scholarly journals Rates of myocardial infarction and coronary artery disease and risk factors in patients treated with radiation therapy for early-stage breast cancer

Cancer ◽  
2007 ◽  
Vol 109 (4) ◽  
pp. 650-657 ◽  
Author(s):  
Reshma Jagsi ◽  
Kent A. Griffith ◽  
Todd Koelling ◽  
Rachel Roberts ◽  
Lori J. Pierce
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Radiation Therapy ◽  
Coronary Artery ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Artery Disease

Stroke Rates and Risk Factors in Patients Treated With Radiation Therapy for Early-Stage Breast Cancer

2006 ◽  
Vol 24 (18) ◽  
pp. 2779-2785 ◽  
Author(s):  
Reshma Jagsi ◽  
Kent A. Griffith ◽  
Todd Koelling ◽  
Rachel Roberts ◽  
Lori J. Pierce
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Radiation Therapy ◽  
Early Stage ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Absolute Excess Risk ◽  
Artery Disease

Purpose To examine whether stroke risk is elevated in American breast cancer patients treated with modern techniques, as well as whether supraclavicular radiation therapy (RT) is associated with increased risk. Methods Observed rates of stroke in 820 eligible early-stage breast cancer patients treated at the University of Michigan Hospital (Ann Arbor, MI) were compared with expected rates. Relationships between potential risk factors and actuarial rate of first stroke were analyzed. Results Median follow-up was 6.8 years. Twenty patients had at least one cerebrovascular accident (CVA) in follow-up; 35 patients had at least one CVA or transient ischemic attack (CVA/TIA). The standardized incidence ratios were 1.74 (0.94 to 2.37) for CVA and 1.68 (1.003 to 2.06) for CVA/TIA. The absolute excess risk per 1,000 patients per year was 1.67 for CVA and 2.76 for CVA/TIA. On bivariate analysis, factors significantly associated with actuarial rate of first CVA included hypertension (P = .002), age (P < .0001), coronary artery disease (P = .001), atrial fibrillation (P = .009), and supraclavicular RT (P = .021). Factors associated with CVA/TIA were hypertension (P < .001), coronary artery disease (P = .002), and age (P < .0001). Tamoxifen use alone was not significant (P = .19), but tamoxifen combined with baseline hypertension led to increased risk of CVA/TIA (log-rank P < .0001). On multivariate analysis, only age (P < .001) and hypertension (P = .003) remained significant predictors of CVA/TIA. Age was the only significant predictor of CVA alone (P < .001). Conclusion American breast cancer survivors may have an elevated risk of stroke compared with the general population, but the absolute excess risk is low. This study found no significant association between supraclavicular RT and stroke after controlling for other factors.

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

Late Cardiac Mortality and Morbidity in Early-Stage Breast Cancer Patients After Breast-Conservation Treatment

2006 ◽  
Vol 24 (25) ◽  
pp. 4100-4106 ◽  
Author(s):  
Eleanor E.R. Harris ◽  
Candace Correa ◽  
Wei-Ting Hwang ◽  
Jessica Liao ◽  
Harold I. Litt ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Breast Conservation ◽  
Cardiac Mortality ◽  
Mortality And Morbidity ◽  
Conservation Treatment ◽  
Breast Conservation Treatment ◽  
Artery Disease

Purpose Several studies have reported increased cardiac mortality related to the use of left-sided breast or chest-wall irradiation. This study was undertaken as a comprehensive examination of the long-term cardiac mortality and morbidity after breast irradiation using contemporary irradiation techniques. Methods The medical records of 961 consecutive patients presenting between 1977 and 1994 with stage I or II breast cancer treated with breast conservation treatment were reviewed. Data was recorded on baseline pretreatment patient, tumor and treatment characteristics and on subsequent cancer or cardiac related events. The median follow-up time was 12 years. Results There was no difference in overall mortality from any cardiac cause (P = .25). Death from any cardiac cause occurred in 2% of right-sided patients and 3.5% of left-sided patients. However, in the second decade after treatment, there was a higher rate of cardiac deaths in left-sided patients, with a cumulative risk of 6.4% (95% CI, 3.5% to 11.5%) for left-sided compared with 3.6% (95% CI, 1.8% to 7.2%) for right-sided patients at 20 years. There were statistically higher rates of chest pain, coronary artery disease, and myocardial infarction diagnosed in left-sided patients (all P ≤ .002). The presence of hypertension was associated with a higher risk of coronary artery disease in left-sided patients. Conclusion Irradiation to the left breast is not associated with a higher risk of cardiac death up to 20 years after treatment, but is associated with an increased rate of diagnoses of coronary artery disease and myocardial infarction compared with right breast treatment.

scholarly journals Coronary angiographic profile of Nepalese people A study of 450 cases in SGNHC

2004 ◽  
Vol 3 (3) ◽  
pp. 19-21
Author(s):  
S Regmi ◽  
R Malla ◽  
S Rajbhandari ◽  
MB KC ◽  
D Sharma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Health Problem ◽  
Stable Angina ◽  
Major Health Problem ◽  
Major Health ◽  
Artery Disease ◽  
Conventional Risk Factors

Coronary Artery disease (CAD) remains a major health problem. Stable angina, unstable angina and myocardial infarction are the major manifestations of CAD. This study is aimed to assess the coronary artery profile in these groups and its relation to the major conventional risk factors and the distribution of the disease in differant ethnic group of Napalase population.

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