Correlation of Smoking and Myocardial Infarction Among Sudanese Male Patients Above 40 Years of Age

Association between the use of electronic cigarettes and myocardial infarction in U.S. adults

BACKGROUND

Compared with conventional cigarettes, electronic cigarettes are less harmful in some studies. However, recent research may indicate the opposite. This study aimed to determine whether e-cigarette use is related to myocardial health in adults in the U.S.

METHODS

This study used data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional survey of adult US residents aged 18 years or older. We examined whether e-cigarette use was related to myocardial infarction byapplying a logistic regression model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The final analytical sample included 198,530 adults in the U.S. Logistic regression indicated that U.S. adults who reported being former and some days of e-cigarette use had 23% and 52% greater odds of ever having an MI, respectively, than did those who reported never using e-cigarettes (OR = 1.23, 95% CI 1.08-1.40, p = 0.001; OR = 1.52, 95% CI 1.10-2.09, p = 0.010).

CONCLUSIONS

The results suggest that former and someday users of e-cigarettes probably have increased odds of myocardial infarction in adults in the U.S. Further research is needed, including long-term follow-up studies on e-cigarettes, since it is still unknown whether they should be discouraged.

Risk factors for in-patient myocardial infarction following total hip arthroplasty

Purpose

The aim of this study was to identify potential risk factors for myocardial infarction immediately following total hip arthroplasty.

Methods

The 2016-2019 Nationwide Inpatient Sample database was used to identify patients who underwent primary total hip arthroplasty (THA) and suffered a myocardial infarction (MI). Patient data including demographics, admission, and comorbidities were recorded. Univariate analysis and subsequent multivariate logistic regression were performed to determine which circumstances affected the odds of MI.

Results

A total of 367,890 patients were identified for THA with 142 of those also having a myocardial infarction. Those who experienced an MI had increased length of stay, total charges, and generally negative dispositions compared to their non-MI counterparts (p < 0.001). Through regression analysis, factors that increased the odds of MI included older age [odds ratio (OR) 1.59, 95 % confidence interval (CI) 1.49-1.70], a female sex (OR 1.46, 95 % CI 1.37-1.55), previous coronary artery bypass graft (OR 1.20, 95 % CI 1.01-1.43), obesity (OR 1.12, 95 % CI 1.04-1.21), colostomy (OR 2.07, 95 % CI 1.21-3.56), and Parkinson's disease (OR 1.48, 95 % CI 1.13-1.95). Factors that decreased that risk included elective admission (OR 0.21, 95 % CI 0.19-0.22) and a tobacco related disorder (OR 0.69, 95 % CI 0.63-0.76).

Conclusions

Patient risk for myocardial infarction following total hip arthroplasty varies in part based on their background and comorbidities. These findings can be used to better recognize those who should receive further precautions and tailor proper treatment strategies for THA.

Heart rate reactivity mediates the relationship between trait gratitude and acute myocardial infarction

OBJECTIVE

This study examines the relationship between trait gratitude and acute myocardial infarction. A burgeoning body of literature suggests that gratitude can play a role in regulating individual's cardiovascular responses to stress which in turn, may reduce the incidence of cardiovascular disease such as acute myocardial infarction. However, to date no research has examined these effects.

METHOD

This study used the Mid-Life in the United States dataset (MIDUS; N = 1031) to assess these relationships. Participants completed a standardised cardiovascular stress-testing laboratory protocol and were assessed at a second time-point; on average 6.7 years later.

RESULTS

Results from logistic parallel mediation models suggest that trait gratitude was found to be significantly associated with reduced risk of acute myocardial infarction through the mechanism of increased heart rate reactivity, β = -0.098, 95%CI [- 0.331, - 0.010]. However, neither systolic nor diastolic blood pressure reactivity mediated this relationship.

CONCLUSIONS

These findings suggest that gratitude may be associated with certain aspects of physical health. Specifically, our study reveals a potential link between gratitude and cardiovascular reactivity, which could be a mechanism through which trait gratitude contributes to reductions in the risk of myocardial infarction. As such, this study highlights the potential utility of positive psychological factors, such as gratitude, in promoting cardiovascular health.

Smoking in Acute Myocardial Infarction Patients: Observations from a Registry Heart Hospital, Qatar

Introduction

Studies from the US and Europe showed a decline in smoking among patients with acute myocardial infarction (AMI), but limited data are available from the Middle East. In this study, we describe the temporal trend in the prevalence, associated risk factors, and outcomes of smoking among patients with AMI in Qatar.

Materials and Methods

A total of 27,648 AMI patients were analyzed from the cardiology registry at Heart Hospital, Doha, Qatar. This spans from January 1991 to May 2022.

Results

Of the total, 13,562 patients (49.1%, 95% confidence interval [CI]: 48%-50%) were smokers, with a clear majority of males (98.5%). Smoking habit was found to decrease in AMI patients with increasing age (age 51-60 years, adjusted odds ratio [OR]: 0.71, 95% CI: 0.67-0.76, P = 0.001, and age ≥61 years, adjusted OR: 0.45, 95% CI: 0.42-0.48, P = 0.001, in comparison to age ≤50 years). Smoking was associated with a lower risk of inhospital mortality (adjusted OR: 0.61, 95% CI: 0.54-0.70, P = 0.001), but triglyceride, obesity, and old myocardial infarction risk factors were associated with a higher risk. A decreasing trend in current smoking habits in each quantile of the 1996-2000 year (adjusted OR: 0.82, 95% CI: 0.71-0.93, P = 0.001), 2001-2005 year (adjusted OR: 0.70, 95% CI: 0.62-0.80, P = 0.001), 2006-2010 year (adjusted OR: 0.75, 95% CI: 0.67-0.84, P = 0.001), 2011-2015 year (adjusted OR: 0.48, 95% CI: 0.42-0.54, P = 0.001), 2016-2020 year (adjusted OR: 0.48, 95% CI: 0.43-0.54, P = 0.001), and ≥2021 year (adjusted OR: 0.46, 95% CI: 0.40-0.53, P = 0.001) was observed in comparison to the quantile 1991-1995 year. Similar results were also observed in the young population (age ≤50 years) including the non-Qataris, who had 25% more smokers in comparison to Qatari nationals.

Conclusion

Smoking trended down significantly; however, it remained prevalent in 50% of patients among AMI patients. Smokers were younger, with fewer traditional risk factors, and had lower inhospital mortality.

Mortality, Cardiovascular, and Medication Outcomes in Patients With Myocardial Infarction and Underweight in a Meta-Analysis of 6.3 Million Patients

Although most of the current evidence on myocardial infarction focuses on obesity, there is growing evidence that patients who are underweight have unfavorable prognosis. This study aimed to explore the prevalence, clinical characteristics, and prognosis of this population at risk. Embase and Medline were searched for studies reporting outcomes in populations who were underweight with myocardial infarction. Underweight and normal weight were defined according to the World Health Organization criteria. A single-arm meta-analysis of proportions was used to estimate the prevalence of underweight in patients with myocardial infarction, whereas a meta-analysis of proportions was used to estimate the odds ratio of all-cause mortality, medications prescribed, and cardiovascular outcomes. Twenty-one studies involving 6,368,225 patients were included, of whom 47,866 were underweight. The prevalence of underweight in patients with myocardial infarction was 2.96% (95% confidence interval 1.96% to 4.47%). Despite having fewer classical cardiovascular risk factors, patients who were underweight had 66% greater hazard for mortality (hazard ratio 1.66, 95% confidence interval 1.44 to 1.92, p <0.0001). The mortality of patients who were underweight increased from 14.1% at 30 days to 52.6% at 5 years. Nevertheless, they were less likely to receive guideline-directed medical therapy. Relative to subjects with normal weight, Asian populations who were underweight had greater mortality risks than those of their Caucasian counterparts (p = 0.0062). In conclusion, in patients with myocardial infarction, those who were underweight tend to have poorer prognostic outcomes. A lower body mass index is an independent predictor of mortality, which calls for global efforts in addressing this modifiable risk factor in clinical practice guidelines.

Interactions between genetic and lifestyle factors on cardiometabolic disease-related outcomes in Latin American and Caribbean populations: A systematic review

Introduction

The prevalence of cardiometabolic diseases has increased in Latin American and the Caribbean populations (LACP). To identify gene-lifestyle interactions that modify the risk of cardiometabolic diseases in LACP, a systematic search using 11 search engines was conducted up to May 2022.

Methods

Eligible studies were observational and interventional studies in either English, Spanish, or Portuguese. A total of 26,171 publications were screened for title and abstract; of these, 101 potential studies were evaluated for eligibility, and 74 articles were included in this study following full-text screening and risk of bias assessment. The Appraisal tool for Cross-Sectional Studies (AXIS) and the Risk Of Bias In Non-Randomized Studies-of Interventions (ROBINS-I) assessment tool were used to assess the methodological quality and risk of bias of the included studies.

Results

We identified 122 significant interactions between genetic and lifestyle factors on cardiometabolic traits and the vast majority of studies come from Brazil (29), Mexico (15) and Costa Rica (12) with FTO, APOE, and TCF7L2 being the most studied genes. The results of the gene-lifestyle interactions suggest effects which are population-, gender-, and ethnic-specific. Most of the gene-lifestyle interactions were conducted once, necessitating replication to reinforce these results.

Discussion

The findings of this review indicate that 27 out of 33 LACP have not conducted gene-lifestyle interaction studies and only five studies have been undertaken in low-socioeconomic settings. Most of the studies were cross-sectional, indicating a need for longitudinal/prospective studies. Future gene-lifestyle interaction studies will need to replicate primary research of already studied genetic variants to enable comparison, and to explore the interactions between genetic and other lifestyle factors such as those conditioned by socioeconomic factors and the built environment. The protocol has been registered on PROSPERO, number CRD42022308488.

Systematic review registration

https://clinicaltrials.gov, identifier CRD420223 08488.

Effect of heavy cigarette and water pipe smoking on antioxidants and lipids in Sudanese male smokers: a case-control study

Background

Tobacco smoking is a source of many toxins such as free radicals, mutagenic substances as well as cause for developing cardiovascular diseases (CVD), particularly atherosclerosis. This study aims to assess the impact of smoking on antioxidants in Sudanese male smokers.

Methods

Cases were 85 and 48 men who smoke cigarettes (CS) and water pipe (WPS) respectively and they were compared with matching 50 non-smoking controls. Blood samples were collected and following parameters: Glutathione peroxidase, Superoxide dismutase, Total cholesterol, Triglyceride, LDL, HDL, Paraoxinase, and Malondialdehyde were measured.

Results

There were no significant differences in biochemical parameters between light CS and WPS compared to controls. In heavy smokers of both WPS and CS, the TC, TG, LDL, and MDA were higher than controls (p>0.05), GPx, SOD, HDL, and PON were lower in smokers than controls (p>0.05). In both groups of smokers; HDL, GPx, SOD, and PON were inversely correlated with duration of smoking (p>0.05), also, HDL was positively correlated with SOD and GPx (p>0.05). Moreover, GPx and SOD were correlated with each other in both groups of smokers (p>0.05).

Conclusion

In Sudanese male smokers' biochemical profile disturbances suggest that heavy smoking was leading to developing CVD, particularly WPS.

Religious Affiliations and Clinical Outcomes in Korean Patients With Acute Myocardial Infarction

Objective

Although religion is expected to have a direct or indirect effect on various aspects of human life, information on the association between religion and acute myocardial infarction (AMI) is inadequate. Hence, in this study, we aimed to investigate the clinical effect of religion on clinical outcomes in patients with AMI.

Methods

A total of 2,348 patients with AMI who were treated by percutaneous coronary intervention (PCI) were enrolled in the study, and they were categorized into two groups depending on their religious belief: religious and non-religious groups. The characteristics and clinical outcomes of both groups were compared.

Results

Compared with the religious group, the non-religious group was younger, included mostly men, was more likely to smoke, and was more likely to be diagnosed with ST-segment elevation myocardial infarction. However, the non-religious group was less likely to have a history of hypertension and tended to receive PCI more quickly with shorter door-to-balloon time. Regarding 1-year clinical outcomes, no differences were found between the two groups.

Conclusion

Despite a growing body of evidence that religious activities have positive effects on human physical health, our results showed a lack of significant differences in 1-year clinical outcomes in patients with AMI irrespective of their religious beliefs.

Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII^®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]_{Quintile 5 vs. 1} 1.43; 95% CI 1.04–1.96) and in women (HR_{Quintile 5 vs. 1} 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HR_{Quintile 5 vs. 1} 1.80; 95% CI 1.03–3.12), obese men (HR_{Quintile 5 vs. 1} 1.77; 95% CI 1.13–2.76) and men who smoked (HR_{Quintile 5 vs. 1} 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HR_{Quintile 5 vs. 1} 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.

The effect of smoke-free legislation on the mortality rate of acute myocardial infarction: a meta-analysis

Background

Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries.

Methods

Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study.

Results

A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I² = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90–0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90–0.95), smaller sample size (RR = 0.92, 95% CI: 0.89–0.95), study location in Europe (RR = 0.90, 95% CI: 0.85–0.94), regional study area (RR = 0.92, 95% CI: 0.89–0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90–0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86–0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89–0.94).

Conclusion

Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7408-7) contains supplementary material, which is available to authorized users.

Knockdown of MicroRNA-122 Protects H9c2 Cardiomyocytes from Hypoxia-Induced Apoptosis and Promotes Autophagy

BACKGROUND Acute myocardial infarction (AMI) is a severe disease causing heart failure and sudden death. Studies indicate that microRNAs (miRNAs) are involved in the pathophysiology of AMI. In the present study, we carefully explored the effects of miR-122 on myocardial hypoxia injury and its possible underlying mechanism. MATERIAL AND METHODS miR-122 expression was analyzed in H9c2 cardiomyocytes after being transfected with miR-122 mimic, ASO-miR-122, or negative control. Cell viability and apoptosis were investigated by CCK-8 assays and flow cytometry analysis, respectively. Cell migration was analyzed using wound-healing assays. Western blotting was performed to analyze the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN)/phosphatidylinositol 3-hydroxy kinase (PI3K)/AKT and LC3-II/LC3-I. RESULTS Hypoxia exposure significantly inhibited H9c2 cell viability (P<0.01). miR-122 overexpression promoted the hypoxia-induced H9c2 cell proliferation and migration loss (P<0.05), and cell apoptosis was increased (P<0.05). miR-122 knockdown enhanced cell viability and decreased cell apoptosis (P<0.05). Knockdown of miR-122 enhanced PTEN/PI3K/AKT activation and cell autophagy. Overexpression of miR-122 inhibited the PTEN/PI3K/AKT pathway and cell autophagy pathway. CONCLUSIONS The expression of miR-122 is involved in hypoxia-induced H9c2 cardiomyocyte injury. Knockdown of miR-122 protects H9c2 cells from hypoxia-induced apoptosis and enhances cell viability.

Cardioprotective effect of Notch signaling on the development of myocardial infarction complicated by diabetes mellitus

The present study aimed to elucidate the role of Notch signaling in the development of myocardial infarction (MI) concomitant with diabetes in vivo and in vitro and evaluated the therapeutic effect of the Notch signaling in vitro. Streptozotocin-induced diabetic rats were subjected to 25 min of ischemia and 2 h of reperfusion. Cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) isoenzyme levels were detected. Infarct size was measured by 2,3,5-triphenyltetrazolium chloride staining. Myocardial apoptosis and fibrosis were examined by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling and Masson Trichrome staining, respectively. The mRNA and protein levels of Notch signaling components, including Notch1, Notch4, Delta-like 1, Jagged1, Mastermind-like protein 1 and p300, were quantified by reverse transcription-quantitative polymerase chain reaction and western blotting analyses, respectively. H9c2 cells were treated with/without 33 mM high glucose (HG) and/or subjected to hypoxia in the presence/absence of Jagged1. Cell viability and apoptosis were determined by MTT assay and Annexin V-fluorescein isothiocyanate/propidium iodide assay. Levels of the Notch signaling pathway members were examined. The present findings revealed that diabetes elevated CK-MB and cTnT, increased infarct size, induced myocardial apoptosis and inhibited the Notch signaling pathway in vivo after ischemia/reperfusion. Ischemia/reperfusion augmented the severity of MI in diabetic rats. Furthermore, HG reduced cell viability and induced cell apoptosis in H9c2 cells after hypoxia exposure, which was inhibited by Jagged1. We also found that HG inhibited Notch signaling in H9c2 cells after hypoxia, whereas Jagged1 exerted its cardioprotective effect on hypoxic injury (in HG environments or not) by activating the Notch signaling pathway. In conclusion, these findings suggest that diabetes promoted the progression of MI in vivo and in vitro via the inhibition of the Notch signaling pathway. Jagged1 may protect against MI in in vitro models by activating Notch signaling.