed up until extinction. MATERIALS AND METHODS Ten cohorts of men (N = 9063) initially aged 40-59, in six countries, were examined and followed-up for 60 years. The major CVD groups were coronary heart disease (CHD), cerebrovascular diseases (STROKE) and other heart diseases of uncertain etiology (HDUE). RESULTS Death rates from CHD were higher in countries with high serum cholesterol levels (USA, Finland and The Netherlands) and lower in countries with low cholesterol levels (Italy, Greece and Japan), but the opposite was observed for STROKE and HDUE, which became the most common CVD mortalities in all countries during the last 20 years of follow-up. Systolic blood pressure and smoking habits were, at an individual level, the common risk factors for the three groups of CVD conditions, while serum cholesterol level was the most common risk factor only for CHD. Overall, death rates for the pooled CVDs were 18% higher in North American and Northern European countries, while CHD rates were 57% higher in the same countries. CONCLUSIONS Differences in lifelong CVD mortalities across different countries were smaller than expected due to the different rates of the three groups of CVD, and the indirect determinant of this seemed to be baseline serum cholesterol levels.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, 00182 Rome, Italy;
- EA 4650, Signalisation, Electrophysiologie et Imagerie des Lésions d’ischémie Reperfusion Myocardique, Université de Normandie, 14032 Caen, France
| | - Anthony G. Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, 71003 Heraklion, Greece
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Hisashi Adachi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
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Menotti A, Puddu PE, Tolonen H, Kafatos A. Cardiovascular mortality in Northern and Southern European cohorts of the Seven Countries Study at 60-year follow-up. J Cardiovasc Med (Hagerstown) 2023; 24:96-104. [PMID: 36583978 DOI: 10.2459/jcm.0000000000001425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of this study was to describe and interpret differences in major cardiovascular disease (CVD) mortality during 60 years between Northern European and Southern European cohorts of the Seven Countries Study of Cardiovascular Diseases. MATERIAL AND METHODS Northern Europe included two cohorts from Finland and one from the Netherlands, and Southern Europe included two cohorts from Italy and two from Greece, for a total of 2360 and 2792 CVD-free men, respectively, at entry examination. Coronary heart disease (CHD), STROKE and other Heart Diseases of Uncertain Etiology (HDUE) deaths were the outcomes and Cox models were solved separately based on 12 risk factors. RESULTS In 60 years, overall death rates were 99.8% in both Northern and Southern Europe and the pooled CVD rates were 46.9% (significantly higher) and 42.2%, respectively: CHD mortality was higher in Northern Europe, whereas STROKE and HDUE mortality were higher in Southern Europe. Significant Cox coefficients for both areas (but not significantly different between areas) were age, smoking habits, SBP and serum cholesterol for CHD, and only age and SBP did so for STROKE and HDUE. Age at death was lower for CHD, intermediate for STROKE and higher for HDUE in both areas. CONCLUSION The advantage for Southern Europe was small in terms of overall CVD death rates, but definitely larger in terms of expectancy of life due to the differences in age at death in the three types of CVD mortality. Mean entry levels of serum cholesterol, 50 mg/dl higher in Northern Europe than in Southern Europe are a major culprit of these outcomes.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, Rome, Italy
- EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, Université de Normandie, Caen, Normandie, France
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anthony Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Crete, Greece
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Zhang R, Shi S, Chen W, Wang Y, Lin X, Zhao Y, Liao L, Guo Q, Zhang X, Li W, Zhang K, Liao Y, Fang Y. Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database. Cardiovasc Diabetol 2023; 22:10. [PMID: 36639637 PMCID: PMC9838037 DOI: 10.1186/s12933-023-01737-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a reliable alternative biomarker of insulin resistance (IR). However, whether the TyG index has prognostic value in critically ill patients with coronary heart disease (CHD) remains unclear. METHODS Participants from the Medical Information Mart for Intensive Care III (MIMIC-III) were grouped into quartiles according to the TyG index. The primary outcome was in-hospital all-cause mortality. Cox proportional hazards models were constructed to examine the association between TyG index and all-cause mortality in critically ill patients with CHD. A restricted cubic splines model was used to examine the associations between the TyG index and outcomes. RESULTS A total of 1,618 patients (65.14% men) were included. The hospital mortality and intensive care unit (ICU) mortality rate were 9.64% and 7.60%, respectively. Multivariable Cox proportional hazards analyses indicated that the TyG index was independently associated with an elevated risk of hospital mortality (HR, 1.71 [95% CI 1.25-2.33] P = 0.001) and ICU mortality (HR, 1.50 [95% CI 1.07-2.10] P = 0.019). The restricted cubic splines regression model revealed that the risk of hospital mortality and ICU mortality increased linearly with increasing TyG index (P for non-linearity = 0.467 and P for non-linearity = 0.764). CONCLUSIONS The TyG index was a strong independent predictor of greater mortality in critically ill patients with CHD. Larger prospective studies are required to confirm these findings.
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Affiliation(s)
- Rongting Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Shanshan Shi
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Weihua Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yani Wang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Xueqin Lin
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Yukun Zhao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Lihua Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Qian Guo
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Xiaoying Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
- The Graduate School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China
| | - Weiguo Li
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Kaijun Zhang
- Department of Pulmonary and Critical Care Medicine, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Ying Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
| | - Yong Fang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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9
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Puddu PE, Menotti A, Jacobs DR, Adachi H, Kafatos A, Tolonen H. Cardiovascular risk factors predict age at death in 60-year follow-up of the Seven Countries Study. Aging Clin Exp Res 2023; 35:193-202. [PMID: 36445565 DOI: 10.1007/s40520-022-02288-5] [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: 09/10/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study age at death (AD) and its determinants in cohorts of middle-aged men followed-up until extinction. MATERIAL AND METHODS A total of 9063 middle-aged men enrolled in 10 cohorts of 6 countries (USA, Finland, the Netherlands, Italy, Greece and Japan) within the Seven Countries Study were examined and then followed up for 60 years until extinction. AD was computed and a small number of risk factors were tested through multiple linear regression as possibly related to attained AD. RESULTS AD ranged across cohorts from 71.8 years in East Finland and 80.5 years in Crete with levels roughly lower in the USA and Northern Europe and higher elsewhere. Across cohorts, the correlation coefficients of systolic blood pressure (R = -0.58) and of CVD prevalence (R = -0.65) versus average AD were the only significant ones. At the individual level in the pool of all cohorts, a multiple linear regression model showed that age, vigorous physical activity, never and ex-smokers were favorably related to AD, while the reverse was true for systolic blood pressure, heart rate, serum cholesterol, CVD prevalence and silent ECG abnormalities. BMI had a parabolic relationship with AD. The predicting power of single risk factors, expressed in years gained or lost, was relatively small, but arbitrary combinations of several of them produced large differences in AD. CONCLUSIONS A small number of CVD risk factors were strongly associated with AD in a life-long follow-up.
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Affiliation(s)
- Paolo Emilio Puddu
- EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions d'ischémie Reperfusion Myocardique, Université de Normandie, Caen, Normandie, France. .,Association for Cardiac Research, Via Savoia, 78, 00198, Rome, Italy.
| | | | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Hisashi Adachi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, School of Medicine, Kurume University, Kurume, Japan
| | - Antony Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Crete, Greece
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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10
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Chambergo-Michilot D, Atamari-Anahui N, Segura-Saldaña P, Brañez-Condorena A, Alva-Diaz C, Espinoza-Alva D. Trends and geographical variation in mortality from coronary disease in Peru. PLoS One 2022; 17:e0273949. [PMID: 36067204 PMCID: PMC9447875 DOI: 10.1371/journal.pone.0273949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background Coronary disease (CD) is the main cause of mortality worldwide. Data about trends and geographical variation in CD mortality is available in some American countries. This information varies among countries since CD risk factors frequencies vary. Objective To describe the trend and geographical variation of coronary disease (CD) mortality in Peru, 2005–2017. Methods Analysis of secondary data of the Peruvian Ministry of Health’s registry of deaths. We analyzed CD mortality. We described the absolute and relative frequency of deaths and age-standardized mortality rate (ASMR) by natural regions, departments, age, sex, and year. We also described the change of ASMR between two periods (2005–2010 vs. 2011–2017). Results There were 64,721 CD deaths between 2005 and 2017 (4.12% among all deaths). The absolute frequency of CD deaths was 5,665 and 6,565 in 2005 and 2017, respectively. CD mortality was more frequent in men and older adults. The ASMR varied among natural regions, being higher in the Coast (19.61 per 100,000 inhabitants). The change between the two periods revealed that almost all departments reduced their ASMRs, except for Callao, Lambayeque, and Madre de Dios. Conclusion CD mortality has increased in Peru. Mortality was higher in men and older adults, and it varied among departments. More political efforts are needed to reduce these trends.
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Affiliation(s)
- Diego Chambergo-Michilot
- CHANGE Research Working Group, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Universidad Científica del Sur, Lima, Perú
- Department of Cardiology Research, Torres de Salud National Research Center, Lima, Peru
| | - Noé Atamari-Anahui
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Perú
- * E-mail:
| | - Pedro Segura-Saldaña
- Department of Cardiology Research, Torres de Salud National Research Center, Lima, Peru
- Ingeniería Biomédica, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Ana Brañez-Condorena
- ADIECS Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Carlos Alva-Diaz
- Universidad Señor de Sipán, Chiclayo, Perú
- Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Perú
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Perú
| | - Daniel Espinoza-Alva
- Servicio de Cardiología Clínica, Instituto Nacional Cardiovascular-INCOR, EsSalud, Lima, Perú
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11
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Menotti A, Puddu PE, Catasta G. Lifestyle behaviours predicting major cardiovascular diseases mortality in a practically extinct cohort of middle-aged men followed-up for 61 years. Acta Cardiol 2022:1-8. [PMID: 35904435 DOI: 10.1080/00015385.2022.2101876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
To study lifetime relationships of three major lifestyle behaviours with cardiovascular mortality in a cohort of middle-aged men that reached practical extinction. In the Italian Areas of the Seven Countries Study of Cardiovascular Diseases (SCS), 1712 men were enrolled and examined in 1960, and behavioural habits were measured: smoking habits, physical activity and diet each divided into three classes. Follow-up for mortality was extended for 61 years. Three groups of major cardiovascular diseases (CVD) were used for analysis, coronary heart disease (CHD), STROKE and other Heart Diseases of Uncertain Aetiology (HDUE). Kaplan-Meier curves, death rates in classes of behaviours and Cox proportional hazard models were computed, the last ones adjusted for other major risk factors.In 61 years of follow-up, 1708 men died and 727 were cases of CVD as defined above. Clear separation of classes in Kaplan-Meier survival curves were seen only for physical activity and diet in CHD, and physical activity for STROKE. Cox proportional hazard ratios (HR, adjusted for age, blood pressure and serum cholesterol) showed the significant protective effect on CHD of Mediterranean diet (HR = 0.72), vigorous physical activity (0.55), never smoking (0.73); on STROKE of vigorous physical activity (0.67); on HDUE of never smoking (0.57). Combination of three healthy versus three unhealthy behaviours was associated for CHD to a lower mortality of 39%. This comparison was not coherent for STROKE and HDUE.Lifetime healthy behaviours are clearly beneficial versus CHD mortality but not necessarily for mortality from HDUE and STROKE that probably represent different morbid conditions.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, Rome, Italy.,EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions d'ischémie Reperfusion Myocardique, UNICAEN, Caen, France
| | - Giovina Catasta
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome, Italy
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12
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Martin-Baranera M. Cardiovascular research and population-based prospective cohort studies: as time goes by. HIPERTENSION Y RIESGO VASCULAR 2022; 39:101-104. [DOI: 10.1016/j.hipert.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 12/01/2022]
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13
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Menotti A, Puddu PE, Tolonen H, Kafatos A, Adachi H. High R wave as a risk factor for cardivoascular and all-cause mortality. A 45-year follow-up of 13 cohorts of the Seven Countries Study. J Electrocardiol 2022; 73:103-107. [PMID: 35759988 DOI: 10.1016/j.jelectrocard.2022.06.005] [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: 02/09/2022] [Revised: 05/25/2022] [Accepted: 06/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To study the role of high R waves predicting cardiovascular (CVD) and all-cause mortality in a male middle-aged population followed-up 45 years. MATERIAL AND METHODS A total of 7985 CVD-free men aged 40-59 years were enrolled in 13 cohorts in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece, Japan) and high R waves were classified by Minnesota Code 3.1 (as a dichotomous variable) from baseline resting otherwise normal ECG at entry examination together with other personal characteristics. Cox models were solved to detect the possible predictive role of high R waves for CVD and all-cause mortality. RESULTS In Cox models high R waves were predictive of 45-year major CVD deaths with a hazard ratio of 1.17 (95% confidence intervals of 1.03-1.33) after adjustment for 6 major CVD risk factors (age, systolic blood pressure, serum cholesterol, cigarette smoking, physical activity and body mass index). The predictive role of high R wave was less evident for 45-year all-cause mortality and after adjustment for the 6 covariates the HR of high R wave lost its significance. A multiple logistic model indicated that body mass index, serum cholesterol, systolic blood pressure and mainly vigorous physical activity were directly related to high R wave prevalence while heart rate, subscapular skinfold, laterality index and shoulder pelvis shape did so in an inverse way. CONCLUSION High R waves seem associated with an excess CVD mortality in a 45-year follow-up of middle-aged men, while their role is diluted when the end-point is all-cause mortality.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, Rome, Italy; EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, UNICAEN, 14000 Caen, France.
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Anthony Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Crete, Greece
| | - Hisashi Adachi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University, School of Medicine, Kurume, Japan
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14
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Jiao Y, Su Y, Shen J, Hou X, Li Y, Wang J, Liu B, Qiu D, Sun Z, Chen Y, Xi Q, Shen M, Fu Z. Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study. Cardiovasc Diabetol 2022; 21:3. [PMID: 34991602 PMCID: PMC8740408 DOI: 10.1186/s12933-021-01443-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/29/2021] [Indexed: 12/13/2022] Open
Abstract
Background With the advancement of the world population aging, more attention should be paid to the prognosis of elderly patients with acute coronary syndrome (ACS). Triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to traditional risk factors of cardiovascular disease (CVD). However, the effect of TyG index on the prognosis of long-term adverse events in elderly ACS patients has not been reported. This study evaluated the prognostic power of TyG index in predicting adverse events in elderly ACS patients. Methods In this study, 662 ACS patients > 80 years old who were hospitalized from January 2006 to December 2012 were enrolled consecutively and the general clinical data and baseline blood biochemical indicators were collected. The follow-up time after discharge was 40–120 months (median, 63 months; interquartile range, 51‒74 months). In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2], and patients were divided into three groups according to the tertile of the TyG index. Results The mean age of the subjects was 81.87 ± 2.14 years, the proportion of females was 28.10%, and the mean TyG index was 8.76 ± 0.72. The TyG index was closely associated with the traditional risk factors of CVD. In the fully-adjusted Cox regression model, the Hazard ratio (95% CI) of all-cause mortality (in tertile 3) was 1.64 (1.06, 2.54) and major adverse cardiac event (MACE) (in tertile 3) was 1.36 (1.05, 1.95) for each SD increase in the TyG index. The subgroup analyses also confirmed the significant association of the TyG index and long-term prognosis. Conclusion The TyG index is an independent predictor of long-term all-cause mortality and MACE in elderly ACS patients.
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Affiliation(s)
- Yang Jiao
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Yongkang Su
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Geriatrics, The Second Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jian Shen
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Xiaoling Hou
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Ying Li
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Jihang Wang
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Cardiology, Hainan Hospital, Chinese PLA General Hospital, Sanya, 572000, Hainan, China
| | - Bing Liu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.,Department of Cardiology, 970 Hospital, Chinese PLA Joint Logistic Support Force, Weihai, 264200, Shandong, China
| | - Dongfeng Qiu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Zhijun Sun
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Yundai Chen
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China
| | - Qing Xi
- The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mingzhi Shen
- Department of Cardiology, Hainan Hospital, Chinese PLA General Hospital, Sanya, 572000, Hainan, China.
| | - Zhenhong Fu
- Senior Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital and Chinese PLA Medical School, Beijing, 100853, China.
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15
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Gor I, Nadeem G, Bataev H, Dorofeev A. Prevalence and Structure of Periodontal Disease and Oral Cavity Condition in Patients with Coronary Heart Disease (Prospective Cohort Study). Int J Gen Med 2021; 14:8573-8581. [PMID: 34849002 PMCID: PMC8627261 DOI: 10.2147/ijgm.s330724] [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: 08/12/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To study the incidence and structure of periodontal disease in elderly Moscow residents suffering from permanent coronary heart disease, as well as examine the oral cavity and tooth structure in patients with generalized periodontitis and coronary heart disease. Patients and Methods Stage 1 (studying the incidence and structure of periodontal diseases) enrolled 330 patients over 50 years old: Group 1 consisted of 180 patients (102 males and 78 females) with stable coronary heart disease; Group 2 consisted of 150 dental patients (90 males and 60 females) with periodontal pathology without associated coronary heart disease. Stage 2 enrolled 216 patients with generalized periodontitis (studying features of the generalized periodontitis course depending on the coronary heart disease presence): Group 1 consisted of 145 patients with coronary heart disease and generalized periodontitis (79 males and 66 females), Group 2 consisted of 71 patients with generalized periodontitis but without coronary heart disease (40 males and 31 females). Results It has been established that 172 (95.6%) patients with coronary heart disease had periodontal disease with a predominance of generalized periodontitis in its structure, present in 145 (84.3%) people with coronary heart disease. A more severe clinical course distinguishes generalized periodontitis in patients with coronary heart disease than those without comorbid coronary heart disease. Moreover, it is characterized by a higher mean number of tooth loss (6.21±0.16 vs 4.83±0.12 teeth, p <0.05), more teeth defects (54.69±2.25% vs 21.15±1.27%, p <0.05), higher caries intensity level (11.07±0.32 vs 8.55±0.41, p < 0,05), clinical attachment loss (5.76±0.09 mm vs 4.85±0.10 mm, p < 0.05), and greater depth of periodontal pockets (4.80±0.17 mm vs 3.64±0.21 mm, p < 0.05). Conclusion Coronary heart disease is a favorable prerequisite for the development and progression of periodontal pathology.
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Affiliation(s)
- Ilana Gor
- Department of Surgical Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Gulrez Nadeem
- Department of Basic Medical Sciences, Ajman University, Ajman, United Arab Emirates
| | - Hizir Bataev
- Department of Faculty Therapy, Federal State Budgetary Institution of Higher Education Kadyrov Chechen State University, Grozny, Russian Federation
| | - Aleksey Dorofeev
- Department of Propaedeutics of Dental Diseases of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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16
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Kunkel KJ, Lemor A, Mahmood S, Villablanca P, Ramakrishna H. 2021 Update for the Diagnosis and Management of Acute Coronary Syndromes for the Perioperative Clinician. J Cardiothorac Vasc Anesth 2021; 36:2767-2779. [PMID: 34400062 PMCID: PMC8297970 DOI: 10.1053/j.jvca.2021.07.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023]
Abstract
In this review, recent key publications related to acute coronary syndrome (ACS) are summarized and placed into context of contemporary practice. Landmark trials examining vascular access in ST-elevation myocardial infarction, the management of multivessel disease, acute myocardial infarction and cardiac arrest are discussed. An update in pharmacology for ACS provides updates in major trials relating to P2Y12 inhibitor initiation, deescalation, and use in special populations. Additional updates in the use of lipid-lowering agents and adjunctive medications in ACS are reviewed. Finally, cardiac pathology related to coronavirus disease 2019 (COVID-19), as well as the impact of the COVID-19 global pandemic on the care of patients with ACS, is summarized.
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Affiliation(s)
| | - Alejandro Lemor
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI
| | - Shazil Mahmood
- Division of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Pedro Villablanca
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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17
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Ibanez B, Roque D, Price S. The year in cardiovascular medicine 2020: acute coronary syndromes and intensive cardiac care. Eur Heart J 2021; 42:884-895. [PMID: 33388774 DOI: 10.1093/eurheartj/ehaa1090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/07/2020] [Accepted: 12/17/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.,Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - David Roque
- Cardiology Department, Prof. Dr. Fernando Fonseca Hospital, Amadora, Portugal
| | - Susanna Price
- Department of Cardiology and Department of Adult Critical Care, Royal Brompton Hospital, London, UK
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18
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Montani JP. Ancel Keys: The legacy of a giant in physiology, nutrition, and public health. Obes Rev 2021; 22 Suppl 2:e13196. [PMID: 33496369 DOI: 10.1111/obr.13196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/28/2022]
Abstract
Ancel Keys, whose life spanned over 100 years (1904-2004), made a wealth of seminal scientific and public health contributions. As a physiologist, nutritionist, and public health scientist, he has left his mark on the 20th century by exploring different areas of physiology and nutrition, as well as by contributing to the understanding of basic public health issues. Among his major achievements one can mention in chronological order: studying adaptation to very high altitude, developing the K ration to enable the US military to survive with light but dense food, dissecting the physiology of starvation and nutritional rehabilitation to optimize recovery of functions, uncovering the link between serum cholesterol and heart disease, coordinating the first multi-country epidemiological longitudinal study in nutrition and health, coining the word "body mass index" (BMI), which he showed to be the best body weight index to predict body fat, and promoting the Mediterranean diet for a healthy life style. This review examines the historical events and scientific intrigues that have surrounded Ancel Keys's major classical studies that have ensured him a central place in the history of medical science.
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Affiliation(s)
- Jean-Pierre Montani
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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19
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Relationship between plasma high-sensitivity c-reactive protein and traditional cardiovascular risk factors among active-duty military personnel in Republic of Serbia. VOJNOSANIT PREGL 2021. [DOI: 10.2298/vsp210122030r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Approximately one third of individuals with no or one risk
factor, as well as 40% individuals with concentraction of cholesterol less
than average die from cardiovascular disease (CVD). Recent study underlined
significant role of inflammation in atherosclerosis and its complications.
Our study is the first one in Serbia which have for the aim that analyses
the association of high-sensitivity C-reactive protein (hs-CRP) with
traditional risk factors for coronary heart disease. Metods: This study is
observational cross-sectional study which included 205 active-duty military
personnel similar socioepidemiological and economic characteristics. Plasma
high-sensitivity C-reactive protein (hs-CRP) and traditional cardiovascular
risk factors were evaluated. The relative cardiovascular risk was staged as
low (hs-CRP <1mg/L), intermediate (hs-CRP between 1 and 3mg/L) and high
(hs-CRP >3mg/L). The Systematic COronary Risk Evaluation (SCORE) system was
used for absolute cardiovascular risk assessment, and total risk (fatal and
non-fatal events). Results: Our study included 205 participants, average
age of 39 (35-43) years, with median and interquartile range values of
hs-CRP 0.80 mg/L (0.43-1.75), with average hs-CRP values 0.71mg/L in the
youngers than 40 years and 1.2 mg/L in the olders. Between the study groups
the significant diferrence in hsCRP-a values was registrated; hs-CRP was
significantly higher in the group older than 40 years ( p=0.006). There was
a significant positive correlation between hsCRP and age (r=0.266, p<0.001);
weight (r=0.223 p=0.001), body mass index (BMI) (r=0.344, p<0.001),
diastolic hypertension (r=0.190, p=0.007), LDL cholesterol (r=0.152,
p=0.032), triglycerides (r=0.144, p=0.039), number of risk factors (r=0.210,
p<0.003), as well as negative correlation with HDL cholesterol concentration
(r=-0.159, p<0.023). There was no significant correlation between hsCRP
concentration and total cholesterol (r=0.131, p=0.062). According to hs-CRP
values, high CV risk was found in 17.7% participants older than 40 years,
and based on SCORE system staging, 90% participants have intermmediate CV
risk. The results of stepwise multiple regression analyses showed that BMI
was independently associated with hsCRP concentration in the group younger
than 40 years. Among the olders, age was found to be associated with
fibrinogen values. Conclusions. In the population of active military
personnel in the Republic of Serbia, hs-CRP is correlated with some of the
risk factors for CVD, and only BMI is independently 4 correlated with hs-CRP
in those under 40 years of age. Levels of serum hs-CRP are increased with
aging, imply that hs-CRP measurement may provide a more accurate assessment
of the individual overall risk profile for CVD in the Serbian military
personnel population.
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20
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Chen Z, Mo J, Xu J, Wang A, Dai L, Cheng A, Yalkun G, Meng X, Zhao X, Li H, Wu S, Wang Y. Effects of individual and integrated cumulative burden of blood pressure, glucose, low-density lipoprotein cholesterol, and C-reactive protein on cardiovascular risk. Eur J Prev Cardiol 2020; 29:127-135. [PMID: 33624037 DOI: 10.1093/eurjpc/zwaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/18/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
This study aimed to demonstrate the impact of cumulative burden of cardiovascular risk factors (CVRFs) on risk of cardiovascular events (CVEs).
Methods and results
A total of 34 959 participants were enrolled who participated in the four surveys during 2006–2013. Cumulative CVRF burden was calculated as number of years (2006–2013) multiplied by the values of CVRFs including systolic blood pressure, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL-C), and high-sensitive C-reactive protein (hs-CRP). The primary outcome was defined as the CVE during 2012–2017, including ischaemic stroke, myocardial infarction, and all-cause mortality. During 4.62 (±0.71) years follow-up on average, there were 2118 (6.06%) CVE, including 847 (2.42%) ischaemic stroke, 221 (0.63%) myocardial infarction, and 1185 (3.39%) all-cause mortality. Higher cumulative burden of individual CVRF was significantly associated with increased risk of outcomes, except for LDL-C for all-cause mortality, FBG for myocardial infarction, and hs-CRP for ischaemic stroke. In Cox proportional hazards model, compared with the group, of the lower quartile of integrated cumulative burden, the hazard ratio (95% confidence intervals) of the upper quartile was 2.45 (2.03–2.94) for CVE, 3.65 (2.68–4.96) for ischaemic stroke, 4.51 (2.19–9.27) for myocardial infarction, and 1.73 (1.36–2.21) for all-cause mortality.
Conclusion
We demonstrated the correlation between cumulative burden of CVRFs and cardiovascular risk, except for cumulative burden of hs-CRP and ischaemic stroke. Thus, our study suggests the necessity to extend the observation duration of CVRFs in order to elucidate the life-course cumulative effect.
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Affiliation(s)
| | - Jinglin Mo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Jie Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Liye Dai
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Aichun Cheng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Gulbahram Yalkun
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xin Hua East Rd, Tangshan 063000, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China
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Schäfer A, Sanchez Martinez C, Flierl U, Leitolf H, Tillmanns J, Bauersachs J. Standardized secondary prevention in patients with ST-elevation myocardial infarction. Eur J Prev Cardiol 2020; 28:e35-e38. [DOI: 10.1093/eurjpc/zwaa078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/25/2020] [Accepted: 09/08/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Andreas Schäfer
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Carolina Sanchez Martinez
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Ulrike Flierl
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Holger Leitolf
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Jochen Tillmanns
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Barbarash OL, Kashtalap VV, Shibanova IA. Cardiovascular Comorbidity: Patient with Coronary Artery Disease and Peripheral Artery Atherosclerosis. How to Identify and Manage the Risks of Ischemic Events? RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-08-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Modern data on comorbidity in coronary artery disease (CAD) are presented in the article, as well as its frequency, dependence on the age, clinical and prognostic significance, and increasing relevance for practical health care. The positions of one of the components of cardiovascular comorbidity – multifocal atherosclerosis – are presented. The existing approaches to the detection and clinical assessment of multifocal atherosclerosis, as well as to the management of the high risk of ischemic events in such patients, are outlined. The main positions on the prevention of the risk of cardiovascular complications in patients with CAD and atherosclerosis of the peripheral arteries using a combination of the anticoagulant – rivaroxaban and the antiplatelet agent – acetylsalicylic acid, are highlighted on the basis of the results of clinical studies. Promising possibilities of using such a therapeutic approach to the management of comorbid patients in routine clinical practice are presented.
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Affiliation(s)
- O. L. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - V. V. Kashtalap
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - I. A. Shibanova
- Research Institute for Complex Issues of Cardiovascular Diseases
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Tai Chi Improves Coronary Heart Disease Risk by Inactivating MAPK/ERK Pathway through Serum miR-126. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4565438. [PMID: 32382289 PMCID: PMC7199556 DOI: 10.1155/2020/4565438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/29/2020] [Accepted: 04/04/2020] [Indexed: 01/20/2023]
Abstract
Background Tai Chi is effective in preventing heart disease (CHD) risk, but the molecular mechanism remains unclear. Mitogen-activated protein kinase (MAPK) signaling plays a critical role in the pathogenesis of CHD and can be activated by miR-126. Tai Chi may exert its protective function through the miR-126-modulated MAPK pathway. Methods The CHD patients after PCI were randomized into the CG group (CG) (n = 19, normal care) and Tai Chi group (TG) (Tai Chi intervention, n = 17). Epicardial adipose tissue volume (EATV) (one main adverse cardiovascular event of CHD), HR (heart rate), QoL (quality of life) scores, and balance performance were measured in the two groups. The body fat content, abdominal subcutaneous fat, and visceral fat were measured to reflect the improvement of adipose tissue dysfunction. The levels of miR-126 and MAPK-associated molecules were measured in peripheral blood leukocytes. Meanwhile, the effects of miR-126 silence and mimic on MAPK-associated molecules were also explored in cardiac cell H9C2. Results After the 3-month intervention, Tai Chi reduced EATV and HR and increased QoL scores and balance performance, respectively (P < 0.05). The fat percentage, body fat mass, and BMI were also significantly reduced after Tai Chi intervention (P < 0.05). The levels of miR-126, MAPK, JNK, and ERK in the TG group were lower than those in the CG group (P < 0.05). The miR-126 levels had a strong relationship with the values of EATV, HR, and QoL scores (P < 0.05). miR-126 silence or mimic inactivated or activated MAPK-associated molecules in the cardiac cell lines. Conclusions Tai Chi improved CHD risk by inactivating the MAPK/ERK pathway via serum miR-126.
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Performance of risk prediction scores for cardiovascular mortality in older persons: External validation of the SCORE OP and appraisal. PLoS One 2020; 15:e0231097. [PMID: 32271825 PMCID: PMC7144969 DOI: 10.1371/journal.pone.0231097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 03/16/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND European guidelines recommend the use of the Systematic COronary Risk Evaluation (SCORE) to assess 10-year risk of fatal cardiovascular events in people aged 40 to 65. The SCORE Older Persons (SCORE OP, 5-year and 10-year versions) was recently developed for people aged 65 or older. We assessed the performance of these risk scores in predicting fatal cardiovascular events in older persons in Berlin. METHODS AND FINDINGS Data from the Berlin Initiative Study (BIS), a prospective, population-based study of older persons recruited from a German public health insurance company database were used. 1,657 participants aged 70 or older without reported previous myocardial infarction were included. We assessed calibration by comparing predicted risks to observed (for 5-year versions, 5y) or projected (for 10-year versions) probabilities. During follow-up (median: 4.8 years), 118 cardiovascular deaths occurred. The calibration assessment of the SCORE OP-H 5y and SCORE OP-L 5y equations revealed 2.1- and 1.5-fold overestimation. Comparing 10-year versions, the SCORE OP showed better discrimination ability compared to the SCORE (C-indices of around 0.80 compared to 0.72) and the SCORE for high-risk regions showed the best calibration (chi-square = 29.68). The SCORE OP overestimated the true risk; 519 and 677 events were predicted using the low-risk and high-risk region SCORE OP equations compared to 397 to 399 events projected based on BIS follow-up data (predicted/actual ratios of 1.3 and 1.7). CONCLUSIONS Given the low transportability of the SCORE OP observed in our population, we caution against its use in routine clinical practice until further information is available to avoid possible overtreatment among older persons in Berlin.
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Menotti A, Puddu PE. How the Seven Countries Study contributed to the launch and development of cardiovascular epidemiology in Italy. A historical perspective. Nutr Metab Cardiovasc Dis 2020; 30:368-383. [PMID: 31848054 DOI: 10.1016/j.numecd.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/31/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
The Italian research group of the Seven Countries Study of Cardiovascular Diseases (SCS), through the independent use of the national cohorts and data, had the lucky opportunity, starting in the early 1960, to launch the Italian research in epidemiology of cardiovascular diseases (CVD). In this way, the Italian Section of that international study became the first investigation with baseline measurements in various cohorts, subsequent re-examinations, systematic search for morbid events, and follow-up for mortality up to 50 years. A large number of scientific aspects has been tackled including estimates of morbidity and mortality rates, the association of risk factors with cardiovascular events and total mortality, the role of risk factor changes, the use of multivariable models, the role of lifestyle behavior, the determinants of all-cause mortality including risk factors rarely measured in other studies, the identification of characteristics of a condition called Heart Disease of Uncertain Etiology (HDUE), the production of predictive tools for practical use and several other issues. All this has been enhanced by the availability of extremely long follow-up data rarely found in other studies. Field work organization, measurement techniques, diagnostic criteria, data handling and computing had the limitations and difficulties typical of those times, the mid of last century, when CVD epidemiology was at its beginning. All this represented anyhow the start of CVD epidemiology research in the country and was the stimulus to the start of other studies and a valuable collaboration with some of them.
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Affiliation(s)
| | - Paolo E Puddu
- Association for Cardiac Research, 00198, Rome, Italy; EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, UNICAEN, 14000, Caen, France; Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, 00161, Rome, Italy.
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