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Allami M. A Cross-Sectional Study on the Epidemiology and Risk Factors of Acute Coronary Syndrome in Northern Iraq. Cureus 2024; 16:e63291. [PMID: 39070425 PMCID: PMC11283251 DOI: 10.7759/cureus.63291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION There is an upward trend in the key cardiovascular risk factors in Iraq. Accordingly, the current study was initiated to address the changing epidemiology of acute coronary heart disease in Iraq. METHODS In this cross-sectional study, a total of 600 patients diagnosed with acute coronary syndrome (ACS) in the period between October 2020 and September 2022, and admitted to the Heart Center at Azadi Teaching Hospital, Duhok, Iraq, were recruited. All patients had detailed histories, clinical examinations, and relevant investigations, with particular scrutiny of the major cardiovascular risk factors at enrollment. Patients were categorized as having ST-segment elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI) following the American Society of Cardiology guidelines. RESULTS The patients had a mean age of 56.2 (SD: 10.5) years, with a male-to-female ratio of 2.5:1. The study included 185 (30.8%) patients with NSTEMI and 415 (69.2%) patients with STEMI. The frequency of regular smokers, those with hyperlipidemia, hypertension, and diabetes mellitus were 57.0%, 56.2%, 47%, and 40.7%, respectively. Family history of coronary heart disease and being overweight were encountered in a further 24.8% and 29.8%, respectively. Females were significantly older, with higher frequencies of hypertension, diabetes, hyperlipidemia, and overweight, while they were less likely to be smokers than males. Patients with hypertension, diabetes, and hyperlipidemia were significantly older, while smokers and those with a family history of ischemic heart disease were significantly younger. STEMI patients were significantly younger, more likely to be males, smokers, and overweight, but less likely to be diabetic than NSTEMI patients. CONCLUSION Iraqi patients with ACS were eight to 10 years younger than their Western counterparts. Males were more frequently involved and were younger than females. Hyperlipidemia and smoking were the most frequent risk factors, with the former's frequency exceeding reports from neighboring countries and the West. STEMI was more frequent and occurred at younger ages than NSTEMI. The results of the study support the need to institute effective targeted preventive and educational programs to reduce the risk of ACS in this part of the world.
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Affiliation(s)
- Mohammed Allami
- Internal Medicine, College of Medicine, University of Duhok, Duhok, IRQ
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2
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Sagris M, Theofilis P, Mistakidou V, Oikonomou E, Tsioufis K, Tousoulis D. Young and older patients with acute myocardial infarction: differences in risk factors and angiographic characteristics. Hellenic J Cardiol 2024:S1109-9666(24)00112-X. [PMID: 38734305 DOI: 10.1016/j.hjc.2024.05.008] [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: 10/31/2023] [Revised: 03/21/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE Although coronary artery disease mainly affects older individuals, the incidence of myocardial infarction (MI) among younger adults (<55 years) has increased during the past decade. Young and older MI patients have different underlying pathophysiologic characteristics, atherosclerotic plaque morphology, and risk factor profiles. METHODS We studied 977 patients (≤55 years old: 322, >55 years old: 655) who were hospitalized for MI in the previous 5 years. Patients' baseline characteristics and daily habits were recorded. Angiographic characteristics and vascular lesions were detected, and further examinations, including flow-mediated dilation (FMD), pulse wave velocity (PWV), and central augmentation index (AIx), were performed. Biomarkers of inflammation (Interleukin-6, Tumor-Necrosis factor-a, Intercellular Adhesion Molecule 1, and Osteopontin) were also tested. RESULTS The median age in the younger age group was 49 years [interquartile range (IQR: 44-53)] and 66 years (IQR: 61-73) in the older age group. Arterial hypertension was less prevalent in the young compared to the elderly with MI (47.4% vs. 76.2%, p < 0.01). The younger counterparts presented significantly lower rates of diabetes mellitus (19.3% vs. 30.6%, p < 0.01), dyslipidemia (59% vs. 70.8%, p < 0.01), and atrial fibrillation (2.6% vs. 9.7%, p < 0.01) and were more casual smokers (49.3% vs. 23.8%, p < 0.01) compared to older patients with MI. In terms of arterial stiffness, lower PWV [7.3 m/s (IQR: 6.5-8.4 m/s) vs. 9 m/s (IQR: 8-10.8 m/s), p < 0.01] and AIx (20.5 ± 10.8 vs. 25.5 ± 7.8, p < 0.01) were recorded in the young compared to the elderly with MI. Concerning angiographic characteristics, younger patients were more likely to have none or single-vessel disease (55.6% vs. 45.8%, p < 0.02), whereas the older participants more frequently had three or more vessel disease (23.5% vs. 13.6% in the young, p < 0.02). Although significant disparities in blood test results were detected during the acute phase, the great majority of young MI patients were undertreated. CONCLUSION Younger patients with MI are more likely to be smokers with impaired PWV measures, present with non-obstructive or single-vessel disease, and often remain undertreated. A better knowledge of the risk factors as well as the anatomic and pathophysiologic processes in young adults will help enhance MI prevention and treatment options in this patient population.
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Affiliation(s)
- Marios Sagris
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.
| | - Panagiotis Theofilis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Vasiliki Mistakidou
- 3rd Cardiology Department, "Sotiria" Chest Disease Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece; 3rd Cardiology Department, "Sotiria" Chest Disease Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Tsioufis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
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Kumar R, Ammar A, Qayyum D, Mujtaba M, Siddiqui MN, Khan MQ, Rahooja K, Rasool M, Samad M, Khan N, Sial JA, Saghir T, Qamar N, Hakeem A, Karim M. Increasing Incidence of ST-Elevation Acute Coronary Syndrome in Young South Asian Population, a Challenge for the World? An Assessment of Clinical and Angiographic Patterns and Hospital Course of Premature Acute Myocardial Infarction. Am J Cardiol 2023; 205:190-197. [PMID: 37611409 DOI: 10.1016/j.amjcard.2023.07.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023]
Abstract
The incidence of premature ischemic heart disease (IHD) is increasing because of urbanization, a sedentary lifestyle, and various other unexplored factors, especially in South Asia. This study aimed to assess the distribution of premature ST-elevation acute coronary syndrome (STE-ACS) with its clinical and angiographic pattern along with hospital course in a contemporary cohort of patients who underwent primary percutaneous intervention at a tertiary care center in the South Asian region. We included consecutive patients of either gender diagnosed with STE-ACS and who underwent primary percutaneous intervention. Patients were stratified based on age as ≤40 years (young) and >40 years (old). Clinical characteristics, angiographic patterns, and hospital course were compared between the 2 groups. Of the total of 4,686 patients, 466 (9.9%) were young (≤40 years). Young patients had a lower prevalence of hypertension (40.8% vs 54.5%, p <0.001), diabetes (26.6% vs 36.4%, p <0.001), metabolic syndrome (14.8% vs 24%, p <0.001), history of IHD (5.8% vs 9.3%, p = 0.013) and a higher frequency of smoking (33% vs 24.7%, p <0.001), positive family history (8.2% vs 3.2%, p <0.001), and single-vessel involvement (60.1% vs 33.2%, p <0.001). The composite adverse clinical outcome occurrence was significantly lower in young patients (14.2% vs 19.5%, p = 0.006). On multivariable analysis, history of IHD in young, whereas age, Killip class III/IV, intubated, arrhythmias on arrival, diabetes, history of IHD, pre-procedure left ventricular end-diastolic pressure, ejection fraction <40%, and slow flow/no-reflow during the procedure were found to be the independent predictors of adverse clinical outcome in old patients. In conclusion, we have a substantial burden of premature STE-ACS, mostly in male patients potentially driven by smoking and positive family history. Despite favorable pathophysiology, with mostly single-vessel hospital courses of STE-ACS in the young equally lethal in nature.
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Affiliation(s)
- Rajesh Kumar
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
| | - Ali Ammar
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Danish Qayyum
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Mustajab Mujtaba
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Maria Noor Siddiqui
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Muhammad Qasim Khan
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Kubbra Rahooja
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Muhammad Rasool
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Maryam Samad
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Naveedullah Khan
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Jawaid Akbar Sial
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Tahir Saghir
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Nadeem Qamar
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Abdul Hakeem
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Musa Karim
- Department of Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan
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Alexim GDA, Rocha LF, Dobri GP, Rosa Júnior ADS, Reis RTB, Nogueira ACC, Soares AADSM, Sposito AC, de Paula AP, de Carvalho LSF. Clinical and economic impact of coronary artery bypass graft and percutaneous coronary intervention in young individuals with acute coronary syndromes and multivessel disease: A real-world comparison in a middle-income country. Front Cardiovasc Med 2022; 9:1000260. [PMID: 36440021 PMCID: PMC9685999 DOI: 10.3389/fcvm.2022.1000260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/17/2022] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND In recent decades, the world watched a dramatic increase in the incidence of acute coronary syndromes (ACS) among young individuals (≤55 years-old) and a relative decrease in the elderly. The management of ACS in young patients with multivessel disease still needs to be elucidated, as these individuals maintain a long life expectancy. RESEARCH QUESTION To compare clinical outcomes and care costs in individuals with premature ACS and multivessel disease undergoing coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). METHODS AND RESULTS Participants included all individuals ≤55 years-old admitted with ACS to public hospitals in Brasília (Brazil) between 2013 and 2015 and who underwent cardiac catheterization with SYNTAX score ≥23 or Duke category 6. Outcomes were adjudicated with death certificates and data from medical records. The primary outcome was the occurrence of major adverse cardiovascular events (MACE), defined as death due to cardiovascular causes, recurrent hospitalizations due to cardiovascular ischemic events, and incident heart failure New York Heart Association III-IV. As secondary outcome we assessed indirect and direct costs by evaluating the cost of lost productivity (in international dollars (Int$) per year) due to illness and death, outpatient costs and costs with new hospitalizations. Multivariate and principal components (PC) adjusted analyzes were performed. RESULTS Among 1,088 subjects (111 CABG and 977 PCI) followed for 6.2 years (IQR: 1.1), 304 primary events were observed. MACE was observed in 20.7% of the CABG group and 28.8% of the PCI group (p = 0.037). In multivariate analyses, PCI was associated with a hazard ratio (HR) = 1.227 (95% CI: 1.004-1.499; p = 0.0457) for MACE, and in PC-adjusted HR = 1.268 (95% CI: 1.048-1.548; p = 0.0271) compared with CABG. Despite direct costs were equivalent, the cost due to the loss of labor productivity was higher in the PCI group (Int$ 4,511 (IQR: 18,062)/year vs Int$ 3,578 (IQR: 13,198)/year; p = 0.049], compared with CABG. CONCLUSIONS Among young individuals with ACS and multivessel disease, surgical strategy was associated with a lower occurrence of MACE and lower indirect costs in the long-term.
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Affiliation(s)
- Gustavo de Almeida Alexim
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
| | - Luiza Ferreira Rocha
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Instituto de Cardiologia e Transplantes do Distrito Federal, Brasília, DF, Brazil
| | - Giovani Prediger Dobri
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Instituto de Cardiologia e Transplantes do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Ana Claudia Cavalcante Nogueira
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Secretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, DF, Brazil
- Aramari Apo Institute, Brasília, DF, Brazil
| | | | - Andrei Carvalho Sposito
- Aramari Apo Institute, Brasília, DF, Brazil
- Department of Cardiology, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ana Patricia de Paula
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
| | - Luiz Sérgio Fernandes de Carvalho
- Medical Sciences Post-Graduation Program, Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
- Medical Sciences Post-Graduation Program, University of Brasília, Brasília, DF, Brazil
- Aramari Apo Institute, Brasília, DF, Brazil
- Laboratory of Data for Quality of Care and Outcomes Research, Clarity Healthcare Intelligence, Jundiaí, SP, Brazil
- Gerontology Post-Graduation Program, Universidade Católica de Brasília, Brasília, DF, Brazil
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5
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Sagris M, Antonopoulos AS, Theofilis P, Oikonomou E, Siasos G, Tsalamandris S, Antoniades C, Brilakis ES, Kaski JC, Tousoulis D. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res 2022; 118:2281-2292. [PMID: 34358302 DOI: 10.1093/cvr/cvab264] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 08/03/2021] [Indexed: 12/18/2022] Open
Abstract
Myocardial infarction (MI) among young adults (<45 years) represents a considerable proportion of the total heart attack incidents. The underlying pathophysiologic characteristics, atherosclerotic plaque features, and risk factors profile differ between young and older patients with MI. This review article discusses the main differences between the younger and elderly MI patients as well as the different pathogenic mechanisms underlying the development of MI in the younger. Young patients with MI often have eccentric atherosclerotic plaques with inflammatory features but fewer lesions, and are more likely to be smokers, obese, and have poor lifestyle, such as inactivity and alcohol intake. Compared to older MI patients, younger are more likely to be men, have familial-combined hyperlipidaemia and increased levels of lipoprotein-a. In addition, MI in younger patients may be related to use of cannabis, cocaine use, and androgenic anabolic steroids. Genomic differences especially in the pathways of coagulation and lipid metabolism have also been identified between young and older patients with MI. Better understanding of the risk factors and the anatomic and pathophysiologic processes in young adults can improve MI prevention and treatment strategies in this patient group. Awareness could help identify young subjects at increased risk and guide primary prevention strategies. Additional studies focusing on gene pathways related to lipid metabolism, inflammation, and coagulation are needed.
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Affiliation(s)
- Marios Sagris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Alexios S Antonopoulos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Panagiotis Theofilis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Evangelos Oikonomou
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Gerasimos Siasos
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Sotirios Tsalamandris
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Centre of Research Excellence, British Heart Foundation, Oxford, OX3 9DU, UK
- Division of Cardiovascular Medicine, Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, OX3 9DU, UK
| | - Emmanouil S Brilakis
- Division of Cardiovascular Medicine, Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN 55407, USA
| | - Juan C Kaski
- Division of Cardiovascular Medicine, Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK
| | - Dimitris Tousoulis
- Division of Cardiovascular Medicine, 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 115 27, Greece
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Gao H, Wang Y, Shen A, Chen H, Li H. Acute Myocardial Infarction in Young Men Under 50 Years of Age: Clinical Characteristics, Treatment, and Long-Term Prognosis. Int J Gen Med 2021; 14:9321-9331. [PMID: 34898997 PMCID: PMC8654686 DOI: 10.2147/ijgm.s334327] [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] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/08/2021] [Indexed: 01/10/2023] Open
Abstract
Aim The prevalence of acute myocardial infarction (AMI) is increasing in young adults, especially in men. This study aims to compare the characteristics and explore the association between age and clinical outcomes in male adults who first experienced AMI. Methods A total of 2737 male patients with AMI were divided into three groups by age: <50, 50–65, and ≥65 years. Clinical characteristics and long-term results (all-cause and cardiac deaths, nonfatal MI, revascularization, nonfatal stroke, cardiac rehospitalization) were identified across different age subgroups. The association between age and the outcomes was assessed by Cox proportional hazard models. Results This population was followed up for a median of 36.7 months. Patients <50 years had a lower prevalence of diabetes (19.4%) and previous stroke (1.8%), while they were more often to be smokers (77.1%), obese (26%), dyslipidemia (74.7%), and with the single-vessel disease (16.2%). The risk of cardiovascular and all-cause death in patients ≥65 years was higher than patients <50 years, which was noticed through competing risk regression analysis after adjusting for confounding factors (adjusted HR 3.24; 95% CI 2.26–4.22, p=0.020 for cardiovascular death, adjusted HR 4.17; 95% CI 1.91–9.10, p<0.001 for all-cause death). Conclusion In conclusion, although men who suffered from first AMI under the age of 50 had lower mortality, they had a higher burden of modifiable traditional risk factors. The management of modifiable lifestyles should be addressed to all young AMI patients.
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Affiliation(s)
- Hui Gao
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Yuan Wang
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Aidong Shen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Hui Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Hongwei Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.,Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, 100069, People's Republic of China
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Ahammed T, Ahmed NU, Uddin MJ. Changes in prevalence, and factors associated with tobacco use among Bangladeshi school students: evidence from two nationally representative surveys. BMC Public Health 2021; 21:579. [PMID: 33757487 PMCID: PMC7989242 DOI: 10.1186/s12889-021-10623-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, tobacco kills more than nine million people per year. Annually in Bangladesh, smoking accounts for 1.2 million illnesses and over one hundred fifty thousand deaths. Worldwide, about one out of five school students smoke tobacco, and this problem is also growing significantly in Bangladesh. There is a need to address this problem. However, to the best of knowledge, no published study has been evaluated the changes in factors associated with tobacco use over time among Bangladeshi adolescent students using large, nationally representative comparable surveys. Our objective was to identify the factors associated with tobacco use among school going students, examine any changes in them over time, and explore policy options based on national surveys. Methods We analysed the data from the 2007 and the 2013 Global Youth Tobacco Survey (GYTS), a school-based survey targeting adolescents age 13–15 years (7th–9th grade), developed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). The samples were selected based on a two-stage cluster sample design. The data were collected in school classes using a self-administered anonymous survey. We applied chi-square tests and survey logistic regression models for analysing the data. Results Overall tobacco usage significantly declined from 8.4 to 6.9% over six years. The prevalence of tobacco use decreased among females (5.22 to 2.84%), those who received anti-tobacco messages (8.93 to 7.24%) and because of age restriction could not buy tobacco products (18.86 to 15.78%). Compared with the female, the odds of overall tobacco smoking among male students was 1.97 (CI: 0.99–3.92) in the year 2007 and it increased (OR = 3.07; CI: 1.56–6.04) in the year 2013. Moreover, the odds of smoking among those exposed to tobacco smoke had increased (OR = 3.26; CI: 1.46–7.29 vs 5.43; CI: 1.63–18.07) from 2007 to 2013. Conclusion There was a decline in tobacco use, especially among female students. Male students were higher tobacco user. It appeared anti-smoking campaign and age restriction policies were working. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10623-0.
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Affiliation(s)
- Tanvir Ahammed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh.
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8
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Islam SMS, Ahmed S, Uddin R, Siddiqui MU, Malekahmadi M, Al Mamun A, Alizadehsani R, Khosravi A, Nahavandi S. Cardiovascular diseases risk prediction in patients with diabetes: Posthoc analysis from a matched case-control study in Bangladesh. J Diabetes Metab Disord 2021; 20:417-425. [PMID: 34222069 DOI: 10.1007/s40200-021-00761-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/01/2021] [Indexed: 01/14/2023]
Abstract
Purpose This study aimed to investigate the estimated 10-year predicted risk of developing cardiovascular diseases (CVD) among participants with and without diabetes in Bangladesh. Methods We performed posthoc analysis from a matched case-control study conducted among 1262 participants. A total of 631 participants with diabetes (case) were recruited from a tertiary hospital, and 631 age, sex and residence matched participants (control) were recruited from the community in Dhaka, Bangladesh. Socioeconomic anthropometric, clinical and CVD risk factor data were collected from the participants. The 10-year estimated CVD risk was calculated using the Framingham Risk Score, which has reasonable validity in South Asians. Results The mean (SD) age of the participants were 51 (10) years. Total 52.3% of cases and 17.2% of controls were at high risk for CVD. The 10-year risk of CVD increased by age and was higher among males in both groups. Among the control group, high CVD risk was more prevalent among higher education and income groups. More than 85% of the tobacco smokers and 70% of chewing tobacco users in the case group were at high risk of CVD. Prevalence of high CVD risk among non-smokers cases was 8.6%. About 35% of hypertensive participants in the control group were at high risk of CVD. Conclusion Bangladeshi patients with diabetes showed a significant burden of CVD risk at a relatively younger age. Strategies for reducing tobacco use and improving BP control in people with diabetes is needed for lowering future CVD risks.
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Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia.,Cardiovascular Division, The George Institute for Global Health, Newtown, Australia.,Sydney Medical School, University of Sydney, Camperdown, Australia
| | - Shyfuddin Ahmed
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL USA.,International Centre for Diarrhoeal Diseases, Bangladesh, Dhaka, Bangladesh
| | - Riaz Uddin
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia
| | - Muhammad U Siddiqui
- Marshfield Clinic Health System, Rice Lake, WI USA.,George Washington University, Washington, D.C. USA
| | - Mahsa Malekahmadi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Nutrition Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdullah Al Mamun
- Department of Computer Science and Engineering, United International University, Dhaka, Bangladesh
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, VIC Australia
| | - Abbas Khosravi
- Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, VIC Australia
| | - Saeid Nahavandi
- Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, VIC Australia
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9
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Akhtar Z, Aleem MA, Ghosh PK, Islam AKMM, Chowdhury F, MacIntyre CR, Fröbert O. In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh. BMC Cardiovasc Disord 2021; 21:85. [PMID: 33568047 PMCID: PMC7877023 DOI: 10.1186/s12872-021-01896-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/31/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information. METHODS We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of all-cause death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE. RESULTS A total of 601 patients, mean age 51.6 ± 10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8 ± 2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI 1.64-13.23). CONCLUSIONS A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.
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Affiliation(s)
- Zubair Akhtar
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Mohammad Abdul Aleem
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Probir Kumar Ghosh
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - A K M Monwarul Islam
- Department of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - C Raina MacIntyre
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ole Fröbert
- Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
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10
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Cannabis and tramadol addiction: Do they imply additive risk for acute myocardial infarction in adults younger than 45 years? Anatol J Cardiol 2020; 24:316-325. [PMID: 33122481 PMCID: PMC7724384 DOI: 10.14744/anatoljcardiol.2020.67206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Acute myocardial infarction (AMI) is the main cause of cardiovascular events worldwide. AMI commonly occurs in elderly patients because of atherosclerotic process related to common risk factors. Consequently, the rupture of atheromatous plaque with deleterious sequela is the common etiology of the disease. However, there are less studied etiological factors in youth compared with the usual population. Therefore, this study aimed to examine the risk profile of Egyptian youth presenting with AMI. METHODS A study was conducted in 106 patients aged ≤45 years admitted with AMI in our university hospital to explore their clinical profile risk factors. RESULTS In the study, 71 (67%) and 35 (33%) patients presented with ST elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Anterior wall MI was predominant in 49 patients (46.2%). Moreover, 93 patients (88%) were smokers, 31 (29.2%) used tramadol, 43 (40.6%) smoked cannabis, 50 (47.2%) had poor sleeping habits, 29 (27.4%) had high stress levels, 37 (34.9%) had hypertension, and 22 (20.8%) had diabetes. Twenty (18.9%) patients had a family history of premature coronary artery disease. High and low high-density lipoprotein (HDL) levels were observed in 20 (18.9%) and 47 (44.3%) patients, respectively. The left anterior descending artery (LAD) was involved in 56% of the studied population associated with tramadol use. A significant association was found between both tramadol use and cannabis smoking and presence of heavy thrombus burden on coronary angiography. CONCLUSION AMI in Egyptian youth was predominantly observed in men, with anterior STEMI as the most common presentation. Cannabis and tramadol addiction were high risk factors for AMI in Egyptian youth.
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11
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Acute myocardial infarction among young adults under 40 years of age. Risk factors, clinical and angiographic characteristics. COR ET VASA 2019. [DOI: 10.33678/cor.2019.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Yang J, Wang L, Sun T, Guo Q, Liu F, Zhou Y. Obesity is associated with worse long-term outcomes in hypertrophic cardiomyopathy patients with acute myocardial infarction. Perfusion 2019; 35:384-392. [PMID: 31674878 DOI: 10.1177/0267659119883996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hypertrophic cardiomyopathy is associated with poor prognosis. In our previous study, it has been reported that patients with acute myocardial infarction and hypertrophic cardiomyopathy exhibited worse long-term outcomes than those with acute myocardial infarction without hypertrophic cardiomyopathy and those with hypertrophic cardiomyopathy without acute myocardial infarction. In this article, we aimed to assess the impact of body mass index on the long-term outcomes of hypertrophic cardiomyopathy patients with acute myocardial infarction. METHODS Seventy-eight consecutive patients with hypertrophic cardiomyopathy and acute myocardial infarction were included. Obesity was defined as body mass index ⩾28 kg/m2 adapted to Chinese. The long-term endpoints were major adverse cardiac events and secondary endpoints, which included re-hospitalization, recurrent angina, thrombosis, bleeding, heart failure, and arrhythmias. RESULTS There were no differences in observed in-hospital mortality or 5-year mortality between the two groups of hypertrophic cardiomyopathy and acute myocardial infarction patients divided by body mass index. However, significantly increased incidence of re-percutaneous coronary intervention and stroke was observed in the obese group (re-percutaneous coronary intervention: 0.0% vs. 21.4%, p = 0.007; stroke: 5.6% vs. 28.6%, p = 0.042). The 5-year outcomes of major adverse cardiac events were inferior in the obese group (log-rank p = 0.020). CONCLUSION Acute myocardial infarction and hypertrophic cardiomyopathy patients who were obese exhibited worse long-term outcomes than those without obesity.
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Affiliation(s)
- Jiaqi Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart Lung and Blood Vessel Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Liangshan Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tienan Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qianyun Guo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Fang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart Lung and Blood Vessel Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
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13
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Kim DY, Wala Z, Islam S, Islam R, Ahn M. Clinical characteristics and outcomes of ST-segment elevation myocardial infarction in a low income setting in rural Bangladesh. IJC HEART & VASCULATURE 2019; 23:100376. [PMID: 31193421 PMCID: PMC6527896 DOI: 10.1016/j.ijcha.2019.100376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND In rural areas of Bangladesh, the majority of patients with ST segment elevation myocardial infarction (STEMI) have little access to reperfusion therapy. Even though thrombolysis can be an affordable life-saving treatment in a low income setting, there are few publications in regards to the clinical and socioeconomic features of STEMI with thrombolytic therapy in rural Bangladesh. METHOD The information of the patients who were admitted for STEMI between 2010 and 2016 from one rural hospital were collected and reviewed. This audit evaluated clinical outcomes and socioeconomic characteristics of the patients. RESULT 164 patients with STEMI were identified in the period and 136 patients (82.93%) underwent thrombolysis. The mean pain-to-door time was 472 min (7.87 h ± 12.40). Only 5.49% of the patients traveled to hospital by ambulances. Overall in-hospital mortality rate and major adverse cardiovascular event (MACE) after STEMI were 19.51% (32/164), 23.17% (38/164), respectively. The need of inotropics (Odds ratio [OR] 16.43, 95% confidence interval [CI] 1.99-135.75, P < 0.01), the use of defibrillation due to ventricular arrhythmias (OR 33.58, 95% CI 2.96-380.49, P < 0.01) were independent predictors of increased in-hospital mortality. CONCLUSION In a rural hospital of Bangladesh, in-hospital mortality rate after STEMI is high in spite of thrombolysis and adherence to published guidelines. The prolonged pain-to-door time and the poor coverage of ambulance services in our study highlight the need of community awareness of acute coronary syndrome and comprehensive emergency medical services in rural Bangladesh.
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Affiliation(s)
- Dong-Yeon Kim
- Corresponding author at: Department of Internal Medicine, LAMB Hospital, Rajabashor, Parbatipur, Dinajpur 5250, Bangladesh.
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14
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The Young Myocardial Infarction Study of the Western Indians: YOUTH
Registry. Glob Heart 2019; 14:27-33. [DOI: 10.1016/j.gheart.2018.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 11/06/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022] Open
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15
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Gupta MD, Girish MP, Sarkar PG, Gupta A, Kategari A, Bansal A, Saijpaul R, Batra V, Rain M, Tyagi S, Pasha Q. Role of ApoE gene polymorphism and nonconventional biochemical risk factors among very young individuals (aged less than 35 years) presenting with acute myocardial infarction. Indian Heart J 2018; 70 Suppl 3:S146-S156. [PMID: 30595248 PMCID: PMC6310748 DOI: 10.1016/j.ihj.2018.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/09/2018] [Accepted: 08/12/2018] [Indexed: 12/11/2022] Open
Abstract
Background Incidence rate of acute myocardial infarction (MI) has increased in younger population over the years. The young patients have a different risk profile, presentation, and prognosis than the elderly. Hence, it is essential to understand the risk factors in young patients for proper treatment. Methods Apolipoprotein E (ApoE) polymorphism and biochemicals such as total cholesterol, serum triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein(a), insulin, interleukin-6, homocysteine, fibrinogen, and highly sensitive C-reactive protein were investigated in very young MI (yMI patients; age ≤ 35 years; n = 125), in old MI (oMI patients; age >35 and < 80 years; n = 111), and healthy controls (age ≤35 years; n = 103). Results HDL-C was significantly lower in yMI patients than in controls (p = 2.63E-04) and oMI patients (p = 1.29E-05). ApoA1 was also lowest in yMI patients, but significant only in comparison to controls (p = 2.62E.04). The yMI group had the highest ratios of total cholesterol:HDL-C (p = 0.027 in yMI patients versus controls and p = 0.018 in yMI patients versus oMI patients), LDL-C:HDL-C (p = 0.002 in yMI patients versus controls and p = 0.005 in yMI patients versus oMI patients), and ApoB:ApoA1 (p = 8.75E-05 in yMI patients versus controls and p > 0.05 in yMI patients versus oMI patients). No significant pattern of ApoE polymorphisms was observed. Conclusion The lower level of HDL-C and ApoA1 and higher ratios of total cholesterol:HDL-C, LDL-C:HDL-C, and ApoB:ApoA1 are risk factors for MI in young patients.
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Affiliation(s)
- Mohit D Gupta
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India.
| | - M P Girish
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Prattay G Sarkar
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Amit Gupta
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Anand Kategari
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Ankit Bansal
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Rajni Saijpaul
- Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Vishal Batra
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Manjari Rain
- Institute of Genomics and Integrative Biology, New Delhi, India
| | - Sanjay Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India; Safdarjung Hospital and Vardhman Institute of Medical Sciences, New Delhi, India
| | - Qadar Pasha
- Institute of Genomics and Integrative Biology, New Delhi, India
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16
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Zhou BY, Gao XY, Zhao X, Qing P, Zhu CG, Wu NQ, Guo YL, Gao Y, Liu G, Dong Q, Li JJ. Predictive value of big endothelin-1 on outcomes in patients with myocardial infarction younger than 35 years old. Per Med 2018; 15:25-33. [PMID: 29714117 DOI: 10.2217/pme-2017-0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM The predictive value of big endothelin-1 (ET-1) for cardiovascular outcomes in myocardial infarction (MI) patients younger than 35 years old has not been characterized. METHODS A total of 565 consecutive MI patients younger than 35 years old were studied and followed up for 37.78 ± 24.9 months. RESULTS Multivariable Cox regression analysis showed that big ET-1 was positively correlated with major adverse cardiovascular events [MACEs] (odds ratio: 3; 95% CI: 1.92-4.68; p < 0.001). The area under receiver operating characteristics curve showing the predictive value of big ET-1 on MACEs was 0.67. CONCLUSION The study first demonstrated that big ET-1 was an independent predictor for MACEs in MI patients younger than 35 years old.
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Affiliation(s)
- Bing-Yang Zhou
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Xiong-Yi Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China.,Division of Chest Pain Center, Guangdong Provincial Hospital of Chinese Medicine & The 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Zhao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Ping Qing
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Cheng-Gang Zhu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Na-Qiong Wu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Yuan-Lin Guo
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Ying Gao
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Geng Liu
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Qian Dong
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
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17
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Gudiño Gomezjurado A, Pujol Freitas B, Contreira Longatto F, Negrisoli J, Aguiar Sousa G. Acute coronary disease, prognosis and prevalence of risk factors in young adults. Medwave 2017; 17:e7088. [PMID: 29149097 DOI: 10.5867/medwave.2017.09.7088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/18/2017] [Indexed: 11/27/2022] Open
Abstract
Acute coronary disease is a rare entity in young people and is mostly related to atherosclerotic disease. However, other causes such as myocardial bridges, coronary artery dissection and antiphospholipid syndrome may be present. The prognosis of the disease in this group of patients is favorable; although women may have a higher morbidity because diagnosis and treatment can be delayed. The goal of this review is to update the knowledge about risk factors and prognosis of young patients with an acute coronary event compared to the older population.
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Affiliation(s)
- Alvaro Gudiño Gomezjurado
- Unidad de coronariopatías, Instituto del Corazón INCOR, Sao Paulo, Brasil. Address: Avenida Dr. Enéas de Carvalho Aguiar 44, Pinheiros, São Paulo, Brasil.
| | | | | | - Juliana Negrisoli
- Unidad de coronariopatías, Instituto del Corazón INCOR, Sao Paulo, Brasil
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18
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Hirota Y, Sawano M, Numasawa Y, Ueda I, Noma S, Suzuki M, Hayashida K, Yuasa S, Maekawa Y, Kohsaka S, Fukuda K. Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention. Cardiovasc Interv Ther 2017; 33:154-162. [DOI: 10.1007/s12928-017-0471-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 02/27/2017] [Indexed: 11/27/2022]
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19
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Feistritzer HJ, Reinstadler SJ, Klug G, Reindl M, Wöhrer S, Brenner C, Mayr A, Mair J, Metzler B. Multimarker approach for the prediction of microvascular obstruction after acute ST-segment elevation myocardial infarction: a prospective, observational study. BMC Cardiovasc Disord 2016; 16:239. [PMID: 27894261 PMCID: PMC5126989 DOI: 10.1186/s12872-016-0415-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/15/2016] [Indexed: 01/29/2023] Open
Abstract
Background Presence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients. Methods This study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO. Admission and peak concentrations of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were measured. Results MVO was detected in 69 patients (54%). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations showed similar prognostic value for the prediction of MVO (area under the curve (AUC) = 0.77, 0.77, 0.68, 0.79, 0.78 and 0.73, all p > 0.05), whereas the prognostic utility of NT-proBNP was weakly lower (AUC = 0.64, p < 0.05). Combination of these biomarkers did not increase predictive utility compared to hs-cTnT alone (p = 0.349). Conclusions hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations provided similar prognostic value for the prediction of MVO. The prognostic utility of NT-proBNP was lower. Combining these biomarkers could not further improve predictive utility compared to hs-cTnT alone.
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Affiliation(s)
- Hans-Josef Feistritzer
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Sebastian Johannes Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Gert Klug
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Sebastian Wöhrer
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Christoph Brenner
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Agnes Mayr
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Johannes Mair
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria.
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20
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Choudhury AR, Choudhury KN, Islam SMS. Relationship of dental diseases with coronary artery diseases and diabetes in Bangladesh. Cardiovasc Diagn Ther 2016; 6:131-7. [PMID: 27054102 DOI: 10.21037/cdt.2016.02.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Evidence suggests that dental diseases might have a role in the development and progression of coronary artery diseases (CAD) and diabetes mellitus (DM). The objective of this study was to determine the relationship of dental diseases with CAD and DM in Bangladesh. METHODS We conducted a cross-sectional study among 216 consecutive patients admitted in a tertiary hospital between March and July 2011. Data were collected on socio-demographic status, smoking, blood pressure (BP), diet, physical activities, and biochemical measurements of lipid profile, glycated hemoglobin (HbA1c), C-reactive protein (CRP), fibrinogen, creatinine kinase MB (CK-MB), troponin, serum creatinine and serum glutamic-pyruvic transaminase (SGPT). CAD was detected using echocardiographic and coronary angiogram (CAG) reports. All patients underwent oral examination for dental disease. Relationship between dental disease with CAD and DM were explored statistically. RESULTS The mean age of the participants was 57.8±12.5 years and almost two-thirds (67.1%) were male. A great majority of the patients had CAD (90.3%) and type 2 DM (83.8%), and only 44% suffered from dental diseases. Less than one-third patients presented with acute myocardial infarction (MI), 23% with old MI, 11% unstable angina (UA) and 26.4% with non-ST elevation MI. Logistic regression results indicated that patients with DM and CAD had approximately 2.6 and 4.6 times more odds of association with dental diseases than those without DM and CAD (both P value <0.001). CONCLUSIONS This study suggests a relationship of dental diseases with CAD and DM among Bangladeshi patients. Further studies are required to confirm these relationships in large clinical studies. Screening for CAD and DM should be considered among those with dental diseases and vice-versa.
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Affiliation(s)
- Arup Ratan Choudhury
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Kamrun Nahar Choudhury
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Sheikh Mohammed Shariful Islam
- 1 Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders (BIRDEM), Shahbagh, Dhaka, Bangladesh ; 2 National Centre for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh ; 3 Center for Control of Chronic Diseases (CCCD), International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh ; 4 Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Munich, Germany
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