Gender and prior beta blockers use in patients presenting with acute coronary syndrome in Arab Middle Eastern population

Abstract Background The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.

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The Prevalence and Outcome of Excess Body Weight Among Middle Eastern Patients Presenting With Acute Coronary Syndrome

Angiology ◽

10.1177/0003319709355801 ◽

2009 ◽

Vol 61 (5) ◽

pp. 456-464 ◽

Cited By ~ 8

Author(s):

Hadi A. R. Hadi ◽

Mohammad Zubaid ◽

Wael Al Mahmeed ◽

Ayman A. El-Menyar ◽

Alawi A. Alsheikh-Ali ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Body Weight ◽

Middle Eastern ◽

Excess Body Weight ◽

Coronary Syndrome

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Assessing oxidative stress resulting from environmental exposure to metals (Oids) in a middle Eastern population

Environmental Geochemistry and Health ◽

10.1007/s10653-021-01065-z ◽

2021 ◽

Author(s):

Ata Rafiee ◽

Juana Maria Delgado-Saborit ◽

Noel J. Aquilina ◽

Hoda Amiri ◽

Mohammad Hoseini

Keyword(s):

Oxidative Stress ◽

Environmental Exposure ◽

Middle Eastern ◽

Eastern Population ◽

Middle Eastern Population

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P3641Role of beta-blockers in a contemporaneous treatment era of patients with acute coronary syndrome: a propensity-score matching analysis from a tertiary single-center

European Heart Journal ◽

10.1093/eurheartj/ehx504.p3641 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

A.T. Timoteo ◽

S.A. Rosa ◽

M. Cruz ◽

R.I. Moreira ◽

R. Carvalho ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Propensity Score ◽

Propensity Score Matching ◽

Beta Blockers ◽

Single Center ◽

Propensity Score Matching Analysis ◽

Coronary Syndrome

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Molecular Characterization of Prostate Cancer in Middle Eastern Population Highlights Differences with Western Populations with Prognostic Implication

10.21203/rs.2.17590/v1 ◽

2019 ◽

Author(s):

Ramy A. Abdelsalam ◽

Ibrahim Khalifeh ◽

Alan Box ◽

Maria Kalantarian ◽

Sunita Ghosh ◽

...

Keyword(s):

Prostate Cancer ◽

Middle Eastern ◽

Genomic Alteration ◽

Published Data ◽

Lower Grade ◽

Eastern Population ◽

Western Population ◽

Pten Loss ◽

Middle Eastern Population ◽

Grade Groups

Abstract Background To investigate the incidence and prognostication of ERG, PTEN and SPINK1 protein expressions in prostate cancer cohort of Middle Eastern descent in comparison to published data from Western populationMethods Immunohistochemistry for ERG, PTEN and SPINK1 was performed in cohort of localized PCa (n=340). Data correlated to pathological and clinical outcomes and compared to Western populations.Results ERG expression and PTEN loss noted in 123/288 (42.7%) and 91/297 (30.6%) of patients, respectively. SPINK1 expression assessed in subset of cases, noted in 6/150 (4%) of patients. Only ERG expression was associated with grade groups, being more common in lower grade groups (1-3 vs 4-5; p=0.04). In contrast to Western population, PTEN loss foci were more likely to be ERG negative, observed in 81% of tumor foci and patients with PTEN neg/ERG pos were more likely to exhibit biochemical recurrence (OR 2.831; 95% CI: 1.10-726, p=0.03). This association remained significant in multivariate analysis (OR 2.68; 95% CI: 0.98-7.33, p=0.05), after adjusting for GG, path stage and surgical margin.Conclusion This study documents significant differences in key molecular events in PCa in Middle Eastern population compared to Western populations that could explain differences in PCa incidence, progression and prognostication. ERG, PTEN and SPINK1 genomic alteration occur less frequently and the enrichment of ERG for PTEN loss is not observed. Additionally, patients with combined PTEN loss/ERG positive are at highest rate for BCR vs North American Caucasian population where PTEN loss alone seems to be associated with the worst clinical outcome. The data presented here further support differences in clonal evolution between Middle Eastern and Western population in relation to PCa and add further insight to understanding PCa molecular pathways.

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COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i9.2201 ◽

2021 ◽

Vol 5 (9) ◽

Author(s):

Rishman Tandi ◽

Tanvi Kumar ◽

Amritpal Singh Kahlon ◽

Aaftab Sethi

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Acute Coronary Syndrome ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Beta Blocker ◽

Beta Blockers ◽

Coronary Syndrome ◽

Group A ◽

Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed. Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

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Abstract P331: Secondary Prevention After Acute Coronary Syndrome with Microsize Myocardial Infarctions in the Reasons for Geographic and Racial Differences in Stroke-Myocardial Infarction (REGARDS-MI) Study

Circulation ◽

10.1161/circ.125.suppl_10.ap331 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Niket Nathani ◽

Monika M Safford ◽

Christopher Gamboa ◽

Mallika Mundkur ◽

Shannon Preston ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Secondary Prevention ◽

Racial Differences ◽

Cardiac Troponin ◽

Beta Blockers ◽

Community Dwelling ◽

Prevention Measures ◽

Coronary Syndrome ◽

Similar Range

Background: Studies have shown increased mortality after myocardial infarction (MI) with low level elevations of cardiac troponin (“microsize MI”) and subsequent risk reduction with intensive medical management. However, non-standard reporting and highly sensitive assays of cardiac troponin can make the clinical recognition of microsize MI difficult, creating barriers to the implementation of appropriate secondary prevention. Methods: REGARDS follows 30,239 community-dwelling participants of the 48 continental states age ≥45 years recruited from 2003-7; 41% of the sample was African American and 55% female by design. Following national consensus guidelines, experts adjudicated cases of acute coronary syndrome (ACS), defined as an admission for acute signs or symptoms of ischemia, and MI from hospital records. We studied first cases of ACS, classified as: 1) ACS without MI, 2) ACS+microsize MI (peak troponin <0.5), and 3) ACS+usual MI (peak troponin ≥0.5), to compare whether secondary prevention medications were prescribed at hospital discharge among these 3 groups. We used multivariable logistic regression to examine odds ratios for receipt of medications at discharge associated with microsize MI and no MI relative to usual MI. Results: The 1,238 cases of ACS were mean age 68.0+/-8.7 years, 59% male, and 66% white. Of these, 917 had discharge medications available. Compared to those with ACS+usual MI, individuals with ACS+microsize MI had lower odds of receiving beta-blockers and statins at discharge in a similar range as those without MI ( Table ). Conclusion: Individuals hospitalized for ACS and microsize MI were less likely to receive guideline appropriate secondary prevention measures than those with usual MI.

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