1
|
Pray C, Narula N, Wong EC, Marshall JK, Rangarajan S, Islam S, Bahonar A, Alhabib KF, Kontsevaya A, Ariffin F, Co HU, Al Sharief W, Szuba A, Wielgosz A, Diaz ML, Yusuf R, Kruger L, Soman B, Li Y, Wang C, Yin L, Erkin M, Lanas F, Davletov K, Rosengren A, Lopez-Jaramillo P, Khatib R, Oguz A, Iqbal R, Yeates K, Avezum Á, Reinisch W, Moayyedi P, Yusuf S. A176 ASSOCIATIONS OF ANTIBIOTICS, HORMONAL THERAPIES, ORAL CONTRACEPTIVES, AND LONG-TERM NSAIDS WITH INFLAMMATORY BOWEL DISEASE: RESULTS FROM THE PROSPECTIVE URBAN RURAL EPIDEMIOLOGY (PURE) STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991214 DOI: 10.1093/jcag/gwac036.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background The pathogenesis of inflammatory bowel disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC), is believed to involve activation of the intestinal immune system in response to the gut microbiome among genetically susceptible hosts. IBD has been historically regarded as a disease of developed nations, though in the past two decades there has been a reported shift in the epidemiological pattern of disease. High-income nations with known high prevalence of disease are seeing a stabilization of incident cases, while a rapid rise of incident IBD is being observed in developing nations. This suggests that environmental exposures may play a role in mediating the risk of developing IBD. The potential environmental determinants of IBD across various regions is vast, though medications have been increasingly recognized as one broad category of risk factors. Purpose Several medications have been considered to contribute to the etiology of IBD. This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Method This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including CD and UC. Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion(s) Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding below: Salim Yusuf is supported by the Heart & Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease. The PURE Study is an investigator-initiated study funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research (SPOR) through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries; these include: Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias, grant number 6566-04-18062; India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia, grant numbers 100 -IRDC/BIOTEK 16/6/21 (13/2007) and 07-05-IFN-BPH 010, Ministry of Higher Education of Malaysia grant number 600 -RMI/LRGS/5/3 (2/2011), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; International Development Research Centre, Canada; Philippines: Philippine Council for Health Research & Development; Poland: Polish Ministry of Science and Higher Education grant number 290/W-PURE/2008/0, Wroclaw Medical University; Saudi Arabia: the Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (research group number RG -1436-013); South Africa: the North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC); Sweden: grants from the Swedish state under the Agreement concerning research and education of doctors; the Swedish Heart and Lung Foundation; the Swedish Research Council; the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under the Läkar Utbildnings Avtalet agreement, and grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates (UAE): Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai UAE. Disclosure of Interest C. Pray: None Declared, N. Narula Grant / Research support from: Neeraj Narula holds a McMaster University Department of Medicine Internal Career Award. Neeraj Narula has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring, E. C. Wong: None Declared, J. K. Marshall Grant / Research support from: John K. Marshall has received honoraria from Janssen, AbbVie, Allergan, Bristol-Meyer-Squibb, Ferring, Janssen, Lilly, Lupin, Merck, Pfizer, Pharmascience, Roche, Shire, Takeda and Teva., S. Rangarajan: None Declared, S. Islam: None Declared, A. Bahonar: None Declared, K. F. Alhabib: None Declared, A. Kontsevaya: None Declared, F. Ariffin: None Declared, H. U. Co: None Declared, W. Al Sharief: None Declared, A. Szuba: None Declared, A. Wielgosz: None Declared, M. L. Diaz: None Declared, R. Yusuf: None Declared, L. Kruger: None Declared, B. Soman: None Declared, Y. Li: None Declared, C. Wang: None Declared, L. Yin: None Declared, M. Erkin: None Declared, F. Lanas: None Declared, K. Davletov: None Declared, A. Rosengren: None Declared, P. Lopez-Jaramillo: None Declared, R. Khatib: None Declared, A. Oguz: None Declared, R. Iqbal: None Declared, K. Yeates: None Declared, Á. Avezum: None Declared, W. Reinisch Consultant of: Speaker for Abbott Laboratories, Abbvie, Aesca, Aptalis, Astellas, Centocor, Celltrion, Danone Austria, Elan, Falk Pharma GmbH, Ferring, Immundiagnostik, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka, PDL, Pharmacosmos, PLS Education, Schering-Plough, Shire, Takeda, Therakos, Vifor, Yakult, Consultant for Abbott Laboratories, Abbvie, Aesca, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, Omass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia, and 4SC, Advisory board member for Abbott Laboratories, Abbvie, Aesca, Amgen, AM Pharma, Astellas, Astra Zeneca, Avaxia, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Danone Austria, DSM, Elan, Ferring, Galapagos, Genentech, Grünenthal, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nestle, Novartis, Ocera, Otsuka, PDL, Pharmacosmos, Pfizer, Procter & Gamble, Prometheus, Sandoz, Schering-Plough, Second Genome, Setpointmedical, Takeda, Therakos, Tigenix, UCB, Zealand, Zyngenia, and 4SC, P. Moayyedi: None Declared, S. Yusuf: None Declared
Collapse
Affiliation(s)
- C Pray
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - N Narula
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University,Population Health Research Institute, McMaster University and Hamilton Health Sciences
| | - E C Wong
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - J K Marshall
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - S Rangarajan
- McMaster University and Hamilton Health Sciences, Population Health Research Institute, Hamilton, Canada
| | - S Islam
- McMaster University and Hamilton Health Sciences, Population Health Research Institute, Hamilton, Canada
| | - A Bahonar
- Isfahan Cardiovascular Research Center, Isfahan, Iran, Islamic Republic Of
| | - K F Alhabib
- King Fahad Cardiac Center, King Saud Medical City, Saudi Arabia
| | - A Kontsevaya
- National research center for therapy and preventive medicine, Moscow, Russian Federation
| | - F Ariffin
- Faculty of Medicine UiTM, Selangor, Malaysia
| | - H U Co
- University of the Philippines College of Medicine, Ermita, Philippines
| | - W Al Sharief
- Family Medicine Department, Medical Education & Research Department in Dubai Health Authority (DHA), Oud Metha-Dubai, United Arab Emirates
| | - A Szuba
- Wroclaw Medical University, Wroclaw, Poland
| | - A Wielgosz
- University of Ottawa Heart Institute, Ottawa, Canada
| | - M L Diaz
- Estudios Clínicos Latino América, Rosario, Argentina
| | - R Yusuf
- Independent University, Bangladesh, Bashundhara , Bangladesh
| | - L Kruger
- Africa Unit for Transdisciplinary Health Research , North West University, Potchefstroom, South Africa
| | - B Soman
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Y Li
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - C Wang
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - L Yin
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - M Erkin
- Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | - F Lanas
- Universidad de La Frontera, Temuco, Chile
| | - K Davletov
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - A Rosengren
- Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - P Lopez-Jaramillo
- Masira Research Institute, Universidad de Santander , Bucaramanga, Colombia
| | - R Khatib
- Institute of Community and Public Health, Birzeit University,, Birzeit, Palestinian, State of
| | - A Oguz
- Internal Medicine, Istanbul Medeniyet University,, Istanbul, -
| | - R Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi City, Pakistan
| | - K Yeates
- Department of Medicine, Queen's University, Kingston, Canada
| | - Á Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - W Reinisch
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - P Moayyedi
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University,Population Health Research Institute, McMaster University and Hamilton Health Sciences
| | - S Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences
| |
Collapse
|
2
|
Sepehrvand N, Colin-Ramirez E, Rathwell S, Ross H, Escobedo J, Macdonald P, Troughton R, Saldarriaga C, Lanas F, Doughty R, McAlister F, Ezekowitz J. SODIUM RESTRICTION IN PATIENTS WITH HEART FAILURE:A SYSTEMATIC REVIEW AND META-ANALYSIS OFRANDOMIZED CLINICAL TRIALS. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
3
|
Salinas A, Lanas F, Canuillan C, Saavedra S, Catrileo E, Tiznado C, Quininir L. P6190Association between air pollution and cardiovascular pathologies consultations in emergency services. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Salinas
- University of La Frontera, Temuco, Chile
| | - F Lanas
- University of La Frontera, Temuco, Chile
| | | | - S Saavedra
- University of La Frontera, Temuco, Chile
| | - E Catrileo
- University of La Frontera, Temuco, Chile
| | - C Tiznado
- University of La Frontera, Temuco, Chile
| | - L Quininir
- University of La Frontera, Temuco, Chile
| |
Collapse
|
4
|
Seron P, Irazola V, Rubinstein A, Calandrelli M, Ponzo J, Olivera H, Gutierrez L, Elorriaga N, Poggio R, Lanas F. Ideal Cardiovascular Health in the southern cone of Latin America. Public Health 2018; 156:132-139. [PMID: 29427769 PMCID: PMC5826849 DOI: 10.1016/j.puhe.2017.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The American Heart Association developed the concept of 'Ideal Cardiovascular Health', which is based on the presence of ideal levels across seven health factors. The goal of this study is to assess the prevalence of Ideal Cardiovascular Health in the Southern Cone of Latin America. STUDY DESIGN We conducted a cross-sectional analysis as part of CESCAS I cohort. METHODS This report included 5458 participants aged between 35 and 75 years who were selected using stratified multistage probability sampling in Argentina, Chile and Uruguay. Interviews included demographic information, the International Physical Activity Questionnaire, and a food frequency questionnaire on dietary habits. Participants were classified as current, former or non-smokers. Weight, height and blood pressure were measured by trained personnel, and fasting cholesterol and glucose plasma levels were measured. RESULTS Only 0.1% (95% confidence interval [CI]: 0.0-0.2) met the seven criteria that define the Ideal Cardiovascular Health. The least prevalent healthy behaviour was having a healthy diet: 0.5% (95% CI: 0.3-0.7), while the least prevalent health factor was having blood pressure < 120/80 mmHg: 23.6% (95% CI: 22.1-25.0). CONCLUSIONS The prevalence of Ideal Cardiovascular Health is very low in a representative sample of population from the Southern Cone of Latin America, and the levels of healthy lifestyle behaviours are even lower than ideal biochemical parameters. These results highlight the challenge of developing strategies to improve the levels of Ideal Cardiovascular Health at primary prevention levels.
Collapse
Affiliation(s)
- P Seron
- Universidad de La Frontera, Claro Solar 115, Temuco, Chile.
| | - V Irazola
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - A Rubinstein
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - M Calandrelli
- Sanatorio San Carlos Bariloche, Av. Ezequiel Bustillo Km. 1, Bariloche, Argentina
| | - J Ponzo
- Universidad de La República, Av. 18 de Julio 1968, Montevideo, Uruguay
| | - H Olivera
- Municipalidad de Marcos Paz, Tucumán 47, Marcos Paz, Argentina
| | - L Gutierrez
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - N Elorriaga
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - R Poggio
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - F Lanas
- Universidad de La Frontera, Claro Solar 115, Temuco, Chile
| |
Collapse
|
5
|
Quininir Salvatici L, Stockins B, Lanas F, Potthoff M, Neira V, Miranda R. P4407Waist-hip ratio but not body-mass index correlates with the prevalence and severity of coronary disease determined by Gensini score. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
6
|
Kirchhof P, Radaideh G, Kim Y, Lanas F, Haas S, Amarenco P, Turpie A, Bach M, Lambelet M, Van Eickels M, Camm J. P3592Safety analysis of rivaroxaban: a pooled analysis of the global XANTUS programme (real-world, prospective, observational studies for stroke prevention in patients with atrial fibrillation). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P. Kirchhof
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - G. Radaideh
- Rashid Hospital, Dubai, United Arab Emirates
| | - Y.H. Kim
- Korea University Medical Centre, Seoul, Korea Republic of
| | - F. Lanas
- University of La Frontera, Centro de Excelencia CIGES, Temuco, Chile
| | - S. Haas
- Vascular Centre, Munich, Germany
| | - P. Amarenco
- Paris-Diderot-Sorbonne University, Department of Neurology and Stroke Centre, Paris, France
| | - A.G.G. Turpie
- McMaster University, Department of Medicine, Hamilton, Canada
| | - M. Bach
- Bayer AG, Medical Affairs, Berlin, Germany
| | - M. Lambelet
- Chrestos Concept GmbH & Co KG, Essen, Germany
| | | | - J. Camm
- St George's University of London, Cardiovascular and Cell Sciences Research Institute, London, United Kingdom
| | | |
Collapse
|
7
|
Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, Palileo-Villaneuva L, Lopez-Jaramillo P, Karaye K, Yusoff K, Orlandini A, Sliwa K, Mondo C, Lanas F, Prabhakaran D, Badr A, Elmaghawry M, Damasceno A, Tibazarwa K, Belley-Cote E, Balasubramanian K, Islam S, Yacoub MH, Huffman MD, Harkness K, Grinvalds A, McKelvie R, Bangdiwala SI, Yusuf S, Campos R, Chacón C, Cursack G, Diez F, Escobar C, Garcia C, Vilamajo OG, Hominal M, Ingaramo A, Kucharczuk G, Pelliza M, Rojas A, Villani A, Zapata G, Bourke P, Lanas F, Nahuelpan L, Olivares C, Riquelme R, Ai F, Bai X, Chen X, Chen Y, Gao M, Ge C, He Y, Huang W, Jiang H, Liang T, Liang X, Liao Y, Liu S, Luo Y, Lu L, Qin S, Tan G, Tan H, Wang T, Wang X, Wei F, Xiao F, Zhang B, Zheng T, Mendoza JA, Anaya MB, Gomez E, de Salazar DM, Quiroz F, Rodríguez M, Sotomayor MS, Navas AT, León MB, Montalvo LF, Jaramillo ML, Patiño EP, Perugachi C, Trujillo Cruz F, Elmaghawry M, Wagdy K, Bhardwaj A, Chaturvedi V, Gokhale GK, Gupta R, Honnutagi R, Joshi P, Ladhani S, Negi P, Roy A, Reddy N, Abdullah A, Hassan MA, Balasinga M, Kasim S, Tan W, Yusoff K, Damasceno A, Banze R, Calua E, Novela C, Chemane J, Akintunde A, Ansa V, Gbadamosi H, Karaye K, Mbakwem A, Mohammed S, Nwafor E, Ojji D, Olunuga T, Sa'idu BOH, Umuerri E, Alcaraz J, Palileo-Villanueva L, Palomares E, Timonera MR, Badr A, Alghamdi S, Alhabib K, Almasood A, Alsaif S, Elasfar A, Ghabashi A, Mimish L, Bester F, Kelbe D, Klug E, Sliwa K, Tibarzawa K, Abdalla O, Dimitri M, Mustafa H, Osman O, Saad A, Mondo C. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. The Lancet Global Health 2017; 5:e665-e672. [DOI: 10.1016/s2214-109x(17)30196-1] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/10/2017] [Accepted: 04/26/2017] [Indexed: 12/13/2022]
|
8
|
Rey-Ares L, Irazola V, Althabe F, Sobrino E, Mazzoni A, Serón P, Lanas F, Calandreli M, Rubinstein A. Lower tract respiratory infection in children younger than 5 years of age and adverse pregnancy outcomes related to household air pollution in Bariloche (Argentina) and Temuco (Chile). Indoor Air 2016; 26:964-975. [PMID: 26615053 PMCID: PMC4884553 DOI: 10.1111/ina.12274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
The main objective of this study was to evaluate the association between household air pollution with lower tract respiratory infection (LRTI) in children younger than 5 years old and adverse pregnancy outcomes. This retrospective cohort study took place in two cities in Patagonia. Using systemic random sampling, we selected households in which at least one child <5 years had lived and/or a child had been born alive or stillborn. Trained interviewers administered the questionnaire. We included 926 households with 695 pregnancies and 1074 children. Household cooking was conducted indoors in ventilated rooms and the use of wood as the principal fuel for cooking was lower in Temuco (13% vs. 17%). In exposed to biomass fuel use, the adjusted OR for LRTI was 1.87 (95% CI 0.98-3.55; P = 0.056) in Temuco and 1.12 (95% CI 0.61-2.05; P = 0.716) in Bariloche. For perinatal morbidity, the OR was 3.11 (95% CI 0.86-11.32; P = 0.084) and 1.41 (95% CI 0.50-3.97; P = 0.518), respectively. However, none of the effects were statistically significant (P > 0.05). The use of biomass fuel to cook in traditional cookstoves in ventilated dwellings may increase the risk of perinatal morbidity and LRTI.
Collapse
Affiliation(s)
- L Rey-Ares
- Southern Cone American Center for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| | - V Irazola
- Southern Cone American Center for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| | - F Althabe
- Maternal and Child's Health Department, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| | - E Sobrino
- Southern Cone American Center for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| | - A Mazzoni
- Maternal and Child's Health Department, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| | - P Serón
- CIGES, Universidad de la Frontera, Temuco, Araucanía, Chile
| | - F Lanas
- CIGES, Universidad de la Frontera, Temuco, Araucanía, Chile
| | - M Calandreli
- Cardiología, Sanatorio San Carlos, San Carlos de Bariloche, Rio Negro, Argentina
| | - A Rubinstein
- Southern Cone American Center for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy - IECS, Buenos Aires, Argentina
| |
Collapse
|
9
|
Lamelas P, Mente A, Diaz R, Avezum A, Lanas F, Lopez Jaramillo P, Donell M, Rangarajan S, Teo K, Yusuf S. PT077 Association of Urinary Sodium Excretion With Blood Pressure and Cardiovascular Clinical Events in 17,033 Latin Americans. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
10
|
Avezum A, Lopes RD, Schulte PJ, Lanas F, Hanna M, Pais P, Erol C, Diaz R, Granger CB, Alexander JH. Apixaban versus warfarin in patients with atrial fibrillation and valvular heart disease: findings from the ARISTOTLE study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
11
|
Lopes RD, Garcia DA, Wojdyla D, Dorian P, Alexander JH, Wallentin L, Lanas F, Hanna M, Held C, Granger CB. Use of apixaban and warfarin in patients undergoing invasive procedures: insights from ARISTOTLE. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
12
|
Lopes R, Garcia D, Wojdyla D, Dorian P, Alexander J, Wallentin L, Lanas F, Hanna M, Held C, Granger C. Use of Apixaban and Warfarin in Patients Undergoing Invasive Procedures: Insights From Aristotle. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
13
|
Nazzal C, Lanas F, Garmendia ML. P2-218 Secondary prevention in acute myocardial infarction in Chile. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
O’Donnell M, Xavier D, Diener C, Sacco R, Lisheng L, Zhang H, Pias P, Truelsen T, Chin S, Rangarajan S, DeVilliers L, Damasceno A, Mondo C, Lanas F, Avezum A, Diaz R, Varigos J, Hankey G, Teal P, Kapral M, Ryglewicz D, Czlonkowska A, Skowronska M, Lopez-Jaramillo P, Dans T, Langhorne P, Yusuf S. Rationale and Design of INTERSTROKE: A Global Case-Control Study of Risk Factors for Stroke. Neuroepidemiology 2010; 35:36-44. [DOI: 10.1159/000306058] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 01/08/2010] [Indexed: 11/19/2022] Open
|
15
|
Saavedra N, Riquelme I, Rivas L, Jaramillo P, Caamaño J, Lanas C, Lanas F, Salazar LA. D 014 A148g Variant of Pon2 Gene in Chilean Individuals with Coronary Disease Confirmed by Angiography and Controls. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Cuevas A, Márquez JL, Jaramillo P, Caamaño J, Saavedra N, Lanas F, Lanas C, Salazar LA. D 012 Capn10 Ucsnp-43 Gene Polymorphism in Chilean Individuals with Coronary Artery Disease and Controls. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Saavedra N, Jaramillo P, Caamaño J, Lanas C, Lanas F, Salazar L. Abstract: P885 GENETIC POLYMORPHISMS OF APOA5 ARE ASSOCIATED WITH HYPERTRIGLYCERIDEMIA AND HYPERGLYCEMIA IN CHILEAN SUBJECTS WITH CAD. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Connolly S, Yusuf S, Budaj A, Camm J, Chrolavicius S, Commerford PJ, Flather M, Fox KAA, Hart R, Hohnloser S, Joyner C, Pfeffer M, Anand I, Arthur H, Avezum A, Bethala-Sithya M, Blumenthal M, Ceremuzynski L, De Caterina R, Diaz R, Flaker G, Frangin G, Franzosi MG, Gaudin C, Golitsyn S, Goldhaber S, Granger C, Halon D, Hermosillo A, Hunt D, Jansky P, Karatzas N, Keltai M, Lanas F, Lau CP, Le Heuzey JY, Lewis BS, Morais J, Morillo C, Oto A, Paolasso E, Peters RJ, Pfisterer M, Piegas L, Pipillis T, Proste C, Sitkei E, Swedberg K, Synhorst D, Talajic M, Trégou V, Valentin V, van Mieghem W, Weintraub W, Varigos J. Rationale and design of ACTIVE: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events. Am Heart J 2006; 151:1187-93. [PMID: 16781218 DOI: 10.1016/j.ahj.2005.06.026] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Accepted: 06/15/2005] [Indexed: 01/13/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most frequently occurring cardiac arrhythmia with often serious clinical consequences. Many patients have contraindications to anticoagulation, and it is often underused in clinical practice. The addition of clopidogrel to aspirin (ASA) has been shown to reduce vascular events in a number of high-risk populations. Irbesartan is an angiotensin receptor-blocking agent that reduces blood pressure and has other vascular protective effects. METHODS AND RESULTS ACTIVE W is a noninferiority trial of clopidogrel plus ASA versus oral anticoagulation in patients with AF and at least 1 risk factor for stroke. ACTIVE A is a double-blind, placebo-controlled trial of clopidogrel in patients with AF and with at least 1 risk factor for stroke who receive ASA because they have a contraindication for oral anticoagulation or because they are unwilling to take an oral anticoagulant. ACTIVE I is a partial factorial, double-blind, placebo-controlled trial of irbesartan in patients participating in ACTIVE A or ACTIVE W. The primary outcomes of these studies are composites of vascular events. A total of 14000 patients will be enrolled in these trials. CONCLUSIONS ACTIVE is the largest trial yet conducted in AF. Its results will lead to a new understanding of the role of combined antiplatelet therapy and the role of blood pressure lowering with an angiotensin II receptor blocker in patients with AF.
Collapse
|
19
|
Prieto JC, Corbalán R, Nazza C, Chávez E, Lanas F, Bartolucci J, Cumsille F. [Changes in the patterns of drug prescription for acute myocardial infarct. Comparison of 2 periods]. Rev Med Chil 2001; 129:481-8. [PMID: 11464528] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Pharmacotherapy of Chilean patients with acute myocardial infarction has been recorded in 37 hospitals since 1993. AIM To compare pharmacotherapy for acute myocardial infarction in the period 1993 to 1995 with the period 1997-1998. PATIENTS AND METHODS Drug prescription during hospital stay was recorded in 2957 patients admitted to Chilean hospitals with an acute myocardial infarction in the period 1993-1995 and compared with that of 1981 subjects admitted in the period 1997-1998. RESULTS When compared with the former period, in the lapse 1997-1998 there was an increase in the frequency of prescription of aspirin (93 and 96.1% respectively) beta blockers (37 and 55.2% respectively) and angiotensin converting enzyme inhibitors (32 and 53%). The prescription of thrombolytic therapy did not change (33 and 33.7% respectively). There was a reduction in the prescription of calcium antagonists and antiarrhythmic drugs. CONCLUSIONS During the period 1997-1998, the prescription of drugs with a potential to reduce the mortality of acute myocardial infarction, increased. The diffusion of guidelines for the management of this disease may have influenced this change.
Collapse
Affiliation(s)
- J C Prieto
- Centro Cardiovascular Hospital Clínico Universidad de Chile y Programa de Farmacología Molecular y Clínica, Facultad de Medicina, Universidad de Chile, Independencia 1027 Casilla 70,000 Santiago 7 Chile
| | | | | | | | | | | | | |
Collapse
|
20
|
Figueroa FE, Fernández MS, Valdés P, Wilson C, Lanas F, Carrión F, Berríos X, Valdés F. Prospective comparison of clinical and echocardiographic diagnosis of rheumatic carditis: long term follow up of patients with subclinical disease. Heart 2001; 85:407-10. [PMID: 11250966 PMCID: PMC1729708 DOI: 10.1136/heart.85.4.407] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [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] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the frequency of occurrence and long term evolution of subclinical carditis in patients with acute rheumatic fever. DESIGN Valvar incompetence was detected by clinical examination and Doppler echocardiographic imaging during the acute and quiescent phases of rheumatic fever. Patients were followed prospectively and submitted to repeat examinations at one and five years after the acute attack. Persistence of acute mitral and aortic lesions detected solely by echocardiography (subclinical disease) was compared with that of disease detected by clinical examination as well (thereby fulfilling the latest 1992 Jones criteria for rheumatic carditis). SETTING Three general hospitals with a university affiliation in Chile. PATIENTS 35 consecutive patients fulfilling the revised Jones criteria for rheumatic fever. Clinical and echocardiographic examination was repeated in 32 patients after one year and in 17 after five years. Ten patients had subclinical carditis on admission, six of whom were followed for five years. MAIN OUTCOME MEASURES Auscultatory and echocardiographic evidence of mitral or aortic regurgitation during the acute attack or at follow up. RESULTS Mitral or aortic regurgitation was detected by Doppler echocardiographic imaging in 25/35 rheumatic fever patients as opposed to 5/35 by clinical examination (p = 0.03). Doppler echocardiography revealed acute valvar lesions in 10 of 20 rheumatic fever patients who had no auscultatory evidence of rheumatic carditis (subclinical carditis). Three of these subclinical lesions and three of the clinical or auscultatory lesions detected on admission were still present after five years of follow up, emphasising that subclinical lesions are not necessarily transient. CONCLUSIONS Doppler echocardiographic imaging improves the detection of rheumatic carditis. Subclinical valve lesions, detected only by Doppler imaging, can persist. Echocardiographic findings should be accepted as a major criterion for the diagnosis of rheumatic fever.
Collapse
Affiliation(s)
- F E Figueroa
- Facultad de Medicina, Universidad de los Andes, Avenida San Carlos de Apoquindo 2200, Santiago de Chile, Chile.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Martí A, Peña-Martí G, Muñoz S, Lanas F, Comunian G. Association between prematurity and maternal anemia in Venezuelan pregnant women during third trimester at labor. Arch Latinoam Nutr 2001; 51:44-8. [PMID: 11515232] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
To determine the association and its magnitude between prematurity and anemia in women in their third trimester of pregnancy and at labor. An incident case-control study was conducted using 2 controls per case. Data was obtained in a tertiary hospital in Valencia, Venezuela. A total of 543 women who delivered between May and December 1996 entered into the study. Women having a preterm delivery, less than 37 weeks of gestation at delivery, were defined as cases (n = 181). Anemia was defined according to WHO as Hb less than 11 g/dL. Logistic regression was used to analyze the data and likelihood ratio test was done for model comparison. Maternal anemia was found to be significantly associated with prematurity (Odds Ratio: 1.70; 95% CI = 1.18 to 2.57 P = .001), after adjusting for Placental Abruption, PROM, Previous Premature Labor, Prenatal Care Visits, and Uterine Bleeding during more than one trimester. Maternal anemia at the end of the third trimester of pregnancy, at labor, was associated with an increased risk of prematurity.
Collapse
Affiliation(s)
- A Martí
- Clinical Epidemiology Unit, Universidad de Carabobo and Ciudad Hospitalaria Dr. Enrique Tejera, Venezuela
| | | | | | | | | |
Collapse
|
22
|
Prieto JC, Corbalán R, Chávez E, Lanas F, Cumsille F, Nazzal C. [Acute myocardial infarction in Chilean hospitals. Final results of the GEMI study]. Rev Med Chil 1999; 127:763-74. [PMID: 10668283] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Acute myocardial infarction is the leading cause of death in Chile. AIM To report the main features, hospital evolution, complications and pharmacological treatment of patients admitted to Chilean hospitals with the diagnosis of acute myocardial infarction. PATIENTS AND METHODS Between 1993 and 1995, the GEMI group registered 2,957 patients admitted to 37 hospitals with the diagnosis of acute myocardial infarction. RESULTS Mean age of patients was 62 +/- 2 years old and 74% were male. Forty six percent had a history of hypertension and 40% were smokers. During the first five days of admission, 93% of patients received aspirin, 95% received intravenous nitrates, 59% intravenous heparin, 56% oral nitrates, 37% beta blockers, 32% angiotensin-converting enzyme inhibitors, 33% thrombolytic agents, 29% antiarrhythmics and 23% calcium antagonists. Coronary angiograms were performed in 28% of patients, angioplasty in 9% and 8% were subjected to a coronary bypass. Global hospital mortality was 13.4% (19.5% in women and 11.1% in men, p < 0.001). CONCLUSIONS This work gives a picture of myocardial infarction in Chilean hospitals. Pharmacological treatment is similar to that used abroad, but certainly it can be optimized.
Collapse
Affiliation(s)
- J C Prieto
- Centro Cardiovascular, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | | | | | | | | |
Collapse
|
23
|
Abstract
We examined the variation in stated practice in the management of acute myocardial infarction (AMI) among doctors in Australia, Brazil, Chile, India and Thailand. Hospitals were identified as primary, secondary or tertiary by investigators from around their own region. All doctors within each hospital who would be expected to treat patients with AMI were asked to indicate which investigations and treatments they would offer to a patient with an AMI who develops angina on Day 3 after admission. The numbers of hospitals ranged from 5 to 26 per country, and doctor response rates varied from 70 to 100%. Within-country variation was large, and statistically significant variations were seen between countries in the use of most interventions. The large variation both between and within a range of countries across the economic spectrum suggests a widespread need for agreement about what constitutes appropriate management after AMI.
Collapse
Affiliation(s)
- R F Heller
- Centre for Clinical Epidemiology and Biostatistics, The University of Newcastle, Faculty of Medicine and Health Sciences, NSW, Australia.
| | | | | | | | | | | | | |
Collapse
|
24
|
Stockins B, Larenas G, Charles M, Standen D, Espinoza O, Illesca M, Opazo JA, Carrasco B, Lanas F, Davis M. [Serum lipids and blood pressure levels in the +Mapuche population living in the Chilean region of Araucanía]. Rev Med Chil 1998; 126:1291-9. [PMID: 10349171] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Chilean aboriginal populations (Mapuche) predominantly live in the region of Araucanía, in the southern part of the country. Their cardiovascular risk factors have not been systematically assessed. AIM To study the prevalence of cardiovascular risk factors in the Mapuche population. SUBJECTS AND METHODS Blood pressure, weight, height, dietary habits, fasting serum total cholesterol, HDL cholesterol and triglycerides were measured in 1.948 adults living in 28 Mapuche communities. RESULTS Thirteen percent of males and 16% of females had high blood pressure. Body mass index was 25.5 kg/m2 in males and 28.1 kg/m2 in females. Forty five percent of women and 24% of men were classified as obese. Mean serum total cholesterol was 186.7 +/- 9.6 mg/dl, HDL cholesterol was 58.7 +/- 30.7 mg/dl, total cholesterol/HDL cholesterol was 3.4 +/- 2 and triglycerides were 155.2 +/- 91.2 mg/dl. Twenty eight percent of males and 9.6% of females smoked. CONCLUSIONS Mapuche individuals have higher levels of HDL cholesterol a better total cholesterol/HDL cholesterol ratio and lower frequency of smoking than non aboriginal Chileans subjects.
Collapse
Affiliation(s)
- B Stockins
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Lanas F, Garcés E, Eggers G, Montecinos A, Díaz M, Gamboa C, Stockins B. [Comparison of the effects of digoxin or enalapril in the treatment of heart failure due to mitral insufficiency]. Rev Med Chil 1998; 126:251-7. [PMID: 9674293] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is not much evidence about the usefulness of digoxin or enalapril in the treatment of heart failure due to mitral insufficiency. AIM To compare digoxin and enalapril in the treatment of heart failure due to mitral insufficiency. PATIENTS AND METHODS Patients with mitral insufficiency, in sinus rhythm, with a heart failure grade II or III and with echocardiographic left ventricular dilatation were eligible for the study. They received sequentially, during 12 weeks each, digoxin 0.25 mg/day or enalapril in doses up to 20 mg/day, with a washout in-between period of 2 weeks. The order of the sequence was determined randomly. At the start and end of treatment, functional class according to NYHA and maximal exercise tolerance in the treadmill were assessed and a color Doppler echocardiogram was done to measure ventricular dimensions, function and degree of mitral insufficiency. RESULTS Nine patients on enalapril and 12 on digoxin improved their functional capacity. Digoxin improved exercise time in 76 +/- 168 sec (p = 0.022), whereas this change was not significant with enalapril (38 +/- 158 sec; p = 0.2). With enalapril treatment, ventricular diastolic dimension decreased from 59.3 +/- 8.1 to 58 +/- 9.3 mm and the area of mitral insufficiency decreased from 8.1 +/- 3.5 to 6.6 +/- 3.1 cm2. Digoxin did not induce any significant echocardiographic change. CONCLUSIONS In these patients, digoxin and enalapril improved functional class. Digoxin improved exercise time and enalapril reduced ventricular dimensions and mitral insufficiency.
Collapse
Affiliation(s)
- F Lanas
- Unidades de Cardiología, Universidad de La Frontera, Temuco, Chile
| | | | | | | | | | | | | |
Collapse
|
26
|
Lanas F, Salvatici R, Castillo G, Montecinos A, Stockins B, Molina E. [Comparison between digoxin and atenolol in chronic atrial fibrillation]. Rev Med Chil 1995; 123:1252-62. [PMID: 8733316] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The benefits of digoxin in patients with atrial fibrillation may be reduced due to its limited effect on atrioventricular conduction. The aim of this work was to compare digoxin and atenolol on functional class, resting and exercise heart rate and exercise capacity in patients with atrial fibrillation. Thirteen subjects with this condition, normal echocardiographic left ventricular function and size, a resting heart rate less than 80 beats/min and with no contraindication for beta blocker or digoxin use were studied. Patients were randomly assigned to receive initially digoxin 0.25 mg o.d. or atenolol 100 mg o.d. in a double blind fashion. The doses were adjusted to obtain a heart rate between 60 and 80 beats/min at the end of the first week of treatment. After two weeks of treatment, outcomes were assessed, patients were left without treatment for one week and crossed over to the other drug after that. Resting heart rates achieved with digoxin and atenolol were similar (67 +/- 11 and 65 +/- 23 beats/min respectively). However, maximal exercise heart rates and maximal exercise time were higher during digoxin treatment (166 +/- 23 vs 135 +/- 27 beats/min and 9.95 +/- 1.68 vs 8.5 +/- 2 min respectively). NYHA functional class deteriorated in three patients receiving atenolol. We conclude that atenolol achieves a better control of heart rate during exercise but also reduces maximal exercise capacity.
Collapse
Affiliation(s)
- F Lanas
- Unidad de Cardiología y Epidemiología Clínica, Universidad de La Frontera, Temuco, Chile
| | | | | | | | | | | |
Collapse
|
27
|
Lanas F, Standen D, Steinmann WC, Montecinos A, Stockins B. [Digoxin is effective in th treatment of patients with heart failure and sinus rhythm]. Rev Med Chil 1994; 122:1147-52. [PMID: 7659880] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Due to differences in treatment effect in studies on the effectiveness of digoxin in patients with congestive heart failure in sinus rhythm, a cross-over placebo-controlled, randomized double blind clinical trial was performed. Thirty one patients, without previous treatment with digoxin, in New York Heart Association (NYHA) functional class II to IV, with a dilated left ventricle and/or ventricular systolic dysfunction were included. Patients received digoxin, adjusted for blood levels, or placebo, during an 8 week period, prior to crossing over to the other treatment for another 8 weeks. The order of treatments was randomly allocated. Outcome measurement were performed at the end of each 8 week period. Digoxin, compared with placebo, improved NYHA class, 6.9% vs 41.4% (p = 0.013) and increased the treadmill exercise time, 406 +/- 204 s vs 484 +/- 185 s (p = 0.003). During the digoxin treatment the left ventricular and systolic diameter was reduced from 52.9 +/- 8.9 to 50.1 +/- 9.7 mm (p = 0.016) and the shortening fraction increased from 21.4 +/- 8.3 to 24.8 +/- 8.1% (p = 0.009). No significant difference was observed in the left ventricular end diastolic diameter (LVED) of the left ventricle and in a estimation of quality of life. In conclusion, digoxin treatment produced a significant improvement in functional capacity, exercise time, and left ventricular performance.
Collapse
Affiliation(s)
- F Lanas
- Unidad de Cardiología, Factultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | | | | | | | | |
Collapse
|
28
|
Lanas F, Davis MR, Standen D, Illesca M, Doghetti J, Stockins B. [Prevalence of cardiovascular risk factors in Temuco City]. Rev Med Chil 1991; 119:247-51. [PMID: 1842115] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A random sample of 200 males from 25 to 64 years of age was surveyed for cardiovascular risk factors in Temuco, a city in Southern Chile. Blood pressure was 130 +/- 18/85 +/- 10 mmHg and total cholesterol was 193 +/- 50 mg/dl. 33% were smokers (mean of 8.2 cigarettes per day) and 34% were ex smokers. Prevalence of hypertension was 6.5% from 35 to 44 years of age, 15% from 45 to 54 and 31.9% from 55 to 64 (mean 15%). Cholesterol levels above 240 mg/dl were found in 11.8, 18.3 and 19.1%, respectively (mean 15.5%). Half of the hypertensive subjects were not aware of their high blood pressure and only 16.6% received therapy.
Collapse
Affiliation(s)
- F Lanas
- Departamento de Medicina Interna y Epidemiologíca Clínica, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile
| | | | | | | | | | | |
Collapse
|
29
|
Lanas F, Eggers G, Stockins B, Iturriaga J. [Prognosis after myocardial infarction]. Rev Med Chil 1990; 118:759-63. [PMID: 2131524] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A group of 102 patients (66 males, age 62 +/- 11 years) surviving an acute myocardial infarction was followed for 6 to 48 months. Survival was analyzed by the method of Kaplan Meier and Cox analysis was used to identify prognostic factors. Thirteen patients died during follow up: 3 had sudden death, 3 a stroke, 3 died from heart failure, 3 had reinfarction and cardiogenic shock and 1 died from cholangitis. Most deaths occurred in the first few months of follow up. Survival was 92% at 6 months, 90% at 1 year, 88% at 2 years and 86% at 3 years after infarction. Single variable analysis disclosed a 2 to 3 fold late mortality risk associated to the presence of age over 60 years, old myocardial infarction, hypertension, diabetes mellitus and ventricular tachycardia or fibrillation during the acute phase. Greater than 3 fold risk was seen for patients developing heart failure or shock during myocardial infarction. Heart failure was the only statistically significant risk factor identified by multivariate analysis.
Collapse
Affiliation(s)
- F Lanas
- Departamentos de Cardiología, Universidad de La Frontera, Temuco, Chile
| | | | | | | |
Collapse
|
30
|
Riedemann P, Lanas F, Montecinos A, Inostroza J, Rodríguez J, Sandoval K. [Ventricular rate in cardiac insufficiency with atrial fibrillation, an adequate index of digitalization?]. Rev Med Chil 1988; 116:651-4. [PMID: 3256908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
31
|
Stockins B, Opazo J, Gamboa C, Salvatici R, Lanas F, Saavedra J, Curimil N, Karstegl P. [Hemodynamic effects of nifedipine in acute myocardial infarction]. Rev Med Chil 1985; 113:193-6. [PMID: 3835623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
32
|
Lanas F, Stockins B, Gamboa C, Salvatici R, Opaso JA, Saavedra J. [Echocardiography in bacterial endocarditis]. Rev Med Chil 1985; 113:203-6. [PMID: 3835625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
33
|
Lanas F, Stokins B, Saavedra J, Opazo JA, Salvatici R, Schulthess L. [Hydralazine in patients with severe aortic insufficiency. Effect on ventricular pressure and volume]. Rev Med Chil 1982; 110:15-20. [PMID: 7156546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
34
|
Lanas F, Oliva ME, Pantoja M, Salvatici R, Opazo JA, Stockin B, Saavedra J. [Program for the prevention of recurrence in rheumatic diseases (Region IX, Chile)]. Rev Med Chil 1981; 109:763-8. [PMID: 7342254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
35
|
Stockins B, Saavedra J, Opazo JA, Salvatici R, Lanas F. [Contrast echocardiography in the diagnosis of atrial septal defect (author's transl)]. Rev Med Chil 1980; 108:612-5. [PMID: 7209181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
36
|
Lanas F, Salvatici R, Opazo JA, Stockins B, Saavedra J, Schulthess L. [Hemodynamic effects of hydralazine at rest and during exercise, in patients with congestive heart failure (author's transl)]. Rev Med Chil 1980; 108:599-604. [PMID: 7209179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
37
|
Lanas F, Salvatici R, Opazo JA, Saavedra J, Iturriaga J. [Treatment of advanced heart failure with hydralazine and isosorbide dinitrate (author's transl)]. Rev Med Chil 1979; 107:926-30. [PMID: 550229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
38
|
Miranda V, Saavedra J, Opazo JA, Stockins B, Contreras M, Lanas F. [Clinical and hemodynamic evaluation of isosorbide dinitrate therapy in heart failure (author's transl)]. Rev Med Chil 1979; 107:721-3. [PMID: 545565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
39
|
Lanas F, Reginato A, Martínez V, Naquira N, Duran G, Bianchi C, Galdames M, García A. [Pathology of excised cardiac valves: correlation with clinical findings (author's transl)]. Rev Med Chil 1979; 107:406-12. [PMID: 515585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
40
|
Baeza H, Chamorro G, Lanas F, Escobar E. [Measurement of cardiac output by thermodilution. Correlation with the direct Fick method (author's transl)]. Rev Med Chil 1978; 106:784-7. [PMID: 741122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
41
|
Lanas F, Reginato A. [Marfan's syndrome (author's transl)]. Rev Med Chil 1978; 106:428-34. [PMID: 715315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
42
|
Reginato A, Lanas F, Blümel E. [Cardiovascular involvement in rheumatic diseases (author's transl)]. Rev Med Chil 1978; 106:379-86. [PMID: 308250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
43
|
Concha E, Zavala C, Veit O, Lanas F. [Postural hypotension in diabetic patients (author's transl)]. Rev Med Chil 1977; 105:168-70. [PMID: 887859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|