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Salerno PR, Chen Z, Bourges-Sevenier B, Qian A, Deo S, Nasir K, Rajagopalan S, Al-Kindi S. Transportation-Related Carbon Footprint of Coronary Heart Disease Ambulatory Care in the United States. Circ Res 2024; 134:1218-1220. [PMID: 38662867 PMCID: PMC11047758 DOI: 10.1161/circresaha.124.324330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Affiliation(s)
- Pedro R.V.O Salerno
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Zhuo Chen
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | | | - Alice Qian
- Surgical Services, Louis Stokes VA Medical Center, Cleveland, OH, United States
| | - Salil Deo
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
- Surgical Services, Louis Stokes VA Medical Center, Cleveland, OH, United States
| | - Khurram Nasir
- Center for Health and Nature & Department of Cardiology, Houston Methodist Hospital, Houston, TX
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Sadeer Al-Kindi
- Center for Health and Nature & Department of Cardiology, Houston Methodist Hospital, Houston, TX
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Rajagopalan S, Brook RD, Salerno PRVO, Bourges-Sevenier B, Landrigan P, Nieuwenhuijsen MJ, Munzel T, Deo SV, Al-Kindi S. Air pollution exposure and cardiometabolic risk. Lancet Diabetes Endocrinol 2024; 12:196-208. [PMID: 38310921 DOI: 10.1016/s2213-8587(23)00361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 02/06/2024]
Abstract
The Global Burden of Disease assessment estimates that 20% of global type 2 diabetes cases are related to chronic exposure to particulate matter (PM) with a diameter of 2·5 μm or less (PM2·5). With 99% of the global population residing in areas where air pollution levels are above current WHO air quality guidelines, and increasing concern in regard to the common drivers of air pollution and climate change, there is a compelling need to understand the connection between air pollution and cardiometabolic disease, and pathways to address this preventable risk factor. This Review provides an up to date summary of the epidemiological evidence and mechanistic underpinnings linking air pollution with cardiometabolic risk. We also outline approaches to improve awareness, and discuss personal-level, community, governmental, and policy interventions to help mitigate the growing global public health risk of air pollution exposure.
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Affiliation(s)
- Sanjay Rajagopalan
- University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Robert D Brook
- Division of Cardiovascular Diseases, Department of Internal Medicine, Wayne State University, Detroit, MI, USA
| | - Pedro R V O Salerno
- University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Philip Landrigan
- Program for Global Public Health and the Common Good, Boston College, Boston, MA, USA; Centre Scientifique de Monaco, Monaco
| | | | - Thomas Munzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; German Center of Cardiovascular Research, Partner-Site Rhine-Main, Germany
| | - Salil V Deo
- Louis Stokes Cleveland VA Medical Center, Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Sadeer Al-Kindi
- DeBakey Heart and Vascular Center, Houston Methodist, Houston, TX, USA
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Neeland IJ, Arafah A, Bourges-Sevenier B, Dazard JE, Albar Z, Landskroner Z, Tashtish N, Eaton E, Friswold J, Porges J, Nennstiel M, Davies A, Rahmani S, Howard QS, Forrest K, Sullivan C, Greene L, Al-Kindi SG, Rajagopalan S. Second-year results from CINEMA: A novel, patient-centered, team-based intervention for patients with Type 2 diabetes or prediabetes at high cardiovascular risk. Am J Prev Cardiol 2024; 17:100630. [PMID: 38223296 PMCID: PMC10787236 DOI: 10.1016/j.ajpc.2023.100630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024] Open
Abstract
Background The care for patients with type 2 diabetes mellitus (T2DM) necessitates a multidisciplinary team approach to reduce cardiovascular (CV) risk but implementation of effective integrated strategies has been limited. Methods and Results We report 2-year results from a patient-centered, team-based intervention called CINEMA at University Hospitals Cleveland Medical Center. Patients with T2DM or prediabetes at high-risk for CV events, including those with established atherosclerotic CVD, elevated coronary artery calcium score ≥100, chronic heart failure with reduced ejection fraction, chronic kidney disease (CKD) stages 2-4, and/or prevalent metabolic syndrome were included. From May 2020 through September 2022, 426 patients were enrolled in the CINEMA program. A total of 227 (54%) completed ≥1 follow-up visit after an initial baseline visit with median (IQR) follow-up time 4 [3], [4], [5], [6], [7] months with maximum follow-up time 19 months. Mean age was 60 years, 47 % were women, and 37 % were Black and 85% had prevalent T2DM, 48 % had established ASCVD, 29% had chronic HF, 27% had CKD and mean baseline 10-year ASCVD risk estimate was 25.1 %; baseline use of a SGLT2i or GLP-1RA was 21 % and 18 %, respectively. Patients had significant reductions from baseline in body weight (-5.5 lbs), body mass index (-0.9 kg/m2), systolic (-3.6 mmHg) and diastolic (-1.2 mmHg) blood pressure, Hb A1c (-0.5 %), total (-10.7 mg/dL) and low-density lipoprotein (-9.0 mg/dL) cholesterol, and triglycerides (-13.5 mg/dL) (p<0.05 for all). Absolute 10-year predicted ASCVD risk decreased by ∼2.4 % (p<0.001) with the intervention. In addition, rates of guideline-directed cardiometabolic medication prescriptions significantly increased during follow-up with the most substantive changes seen in rates of SGLT2i and GLP-1RA use which approximately tripled from baseline (21 % to 57 % for SGLT2i and 18 % to 65 % for GLP-1RA, p<0.001 for both). Conclusions The CINEMA program, an integrated, patient-centered, team-based intervention for patients with T2DM or prediabetes at high risk for cardiovascular disease has continued to demonstrate effectiveness with significant improvements in ASCVD risk factors and improved use of evidence-based therapies. Successful implementation and dissemination of this care delivery paradigm remains a key priority.
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Affiliation(s)
- Ian J. Neeland
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Ala’ Arafah
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Brendan Bourges-Sevenier
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Jean-Eudes Dazard
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Zainab Albar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
| | - Zoe Landskroner
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Nour Tashtish
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Elke Eaton
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Janice Friswold
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Jodie Porges
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Matthew Nennstiel
- University Hospitals Health System, Cleveland, OH 44106, United States
| | - Amanda Davies
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sara Rahmani
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Quiana S. Howard
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Katherine Forrest
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Claire Sullivan
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Lloyd Greene
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sadeer G. Al-Kindi
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Sanjay Rajagopalan
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States
- Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
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Zhong J, Bourges-Sevenier B, Francesco P, Rajagopalan S. Planting a seed for sustainable hospital menus. Eur Heart J 2024; 45:152-153. [PMID: 37658782 DOI: 10.1093/eurheartj/ehad544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Affiliation(s)
- Jeffrey Zhong
- University Hospitals, Case Western Reserve School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Brendan Bourges-Sevenier
- University Hospitals, Case Western Reserve School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Paneni Francesco
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Sanjay Rajagopalan
- University Hospitals, Case Western Reserve School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA
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Lababidi H, Salerno PRVO, Wass SY, Shafiabadi Hasani N, Bourges-Sevenier B, Al-Kindi S. The Global Burden of premature cardiovascular disease, 1990-2019. Int J Cardiol Cardiovasc Risk Prev 2023; 19:200212. [PMID: 37876911 PMCID: PMC10590819 DOI: 10.1016/j.ijcrp.2023.200212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 10/26/2023]
Abstract
Aims Premature cardiovascular disease (pCVD) definition varies in literature, with age cut-offs ranging from 50-65 years. While there is some literature available on pCVD in North America, comprehensive data on its global burden is still lacking which hinders the development of efficient strategies for early detection and prevention. In this study we aimed to investigate the global trends in pCVD related morbidity and mortality from 1990 to 2019. Methods The 1990-2019 Global Burden of Disease (GBD) database was utilized to examine global trends in cardiovascular disease-related total mortality, mortality rates, and Disability-Adjusted Life Years (DALYs) within individuals aged 15-49 years. The findings were further analyzed based on factors such as age, sex, and Socio-Demographic Index (SDI). Results From 1990 to 2019, the number of global annual pCVD deaths increased by 25%, from 992,067 (95% UI 1,042,261 - 946,383) to 1,241,484 (95% UI 1,339,193 -1,146,252). The rate of associated mortality decreased by 13%. Metabolic conditions were the most significant risk factors for pCVD mortality. Ischemic heart disease and stroke are the leading causes of death across all age groups. pCVD mortality presented progressive widening between high and low SDI regions. Additionally, sex-specific disparities in CVD mortality were significantly greater in the premature age group as compared to all-age groups. Conclusion pCVD is an increasingly significant global cause of morbidity and mortality that disproportionately affects males and individuals living in less privileged regions. Furthermore, ischemic heart disease and stroke were identified as the main drivers of pCVD global burden.
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Affiliation(s)
- Hossam Lababidi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Pedro RVO. Salerno
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sojin Youn Wass
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Neda Shafiabadi Hasani
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Brendan Bourges-Sevenier
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Sadeer Al-Kindi
- Division of Cardiovascular Prevention and Wellness, DeBakey Heart and Vascular Center, Houston Methodist, Houston, TX, USA
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Salerno PRVDO, Motairek I, Dallan LAP, Bourges-Sevenier B, Rajagopalan S, Al-Kindi SG. Excess Systolic Blood Pressure Associated with Fine Particulate Matter Air Pollution above the WHO Guidelines in Brazil. Arq Bras Cardiol 2023; 120:e20230347. [PMID: 38126515 PMCID: PMC10763691 DOI: 10.36660/abc.20230347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/01/2023] [Accepted: 10/04/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
| | - Issam Motairek
- Harrington Heart and Vascular Institute , University Hospitals Cleveland Medical Center , Cleveland , Ohio - EUA
| | - Luis Augusto Palma Dallan
- Harrington Heart and Vascular Institute , University Hospitals Cleveland Medical Center , Cleveland , Ohio - EUA
| | - Brendan Bourges-Sevenier
- Harrington Heart and Vascular Institute , University Hospitals Cleveland Medical Center , Cleveland , Ohio - EUA
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute , University Hospitals Cleveland Medical Center , Cleveland , Ohio - EUA
- Case Western Reserve University School of Medicine , Cleveland , Ohio - EUA
| | - Sadeer G Al-Kindi
- Harrington Heart and Vascular Institute , University Hospitals Cleveland Medical Center , Cleveland , Ohio - EUA
- Case Western Reserve University School of Medicine , Cleveland , Ohio - EUA
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