830 Why We Should Be Looking for A Diagonal Ear Lobe Crease In ENT. A Meta-Analysis of Diagonal Ear Lobe Crease and Coronary Artery Disease

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Curtis ◽  
S Walford
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Increased Risk ◽  
Artery Disease ◽  
The Relationship

Abstract Introduction An association between a diagonal ear lobe crease (DELC) and cardiovascular disease, was first suggested by Sanders T. Frank in 1973(1). Since then, there have been numerous further studies that have investigated the association of ‘Frank’s Sign’ with carotid disease, cerebral vascular disease, and diabetic retinopathy. This review looks to see if there is a significant association between the presence of a DELC and coronary artery disease (CAD). Method Meta-analysis of selected studies, published between 1974 and 2017, using the PRISMA checklist(2). Results We included 12 studies in the pooled analysis, which included 2415 cases and 2545 controls. Our study found that patients with DELC, have an increased likelihood of having CAD (OR 4.61). Also, despite some previous studies suggesting that DELC was simply a result of age, all ten of the included studies that looked at this found that the relationship between DELC and CAD was independent of both age and other known cardiovascular risk factors. Conclusions We found that DELC is associated with CAD independently of other known cardiovascular risk factors, including age. Patients with DELC appear to have a substantially increased risk of CAD, and this may be higher for patients with bilateral DELC.

scholarly journals Asymmetrical Dimethylarginine Independently Predicts Total and Cardiovascular Mortality in Individuals with Angiographic Coronary Artery Disease (The Ludwigshafen Risk and Cardiovascular Health Study)

2007 ◽  
Vol 53 (2) ◽  
pp. 273-283 ◽  
Author(s):  
Andreas Meinitzer ◽  
Ursula Seelhorst ◽  
Britta Wellnitz ◽  
Gabriele Halwachs-Baumann ◽  
Bernhard O Boehm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Mortality ◽  
Asymmetrical Dimethylarginine ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Artery Disease

Abstract Background: Asymmetrical dimethylarginine (ADMA) is increased in conditions associated with increased risk of atherosclerosis. We investigated the use of ADMA to predict total and cardiovascular mortality in patients scheduled for coronary angiography. Methods: In 2543 persons with and 695 without coronary artery disease (CAD) identified by angiography we measured ADMA and recorded total and cardiovascular mortality during a median follow-up of 5.45 years. Results: ADMA was correlated positively to age, female sex, diabetes mellitus, former and current smoking, and C-reactive protein and inversely to HDL cholesterol and triglycerides. ADMA was not associated with body mass index, hypertension, LDL cholesterol, or the presence or absence of angiographic CAD. Glomerular filtration rate and homocysteine were the strongest predictors of ADMA. At the 2nd, 3rd and 4th quartile of ADMA, hazard ratios for all-cause mortality adjusted for age, sex, and cardiovascular risk factors were 1.12 [95% confidence interval (CI) 0.83–1.52], 1.35 (95% CI 1.01–1.81), and 1.87 (95% CI 1.43–2.44), respectively, compared with the 1st quartile. Hazard ratios for cardiovascular death were 1.13 (95% CI 0.78–1.63), 1.42 (95% CI 1.00–2.02), and 1.81 (95% CI 1.31–2.51). ADMA in the highest quartile remained predictive of mortality after accounting for medication at baseline. The predictive value of ADMA was similar to that in the entire cohort in persons with CAD, stable or unstable, but was not statistically significant in persons without angiographic CAD. Conclusions: ADMA concentration predicts all-cause and cardiovascular mortality in individuals with CAD independently of established and emerging cardiovascular risk factors.

Recreational opium use as a risk factor for coronary artery disease: results from the premature coronary artery disease Milano-Iran (MIran) study

2020 ◽  
Author(s):  
Alberto Maino ◽  
Saeed Sadeghian ◽  
Ilaria Mancini ◽  
Seyed Hesameddin Abbasi ◽  
Hamidreza Poorhosseini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Premature Coronary Artery Disease ◽  
Control Analysis ◽  
Increased Risk ◽  
Artery Disease ◽  
Opium Use

Abstract The spreading of recreational opium use pose new health related concerns. In some areas of Asia its use is believed to protect from cardiovascular disorders, such as coronary artery disease (CAD). However, whether opium use has an association with CAD is unclear. We aimed to investigate the association between opium use and CAD. We set up a case-control analysis, i.e., the premature CAD Milano-Iran (MIran) study by enrolling consecutive young patients who underwent a coronary angiography at the Tehran Heart Center, between 2009 and 2012. Incident cases with CAD were contrasted with controls for recreational opium use. Relative risks were calculated in terms of odds ratios (ORs) by logistic regression models adjusted for age, sex, cigarette smoking, body mass index, hypertension, hyperlipidaemia, and diabetes. Interaction analyses were performed between opium and major cardiovascular risk factors. 1011 patients with CAD (mean age 43.6 years) and 2002 controls (mean age 54.3 years) were included in the study. Habitual opium users had a 3.8-fold increased risk of CAD (95%CI 2.4–6.2) compared with non-users. The association was strongest for men, with a fully adjusted OR of 5.5 (95%CI 3.0-9.9). No interaction was observed for the combination of opium addiction and hypertension, or diabetes, but an excess in risk was found in opium users with hyperlipidaemia (OR 16.8, 95%CI 8.9–31.7, expected OR 12.2), suggesting supra-additive interaction. In conclusion, despite common beliefs, we showed that recreational opium use is associated with an increased risk of CAD, even when other cardiovascular risk factors are taken into account.

scholarly journals Epidemiological Analysis of Major Cardiovascular Risk Factors in 1,508 Indian Adults Stratified by Age and Gender

2021 ◽  
Vol 8 (11) ◽  
pp. 608-612
Author(s):  
Sunil S. Thanvi ◽  
Sunil K. Karna ◽  
Utsav B Patel
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Vitamin D3 ◽  
Density Lipoprotein ◽  
Age And Gender ◽  
Artery Disease ◽  
And Gender

BACKGROUND Routine screening of healthy individuals for the presence of cardiovascular risk factors is important for identification of high-risk coronary artery disease (CAD) patients at early stage and to provide preventive care. Considering the high burden of CAD, such investigations are of significant importance in Indian context. METHODS In this cross-sectional study, adult individuals (18 – 68 years) were evaluated for pre-existing diseases, lipid profile, blood glucose profile, thyroid profile, haemoglobin (Hb) and vitamins D3 and B12 levels after obtaining informed consent. These variables were compared between patients stratified based on their gender and age (< 40, 40 – 60, > 60 years). RESULTS A total of 1,508 participants (mean age: 49 ± 11 years; 49.9 % females) were investigated. Hypertension, diabetes, dyslipidaemia, anaemia, vitamin D3 and B12 deficiencies, hyperthyroidism, and hypothyroidism were observed in 31.2 %, 26.5 %, 32.0 %, 8.6 %, 35.3 %, 25.1 %, 21.0 % and 0.6 % of patients respectively. Prevalence of hypertension, diabetes, and dyslipidaemia increased with ageing, while deficiencies of Hb, vitamin D3, and vitamin B12 as well as hyperthyroidism and hypothyroidism were comparable across all age groups. Males were more prone to hypertension, diabetes, and dyslipidaemia, while females were more prone to have Hb deficiency, hyperthyroidism, and hypothyroidism. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS), vitamin D3, and vitamin B12 were elevated with increase in age, while Hb levels decreased. Males exhibited higher levels of TG, low-density lipoprotein cholesterol (LDL-C), TC / HDL, LDL / HDL, FBS, and Hb, while females displayed higher levels of vitamin D3 and B12. CONCLUSIONS Our findings verify the role of age and gender on majority of cardiovascular risk factors. The high prevalence of cardiovascular risk factors is alarming and demands the need for appropriate health-care measures. KEYWORDS Age, Coronary Artery Disease, Gender, Risk Factor

Abstract 6133: Microvascular Dysfunction and Chronic Inflammation in Patients without Cardiovascular Risk Factors

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alejandro Recio-Mayoral ◽  
Justin C Mason ◽  
Juan C Kaski ◽  
Michael B Rubens ◽  
Olivier A Harari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Chronic Inflammation ◽  
Coronary Atherosclerosis ◽  
Microvascular Dysfunction ◽  
Early Marker ◽  
Artery Disease

Premature coronary atherosclerosis, which is actually seen as an active inflammatory process, is an established complication of systemic autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). We hypothesized that exposure to chronic inflammation, even in the absence of classical cardiovascular risk factors (CVRF), could result in coronary microvascular dysfunction (CMD), an early marker of coronary atherosclerosis. By means of positron emission tomography in combination with oxygen-15 labeled water, myocardial blood flow (MBF) was measured at rest and during iv adenosine infusion (140 μg/kg/min) in 13 SLE and 12 RA patients (mean [±SD] age 44±10 years) without CVRF. All patients underwent coronary angiography using multi-slice (64 slices) computed tomography and only those with none or trivial coronary artery disease (<30% luminal stenosis) were included. A group of 25 age- and gender-matched controls were also studied. There were no differences between patients and controls regarding body-mass index, blood pressure and lipid parameters. RA and SLE patients showed similar mean disease duration (16±11 and 11±7 years, respectively; p=0.12). Resting MBF was similar in patients and controls (1.25±0.27 vs 1.15±0.24 ml/min/g, p=0.15). However, during adenosine stress patients had lower MBF compared with controls (2.94±0.83 vs 4.11±0.84 ml/min/g, p<0.001). As result, coronary flow reserve (CFR; adenosine/resting MBF) was significantly reduced in patients (2.44±0.78) compared with controls (3.81±1.07; p<0.001). Seven patients showed ischemic electrocardiographic changes during adenosine and had a more severe reduction in CFR (1.76±0.81) and more years of disease (21±7 years) compared with those patients without ischemic changes (CFR 2.49±0.54; p=0.006; duration of disease 14±5 years; p=0.03). CFR was inversely correlated with years of disease (r=−0.65, p<0.001), but not with corticosteroid cumulative dose (r=0.20, p=0.39). Chronic inflammation in the absence of traditional CVRF is characterized by severe CMD. This may represent an early marker of disease which precedes and contributes to premature coronary artery disease in patients with RA and SLE.

scholarly journals Diabetes mellitus and other cardiovascular risk factors in lower-extremity peripheral artery disease versus coronary artery disease: an analysis of 1,121,359 cases from the nationwide databases

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mitsuyoshi Takahara ◽  
◽  
Osamu Iida ◽  
Shun Kohsaka ◽  
Yoshimitsu Soga ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Lower Extremity ◽  
Cardiovascular Risk Factors ◽  
Clinical Profile ◽  
Peripheral Artery ◽  
Artery Disease

Abstract Background Lower-extremity peripheral artery disease (LE-PAD) and coronary artery disease (CAD) are both pathologically rooted in atherosclerosis, and their shared clinical features regarding the exposure to cardiovascular risk factors have been emphasized. However, comparative data of the two cardiovascular diseases (CVDs) were so far lacking. The purpose of this study was to directly compare the clinical profile between cases undergoing endovascular therapy (EVT) for LE-PAD and those undergoing percutaneous coronary intervention (PCI). Methods Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. A total of 1,121,359 cases (103,887 EVT cases for critical limb ischemia [CLI] or intermittent claudication and 1,017,472 PCI cases for acute coronary syndrome [ACS] or stable angina) were analyzed. Heterogeneity in clinical profile between CVDs was evaluated using the C statistic of the logistic regression model for which dependent variable was one CVD versus another, and explanatory variables were clinical profile. When two CVDs were completely discriminated from each other by the developed model, the C statistic (discrimination ability) of the model would be equal to 1, indicating that the two CVDs were completely different in clinical profile. On the other hand, when two CVDs were identical in clinical profile, the developed model would not discriminate them at all, with the C statistic equal to 0.5. Results Mean age was 73.5 ± 9.3 years in LE-PAD patients versus 70.0 ± 11.2 years in CAD patients (P < 0.001). The prevalence of diabetes mellitus and end-stage renal disease was 1.96- and 6.39-times higher in LE-PAD patients than in CAD patients (both P < 0.001). The higher prevalence was observed irrespective of age group. The exposure to other cardiovascular risk factors and the likelihood of cardiovascular risk clustering also varied between the diseases. The between-disease heterogeneity in patient profile was particularly evident between CLI and ACS, with the C statistic equal to 0.833 (95% CI 0.831–0.836). Conclusions The current study, an analysis based on nationwide procedural databases, confirmed that patient profiles were not identical but rather considerably different between clinically significant LE-PAD and CAD warranting revascularization.

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