The relationship between history of thyroid diseases and risk of in-hospital cardiovascular outcomes in patients with atrial fibrillation: Findings From the CCC-AF (Improving Care for Cardiovascular Disease in China-Atrial Fibrillation) Project

Background: The genetic variant rs9923231 (VKORC1) is associated with differences in the coagulation of blood and consequentially with sensitivity to the drug warfarin. Variation in VKORC1 has been linked in a gene-based test to dementia/Alzheimer’s disease in the parents of participants, with suggestive evidence for an association for rs9923231 (p = 1.8×10–7), which was included in the genome-wide significant KAT8 locus. Objective: Our study aimed to investigate whether the relationship between rs9923231 and dementia persists only for certain dementia sub-types, and if those taking warfarin are at greater risk. Methods: We used logistic regression and data from 238,195 participants from UK Biobank to examine the relationship between VKORC1, risk of dementia, and the interplay with warfarin use. Results: Parental history of dementia, APOE variant, atrial fibrillation, diabetes, hypertension, and hypercholesterolemia all had strong associations with vascular dementia (p < 4.6×10–6). The T-allele in rs9923231 was linked to a lower warfarin dose (βperT - allele = –0.29, p < 2×10–16) and risk of vascular dementia (OR = 1.17, p = 0.010), but not other dementia sub-types. However, the risk of vascular dementia was not affected by warfarin use in carriers of the T-allele. Conclusion: Our study reports for the first time an association between rs9923231 and vascular dementia, but further research is warranted to explore potential mechanisms and specify the relationship between rs9923231 and features of vascular dementia.

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Hypertension Burden and the Risk of New-Onset Atrial Fibrillation

Hypertension ◽

10.1161/hypertensionaha.120.16659 ◽

2021 ◽

Vol 77 (3) ◽

pp. 919-928

Author(s):

So-Ryoung Lee ◽

Chan Soon Park ◽

Eue-Keun Choi ◽

Hyo-Jeong Ahn ◽

Kyung-Do Han ◽

...

Keyword(s):

Atrial Fibrillation ◽

Total Study Population ◽

Increased Risk ◽

Burden Scale ◽

History Of ◽

Study Population ◽

Korean National Health Insurance ◽

Stage 1 ◽

The Relationship

The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.

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Perception of Cardiovascular Risk and Use of Technologies in Health in Adults with Obesity

Enfermería Global ◽

10.6018/eglobal.18.3.336891 ◽

2019 ◽

Vol 18 (3) ◽

pp. 246-269

Author(s):

Carlos Milton Guevara-Valtier ◽

Ana Victoria Ramírez-Rodríguez ◽

Velia Margarita Cárdenas-Villarreal ◽

Tirso Duran-Badillo ◽

Juana Mercedes Gutiérrez-Valverde ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Perception ◽

Information And Communication Technologies ◽

Perception Of Risk ◽

Health History ◽

Level Of Use ◽

Information And Communication ◽

History Of ◽

Relationship Of ◽

The Relationship

En este articulo se determinó la relación entre la Percepción del riesgo de enfermedad cardiovascular con el Nivel de uso de Tecnologías de la Información y Comunicación (TIC´s), así como el efecto explicativo del nivel de uso de las TIC´s y antecedentes para enfermedad cardiovascular en la Percepción del riesgo de enfermedad cardiovascular en adultos con obesidad. Este estudio es pertinente dado que la relación entre las variables propuestas, así como la relación de las TIC´s y otras variables sobre la percepción de riesgo de enfermedad cardiaca y cerebral aún no es del todo clara. Se realizó un estudio descriptivo-analítico realizado en una muestra de 260 adultos con obesidad. Se usaron los cuestionarios Percepción del Riesgo de enfermedad cardiovascular y Uso de TICS en pacientes atendidos en un centro de salud, se respetaron las normas éticas y se utilizó estadística descriptiva e inferencial. Se encontró relación entre la Percepción del riesgo de enfermedad cardiovascular y el uso de las TIC´s (rs =0,142, p=0,022). El Nivel de uso de TICS y antecedentes personales/familiares para el desarrollo de enfermedad cardiovascular fue un 14,3% en la percepción del riesgo de enfermedad cardiovascular. Se concluyó que la percepción del riesgo de enfermedad cardiovascular se relaciona con el Nivel de uso de Tecnologías de la información y comunicación en salud y es explicada en parte por el Nivel de uso de tecnologías de la información y comunicación y antecedentes de salud. Objective: This paper determined the relationship between the perception of risk of a cardiovascular disease with the level of use of Information and Communication Technology or ICT, as well as the explanatory effect of these ICTs and the history of cardiovascular disease in the perception of risk of cardiovascular disease in adults with obesity.Methods: This study is relevant since the relationship between the proposed variables, and the relationship of the ICTs and other variables about the risk perception of heart and brain disease is not very clear yet. An analytical-descriptive research was made on a sample of 260 obese adults. Questionnaires of risk perception of a cardiovascular disease and use of ICT in patients who receive care in a health center were used; ethical standards were observed and descriptive statistics and statistical inference were applied.Results: A relationship between risk perception of a cardiovascular disease and the use of ICTs was found (rs=0,142, p=0,022). The level of use of ICTs and personal/family history of disease for the development of a cardiovascular disease explain a 14,3% in the perception of risk of the disease.Conclusions: It was concluded that the perception of risk of cardiovascular disease was related to the level of use of Information and Communication Technologies regarding health, and it is partially explained by the level of use of the ICTs and health history.

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1203Typical atrial flutter is a manifestation of previously silent coronary artery disease

European Heart Journal ◽

10.1093/eurheartj/ehz748.0033 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L Iden ◽

S Groschke ◽

R Weinert ◽

R Toelg ◽

G Richardt ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiovascular Disease ◽

Family History ◽

Atrial Flutter ◽

Smoking Status ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Typical Atrial Flutter ◽

Silent Coronary Artery Disease ◽

History Of

Abstract Background Long-term mortality after ablation of typical atrial flutter has been found to be increased two fold in comparison to atrial fibrillation ablations through a period of five years with unclear mechanism. Methods We analysed 189 consecutive patients who underwent ablation for typical atrial flutter (AFL), in which the incidence of atrial flutter was the first manifestation of cardiac disease. According to clinical standards of our center, the routine recommendation was to evaluate for CAD by invasive angiogram or CT-scan. We compared the AFL patients to 141 patients with paroxysmal atrial fibrillation (AFIB) without known structural heart disease who underwent ablation in the same period and who had routine coronary angiograms performed. Results Out of 189 patients who presented with AFL, coronary status was available in 152 patients (80.4%). Both groups were balanced for mean age (64.9 years in AFL vs. 63.2 years in AFIB; p=0.15), body-mass-index (BMI; 28.8 vs. 28.5 kg/m2; p=0.15), CHA2DS2-VASc-Score (2.20 vs. 2.04; p=0.35), smoking status (22.2% smokers vs. 28.4%; p=0.23) and renal function (GFR >60 ml/min in 96.7% of all patients vs. 95.7%; p=0.76). There were significantly lower values for left-ventricular ejection fraction (52.5% vs. 59.7%; p<0.001), female sex (17.0% vs. 47.5%; p<0.001), hyperlipidemia (37.9% vs. 58.9%; p<0.001) and family history of cardiovascular disease (15.0 vs. 31.9%; p=0.001) in the AFL vs. AFIB cohorts. CAD with stenoses >50% was found in 26.3% of all patients with available coronary status in AFL and in 7.0% in AFIB (p<0.001). CAD with stenoses >75% in 16.4% in AFL whereas only in 1.4% in AFIB (p<0.001). Multivessel disease was detected in 10.5% in AFL and 0.7% in AFIB (p<0.001). After correction for age, LVEF, BMI, CHA2DS2-VASc-Score and it's individual components, smoking status, hyperlipidemia and family history of cardiovascular disease, there was a more than five-fold increase in the likelihood of CAD with stenosis >50% in AFL as compared to AFIB (OR 5.26). A multivariate analysis was performed in the AFL group. Patients with clinically relevant stenoses (>75%) were older (70.6 years vs. 63.8 years; p=0.001), had a higher number of risk factors (3.08 vs. 2.24; p≤0.0016) and a higher CHA2DS2-VASc-Score (3.20 vs 2.00; p<0.0001). With logistic regression, significant CAD could be predicted by higher values for CHA2DS2-VASc-Score with an exponential rise to a pretest-probability of 42.1% at a value of 4 points. Odds ratios of CAD with AFL vs AFIB Discussion This data suggests that typical atrial flutter constitutes a manifestation for previously asymptomatic CAD. Due to the inclusion criteria, CAD has to be considered silent and stable in most of the patients. Therefore, the presence of typical atrial flutter in formerly healthy patients should raise suspicion of otherwise silent CAD and initiate further investigations and risk-stratification with particular emphasis on the individual CHA2DS2-VASc-Scores.

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History of Cardiovascular Disease, Intensive Lifestyle Intervention, and Cardiovascular Outcomes in the Look AHEAD Trial

Obesity ◽

10.1002/oby.22676 ◽

2020 ◽

Vol 28 (2) ◽

pp. 247-258

Author(s):

◽

Cora E. Lewis ◽

John P. Bantle ◽

Alain G. Bertoni ◽

George Blackburn ◽

...

Keyword(s):

Cardiovascular Disease ◽

Lifestyle Intervention ◽

Cardiovascular Outcomes ◽

Intensive Lifestyle Intervention ◽

Look Ahead ◽

History Of ◽

The Look

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O050 Prior history of falls and risk of cardiovascular outcomes in atrial fibrillation:The Loire Valley Atrial Fibrillation Project

Global Heart ◽

10.1016/j.gheart.2014.03.1264 ◽

2014 ◽

Vol 9 (1) ◽

pp. e12-e13

Author(s):

Amitava Banerjee ◽

Laurent Fauchier ◽

Gregory Y. Lip

Keyword(s):

Atrial Fibrillation ◽

Cardiovascular Outcomes ◽

Prior History ◽

History Of ◽

Loire Valley

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Abstract MP63: Established Cardiovascular Disease Risk Factors Mediate The Relationship Between Hypertensive Disorders In First Pregnancy And Maternal Cardiovascular Disease

Circulation ◽

10.1161/circ.141.suppl_1.mp63 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Jennifer J Stuart ◽

Lauren J Tanz ◽

Eric B Rimm ◽

Donna Spiegelman ◽

Stacey A Missmer ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Chronic Hypertension ◽

Cvd Risk Factors ◽

First Birth ◽

Cvd Risk ◽

Hypertensive Disorders ◽

Increased Risk ◽

History Of ◽

The Relationship

Introduction: Women with a history of hypertensive disorders in pregnancy (HDP; gestational hypertension [GHTN] or preeclampsia) have an increased risk of CVD risk factors and events compared to women with normotensive pregnancies. However, the extent to which the relationship between HDP and CVD events is mediated by established CVD risk factors is less clear. Hypothesis: We hypothesized that a large proportion of the HDP-CVD relationship would be mediated by subsequent CVD risk factors — chronic hypertension (CHTN), type 2 diabetes (T2D), hypercholesterolemia, and BMI. Methods: Parous women free of prior CVD events, CHTN, T2D, and hypercholesterolemia at first birth in the Nurses’ Health Study II comprised the analytic sample (n=57,974). Pregnancy history was retrospectively reported in 2009. Women were followed for confirmed CVD events (coronary heart disease [non-fatal or fatal MI, fatal CHD] or stroke [non-fatal or fatal]) from first birth through 2015. Potential mediators were self-reported on biennial questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the relationship between HDP in first pregnancy (preeclampsia or GHTN vs. normotension [ref]) and CVD, adjusting for age, race/ethnicity, parental education, family history of CVD before age 60, and pre-pregnancy risk factors (e.g., smoking, diet, and BMI). To evaluate the proportion of the HDP-CVD association that was jointly mediated by the CVD risk factors we used the difference method, comparing a model including these four factors to a model without them. Results: Nine percent of women (n=5,306) had a history of HDP in first pregnancy (preeclampsia: 6.3%; GHTN: 2.9%). CVD events occurred in 650 women with normotension in first pregnancy, 30 with GHTN, and 81 with preeclampsia. Adjusting for pre-pregnancy confounders, women with HDP in first pregnancy had a 63% higher rate of incident CVD (CI: 1.33-2.00) compared to women with normotension in first pregnancy; in particular, the strongest association was observed between preeclampsia and CHD (HR=2.18, CI: 1.62-2.93). The overall HDP-CVD association was largely mediated by the group of four CVD risk factors (HDP: proportion mediation [PM]=65%, CI: 35-87; preeclampsia: PM=57%, CI: 21-87; GHTN: PM=99%, CI: inestimable). All CVD risk factors contributed to mediation, but chronic hypertension accounted for the largest proportion. Conclusions: While approximately 40% of the association between preeclampsia and CVD remained unexplained, almost all the increased risk of CVD conferred by a history of GHTN was jointly accounted for by the development of established risk factors postpartum. Screening for CHTN, T2D, hypercholesterolemia, and overweight/obesity after pregnancy may be especially helpful in CVD prevention among women with a history of HDP.

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Infarction or Pseudo-infarction?

Journal of Insurance Medicine ◽

10.17849/insm-47-01-50-54.1 ◽

2017 ◽

Vol 47 (1) ◽

pp. 50-54

Author(s):

Ross MacKenzie

Keyword(s):

Myocardial Infarction ◽

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Alternative Explanation ◽

Inferior Wall ◽

T Wave ◽

History Of ◽

The Relationship ◽

Q Wave

An applicant with a history of paroxysmal atrial fibrillation is found to have QS waves in leads III and AVF suggestive of a prior inferior wall myocardial infarction. Using the relationship between Q wave and T wave vectors in the inferior leads, an alternative explanation is explored.

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Assessing the relationship between chronic pain and cardiovascular disease: A systematic review and meta-analysis

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2016.06.005 ◽

2016 ◽

Vol 13 (1) ◽

pp. 76-90 ◽

Cited By ~ 20

Author(s):

Alan Fayaz ◽

Salma Ayis ◽

Sukhmeet S. Panesar ◽

Richard M. Langford ◽

Liam J. Donaldson

Keyword(s):

Cardiovascular Disease ◽

Chronic Pain ◽

Confidence Intervals ◽

Dose Response ◽

Odds Ratio ◽

Meta Analysis ◽

Cardiovascular Outcomes ◽

Pool Data ◽

Confounding Variables ◽

The Relationship

AbstractBackground and AimsChronic pain is a potentially disabling condition affecting one in three people through impaired physical function and quality of life. While the psychosocial impact of chronic pain is already well established, little is known about the potential biological consequences. Chronic pain may be associated with an increased prevalence of cardiovascular disease, an effect that has been demonstrated across a spectrum of chronic pain conditions including low back pain, pelvic pain, neuropathic pain and fibromyalgia. The aim of this study was to review and summarize the evidence for a link between chronic pain and cardiovascular disease. We sought to clarify the nature of the relationship by examining the basis for a dose-response gradient (whereby increasing pain severity would result in greater cardiovascular disease), and by evaluating the extent to which potentially confounding variables may contribute to this association.MethodsMajor electronic databases MEDLINE, EMBASE, Psychinfo, Cochrane, ProQuest and Web of Science were searched for articles reporting strengths of association between chronic pain (pain in one or more body regions, present for three months or longer) and cardiovascular outcomes (cardiovascular mortality, cardiac disease, and cerebrovascular disease). Meta-analysis was used to pool data analysing the association between chronic pain and the three principal cardiovascular outcomes. The impact of pain severity, and the role of potentially confounding variables were explored narratively.ResultsThe searches generated 11,141 studies, of which 25 matched our inclusion criteria and were included in the review. Meta-analysis (of unadjusted study outcomes) demonstrated statistically significant associations between chronic pain and mortality from cardiovascular diseases: pooled odds ratio 1.20, (95% confidence intervals 1.05–1.36); chronic pain and cardiac disease: pooled odds ratio 1.73 (95% confidence intervals 1.42–2.04); and chronic pain and cerebrovascular disease: pooled odds ratio 1.81 (95% confidence intervals 1.51–2.10). The systematic review also found evidence supporting a dose-response relationship, with greater pain intensity and distribution producing a stronger association with cardiovascular outcomes.All of the included studies were based on observational data with considerable variation in chronic pain taxonomy, methodology and study populations. The studies took an inconsistent and incomplete approach in their adjustment for potentially confounding variables, making it impossible to pool data after adjustments for confounding variables, so it cannot be concluded that these associations are causal.ConclusionsOur review supports a possible dose-response type of association between chronic pain and cardiovascular disease, supported by a range of observational studies originating from different countries. Such research has so far failed to satisfactorily rule out that the association is due to confounding variables. What is now needed are further population based longitudinal studies that are designed to allow more robust exploration of a cause and effect relationship.ImplicationsGiven the high prevalence of chronic pain in developed and developing countries our results highlight a significant, but underpublicized, public health concern. Greater acknowledgement of the potentially harmful biological consequences of chronic pain may help to support regional, national and global initiatives aimed at reducing the burden of chronic pain.

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