scholarly journals Hemodialysis patients with better coronary flow reserve and nutrition status have surprising prognosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Imaoka ◽  
N Umemoto ◽  
S Oshima
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Ischemic Heart ◽  
Nutrition Status ◽  
Flow Reserve ◽  
All Cause Mortality ◽  
Conventional Risk Factors

Abstract Background In clinical setting, ischemic heart disease is a challenging problem in hemodialysis (HD) population. Coronary flow reserve (CFR) measured by 13 ammonia positron emitting tomography (13NH3PET) is an established and reliable modality for detecting coronary artery disease. Furthermore, some prior studies show CFR is an important and independent predictor for cardiovascular event and mortality. On the other hand, HD patients with malnutrition status have poor prognosis. We have reported about the relationship between cardiovascular events and geriatric nutrition risk index (GNRI). Now, we wonder the predictability of combination of CFR and GNRI. Methods and result We collected 438 consecutive HD patients who received 13NH3PET in our hospital suspected for ischemic heart disease. 29 patients were excluded due to undergoing coronary revascularization within 60 days, 103 patients were excluded due to incomplete database. In total, 306 HD patients were classified into 4 group according the median value of CFR (1.99) and GNRI (97.73); Low CFR Low GNRI group (n=77), High CFR and Low GNRI group (n=76), Low CFR High GNRI group (n=78) and High CFR High GNRI group (n=75). We collected their follow up data up to 1544 days (median 833 days) about all-cause mortality and cardiovascular (CV) mortality. Surprisingly, there is no mortality event in High CFR High GNRI group. We analyzed about all-cause mortality, CV mortality. Kaplan-Meyer analysis shows there are statistically intergroup differences in each (all-cause mortality; log rank p<0.01, CV mortality; log rank p=0.02). Furthermore, we calculated area under the curve (AUC) analysis, net reclassification improvement (NRI) and integrated discrimination improvement (IDI)m adding GNRI and CFR on conventional risk factors. There are intergroup differences for all-cause mortality in AUC [conventional risk factors, +GNRI, +GNRI+CFR; 0.70, 0.72 (p=0.29), 0.79 (p<0.01)], NRI [+GNRI; 0.32 (p=0.04), +GNRI+CFR 0.82 (p<0.01)] and IDI [+GNRI; 0.01 (p=0.05), +GNRI+CFR 0.09 (p<0.01)]. Conclusion HD patients with low CFR and malnutrition status has statistically significant poorer prognosis comparing HD patients with high CFR and without malnutrition status. Adding combination of GNRI and CFR on conventional risk factors improves the predictability of HD population's prognosis. Funding Acknowledgement Type of funding source: None

Ischemic Heart Disease in Subjects of Young Age: Current State of the Problem. Features of Etiology, Clinical Manifestation and Prognosis

Kardiologiia ◽  
2018 ◽  
Vol 58 (11) ◽  
pp. 24-34 ◽  
Author(s):  
E. Yu. Andreenko ◽  
I. S. Yavelov ◽  
М. М. Loukianov ◽  
A. N. Vernohaeva ◽  
O. M. Drapkina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Molecular Genetic ◽  
Young Patients ◽  
Ischemic Heart ◽  
Coronary Syndrome ◽  
Current State ◽  
Monogenic Diseases ◽  
Conventional Risk Factors

In addition to conventional risk factors in young patients with ischemic heart disease (IHD) numerous other risk factors including genetics play an important role in its causation. Molecular genetic testing is recommended for the detection of monogenic diseases with a high risk of developing IHD, such as familial hypercholesterolemia. In majority ofyoung patients, the first manifestation of IHD is an acute coronary syndrome. Young patients with IHD more often have normal coronary arteries or single-vessel coronary disease, and in up to 20% of them cause of myocardial ischemia is not related to atherosclerosis. In general, young patients with IHD have better prognosis. However, there are sex differences in IHD outcomes the prognosis of patients with premature IHD and reason for this is still unclear.

scholarly journals Prevalence of ischemic heart disease depending on factors of psychoemotional stress among men of mature age (epidemiological study)

2021 ◽  
Vol 93 (1) ◽  
pp. 25-29
Author(s):  
Ekaterina V. Akimova ◽  
Mikhail Y. Akimov ◽  
Marina M. Kayumova ◽  
Valery V. Gafarov
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Epidemiological Study ◽  
Emotional Stress ◽  
Stress Factors ◽  
Ischemic Heart ◽  
Psychoemotional Stress ◽  
Open Population ◽  
Conventional Risk Factors

Aim. To establish associations of the prevalence of ischemic heart disease (IHD) and factors of psychoemotional stress in men of the open urban population in the age group 4564 years after two decades of life. Materials and methods. A cross-sectional epidemiological study using a model of the city of Tyumen was conducted on a representative sample of the population among males of mature age (4564 years). Based on standard epidemiological methods, IHD was established according to strict epidemiological criteria definite IHD. The study of the factors of psycho-emotional stress (depression, hostility, life exhaustion) was carried out according to the algorithms of the World Health Organization program MONICA-psychosocial. When calculating the odds ratio for the development of IHD, a low level of psycho-emotional stress factors was regarded as the absence of a sign, a combination of medium and high levels as a presence. Results. The prevalence of ischemic heart disease in the open population (on the model of Tyumen) according to strict epidemiological criteria in men aged 4554 years was 8.2%, at the age of 5564 years 19.2%, a predominance of painless form of ischemic heart disease was revealed. According to the levels of factors of psychoemotional stress in mature men, mainly the average level of depression and life exhaustion, a high level of hostility were established. In men of an open population (on the model of Tyumen), depending on the psychoemotional stress, a high risk of developing a certain coronary heart disease was established in the age categories 4554 and 5564 years old in the presence of depression, at the age of 5564 years in the presence of hostility or life exhaustion. Conclusion. Consequently, the data obtained indicate the importance of further studying the factors of psychoemotional stress in men of mature age in Siberian populations, their relationships with conventional risk factors for coronary artery disease, as well as the advisability of preventive measures aimed at weakening the influence of not only conventional risk factors, but also factors of psycho-emotional stress. among the Russian population.

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