Prognostic role of heart rate in patients referred for coronary angiography: age and sex differences

Lipoprotein(a), Cardiovascular Events and Sex Differences: A Single Cardiological Unit Experience

Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the relationship between Lp(a) and cardiovascular disease, especially in terms of prognosis. This study aimed at evaluating the predictive value of Lp(a) (cut-off 30 mg/dL) for hard events (HEs: mortality and non-fatal myocardial infarction) according to sex and cardiometabolic risk factors in 2110 patients (1501 males, mean age: 68 ± 9 years) undergoing coronary angiography for known or suspected coronary artery disease. There were 211 events over a median follow-up period of 33 months. Lp(a) > 30 mg/dL did not confer a worse prognosis on the overall population. However, Kaplan-Meier subgroup analysis evidenced a worse prognosis in type 2 diabetes (T2D) females with elevated Lp(a) (log-rank test: p = 0.03) vs. T2D males and no-T2D patients, but not in other high-risk cardiovascular states (e.g., smoking, hypertension, reduced left ventricular ejection fraction or obesity). After Cox multivariate adjustment, Lp(a) remained an independent determinant for HEs in the T2D female subgroup, conferring an HR of 2.9 (95% CI 1.1-7.7, p < 0.05). Lp(a) is therefore a strong independent predictor of HR in T2D women, but not in T2D men, or in noT2D patients.

Tracking changes in maximal oxygen consumption with the heart rate index in female collegiate soccer players

The purpose of this study was to determine if the HRindex Method (VO_2max = [6 x HRindex – 5] x 3.5, where HRindex = HRmax/HRrest) was accurate for tracking changes in VO_2max following 8-weeks of endurance training among collegiate female soccer players. Predicted VO_2max via the HRindex Method and observed VO_2max from a maximal exercise test on a treadmill were determined for a group of female soccer athletes (n = 15) before and following an 8-week endurance training protocol. The predicted (pVO_2max) and observed (aVO_2max) values were compared at baseline and within 1-week post-training. Change values (i.e., the difference between pre to post) for each variable were also determined and compared. There was a significant difference between aVO_2max before (43.2 ± 2.8 ml·kg·min⁻¹) and following (46.2 ± 2.1 ml·kg·min⁻¹) the 8-week training program (p < 0.05). However, pVO_2max did not significantly change following training (pre = 43.4 ± 4.6 ml·kg·min⁻¹, post = 42.9 ± 4.1 ml·kg·min⁻¹, p = 0.53). Furthermore, the correlation between the change in aVO_2max and the change in pVO_2max was trivial and non-significant (r = 0.30, p = 0.28). The HRindex Method does not appear to be suitable for predicting changes in VO_2max following 8-weeks of endurance training in female collegiate soccer players.