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Mateen S, Masakputra V, Siddiqi Z, Fatima J. Incidence, Pattern, Causes, and Outcome of Acute Chest Pain Among Patients Presenting in the Emergency Department of a Tertiary Care Hospital in North India. Cureus 2024; 16:e56115. [PMID: 38618438 PMCID: PMC11014751 DOI: 10.7759/cureus.56115] [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: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Acute chest pain is a common presentation in emergency departments worldwide. Differentiating between cardiac and non-cardiac chest pain is crucial for patient management and resource allocation. METHODS This study analyzed 714 patients presenting with acute chest pain in a tertiary care hospital in North India. We investigated demographic characteristics, chief complaints, risk factors, ECG findings, and final diagnoses to identify patterns associated with cardiac (CCP) and non-cardiac chest pain (NCCP). RESULTS CCP was diagnosed in 53.7% (n=383) and NCCP in 46.3% (n=331). Significant predictors of CCP included age (OR=1.05, p<0.001), smoking (OR=2.22, p<0.001), diabetes (OR=1.57, p=0.003), hypertension (OR=1.82, p<0.001), and family history of ischemic heart disease (IHD) (OR=1.42, p=0.01). Central chest pain was more common in CCP (60% vs. 40%, p<0.001), as were abnormal ECG findings such as ST-segment depression (35% vs. 10%, p<0.001) and elevation (29% vs. 6%, p<0.001). Normal ECG was more prevalent in NCCP (60%, p<0.001). CONCLUSION Traditional cardiovascular risk factors remain strongly associated with CCP. Smoking has a particularly high odds ratio, suggesting the need for targeted interventions. ECG findings significantly aid in differentiating CCP from NCCP. This study underscores the importance of a comprehensive approach in evaluating acute chest pain to ensure accurate diagnosis and effective treatment.
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Affiliation(s)
- Saboor Mateen
- Internal Medicine, Era's Lucknow Medical College and Hospital, Lucknow, IND
| | - Vasim Masakputra
- Internal Medicine, Era's Lucknow Medical College and Hospital, Lucknow, IND
| | - Zeba Siddiqi
- Internal Medicine, Era's Lucknow Medical College and Hospital, Lucknow, IND
| | - Jalees Fatima
- Internal Medicine, Era's Lucknow Medical College and Hospital, Lucknow, IND
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2
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Li X, Peng X, Zoulikha M, Boafo GF, Magar KT, Ju Y, He W. Multifunctional nanoparticle-mediated combining therapy for human diseases. Signal Transduct Target Ther 2024; 9:1. [PMID: 38161204 PMCID: PMC10758001 DOI: 10.1038/s41392-023-01668-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 09/14/2023] [Accepted: 10/10/2023] [Indexed: 01/03/2024] Open
Abstract
Combining existing drug therapy is essential in developing new therapeutic agents in disease prevention and treatment. In preclinical investigations, combined effect of certain known drugs has been well established in treating extensive human diseases. Attributed to synergistic effects by targeting various disease pathways and advantages, such as reduced administration dose, decreased toxicity, and alleviated drug resistance, combinatorial treatment is now being pursued by delivering therapeutic agents to combat major clinical illnesses, such as cancer, atherosclerosis, pulmonary hypertension, myocarditis, rheumatoid arthritis, inflammatory bowel disease, metabolic disorders and neurodegenerative diseases. Combinatorial therapy involves combining or co-delivering two or more drugs for treating a specific disease. Nanoparticle (NP)-mediated drug delivery systems, i.e., liposomal NPs, polymeric NPs and nanocrystals, are of great interest in combinatorial therapy for a wide range of disorders due to targeted drug delivery, extended drug release, and higher drug stability to avoid rapid clearance at infected areas. This review summarizes various targets of diseases, preclinical or clinically approved drug combinations and the development of multifunctional NPs for combining therapy and emphasizes combinatorial therapeutic strategies based on drug delivery for treating severe clinical diseases. Ultimately, we discuss the challenging of developing NP-codelivery and translation and provide potential approaches to address the limitations. This review offers a comprehensive overview for recent cutting-edge and challenging in developing NP-mediated combination therapy for human diseases.
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Affiliation(s)
- Xiaotong Li
- School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China
| | - Xiuju Peng
- School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China
| | - Makhloufi Zoulikha
- School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China
| | - George Frimpong Boafo
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, 410013, PR China
| | - Kosheli Thapa Magar
- School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China
| | - Yanmin Ju
- School of Pharmacy, China Pharmaceutical University, Nanjing, 2111198, PR China.
| | - Wei He
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
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3
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Dubey R, Sinha N, Jagannathan NR. Potential of in vitro nuclear magnetic resonance of biofluids and tissues in clinical research. NMR IN BIOMEDICINE 2023; 36:e4686. [PMID: 34970810 DOI: 10.1002/nbm.4686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/18/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Body fluids, cells, and tissues contain a wide variety of metabolites that consist of a mixture of various low-molecular-weight compounds, including amino acids, peptides, lipids, nucleic acids, and organic acids, which makes comprehensive analysis more difficult. Quantitative nuclear magnetic resonance (NMR) spectroscopy is a well-established analytical technique for analyzing the metabolic profiles of body fluids, cells, and tissues. It enables fast and comprehensive detection, characterization, a high level of experimental reproducibility, minimal sample preparation, and quantification of various endogenous metabolites. In recent times, NMR-based metabolomics has been appreciably utilized in diverse branches of medicine, including microbiology, toxicology, pathophysiology, pharmacology, nutritional intervention, and disease diagnosis/prognosis. In this review, the utility of NMR-based metabolomics in clinical studies is discussed. The significance of in vitro NMR-based metabolomics as an effective tool for detecting metabolites and their variations in different diseases are discussed, together with the possibility of identifying specific biomarkers that can contribute to early detection and diagnosis of disease.
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Affiliation(s)
- Richa Dubey
- Centre of Biomedical Research, SGPGIMS Campus, Lucknow, India
| | - Neeraj Sinha
- Centre of Biomedical Research, SGPGIMS Campus, Lucknow, India
| | - Naranamangalam R Jagannathan
- Department of Radiology, Chettinad Hospital & Research Institute, Chettinad Academy of Research & Education, Kelambakkam, India
- Department of Radiology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
- Department of Electrical Engineering, Indian Institute Technology, Madras, Chennai, India
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4
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Antiobesity and Antidiabetic Effects of Portulaca oleracea Powder Intake in High-Fat Diet-Induced Obese C57BL/6 Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5587848. [PMID: 34257685 PMCID: PMC8257357 DOI: 10.1155/2021/5587848] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/30/2021] [Indexed: 11/17/2022]
Abstract
This study investigated the hypothesis that Portulaca oleracea L. exerts antiobesity and antidiabetic effects by evaluating blood lipid profiles, blood glucose control factors, protein expression of lipid metabolism, and insulin sensitivity improvement. Three groups of high-fat diet (HFD) induced obese C57BL/6 mice (n = 8) received treatment with low (5%; HFD + PO5%) or high (10%; HFD + PO10%) concentrations of P. oleracea powder for 12 weeks or no treatment (HFD) and were compared with each other and a fourth control group. Weight gain was reduced by 34% in the HFD + PO10% group compared to the HFD group. Moreover, the perirenal and epididymal fat contents in the HFD + PO10% group were 6.3-fold and 1.5-fold, respectively, lower than those in the HFD group. The atherogenic index (AI) and cardiac risk factor (CRF) results in the P. oleracea-treated groups were significantly lower than those in the HFD group. The homeostasis model assessment of insulin resistance (HOMA-IR) levels was lower in the HFD + PO10% group than in the HFD group. The protein expression levels of the proliferator-activated receptor (PPAR)-α, glucose transporter (GLUT) 4 and PPAR-γ were upregulated in the HFD + PO10% group compared to the HFD group. However, the protein expression levels of tumor necrosis factor (TNF)-α were lower in the P. oleracea-treated groups than in the HFD group. Our results demonstrate that P. oleracea powder could be effectively used to treat and prevent obesity and diabetes-associated diseases through suppression of weight gain and reduction in body fat and blood glucose levels.
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Voutyritsa E, Kyriakos G, Patsouras A, Damaskos C, Garmpi A, Diamantis E, Garmpis N, Savvanis S. Experimental Agents for the Treatment of Atherosclerosis: New Directions. J Exp Pharmacol 2021; 13:161-179. [PMID: 33633471 PMCID: PMC7901406 DOI: 10.2147/jep.s265642] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/27/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular and related metabolic disorders constitute a worldwide health challenge. Atherosclerosis is a chronic inflammatory condition based on both dyslipidemia and inflammation. Therefore, even when dyslipidemia is controlled, the risk of atherosclerosis remains. Among the most efficient inflammatory mediators used as therapeutic tools in cardiovascular disease are the interleukins, which are pro-inflammatory mediators like cytokines. Moreover, a protein kinase inhibitors, p38 mitogen-activated protein kinase (MAPK) inhibitor, and an inhibitor of a leukocyte adhesion molecule, P-Selectin, have also presented therapeutic potential for this disorder. Colchicine, being an inexpensive therapeutic option, has been proved to be suitable for the prevention of atherosclerosis. In this review, we summarize all the studies, from 2010 to 2020, in which treatment approaches based on the agents mentioned above are evaluated in the management of atherosclerosis.
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Affiliation(s)
- Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Kyriakos
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Savvanis
- Internal Medicine Department, Elpis General Hospital, Athens, Greece
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Kuroda M, Ninomiya K. Association between soup consumption and obesity: A systematic review with meta-analysis. Physiol Behav 2020; 225:113103. [PMID: 32712209 DOI: 10.1016/j.physbeh.2020.113103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022]
Abstract
This systematic review aimed to determine the correlation between soup consumption and obesity. The observational studies on the association of soup consumption to obesity-related parameters were screened by database search. From 1873 identified articles, 7 cross-sectional studies were included in the review. All studies indicated a significant inverse correlation between soup consumption and obesity. The meta-analysis of the studies of which outcome is odds ratio for obesity revealed that soup consumption is significantly related to lower odds ratio of obesity in combined data (n=45292, OR: 0.85, 95% CI: 0.79-0.91, p<0.0001), suggesting that soup consumption was inversely correlated with a risk of obesity.
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Affiliation(s)
- Motonaka Kuroda
- Institute of Food Sciences & Technologies, Ajinomoto Co., Inc., Kawasaki, Japan.
| | - Kumiko Ninomiya
- Umami Information Center, Non-Profit Organization, Tokyo, Japan
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7
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Ramos L, Novo J, Barreira N, Rouco J, Penedo MG, Ortega M. Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis. J Vis Exp 2018:58132. [PMID: 30320756 PMCID: PMC6235331 DOI: 10.3791/58132] [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] [Indexed: 10/31/2022] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death throughout the world. The total risk of developing CVD is determined by the combined effect of different cardiovascular risk factors (e.g., diabetes, raised blood pressure, unhealthy diet, tobacco use, stress, etc.) that commonly coexist and act multiplicatively. Most CVDs can be prevented by an early identification of the highest risk factors and an appropriate treatment. The stratification of cardiovascular risk factors involves a wide range of parameters and tests that specialists use in their clinical practice. In addition to cardiovascular (CV) risk stratification, ambulatory blood pressure monitoring (ABPM) also provides relevant information for diagnostic and treatment purposes. This work presents a list of protocols based on the Hydra platform, a web-based system for clinical decision support which incorporates a set of functionalities and services that are required for complete cardiovascular analysis, risk assessment, early diagnosis, treatment and monitoring of patients over time. The program includes tools for inputting and managing comprehensive patient data, organized into different checkups to track the evolution over time. It also has a risk stratification tool to compute a CV risk factor based upon several risk stratification tables of reference. Additionally, the program includes a tool that incorporates ABPM analysis and allows the extraction of valuable information by monitoring blood pressure over a specific period of time. Finally, the reporting service summarizes the most relevant information in a set of reports that aid clinicians in their clinical decision-making process.
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Affiliation(s)
- Lucía Ramos
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña
| | - Jorge Novo
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña;
| | - Noelia Barreira
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña
| | - José Rouco
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña
| | - Manuel G Penedo
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña
| | - Marcos Ortega
- Department of Computer Science, University of A Coruña; CITIC-Research Center for Information and Communication Technologies, University of A Coruña
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8
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Gao S, Park BM, Cha SA, Bae UJ, Park BH, Park WH, Kim SH. Oxidative stress increases the risk of pancreatic β cell damage in chronic renal hypertensive rats. Physiol Rep 2017; 4:4/16/e12900. [PMID: 27535482 PMCID: PMC5002910 DOI: 10.14814/phy2.12900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 07/25/2016] [Indexed: 01/02/2023] Open
Abstract
Hypertension often occurs in conjunction with insulin resistance. The purpose of this study was to evaluate whether sustained renal hypertension increases the risk of diabetes mellitus in rats, and to define the underlying mechanisms. Two-kidney, one-clip hypertensive (2K1C) rats received captopril (50 mg/kg/day), α-lipoic acid (100 mg/kg/day), or vehicle treatment for 3 months after surgery. Blood pressure was measured by tail cuff plethysmography. Oral glucose tolerance test (OGTT), immunohistochemistry, and western blotting were performed. In addition, insulin secretion from islet cells was measured. OGTT yielded abnormal results, and the number of islet cells and the size of pancreatic β/α cells were decreased in 2K1C rats. Basal insulin levels were also reduced in the plasma. Insulin secretion from pancreatic islet cells in response to high glucose was also attenuated in 2K1C rats compared with sham rats. The levels of oxidative stress markers, including 8-hydroxydeoxyguanosine and NADPH oxidase-4, were increased in pancreatic tissue and pancreatic islets in 2K1C rats. The abnormalities observed in 2K1C rats were improved by captopril or α-lipoic acid treatment. These findings indicate that sustained renal hypertension may lead to pancreatic dysfunction, increasing oxidative stress in pancreatic islets.
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Affiliation(s)
- Shan Gao
- Department of Physiology, Chonbuk National University Medical School, Jeonju, Korea Department of Pharmacology, Taishan Medical University, Shandong, China
| | - Byung M Park
- Department of Physiology, Chonbuk National University Medical School, Jeonju, Korea
| | - Seung A Cha
- Department of Physiology, Chonbuk National University Medical School, Jeonju, Korea
| | - Ui J Bae
- Department of Biochemistry, Research Institute for Endocrine Sciences, Chonbuk National University Medical School, Jeonju, Korea
| | - Byung H Park
- Department of Biochemistry, Research Institute for Endocrine Sciences, Chonbuk National University Medical School, Jeonju, Korea
| | - Woo H Park
- Department of Physiology, Chonbuk National University Medical School, Jeonju, Korea
| | - Suhn H Kim
- Department of Physiology, Chonbuk National University Medical School, Jeonju, Korea
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9
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Niccoli G, Roberto M, D'Amario D, Scalone G, Fracassi F, Cosentino N, Candelli M, Franceschi F, Crea F. Cytotoxin-associated gene antigen-positive strains of Helicobacter pylori and recurring acute coronary syndromes. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2017; 6:535-544. [PMID: 26798071 DOI: 10.1177/2048872615627708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cytotoxin-associated gene antigen (CagA)-positive strains of Helicobacter pylori have previously been associated with acute coronary syndromes. However, the role of CagA-positive strains of Helicobacter pylori in recurring cardiac events after ST-segment elevation myocardial infarction (STEMI) has not yet been assessed. METHODS We enrolled 181 consecutive patients (155 men, mean age 64±13 years) presenting with STEMI. In all patients, serum levels of IgG anti-CagA were assessed. Levels of IgG anti-hepatitis A virus were also evaluated in all patients in order to exclude the presence of a bystander activation of the immune system. Finally, a previous history of acute coronary syndrome and the rate of major adverse cardiovascular events as a composite of cardiovascular death, recurring myocardial infarction and target lesion revascularisation within 2 years follow-up were evaluated. RESULTS Anti-CagA IgG seropositive patients presented more frequently with a previous history of acute coronary syndrome compared with seronegative patients (28.3% vs. 14%, P=0.019). Interestingly, no differences were observed between anti-CagA IgG seropositive and anti-CagA IgG seronegative patients concerning the prevalence of anti-hepatitis A virus IgG seropositivity (20% vs. 21.4%, P=0.48). At 2-year follow-up, 40 patients experienced major adverse cardiovascular events. The major adverse cardiovascular event rate was higher in anti-CagA IgG seropositive compared with seronegative patients (hazard ratio 2.25, 95% confidence interval 1.34-2.95, P=0.013), which was confirmed at Cox multivariate analysis (hazard ratio 2.33, 95% confidence interval 1.30-3.14, P=0.009). CONCLUSIONS CagA-positive strains of Helicobacter pylori seem to be involved in the pathogenesis of recurring acute coronary syndromes, and seropositivity for anti-CagA IgG predicts prognosis after STEMI, possibly due to the increased risk of recurring cardiac events.
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Affiliation(s)
- Giampaolo Niccoli
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Marco Roberto
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Domenico D'Amario
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Giancarla Scalone
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Francesco Fracassi
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Nicola Cosentino
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
| | - Marcello Candelli
- 2 Department of Emergency Medicine, Catholic University of the Sacred Heart, Italy
| | - Francesco Franceschi
- 3 Department of Internal Medicine and Gastroenterology, Catholic University of the Sacred Heart, Italy
| | - Filippo Crea
- 1 Institute of Cardiology, Catholic University of the Sacred Heart, Italy
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Novo J, Hermida A, Ortega M, Barreira N, Penedo MG, López JE, Calvo C. Hydra: A web-based system for cardiovascular analysis, diagnosis and treatment. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 139:61-81. [PMID: 28187896 DOI: 10.1016/j.cmpb.2016.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular (CV) risk stratification is a highly complex process involving an extensive set of clinical trials to support the clinical decision-making process. There are many clinical conditions (e.g. diabetes, obesity, stress, etc.) that can lead to the early diagnosis or establishment of cardiovascular disease. In order to determine all these clinical conditions, a complete set of clinical patient analyses is typically performed, including a physical examination, blood analysis, electrocardiogram, blood pressure (BP) analysis, etc. This article presents a web-based system, called Hydra, which integrates a full and detailed set of services and functionalities for clinical decision support in order to help and improve the work of clinicians in cardiovascular patient diagnosis, risk assessment, treatment and monitoring over time. METHODS Hydra integrates a number of different services: a service for inputting all the information gathered by specialists (physical examination, habits, BP, blood analysis, electrocardiogram, etc.); a tool to automatically determine the CV risk stratification, including well-known standard risk stratification tables; and, finally, various tools to incorporate, analyze and graphically present the records of the ambulatory BP monitoring that provides BP analysis over a given period of time (24 or 48 hours). In addition, the platform presents a set of reports derived from all the information gathered from the patient in order to support physicians in their clinical decisions. RESULTS Hydra was tested and validated in a real domain. In particular, internal medicine specialists at the Hypertension Unit of the Santiago de Compostela University Hospital (CHUS) validated the platform and used it in different clinical studies to demonstrate its utility. It was observed that the platform increased productivity and accuracy in the assessment of patient data yielding a cost reduction in clinical practice. CONCLUSIONS This paper proposes a complete platform that includes different services for cardiovascular clinical decision support. It was also run as a web-based application to facilitate its use by clinicians, who can access the platform from any remote computer with Internet access. Hydra also includes different automated methods to facilitate the physicians' work and avoid potential errors in the analysis of patient data.
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Affiliation(s)
- J Novo
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain.
| | - A Hermida
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - M Ortega
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - N Barreira
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - M G Penedo
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - J E López
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - C Calvo
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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11
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Effect of classic ketogenic diet treatment on lipoprotein subfractions in children and adolescents with refractory epilepsy. Nutrition 2017; 33:271-277. [DOI: 10.1016/j.nut.2016.06.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/01/2016] [Accepted: 06/24/2016] [Indexed: 01/01/2023]
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12
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Paula RS, Souza VC, Machado-Silva W, Almeida BRS, Daros AC, Gomes L, Ferreira AP, Brito CJ, Córdova C, Moraes CF, Nóbrega OT. Serum Klotho (but not haplotypes) associate with the post-myocardial infarction status of older adults. Clinics (Sao Paulo) 2016; 71:725-732. [PMID: 28076518 PMCID: PMC5175288 DOI: 10.6061/clinics/2016(12)09] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/13/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES: The number of deaths from vascular diseases is incredibly high worldwide, and reliable markers for major events are still needed. The current cross-sectional study investigated the association of Klotho haplotypes and Klotho serum levels with classic risk factors and a clinical history of vascular events. METHODS: Clinical, anthropometric, biochemical and nutritional assessments were conducted with 168 older adults, complemented by genotyping (rs9536314 and rs9527025) and the detection of serum Klotho (ELISA). RESULTS: Klotho levels and haplotypes did not associate with most classic risk factors for vascular events, including markers such as C-reactive protein and homocysteine. A positive association was only found between Klotho levels and the previous occurrence of a myocardial infarction by both correlational (p=0.006) and variance analyses (p<0.001), and these associations were independent of the context. CONCLUSION: Our results suggest that serum Klotho is higher in individuals with a clinical history of myocardial infarction but not with a history of coronary artery disease or stroke. None of the Klotho haplotypes were associated with the variables investigated herein.
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Affiliation(s)
| | | | | | | | - Andersen C Daros
- Centro Universitário de Brasília (UNICEUB), Brasília/, DF, Brazil
| | - Lucy Gomes
- Universidade Católica de Brasília (UCB-DF), Brasília/, DF, Brazil
| | - Aparecido P Ferreira
- Universidade Católica de Brasília (UCB-DF), Brasília/, DF, Brazil
- Faculdades Promove (ICESP), Brasília/, DF, Brazil
| | - Ciro J Brito
- Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora/, MG, Brazil
| | - Cláudio Córdova
- Universidade Católica de Brasília (UCB-DF), Brasília/, DF, Brazil
| | - Clayton F Moraes
- Universidade de Brasília (UnB), Brasília/, DF, Brazil
- Universidade Católica de Brasília (UCB-DF), Brasília/, DF, Brazil
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Malik A, Sharma U, Lakshmy R, Narang R, Jagannathan NR. Biochemical characterization of blood plasma of coronary artery disease patients by in vitro high-resolution proton NMR spectroscopy. J Biosci 2015; 40:31-9. [DOI: 10.1007/s12038-014-9493-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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14
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Kim YA, Kim ES, Hwang HK, Lee KB, Lee S, Jung JW, Kwon YJ, Cho DH, Park SS, Yoon J, Jang YS. Prevalence and Risk Factors for the Peripheral Neuropathy in Patients with Peripheral Arterial Occlusive Disease. Vasc Specialist Int 2014. [PMID: 26217631 PMCID: PMC4480317 DOI: 10.5758/vsi.2014.30.4.125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Peripheral neuropathy (PN) is known as a major contributor of the worsening of ischemic symptoms and the foot ulceration in patients with peripheral arterial occlusive disease (PAOD). However, there are few studies reporting the prevalence and risk factors for PN in PAOD. This study aimed to evaluate these issues for PN and to establish the importance of screening as additional treatment target for PN in PAOD. MATERIALS AND METHODS A total of 52 limbs with PAOD were enrolled from January 2011 to December 2012. PN was divided into radiculopathy, ischemic PN (IPN), and diabetic PN (DPN), based on electromyographic findings. We investigated the prevalence of overall PN and subtypes of PN and then analyzed the risk factors. RESULTS The prevalence of overall PN in PAOD was 43 of 52 limbs (82.7%). In terms of subtypes of PN, the prevalence rate of radiculopathy and IPN was 30.8% and 23.1%, respectively. DPN showed in 22 limbs (73.3%) among 30 diabetic limbs. There was no significant correlation between each type of PN and ischemic symptoms. Our analysis showed that coronary artery disease (CAD) was a significant risk factor (P=0.01) for IPN, however, did not identify any significant risk factors for DPN. CONCLUSION This present study indicated that most patients with PAOD had PN and CAD was a risk factor for IPN. In particular, PAOD with diabetes represented a higher prevalence for DPN. Our study suggests that PN should be evaluated and considered as another treatment target in patients with PAOD.
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Affiliation(s)
- Young Ae Kim
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Eun Su Kim
- Rehabilitation Medicine, Seoul Medical Center, Seoul, Korea
| | | | - Kyung Bok Lee
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Sol Lee
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Ji Woong Jung
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Yu Jin Kwon
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Dong Hui Cho
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Sang Su Park
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Jin Yoon
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
| | - Yong-Seog Jang
- Departments of Surgery, Seoul Medical Center, Seoul, Korea
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15
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Abstract
Peripheral arterial disease (PAD) is an atherosclerotic-driven condition that remains underdiagnosed and undertreated. In diabetic patients, PAD begins early, progresses rapidly, and is frequently asymptomatic, making it difficult to diagnose. Strict management of the metabolic instigators and use of screening techniques for PAD in diabetes can facilitate early diagnosis and reduce progression. Exercise is an equally effective treatment option in improving walking distance. Early revascularization must be offered early in suitable patients. Surgical bypass and endovascular revascularization are complementary and the choice of intervention should be applied appropriately by a multidisciplinary vascular team on a selective, patient-specific basis.
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Affiliation(s)
- Janice V Mascarenhas
- Department of Endocrinology, Tameside Hospital NHS Foundation Trust, Fountain Street, Ashton-Under-Lyne, Lancashire OL6 9RW, UK; University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Mostafa A Albayati
- Department of Vascular Surgery, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, Hampshire SO16 6YD, UK
| | - Clifford P Shearman
- Department of Vascular Surgery, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, Hampshire SO16 6YD, UK
| | - Edward B Jude
- Department of Endocrinology, Tameside Hospital NHS Foundation Trust, Fountain Street, Ashton-Under-Lyne, Lancashire OL6 9RW, UK; University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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16
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Goonasekara CL, Balse E, Hatem S, Steele DF, Fedida D. Cholesterol and cardiac arrhythmias. Expert Rev Cardiovasc Ther 2014; 8:965-79. [DOI: 10.1586/erc.10.79] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Frequency of Soup Intake Is Inversely Associated with Body Mass Index, Waist Circumference, and Waist-to-Hip Ratio, but Not with Other Metabolic Risk Factors in Japanese Men. ACTA ACUST UNITED AC 2011; 111:137-42. [DOI: 10.1016/j.jada.2010.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Accepted: 07/26/2010] [Indexed: 11/20/2022]
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18
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Eandi M. Drug Therapy and Follow-Up. ATHEROSCLEROSIS DISEASE MANAGEMENT 2011:563-631. [DOI: 10.1007/978-1-4419-7222-4_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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19
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D'Eramo Melkus G, Chyun D, Vorderstrasse A, Newlin K, Jefferson V, Langerman S. The Effect of a Diabetes Education, Coping Skills Training, and Care Intervention on Physiological and Psychosocial Outcomes in Black Women With Type 2 Diabetes. Biol Res Nurs 2010; 12:7-19. [DOI: 10.1177/1099800410369825] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An 11-week culturally relevant group diabetes self-management training (DSMT), coping skills training (CST), and diabetes care intervention was compared to a 10-week usual diabetes education and diabetes care intervention on physiological and psychosocial outcomes in 109 Black women (aged 48 ± 10 years) with type 2 diabetes in primary care (PC). Strong time effects for hemoglobin A1c improvement were seen in both groups from baseline to 3 months and remained similar at 12 and 24 months (p < .0001). Systolic blood pressure (p =.01) and low-density lipoprotein cholesterol levels (p = .05) improved in both groups from baseline to 24 months. Baseline quality of life ([QOL]; Medical Outcome Study Short Form-36) was low. Social function, role-emotional, and mental health domains increased initially in both groups then declined slightly, with less decline for the experimental group at 12 months. At 24 months, experimental group scores increased. General health (p = .002), vitality (p = .01), role-physical, and bodily pain (p = .02) domains increased in both groups over time. Perceived provider support for diet (p = .0001) and exercise (p = .0001) increased in both groups over time. Diabetes-related emotional distress decreased in the experimental compared to the control group (group x time, p = .01). Findings suggest that both methods of diabetes education combined with care can improve metabolic control, QOL, and perceptions of provider care. CST may further assist in long-term improvements in health outcomes. Behavioral interventions are needed in addition to routine diabetes care, particularly in PC.
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20
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Gil-Guillén V, Orozco-Beltrán D, Pérez RP, Alfonso JL, Redón J, Pertusa-Martínez S, Navarro J, Cea-Calvo L, Quirce-Andrés F, Merino-Sánchez J, Carratalá C, Martín-Moreno JM. Clinical inertia in diagnosis and treatment of hypertension in primary care: Quantification and associated factors. Blood Press 2009; 19:3-10. [PMID: 19929287 DOI: 10.3109/08037050903350762] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Vicente Gil-Guillén
- Departamento de Medicina Clinica, Miguel Hernández University, Elche, Alicante, Spain.
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21
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Li Y, South T, Han M, Chen J, Wang R, Huang XF. High-fat diet decreases tyrosine hydroxylase mRNA expression irrespective of obesity susceptibility in mice. Brain Res 2009; 1268:181-189. [PMID: 19285041 DOI: 10.1016/j.brainres.2009.02.075] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 02/24/2009] [Accepted: 02/26/2009] [Indexed: 10/21/2022]
Abstract
Tyrosine hydroxylase is the rate-limiting enzyme in the synthesis of dopamine, a key neurotransmitter in the regulation of food intake. This study examined tyrosine hydroxylase mRNA expression in obese mice fed a high-fat diet. After 8 week feeding of high-fat diet mice were classified as diet-induced obese and obese-resistant according to body weight gain. They were then placed on different dietary interventions including a high-fat diet, a low-fat diet and an energy-restricted high-fat diet for six weeks. The control group was fed a low-fat diet. The results revealed that tyrosine hydroxylase mRNA expression was significantly decreased in the ventral tegmental area (VTA), ventromedial hypothalamic nucleus (VMH), and substantia nigra (SN) of the high-fat diet-induced obese (-29%, -26% and -26%) and obese-resistant mice (-21%, -24% and -18%) compared to controls. After switching the diet from high to low-fat diet tyrosine hydroxylase mRNA was increased in the VTA, VMH, and SN of the diet-induced obese mice and in the VMH, and SN of the obese-resistant mice. Energy restriction, even with high-fat feeding, reduced tyrosine hydroxylase mRNA expression in the VTA, VMH, and SN compared to controls. In addition, tyrosine hydroxylase mRNA expression in the VTA, VMH, and SN showed a significant negative correlation with plasma leptin levels. This study suggests that the up- or down-regulation of tyrosine hydroxylase mRNA expression in the VTA, VMH, and SN is mainly due to the intake of macronutrient type rather than body weight.
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Affiliation(s)
- Yulin Li
- Institute of Biochemistry and Molecular Biology, Lanzhou University, PR China; Centre for Translational Neuroscience, School of Health Sciences, University of Wollongong, NSW2522, Australia
| | - Timothy South
- Centre for Translational Neuroscience, School of Health Sciences, University of Wollongong, NSW2522, Australia
| | - Mei Han
- Centre for Translational Neuroscience, School of Health Sciences, University of Wollongong, NSW2522, Australia
| | - Jiezhong Chen
- Centre for Translational Neuroscience, School of Health Sciences, University of Wollongong, NSW2522, Australia
| | - Rui Wang
- Institute of Biochemistry and Molecular Biology, Lanzhou University, PR China.
| | - Xu-Feng Huang
- Centre for Translational Neuroscience, School of Health Sciences, University of Wollongong, NSW2522, Australia.
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22
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Zamorano J, Rodriguez Padial L, Cosín J, Hernandiz A, Gutierrez-Chico JL, Pérez de Isla L, Arístegui R, Masramon X. Amlodipine reduces predicted risk of coronary heart disease in high-risk patients with hypertension in Spain (The CORONARIA Study). J Int Med Res 2008; 36:1399-417. [PMID: 19094452 DOI: 10.1177/147323000803600630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We evaluated the efficacy and safety of amlodipine besylate alone or in combination with other antihypertensive agents in high-risk hypertensive patients in Spanish primary care. In this 1-year, open-label, prospective cohort study, 7468 patients were treated with amlodipine 5 - 10 mg as a monotherapy or as an add-on therapy to attain blood pressure control (target of < 140/90 mmHg or, in patients with conditions such as diabetes or chronic kidney disease, < 130/85 mmHg). At 12 months, the primary outcome (change from baseline in predicted 10-year coronary heart disease risk) was -8.6%, down from 24.7% at baseline (relative risk reduction, 31.6%). Change in blood pressure from baseline (162.5/95.3 mmHg) was -26.7/-14.6 mmHg, and 38.6% of patients achieved their blood pressure target. In summary, significant reductions in predicted coronary heart disease risk and blood pressure were observed with amlodipine both as a monotherapy and as an add-on therapy. Amlodipine was well tolerated and compliance with treatment was good.
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Affiliation(s)
- J Zamorano
- Hospital Clínico San Carlos, Madrid, Spain.
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23
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Liou CW, Tan TY, Lin TK, Wang PW, Yip HK. Metabolic syndrome and three of its components as risk factors for recurrent ischaemic stroke presenting as large-vessel infarction. Eur J Neurol 2008; 15:802-9. [DOI: 10.1111/j.1468-1331.2008.02181.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Single-Dose and Fractionated Irradiation Promote Initiation and Progression of Atherosclerosis and Induce an Inflammatory Plaque Phenotype in ApoE−/− Mice. Int J Radiat Oncol Biol Phys 2008; 71:848-57. [DOI: 10.1016/j.ijrobp.2008.02.031] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Revised: 01/18/2008] [Accepted: 01/23/2008] [Indexed: 12/14/2022]
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25
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Carvalho DFD, Paiva ADA, Melo ASDO, Ramos AT, Medeiros JDS, Medeiros CCMD, Cardoso MAA. Perfil lipídico e estado nutricional de adolescentes. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2007. [DOI: 10.1590/s1415-790x2007000400007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: Avaliar a associação entre obesidade e dislipidemias em adolescentes do ensino público e privado de Campina Grande-PB, Brasil. MÉTODOS: Estudo transversal com 180 adolescentes de 14 a 17 anos matriculados no ensino público e privado de Campina Grande-PB. O estado nutricional foi classificado segundo os percentis do Índice de Massa Corporal para sexo e idade. Foi realizada coleta sangüínea para avaliação do perfil lipídico (colesterol total, frações HDL-colesterol, LDL-colesterol e triglicerídeos). Considerou-se dislipidemia a existência de alteração em pelo menos um dos exames. As análises estatísticas foram realizadas a partir do Epi Info 3.3 e Stata 7.0. RESULTADOS: A prevalência de sobrepeso foi de 14,4% enquanto que 83,9% dos estudantes eram eutróficos e 1,7% apresentavam baixo peso. Não foram encontradas diferenças estatisticamente significantes para o estado nutricional quando estratificado por sexo e tipo de escola. Todas as taxas bioquímicas investigadas mostraram algum nível de alteração. Chamou à atenção a prevalência de dislipidemia, observada em 66,7% dos estudantes, e a alteração do HDL-colesterol, verificada em 56,7% destes. Registrou-se associação estatisticamente significante (p<0,05) do Índice de Massa Corporal, categorizado em tercis, com o colesterol total e sua fração LDL, inclusive quando estratificados por sexo e tipo de escola. CONCLUSÕES: Considerando-se a faixa etária estudada, foram elevados os achados de sobrepeso e dislipidemia. Recomenda-se a adição de medidas preventivas, a fim de evitar que cada vez mais crianças e adolescentes venham a se tornar adultos portadores de obesidades e outras doenças crônicas.
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26
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Abstract
BACKGROUND The Third Joint European Guidelines on Cardiovascular Disease (CVD) Prevention highlight the importance of total cardiovascular risk prediction in planning preventive strategies. AIM To review the development of risk prediction systems in Europe and the practicalities of utilizing risk prediction in everyday clinical practice. METHODS Randomised clinical trials, cohort studies and current guidelines for the management of cardiovascular risk were reviewed. Relevant articles published between 1960 and 2004 were identified on PubMed and the Internet. RESULTS Several risk factors have been confirmed as major independent predictors of CVD, with their modification reducing cardiovascular risk. Total risk assessment is essential as multiple risk factors confer greater risk than the sum of their components. Framingham Heart Study data have been used as the basis for several risk prediction systems, which have been incorporated into numerous guidelines. However, these data are from a relatively small American cohort and tend to overestimate risk in some European populations. This and other limitations prompted the development of the SCORE (Systematic Coronary Risk Evaluation) risk charts using a much larger dataset from 12 European cohort studies. An electronic version of the charts, HeartScore, is now available to provide practitioners with an interactive risk prediction and management system that can be tailored to individual countries. CONCLUSION Evidence-based risk assessment systems can facilitate logical, individually tailored risk management and contribute to better patient care. Secular changes in coronary heart disease (CHD) incidence and mortality as well as in risk factors such as obesity and diabetes mean that such systems should be capable of modification and evolution.
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Affiliation(s)
- Ian M Graham
- Trinity College, Dublin, Ireland, Royal College of Surgeons, Dublin, Ireland.
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27
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Sato S, Ajiki W, Kobayashi T, Awata N. Pravastatin use and the five-year incidence of cancer in coronary heart disease patients: from the prevention of coronary sclerosis study. J Epidemiol 2006; 16:201-6. [PMID: 16951539 PMCID: PMC7683703 DOI: 10.2188/jea.16.201] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Although the short-term safety of statins is well established, their potential carcinogenicity in the long term is still being debated. The aim of this study was to investigate the association between statin-therapy and the incidence of cancer in coronary heart disease patients. METHODS The subjects were 263 patients with coronary heart disease who were from Osaka prefecture and who were admitted to the Osaka Medical Center for Cancer and Cardiovascular Diseases between September 28, 1991 and March 31, 1995. The five-year cancer incidence among the subjects was checked using the database of the institution-based cancer registry of the hospital as well as the population-based Osaka Cancer Registry. The Cox’s proportional hazards ratios (HRs) of all cancer incidence and observed/expected (O/E) ratios by cancer site were calculated. RESULTS Cancer incidence was observed in 17 patients during the follow-up period. Age (HR=1.16 per one year of age) and continuous smoking during the period (HR=5.82 compared to not smoking during the period) were significantly associated with cancer incidence using multivariable analysis. After being adjusted for sex, age, total serum cholesterol level and smoking habit, the HR of cancer incidence with pravastatin use was 0.78 (95% confidence interval: 0.18-3.46). In the O/E analysis, significantly elevated risks were found for bladder cancer in all the subjects (HR=8.93), as well as in the pravastatin use patients (HR=13.76). CONCLUSIONS Pravastatin use for 5 years did not indicate an increase in over all cancer risk.
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Affiliation(s)
- Shinichi Sato
- Osaka Medical Center for Health Science and Promotion, Nakamichi, Osaka, Japan.
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28
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Ling S, Dai A, Guo Z, Yan X, Komesaroff PA. Effects of a Chinese herbal preparation on vascular cells in culture: mechanisms of cardiovascular protection. Clin Exp Pharmacol Physiol 2006; 32:571-8. [PMID: 16026517 DOI: 10.1111/j.1440-1681.2005.04232.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
1. The use of traditional Chinese medicinal herbs or their pharmaceutical products for disease prevention and management is becoming increasingly popular in Western countries. Mixtures of various Chinese herbs have been used for the treatment of syndromes clinically overlapping Western cardiovascular syndromes. One modern preparation, known as the 'Cardiotonic Pill' (CP), is a pharmaceutical product derived mainly from a medicinal herb, Salvia miltiorrhiza bunge, and recently widely used in Chinese hospitals for the prevention and management of ischaemic cardiovascular diseases. Although the CP is believed to confer an extensive range of benefits, little is known about the physiological actions of this medicine, particularly at the cellular and molecular levels. Therefore, the aim of the present study was to explore possible cellular mechanisms of the CP on the cardiovascular system. 2. Cultured human vascular endothelial cells (EC) and vascular smooth muscle cells (VSMC) were exposed to the CP at various concentrations for periods ranging from hours to days. Cellular DNA synthesis was determined by a [(3)H]-thymidine incorporation assay, proliferation and death were assessed by investigations of cell numbers and apoptosis, whereas the expression of extracellular adhesion molecules was analysed by flow-cytometry and Western blotting. 3. The CP extract at concentrations of less than 200 microg/mL was not associated with cell damage. At doses beyond the therapeutic range (10-20 microg/mL), the CP appeared to exert a mild inhibitory effect on DNA synthesis and proliferation of EC in serum-enriched cultures. The CP significantly attenuated tumour necrosis factor-alpha-induced expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in a dose-dependent manner, with 50 and 100 microg/mL CP producing decreases in the expression of ICAM-1 of 26-32% and 32-44%, respectively, and of VCAM-1 of approximately 23% and 27-42%, respectively. The CP did not affect apoptosis in EC under conditions of serum-deprivation. 4. In VSMC, the CP significantly inhibited platelet-derived growth factor BB-induced DNA synthesis and cell proliferation in a dose-dependent manner. The CP did not affect VSMC expression of adhesion molecules. 5. We conclude that the CP inhibits expression of ICAM-1 and VCAM-1 in EC and proliferation of VSMC in a manner that has potentially beneficial therapeutic effects.
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MESH Headings
- Apoptosis/drug effects
- Becaplermin
- Blotting, Western
- Cardiovascular Agents/pharmacology
- Cell Proliferation/drug effects
- Cells, Cultured
- Dose-Response Relationship, Drug
- Drugs, Chinese Herbal/pharmacology
- Endothelium, Vascular/cytology
- Endothelium, Vascular/drug effects
- Humans
- Intercellular Adhesion Molecule-1/metabolism
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/drug effects
- Panax/chemistry
- Plant Preparations/pharmacology
- Platelet Endothelial Cell Adhesion Molecule-1/metabolism
- Platelet-Derived Growth Factor/metabolism
- Proto-Oncogene Proteins c-sis
- Salvia miltiorrhiza/chemistry
- Thymidine/metabolism
- Tritium
- Tumor Necrosis Factor-alpha/pharmacology
- Vascular Cell Adhesion Molecule-1/metabolism
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Affiliation(s)
- Shanhong Ling
- Department of Medicine, Central and Eastern Clinical School, Monash University, Prahran, Victoria, Australia
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Saini HK, Xu YJ, Arneja AS, Tappia PS, Dhalla NS. Pharmacological basis of different targets for the treatment of atherosclerosis. J Cell Mol Med 2006; 9:818-39. [PMID: 16364193 PMCID: PMC6740287 DOI: 10.1111/j.1582-4934.2005.tb00382.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The development of atherosclerotic plaque is a highly regulated and complex process which occurs as a result of structural and functional alterations in endothelial cells, smooth muscle cells (SMCs), monocytes/macrophages, T-lymphocytes and platelets. The plaque formation in the coronary arteries or rupture of the plaque in the peripheral vasculature in latter stages of atherosclerosis triggers the onset of acute ischemic events involving myocardium. Although lipid lowering with statins has been established as an important therapy for the treatment of atherosclerosis, partially beneficial effects of statins beyond decreasing lipid levels has shifted the focus to develop newer drugs that can affect directly the process of atherosclerosis. Blockade of renin angiotensin system, augmentation of nitric oxide availability, reduction of Ca(2+) influx, prevention of oxidative stress as well as attenuation of inflammation, platelet activation and SMC proliferation have been recognized as targets for drug treatment to control the development, progression and management of atherosclerosis. A major challenge for future drug development is to formulate a combination therapy affecting different targets to improve the treatment of atherosclerosis.
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Affiliation(s)
- Harjot K Saini
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre and Department of Physiology, Faculty of Medicine, University of Manitoba, Winnipeg, Canada
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30
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Ortlepp JR, Krantz C, Kimmel M, von Korff A, Vesper K, Schmitz F, Mevissen V, Janssens U, Franke A, Hanrath P, Zerres K, Hoffmann R. Additive effects of the chemokine receptor 2, vitamin D receptor, interleukin-6 polymorphisms and cardiovascular risk factors on the prevalence of myocardial infarction in patients below 65 years. Int J Cardiol 2006; 105:90-5. [PMID: 16207551 DOI: 10.1016/j.ijcard.2005.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2004] [Revised: 03/02/2005] [Accepted: 03/02/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular risk factors (CRF) have been associated with myocardial infarction (MI), while the role of genetic risk factors (GRF) remains undetermined. METHODS Cineventriculograms of 3436 were analyzed for presence of regional function impairment as sign of MI. Genotyping for genetic polymorphism (vitamin D receptor VDR BsmI, interleukin-6 IL6-174 G/C, chemokine receptor 2 CCR2 64 V/I) was performed. CRF were assessed (hypertension, hypercholesterolemia, smoking, and diabetes mellitus). RESULTS In patients <65 years (n=1946) genotypes (VDR BB, IL6 GC/CC, CCR2 VI/II, defined as GRF) were significantly associated with the presence of MI (BB: OR 1.38, 95%CI 1.07-1.79, p=0.016 GC/CC: 1.28, 95%CI 1.03-1.60, p=0.028 VI/II: 1.49, 95%CI 1.17-1.88, p=0.001). Combining four CRF (14% vs. 21% vs. 27% vs. 31% vs. 38%, p<0.0001) and three GRF (21% vs. 25% vs. 32% vs. 44%, p<0.0001) revealed additive effects on the prevalence of MI. The more combined CRF and GRF were present (from 0 to 7) the higher was the prevalence of MI (11% vs. 12% vs. 21% vs. 27% vs. 30% vs. 34% vs. 59%, p< 0.0001). Age was not associated with MI. In patients > or =65 years (n=1490) the combination of CRF was only weakly associated with MI, while GRF were not. In these patients age was a predictor of MI. CONCLUSION Certain GRF might have additive but small effects on the disposition for MI before the age of 65. In older patients the tested GRF had no effect, possibly indicating a mechanism of aging rather than a purely genetic determined entity. Given the small effect of the tested genetic polymorphisms the value of testing GRF remains uncertain.
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Affiliation(s)
- Jan R Ortlepp
- Medical Clinic I, University Hospital of Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany.
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31
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Abstract
Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide and its incidence is likely to increase. Multiple risk factors contribute to CVD. Elevated LDL-cholesterol (LDL-C) and triglyceride levels, low HDL-cholesterol levels, hypertension, type 2 diabetes, and smoking are key modifiable risk factors. Such risk factors are present in 80-90% of coronary heart disease (CHD) patients. For many factors, modification can significantly reduce CVD incidence. For example, statin-induced LDL-C reductions reduce cardiovascular events by 24-37% and smoking cessation reduces CHD mortality by 36%. The need to identify and treat these risk factors has led many national and local groups to develop clinical practice guidelines for management of CVD. Although the aim of such guidelines is to provide practitioners with a framework to identify, prioritize, and manage patients, the plethora of guidelines can cause confusion. In addition, research indicates that guidelines are not being optimally implemented. This review considers these practical issues, highlights the common goals shared by many guidelines, and focuses on how these can be best achieved. It also highlights areas where the guidelines differ and discusses points to consider when selecting the most appropriate recommendation.
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Affiliation(s)
- Christie Ballantyne
- Arteriosclerosis and Lipoprotein Section, Baylor College of Medicine, Houston, TX, USA
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32
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Conthe P, Visús E. Importancia del cumplimiento terapéutico en la insuficiencia cardíaca. Med Clin (Barc) 2005; 124:302-7. [PMID: 15755393 DOI: 10.1157/13072325] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
It is recognized that the irregularity in therapeutic compliance is one of the main unstabilizing factors leading to hospitalization in patients with heart failure (HF). In this review, we specifically deal with the Pharmacological Therapeutic Adherence (PTA) in HF patients, and especially with the adherence problems related to those drugs which have been shown to improve the prognosis of the disease. The impact of a deficient PTA (DPTA) jeopardizes the efficiency of the new neurohormonal inhibitor drugs which have proven benefit in wide and expensive clinical trials. It is necessary to have more information about PTA, to develop skills and methods to identify noncompliant patients and to practically improve those actions which have shown some positive effect on DPTA. Some DPTA-related problems owe to inappropriate therapeutic schemes, adverse effects, social deprivation, scarce interaction with the physician and an inadequate health education. Uninformed patients use to believe that they must take the medicines only when they feel sick and have symptoms, yet they believe that drugs can be withdrawn when they feel better. Different pharmacological groups may have different adherence problems in HF. It is estimated that those interventions aimed at improving adherence are useful for the reduction of health costs are they are likely more effective than the effects caused by choosing a given drug. The choosing method to assess PTA in practice with reliability is the counting of pills combined with a compliance survey. Time spent to improve adherence not only can improve it but also it can diminish the total time spent by the physician in the follow-up of these patients.
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Affiliation(s)
- Pedro Conthe
- Servicio de Medicina Interna I, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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Alm-Roijer C, Stagmo M, Udén G, Erhardt L. Better knowledge improves adherence to lifestyle changes and medication in patients with coronary heart disease. Eur J Cardiovasc Nurs 2005; 3:321-30. [PMID: 15572021 DOI: 10.1016/j.ejcnurse.2004.05.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2004] [Revised: 05/05/2004] [Accepted: 05/27/2004] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients with coronary heart disease (CHD) are not managed adequately, and we often fail to reach treatment targets. AIM To investigate if knowledge of risk factors for CHD, measured by a questionnaire, would show any relation to advice to compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. METHOD Men and women <71 years who had had a cardiac event were screened consecutively (509) from the medical records. Responders (392) were interviewed, examined and received a questionnaire. Three hundred and forty-seven patients answered the questionnaire regarding their general knowledge of risk factors for CHD, compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. RESULTS There were statistically significant correlations between general knowledge about risk factors for CHD and compliance to certain lifestyle changes: weight, physical activity, stress management, diet, attainment of lipid level goals and the likelihood of taking prescribed blood pressure-lowering drugs. General knowledge of risk factors had no correlation to blood glucose or blood pressure levels nor on smoking habits or treatment patterns for prescribed lipid- and blood glucose-lowering drugs. CONCLUSION Knowledge correlates to patient behaviour with respect to some risk factors, which should be recognised in preventive programs.
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Affiliation(s)
- Carin Alm-Roijer
- Department of Cardiology, Malmö University Hospital, S-205 02, Malmö, Sweden.
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Sierra Benito C. Hipertensión arterial en las enfermedades autoinmunes y sistémicas. HIPERTENSION Y RIESGO VASCULAR 2005. [DOI: 10.1016/s1889-1837(05)71523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
The metabolic syndrome is a constellation of metabolic risk factors for atherosclerotic cardiovascular disease (ASCVD) occurring in one individual. There are five cardiovascular risk factors that accompany the metabolic syndrome: atherogenic dyslipidemia [elevated apolipoprotein B (apo B), elevated triglyceride, small low-density lipoprotein (LDL) particles, and low high-density lipoprotein (HDL)cholesterol], elevated blood pressure, elevated glucose, a prothrombotic state, and a proinflammatory state. The likelihood of an individual developing metabolic syndrome is enhance by underlying risk factors, notably, obesity, insulin resistance, lack of physical activity, advancing age, and hormonal factors (e.g., androgens and corticosteroids). Besides being at higher risk for ASCVD, persons with the metabolic syndrome are at increased risk for type 2 diabetes. Persons with the metabolic syndrome deserve management in the clinical setting to reduce the risk for both ASCVD and type 2 diabetes. The two major therapeutic strategies for treatment of affected persons are modification of the underlying risk factors and separate drug treatment of the particular metabolic risk factors when appropriate. First-line therapy for underlying risk factors is therapeutic lifestyle changes, i.e., weight loss in obese persons, increased physical activity, and anti-atherogenic diet. These changes will improve all of the metabolic risk factors. Whether use of drugs to reduce insulin resistance is effective, safe, and cost-effective before the onset of diabetes awaits the results of more clinical research. Turning to individual risk components, for atherogenic dyslipidemia, drug therapies that promote lowering of apo B and raise HDL cholesterol will be needed for higher risk patients. Treatment of categorical hypertension with drugs has become standard practice. When hyperglycemia reaches the diabetic level, glucose-lowering agents will become necessary when dietary control is no longer effective, and reduction of a prothrombotic state with low-dose aspirin may be indicated in higher-risk patients.
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Affiliation(s)
- S M Grundy
- Center for Human Nutrition and Department of Clinical Nutrition, University of Texas Southwestern Medical Center at Dallas, TX 75390-9052, USA.
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Ortlepp JR, Metrikat J, Albrecht M, Maya-Pelzer P. Relationship between physical fitness and lifestyle behaviour in healthy young men. ACTA ACUST UNITED AC 2004; 11:192-200. [PMID: 15179099 DOI: 10.1097/01.hjr.0000131578.48136.85] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is substantial knowledge about the inverse association of physical fitness and CVD risk factors and CVD mortality. However, physical fitness per se might be influenced by lifestyle conditions such as physical training, smoking and drinking habits. HYPOTHESIS We evaluated the relationship between physical fitness, physical activity, endurance training, smoking and drinking habits and blood pressure, lipids and leukocytes as surrogate cardiovascular risk markers in a large-scale cross-sectional study of healthy young men. STUDY DESIGN AND METHODS A total of 6748 healthy young men were selected during their primary flight medical examination for military flying duties. Physical fitness was assessed by achieved physical working capacity at a heart rate of 170 beats per min (PWC170) during cycle ergometry. Parameters such as physical activity, endurance sports, smoking of cigarettes and drinking of alcoholic beverages were assessed by means of standardized questionnaires. Systolic and diastolic blood pressures were measured manually. Fasting cholesterol and triglycerides as well as white blood counts were obtained. RESULTS Physical activity itself was not related to significant differences in the tested variables, whereas good physical fitness showed a significant association with improved blood pressure and blood lipids (P<0.001) with no detectable threshold. This effect was independent of endurance training, smoking and drinking. Whereas drinking was associated with elevated systolic blood pressure, smoking was associated with markedly increased triglycerides as well as with elevated leukocytes. CONCLUSION Physical fitness is associated with improved blood pressure and blood lipids. This effect is independent of participating mainly in endurance or nonendurance sports, of physical activity per se, and it does not depend on smoking and drinking habits. Smoking itself revealed relevant higher inflammation independent of fitness.
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Affiliation(s)
- Jan R Ortlepp
- German Air Force Institute of Aviation Medicine, Div. I, Baumbachstrasse 308, 82242 Fürstenfeldbruck, Germany.
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Effect of Seatangle Oligosaccharide Drink on Serum and Hepatic Lipids in Rats Fed a Hyperlipidemic Diet. ACTA ACUST UNITED AC 2003. [DOI: 10.3746/jkfn.2003.32.8.1364] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ortlepp JR, Schmitz F, Bozoglu T, Hanrath P, Hoffmann R. Cardiovascular risk factors in patients with aortic stenosis predict prevalence of coronary artery disease but not of aortic stenosis: an angiographic pair matched case-control study. Heart 2003; 89:1019-22. [PMID: 12923015 PMCID: PMC1767856 DOI: 10.1136/heart.89.9.1019] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Traditional cardiovascular risk factors have been associated with aortic stenosis and coronary artery disease. As these two conditions often co-exist, the association of cardiovascular risk factors with aortic stenosis may reflect confounding. OBJECTIVE To compare the cardiovascular risk profile in patients with severe aortic stenosis undergoing elective coronary angiography with that of patients without aortic stenosis or calcification undergoing coronary angiography for suspected coronary artery disease. METHODS 523 patients referred for elective diagnostic left heart catheterisation because of severe aortic stenosis formed the case population; 3925 patients without valve disease referred for elective diagnostic left heart catheterisation formed the base control population. Of the latter, 523 were pair matched to the case population for sex, age, and prevalence of relevant coronary artery disease, forming a pair matched control population. Cardiovascular risk factors (male sex, hypertension, hypercholesterolaemia, smoking, diabetes mellitus, family history of coronary artery disease) were assessed in all the patients. RESULTS None of the cardiovascular risk factors was more prevalent in patients with aortic stenosis than in the base control population or in the pair matched control population. However, male sex, hypercholesterolaemia, smoking, diabetes mellitus, and a family history of coronary artery disease were significantly associated with the presence of additional coronary artery disease in patients with aortic stenosis. CONCLUSIONS Cardiovascular risk factors are commonly present in patients with aortic stenosis. However, when compared with controls matched for age, sex, and angiographically defined coronary artery disease, no risk factor was significantly associated with the prevalence of aortic stenosis. Thus other factors are likely to be more important in the pathogenesis of aortic stenosis.
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Affiliation(s)
- J R Ortlepp
- Medical Clinic I, University Hospital of Aachen, Germany.
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Ortlepp JR, Metrikat J, Albrecht M, Maya-Pelzer P, Pongratz H, Hoffmann R. Relation of body mass index, physical fitness, and the cardiovascular risk profile in 3127 young normal weight men with an apparently optimal lifestyle. Int J Obes (Lond) 2003; 27:979-82. [PMID: 12861240 DOI: 10.1038/sj.ijo.0802319] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity is a well-accepted cardiovascular risk factor associated with hypertension and hyperlipidaemia. A body mass index (BMI) within the range of 18.5-25 kg/m(2) is considered normal. To prevent cardiovascular diseases regular physical activity and abstinence from smoking are strongly recommended. Since it is not evident that a lower optimal threshold exists concerning cardiovascular risk factors if other lifestyle conditions are apparently optimised, we studied the relation between BMI and vascular risk factors in 3127 hyperhealthy Caucasian males. They were aged between 18 and 23 y, were nonsmokers, without regular alcohol intake, and had at least 3 h of sports activity per week. Their BMI was below 25 kg/m(2). Low BMI revealed to be significantly associated with high physical fitness, low blood pressure, and low serum lipids. The lower the BMI was, the more favourable these parameters were. Thus, the threshold for an optimal BMI concerning cardiovascular risk factors might be far below 25 kg/m(2) even if other lifestyle conditions are apparently optimal.
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Affiliation(s)
- J R Ortlepp
- Medical Clinic I, University Hospital of Aachen, Aachen, Germany.
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Bulliyya G. Influence of fish consumption on the distribution of serum cholesterol in lipoprotein fractions: comparative study among fish-consuming and non-fish-consuming populations. Asia Pac J Clin Nutr 2003; 11:104-11. [PMID: 12074175 DOI: 10.1046/j.1440-6047.2002.00256.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The objective of this study was to investigate serum lipoprotein levels in order to assess cardiovascular disease (CVD) risk factors between fish-consuming populations and non-fish-consuming populations, as it has been speculated that fish intake reduces CVD risk. A representative sample of one thousand subjects (529 men and 471 women) were selected, with ages ranging from 20 to 70 years, from 40 villages belonging to fish-consuming (500) or non-fish-consuming (500) populations. Serum lipoprotein lipids such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were analysed biochemically using standard procedures. The ratios of TC: HDL-C and LDL-C: HDL-C were computed. Mean values of serum LDL-C and the ratios of LDL-C: HDL-C and TC: HDL-C were significantly lower and HDL-C levels were higher in fish-consumers than in non-fish-consumers. The concentrations of HDL-C decreased with increasing age, while the reverse was true for LDL-C and for the LDL-C: HDL-C and TC: HDL-C ratios. There were significant sex differences for certain age groups in both of the population groups. The 5th, 50th and 95th percentile cut-off values for these parameters were lower in fish-consumers than in non-fish-consumers. The prevalence of individuals at risk of CVD because of low HDL-C (<35 mg/dL), high LDL-C (>130 mg/dL) and their atherogenic ratios (LDL-C: HDL-C >3.5 and TC: HDL-C>4.5) was significantly greater in non-fish-consumers. This study highlights that the fish-consuming population had a lower atherogenic risk than the non-fish-consuming population. The intake of fish may have substantial implications for public health and health economy by decreasing the risk of CVD. However, more studies are warranted to better define the mechanisms of cardioprotection by dietary fish and fish oils.
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Affiliation(s)
- Gandham Bulliyya
- Department of Physical Anthropology, School of Biological Sciences, Sri Venkateswara University, Tirupati, India.
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Gutiérrez PC, Lobos Bejarano JM, González Juanatey JR, Gil Núñez A, Pajuelo Fernández FJ, Sardá AN. Diferencias en la atención de las mujeres con alto riesgo cardiovascular respecto a los varones: estudio multidisciplinario. Med Clin (Barc) 2003. [DOI: 10.1016/s0025-7753(03)73736-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Giner Galvañ V, Lozano Vidal JV, Redón I Mas J. [Treatment of non-complicated essential arterial hypertension]. Rev Clin Esp 2002; 202:161-72. [PMID: 11996746 DOI: 10.1016/s0014-2565(02)71014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V Giner Galvañ
- Unidad de Hipertensión. Servicio de Medicina Interna. Hospital Clínico Universitario. Universidad de Valencia. Spain
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Wroblewski Lissin L, Cooke JP. Maintaining the endothelium: preventive strategies for vessel integrity. PREVENTIVE CARDIOLOGY 2002; 3:172-177. [PMID: 11834938 DOI: 10.1111/j.1520-037x.2000.803811.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The endothelium is a diaphanous membrane, only one cell layer thick, that lines all of our blood vessels. Despite its apparent fragility, it exerts profound control over vascular tone, structure, and interaction with circulating blood elements. One of the factors that the endothelium synthesizes is nitric oxide, which is the most potent endogenous vasodilator known. In addition to its blood flow regulating effects, nitric oxide also inhibits key processes in atherosclerosis, including monocyte adherence, platelet aggregation, and proliferation of vascular smooth muscle cells. Nitric oxide synthesis is impaired, and its degradation is accelerated, in many of the conditions associated with atherosclerosis, including hypercholesterolemia. Restoration of nitric oxide synthesis and activity in these disorders can improve blood flow, relieve symptoms, and perhaps reduce the progression of atherosclerosis (part 1 of 2 parts). (c) 2000 by CHF, Inc.
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Affiliation(s)
- L Wroblewski Lissin
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA 94305
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Lissin LW, Cooke JP. Maintaining the endothelium: preventive strategies for vessel integrity. PREVENTIVE CARDIOLOGY 2002; 4:28-37. [PMID: 11828196 DOI: 10.1111/j.1520-037x.2001.90810.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The endothelium is a diaphanous membrane, only one cell layer thick, that lines all of our blood vessels. Despite its apparent fragility, it exerts profound control over vascular tone, structure, and intersection with circulating blood elements. One of the factors that the endothelium synthesizes is nitric oxide, which is the most potent endogenous vasodilator known. In addition to its blood flow regulating effects, nitric oxide also inhibits key processes in atherosclerosis, including monocyte adherence, platelet aggregation, and proliferation of vascular smooth muscle cells. Nitric oxide synthesis is impaired, and its degradation is accelerated, in many of the conditions associated with atherosclerosis, including hypercholesterolemia. Restoration of nitric oxide synthesis and activity in these disorders can improve blood flow, relieve symptoms, and perhaps reduce the progression of atherosclerosis.(c) 2001 by CHF, Inc.
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Affiliation(s)
- L W Lissin
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA
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Salmon B. Differences between men and women in compliance with risk factor reduction: before and after coronary artery bypass surgery. JOURNAL OF VASCULAR NURSING 2001; 19:73-7; quiz 78-9. [PMID: 11533579 DOI: 10.1067/mvn.2001.117985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine whether a difference exists between genders in compliance to a heart-healthy lifestyle and whether the stress of coronary artery bypass graft (CABG) surgery caused one of the genders to become more compliant. A convenience sample of 30 men and 30 women who had CABG surgery at least 1 year earlier and were enrolled in a follow-up program through a cardiovascular surgeon's office were interviewed to assess coronary artery disease risk. The instrument used was the RISKO Heart Hazard Appraisal Tool. Preoperative records were also reviewed with the same tool to assess a person's preoperative risk. The research design used was 2 x 2 repeated measures. Data were analyzed with 2 x 2 repeated measures analysis of variance (ANOVA). Two findings were discovered. First, a statistically significant difference exists between men and women (F = 5.82 P =.019), with men scoring lower RISKO scores than women, indicating lower cardiovascular risk and better compliance to a healthy lifestyle, both before and after surgery. Second, a significant difference exists between preoperative and postoperative RISKO scores in the total population (F = 8.77 P =.004). Postoperative RISKO scores were lower, indicating an improvement in cardiovascular risk. The risk factors assessed are applicable to both heart disease and peripheral vascular disease.
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Affiliation(s)
- B Salmon
- Indiana University-Purdue University, Ft Wayne 46805, USA
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Wu DM, Pai L, Chu NF, Sung PK, Lee MS, Tsai JT, Hsu LL, Lee MC, Sun CA. Prevalence and clustering of cardiovascular risk factors among healthy adults in a Chinese population: the MJ Health Screening Center Study in Taiwan. Int J Obes (Lond) 2001; 25:1189-95. [PMID: 11477504 DOI: 10.1038/sj.ijo.0801679] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2000] [Revised: 02/12/2001] [Accepted: 02/22/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To gain insight into the prevalence and clustering of multiple cardiovascular risk factors in a healthy Chinese adult population in Taiwan. DESIGN A cross-sectional study was carried out in 1996. SUBJECTS A total of 46,603 subjects (23,485 men and 23,118 women) who were aged 20--59 y and attended a private health screening center for health examination of their own volition. MEASUREMENTS Multiple cardiovascular risk factors including cigarette smoking, overweight (23 kg/m(2)< or =body mass index (BMI)<25 kg/m(2)) and obesity (BMI> or =25 kg/m(2)), lipid disorder (a ratio of total cholesterol level to the level of high density lipoprotein cholesterol>5 or use of lipid-lowering drugs), hypertension (systolic blood pressure> or =140 mmHg or diastolic blood pressure> or =90 mmHg or use of anti-hypertensive medications), and diabetes mellitus (fasting serum plasma glucose level> or =126 mg/dl or use of anti-diabetic medications) were determined. RESULTS In comparison to women, men had a higher prevalence of current smoking (42.1 vs 5.6%), overweight (25.1 vs 17.1%) and obesity (33.1 vs 21.5%), lipid disorder (45.1 vs 19.6%), hypertension (17.4 vs 13.2%), as well as diabetes mellitus (4.1 vs 3.4%). The prevalence of men or women having two or more of the cardiovascular risk factors of interest was 54.3 and 21.7%, respectively. With advancing age, the prevalence of risk factors became greater for both genders. More importantly, the clustering of risk factors increased monotonically with increasing BMI levels for men and women. CONCLUSIONS The prevalence and clustering of cardiovascular risk factors are commonplace in this healthy Chinese adult population. Considering the significant association between clustering of risk factors under study and BMI levels, this study gives an indication that population-based multifactorial interventions may work out favorably for specific groups.
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Affiliation(s)
- D M Wu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Jacobsson LT, Turesson C, Hanson RL, Pillemer S, Sievers ML, Pettitt DJ, Bennett PH, Knowler WC. Joint swelling as a predictor of death from cardiovascular disease in a population study of Pima Indians. ACTA ACUST UNITED AC 2001; 44:1170-6. [PMID: 11352251 DOI: 10.1002/1529-0131(200105)44:5<1170::aid-anr200>3.0.co;2-t] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Markers of inflammation have recently been shown to be predictive of cardiovascular disease (CVD). Furthermore, the excess mortality in rheumatoid arthritis (RA), a disease characterized by chronic polyarthritis, is chiefly due to death from CVD. With this background, we studied the effect of inflammation, as reflected by the number of joints with soft tissue swelling, and rheumatoid factor (RF) seropositivity on CVD-related mortality. METHODS Mortality rates and rate ratios for all-cause and CVD-related deaths were computed in a longitudinal, population-based cohort of Pima Indians in Arizona from 1965 through 1994. Repeated health examinations were performed, involving systematic assessment of the features of RA, cardiovascular risk factors, serum titers of RF, as well as mortality. The cohort comprised 4,120 subjects (1,861 men, 2,259 women) who were examined an average of 3.5 times during a mean followup of 14 years. RESULTS During the followup period, 182 CVD-related deaths ocurred. The age- and sex-adjusted CVD-related mortality rates increased significantly with the presence of a higher number of joints with soft tissue swelling (Ptrend = 0.04), and were 2.07 (95% confidence interval [95% CI] 1.30-3.31) times as high in those subjects who had 2 or more swollen joints as in those who had none. There were no significant additional effects on CVD-related mortality when seropositivity for RF or a previous diagnosis of RA were considered. In age- and sex-adjusted proportional hazards analyses, which were controlled for possible confounders, the effect of swollen joints remained significant (mortality rate ratio 1.33, 95% CI 1.04-1.71 per category increase [no swollen joints, 1 swollen joint, at least 2 swollen joints]). CONCLUSION Joint swelling is a significant risk factor for CVD-related death, independent of other known risk factors including a diagnosis of RA. This finding supports the hypothesis that inflammatory mechanisms are important for the development of CVD.
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Affiliation(s)
- L T Jacobsson
- Department of Rheumatology, Malmö University Hospital, Sweden
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Sato S, Kobayashi T, Awata N, Reiber JH, Nakagawa Y, Hiraoka H, Katoh O, Kirino M, Kobayashi T, Iida M, Itoh T, Shibata N. Randomized, controlled trial of secondary prevention of coronary sclerosis in normocholesterolemic patients using pravastatin: two-year follow-up of the prevention of coronary sclerosis study. Curr Ther Res Clin Exp 2001. [DOI: 10.1016/s0011-393x(01)80058-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Tataru MC, Schulte H, von Eckardstein A, Heinrich J, Assmann G, Koehler E. Plasma fibrinogen in relation to the severity of arteriosclerosis in patients with stable angina pectoris after myocardial infarction. Coron Artery Dis 2001; 12:157-65. [PMID: 11352071 DOI: 10.1097/00019501-200105000-00001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Authors both of retrospective and of prospective studies have demonstrated that there is a relationship between concentration of fibrinogen in plasma and the angiographically determined severity of coronary heart disease (CHD). OBJECTIVE To determine the relevance of the plasma fibrinogen concentration for the severity of CHD, particularly in cases with additional arteriosclerotic changes in the extracranial arteries supplying the brain [cerebrovascular disease (CVD)], in the pelvic/leg arteries [peripheral occlusive arterial disease (POAD)], or in both. PATIENTS AND METHODS In a retrospective cross-sectional survey the cardiological and angiographical status of a total of 1112 male and 299 female patients with stable angina pectoris after sustained myocardial infarction and an age-matched control group of 326 male and 138 female subjects with no clinical symptoms of CHD was determined, together with measurements of plasma fibrinogen, dynamic plasma viscosity and D-dimers. RESULTS More than two-thirds of the patients with arteriosclerosis had plasma fibrinogen concentrations in the uppermost tertile of the control range (men > 2.75; women > 2.83 g/l). Plasma fibrinogen concentration was correlated to the severity of CHD (for men r = 0.173, P < 0.001; for women r= 0.144, P < 0.013). Patients with generalized arteriosclerosis had higher plasma fibrinogen concentrations than did those suffering from CHD only (for men, control 2.65 +/- 0.51, CHD 3.07 +/- 0.73, CHD plus POAD 3.17 +/- 0.77 and CHD plus POAD plus CVD 3.45 +/- 0.78 g/l; for women, control 2.69 +/- 0.44, CHD 3.25 +/- 0.67, CHD plus POAD 3.19 +/- 0.77, CHD plus POAD plus CVD 3.60 +/- 0.84 g/l). Multivariate analysis showed that C-reactive protein, D-dimers and dynamic plasma viscosity accounted for 48.2% (for men) and 49.4% (for women) of the variance in plasma fibrinogen concentration. CONCLUSIONS Our findings demonstrate that there is not only a correlation between plasma fibrinogen concentration and the severity of CHD, but also a correlation to the incidence of additional POAD or CVD.
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Affiliation(s)
- M C Tataru
- Herz- und Gefässklinik, Bad Neustadt an der Saale, Rhön-Klinikum AG, D-Bad Neustadt, Germany.
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Clark LT, Ferdinand KC, Flack JM, Gavin JR, Hall WD, Kumanyika SK, Reed JW, Saunders E, Valantine HA, Watson K, Wenger NK, Wright JT. Coronary heart disease in African Americans. HEART DISEASE (HAGERSTOWN, MD.) 2001; 3:97-108. [PMID: 11975778 DOI: 10.1097/00132580-200103000-00007] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
African Americans have the highest overall mortality rate from coronary heart disease (CHD) of any ethnic group in the United States, particularly out-of-hospital deaths, and especially at younger ages. Although all of the reasons for the excess CHD mortality among African Americans have not been elucidated, it is clear that there is a high prevalence of certain coronary risk factors, delay in the recognition and treatment of high-risk individuals, and limited access to cardiovascular care. The clinical spectrum of acute and chronic CHD in African Americans is similar to that in whites. However, African Americans have a higher risk of sudden cardiac death and present more often with unstable angina and non-Q-wave myocardial infarction than whites. African Americans have less obstructive coronary artery disease on angiography, but may have a similar or greater total burden of coronary atherosclerosis. Ethnic differences in the clinical manifestations of CHD may be explained largely by the inherent heterogeneity of the coronary syndromes, and the disproportionately high prevalence and severity of hypertension and type 2 diabetes in African Americans. Identification of high-risk individuals for vigorous risk factor modification-especially control of hypertension, regression of left ventricular hypertrophy, control of diabetes, treatment of dyslipidemia, and smoking cessation--is key for successful risk reduction.
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Affiliation(s)
- L T Clark
- Division of Cardiovascular Medicine, State University of New York Health Science Center, Brooklyn, New York, USA
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