scholarly journals Impaired endothelial glycocalyx predicts adverse outcome in subjects without overt cardiovascular disease: a 6-year follow-up study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
J Thymis ◽  
P Simitsis ◽  
S Katsanos ◽  
C Triantafyllou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Family History ◽  
Adverse Outcome ◽  
Endothelial Glycocalyx ◽  
Lipid Lowering ◽  
C Statistic ◽  
History Of

Abstract Aim Endothelial glycocalyx is involved in the clinical course of atherogenesis. The purpose of this study was to investigate whether disturbance of glycocalyx integrity is related with increased cardiovascular risk. Methods Perfused Boundary Region (PBR), a marker of glycocalyx integrity, was measured non-invasively in sublingual microvessels with a diameter ranging from 5–25 μm using a dedicated camera (Sideview, Darkfield Imaging). Increased PBR indicates reduced glycocalyx thickness. We measured baseline PBR in 400 apparently healthy subjects, without established cardiovascular disease. We prospectively monitored the occurrence of major cardiovascular events (MACE-death, myocardial infarction, stroke and heart failure hospitalization) during a 6-year follow-up period using electronic records and clinic visits. Results Forty-three MACE were documented during follow-up. Subjects with PBR at 5–9 μm microvessel diameter greater than 1.15 μm (mean value of the study cohort) had 2-fold higher risk for MACE than those with lower PBR in a model including sex, age, hyperlipidemia, diabetes, hypertension, current smoking, family history of coronary artery disease and treatment with ACEi/ARBs or lipid lowering agents (hazard ratio (HR): 2.49; 95% CI: 1.23–5.02, p=0.011, net reclassification improvement (NRI): 25%; C-statistic: 0.738). PBR5-9 ≥1.15 was an independent and additive predictor of outcome when added in a model including SCORE, risk factors not included in SCORE (diabetes, family history of CAD) and medication (HR: 2.48 NRI: 23.8%, C-statistic increase from 0.629 to 0.678, for all cardiac events and HR: 4.19, NRI: 33.1%, C-statistic increase from 0.654 to 0.734 for death myocardial infarction and stroke, p<0.01). Conclusion Endothelial glycocalyx integrity is an independent and additive predictor to atherosclerotic risk factors for adverse outcome at 6 years follow-up in individuals without diagnosed cardiovascular disease. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Wahrenberg ◽  
P Magnusson ◽  
R Kuja-Halkola ◽  
H Habel ◽  
K Hambraeus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Family History ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Funding Source ◽  
History Of ◽  
First Time ◽  
Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

Abstract 156: Everyday Discrimination and Risk of Myocardial Infarction Among Women

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Aryana S Jacobs ◽  
Julius S Ngwa ◽  
Natalie Slopen ◽  
Alan M Zaslavsky ◽  
Rimma Dushkes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factors ◽  
Smoking History ◽  
History Of ◽  
Everyday Discrimination

Background: Discrimination, a form of chronic psychological stress, is related to certain chronic health conditions such as poor physical health and hypertension. However, little is known about the associations of everyday discrimination with risk of myocardial infarction. Methods and Results: We assessed the association between everyday discrimination (discrimination) and myocardial infarction (MI) using a prospective, nested case control study of 548 women (267 cases, 281 controls), selected from 26,763 women without a history of cardiovascular disease at baseline who participated in the Women’s Heath Study (WHS). Among 267 MI cases, there was a mean follow-up of 8.8 + 4.1 years from date of WHS randomization to date of MI event. At baseline, the mean age of participants was 53.6 + 6.1 years. Cases and controls were matched for age and smoking history. Discrimination was assessed by 5 questions where women reported whether they were: 1) treated with less courtesy/respect than others; 2) treated as not being smart; 3) treated as if others were afraid of them; 4) received poorer service at restaurants/stores; or 5) felt threatened/harassed. Responses were based on a Likert scale of 1=never to 5=at least once/weekly with higher scores indicating more experiences with discrimination. In unadjusted logistic regression models of increasing tertiles of discrimination, we found no significant association between discrimination and odds of MI [Odds Ratios (OR) and 95% confidence intervals (95%CI): 1.00, 1.28 (0.85-1.94), 1.06 (0.69-1.64); p trend =0.5]. Adjustment for cardiovascular disease risk factors (lipid parameters, hsCRP, family history of MI, hypertension, body mass index, diabetes, and alcohol consumption) revealed an inverse-U-shaped relationship [OR, 95%CI: 1.00, 2.14 (1.21-3.77), 1.55 (0.87-2.78); p trend = 0.03], suggesting that these factors obscured the association in unadjusted models. Notably, addition of education and income to the crude model alone [1.00, 1.38 (0.89, 2.15), 0.97 (0.61, 1.54) p trend = 0.2] or to the model with the cardiovascular risk factors [1.00, 2.27 (1.25-4.10), 1.36 (0.73, 2.53); p trend = 0.02] had minimal impact on odds of MI in these women. Conclusion: Among women participating in the WHS follow-up cohort, higher levels of everyday discrimination were related to increased odds of myocardial infarction in an inverse-U-shaped manner, a finding that is obscured by traditional cardiovascular disease risk factors. Access to measures associated with a healthy heart might be important to myocardial infarction risk attenuation among women reporting everyday discrimination. Further research is warranted to elucidate the relationship between everyday discrimination and increased risk of MI.

The burden of cardiovascular disease risk factors in the Middle East: A systematic review and meta-analysis focusing on primary prevention

2020 ◽  
Vol 18 ◽  
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Abdullah Shehab ◽  
Anhar Ullah ◽  
Jamal Rahmani
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Family History ◽  
Primary Prevention ◽  
Middle East ◽  
Disease Risk ◽  
Meta Analysis ◽  
Middle Eastern ◽  
History Of

Background: The increasing incidence of cardiovascular disease (CVD) threatens the Middle Eastern population. Several epidemiological studies have assessed CVD and its risk factors in terms of the primary prevention of CVD in the Middle East. Therefore, summarizing the information from these studies is essential. Aim: We conducted a systematic review to assess the prevalence of CVD and its major risk factors among Middle Eastern adults based on the literature published between January 1, 2012 and December 31, 2018 and carried out a meta-analysis. Methods: We searched electronic databases such as PubMed/Medline, ScienceDirect, Embase and Google Scholar to identify literature published from January 1, 2012 to December 31, 2018. All the original articles that investigated the prevalence of CVD and reported at least one of the following factors were included: hypertension, diabetes, dyslipidaemia, smoking and family history of CVD. To summarize CVD prevalence, we performed a random-effects meta-analysis. Results: A total of 41 potentially relevant articles were included, and 32 were included in the meta-analysis (n=191,979). The overall prevalence of CVD was 10.1% (95% confidence interval (CI): 7.1-14.3%, p<0.001) in the Middle East. A high prevalence of CVD risk factors, such as dyslipidaemia (43.3%; 95% CI: 21.5-68%), hypertension (26.2%; 95% CI: 19.6-34%) and diabetes (16%; 95% CI: 9.9-24.8%), was observed. The prevalence rates of other risk factors, such as smoking (12.4%; 95% CI: 7.7-19.4%) and family history of CVD (18.7%; 95% CI: 15.4-22.5%), were also high. Conclusion: The prevalence of CVD is high (10.1%) in the Middle East. The burden of dyslipidaemia (43.3%) in this region is twice as high as that of hypertension (26.2%) and diabetes mellitus (16%). Multifaceted interventions are urgently needed for the primary prevention of CVD in this region.

scholarly journals Cardiovascular risk factors in adolescents with a family history of cardiovascular disease

2017 ◽  
Vol 46 (4) ◽  
pp. 326 ◽  
Author(s):  
Rohit Vohra ◽  
Minakshi Bansal ◽  
Neelam Grover ◽  
Parveen Bhardwaj ◽  
Pancham Kumar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Risk Factors ◽  
History Of

scholarly journals Serum Uric Acid as a Prognostic Factor of Acute Myocardial Infarction in Hospitalized Patients

2021 ◽  
Vol 34 (1) ◽  
pp. 26-32
Author(s):  
Md Amzad Hossain Sardar ◽  
Md Khalilur Rahman ◽  
Md Mahidul Alam ◽  
Md Aminul Hasan ◽  
Ashoke Sarker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Uric Acid ◽  
Family History ◽  
Serum Uric Acid ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
High Serum ◽  
History Of

Background: Among non-communicable diseases, acute myocardial infarction (AMI) is a common killer of people in the world. The management of AMI patients is one of the major challenges in the field of cardiology. Uric acid has several effects of potential interest in cardiovascular disease. There are some markers indicating an unfavorable prognosis in AMI patients. Uric acid is one of the markers that have been evaluated in research. Objective: The aim of this study was to assess the association between serum uric acid level and in-hospital outcomes of AMI patients. Patients and methods: This longitudinal descriptive study was conducted over 115 AMI patients in the Cardiology Unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Baseline characteristics such as age, sex, BMI, BP, RBS, risk factors (hypertension, DM, smoking, family history of IHD, dyslipidemia), and outcomes of AMI patients (acute LVF, arrhythmia, conduction block, cardiogenic shock, death) were recorded. We measured the serum uric acid of this patient at admission.  Results: The mean age of patients was 52.83±10.71 years. Out of 115 patients, 83.5% were male, and 16.5% were female. Among the risk factors, 65.2% of patients had HTN, 20.9% DM, 64.3% smoking, 16.5% family history of IHD, and 47.8% dyslipidemia. Out of 115, 35.7% of patients demonstrated high serum uric acid. In outcomes of AMI patients, acute LVF 24.4% (p=0.031) and death 12.2% (p=0.041) were significantly higher in patients with high serum uric acid levels. Conclusion: Significant association was found between high serum uric acid level and in-hospital outcomes of AMI patients. So, estimation of serum uric acid may offer an inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2021; 34: No-1: 26-32

scholarly journals Epidemiology of Heart Failure Stages in Middle‐Aged Black People in the Community: Prevalence and Prognosis in the Atherosclerosis Risk in Communities Study

2021 ◽  
Author(s):  
Ramachandran S. Vasan ◽  
Solomon K. Musani ◽  
Kunihiro Matsushita ◽  
Walter Beard ◽  
Olushola B. Obafemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Left Ventricular ◽  
Study Cohort ◽  
Atherosclerosis Risk In Communities ◽  
Cardiovascular Morbidity And Mortality ◽  
Atherosclerosis Risk

Background Black individuals have a higher burden of risk factors for heart failure (HF) and subclinical left ventricular remodeling. Methods and Results We evaluated 1871 Black participants in the Atherosclerosis Risk in Communities Study cohort who attended a routine examination (1993–1996, median age 58 years) when they underwent echocardiography. We estimated the prevalences of 4 HF stages: (1) Stage 0 : no risk factors; (2) Stage A : presence of HF risk factors (hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, coronary artery disease without clinical myocardial infarction), no cardiac structural/functional abnormality; (3) Stage B : presence of prior myocardial infarction, systolic dysfunction, left ventricular hypertrophy, regional wall motion abnormality, or left ventricular enlargement; and (4) Stage C/D : prevalent HF. We assessed the incidence of clinical HF, atherosclerotic cardiovascular disease events, and all‐cause mortality on follow‐up according to HF stage. The prevalence of HF Stages 0, A, B, and C/D were 3.8%, 20.6%, 67.0%, and 8.6%, respectively, at baseline. On follow‐up (median 19.0 years), 309 participants developed overt HF, 390 incurred new‐onset cardiovascular disease events, and 651 individuals died. Incidence rates per 1000 person‐years for overt HF, cardiovascular disease events, and death, respectively, were Stage 0, 2.4, 0.8, and 7.6; Stage A, 7.4, 9.7, and 13.5; Stage B 13.6, 15.9, and 22.0. Stage B HF was associated with a 1.5‐ to 2‐fold increased adjusted risk of HF, cardiovascular disease events and death compared with Stages 0/A. Conclusions In our large community‐based sample of Black individuals, we observed a strikingly high prevalence of Stage B HF in middle age that was a marker of high cardiovascular morbidity and mortality.

Abstract WP226: The Association of Green Tea and Coffee Consumption With Mortality From Cardiovascular Disease and All Causes Among Persons With and Without History of Stroke or Myocardial Infarction: The JACC Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Masayuki Teramoto ◽  
Isao Muraki ◽  
Kokoro Shirai ◽  
Akiko Tamakoshi ◽  
Hiroyasu Iso
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
General Population ◽  
Green Tea ◽  
Coffee Consumption ◽  
Tea Consumption ◽  
Food Frequency ◽  
All Cause Mortality ◽  
History Of

Background: Both green tea and coffee consumption have been associated with lower risks of mortality from cardiovascular disease (CVD) and all causes in general population, but little is known about those impact on persons with history of CVD. We examined the association of those consumption with these mortalities among persons with and without history of stroke or myocardial infarction in general population. Methods: The study subjects were 60,664 participants (896 stroke and 1751 myocardial infarction survivors and 58,017 persons with no history of stroke or myocardial infarction), aged 40-79 years at the baseline (1988-1990), who completed a lifestyle and medical history questionnaire including self-administered food frequency under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). Results: During the median follow-up of 18.5 years, a total of 12,745 (7,458 men and 5,287 women) deaths including 3,737 CVD deaths were documented. Green tea and coffee consumption were inversely associated with CVD and all-cause mortality among myocardial infarction survivors as well as persons without history of stroke or myocardial infarction. After adjustment for known cardiovascular risk factors, the lower risks of mortality from CVD and all-causes associated with frequent green tea consumption (5-6 and ≥7 cups/day) or coffee consumption (≥2 cups/day) remained statistical. Conclusions: Both green tea and coffee consumption were inversely associated with risks of CVD and all-cause mortality among myocardial infarction survivors and persons without history of stroke or myocardial infarction.

scholarly journals Patients with History of Myocardial Infarction and Acute Cerebrovascular Accidentin Clinical Practice: Demographic, Clinical Characteristics, Drug Treatment and Outcomes (Data of Outpatient and Hospital Registry REGION)

2019 ◽  
Vol 15 (5) ◽  
pp. 656-662 ◽  
Author(s):  
E. Yu. Okshina ◽  
M. M. Loukianov ◽  
S. Yu. Martsevich ◽  
S. S. Yakushin ◽  
N. P. Kutishenko ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Practice ◽  
Family History ◽  
Drug Treatment ◽  
Clinical Characteristics ◽  
Beta Blockers ◽  
All Cause Mortality ◽  
History Of ◽  
Hospital Registry

Aim. To assess the demographic and clinical characteristics, drug treatment and outcomes in patients with a history of acute cerebrovascular accident (ACVA) and with concomitant history of myocardial infarction (MI) in clinical practice based on outpatient and hospital parts of REGION registry.Material and methods. The total 1886 patients with a history of ACVA (aged of 70.6±12.5 years, 41.9% men) were enrolled into the outpatient registry REGION (Ryazan) and the hospital registry REGION (Moscow). 356 patients had ACVA and a history of MI (group “ACVA+MI” and 1530 patients had ACVA without history of MI (group “ACVA without MI”). The incidence of cardiovascular diseases (CVD), non-CVD comorbidities, drug therapy and outcomes were analyzed.Results. In the group ACVA+MI compared with group ACVA without MI the significantly higher proportions of patients with the following conditions (diagnosis) were revealed: arterial hypertension (AH) – 99.1% and 94.2%; coronary heart disease (CHD) – 100% and 57%; chronic heart failure (CHF) – 61.5% and 41.8%; atrial fibrillation (AF) – 42.7% and 23.8%; repeated ACVA – 32.9% and 18.9%, respectively, p<0.0001 for all. In ACVA+MI and ACVA without MI groups the respective proportions of patients were smokers – 16.2% and 23.7% (p=0.10), had a family history of premature CVD – 3.2% and 1.2% (p=0.01), and had a hypercholesterolemia – 47% and 59.7% (p<0.001). The incidence of drug administration with proved positive prognostic effect was insufficient in both groups, but higher in the ACVA+MI group compared with ACVA without MI group (on average 47.1% and 40%, respectively), including: anticoagulants in AF – 19.1% and 21.4% (p=0.55); antiplatelets in CHD without AF – 69.4% and 42% (p<0.001); statins in CHD – 26.4% and 17.2% (p<0.001); beta-blockers in CHF – 39% and 23.8% (p=0.002), respectively. During 4- year follow-up in the group ACVA+MI compared with group ACVA without MI there were significantly higher all-cause mortality – 44.9% and 26.8% (p<0.001), nonfatal recurrent ACVA – 13.7% and 5.6% (p=0.0001), and nonfatal MI – 6.9% and 1.0% (p<0.0001), respectively.Conclusion. The proportion of patients with a history of MI was 18.9% among the patients with a history of ACVA. In patients of ACVA+MI group, compared with patients of ACVA without MI group a higher incidence of the following characteristics was revealed: a presence of AH, CHD, CHF, AF, repeated ACVA and a family history of premature CVD. The incidence of taking drug with proved positive effect on prognosis in patients of the compared groups was insufficient, especially of statins and anticoagulants in AF. During the follow-up period ACVA+MI group was characterized by a higher all-cause mortality and higher incidence of nonfatal ACVA and MI. In these patients the improvement of the quality of pharmacotherapy and of the secondary prevention effectiveness are the measures of especial importance. 

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