Tissue Factor and Platelet Glycoprotein Ib-α Alleles Are Associated with Age at First Coronary Bypass Operation

2003 ◽  
Vol 99 (6) ◽  
pp. 1287-1294 ◽  
Author(s):  
Brian S. Donahue ◽  
Daniel W. Byrne ◽  
David Gailani ◽  
Alfred L. George
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Tissue Factor ◽  
Multivariate Regression ◽  
Coronary Bypass ◽  
Platelet Glycoprotein ◽  
Glycoprotein Ib ◽  
Younger Age ◽  
Traditional Risk Factors ◽  
The Impact

Background Age is a known risk factor for postoperative complications, but the genetic factors that account for variability in age at presentation for surgery have not been characterized. Because thrombosis is a critical process in the development of coronary syndromes, the authors hypothesized that patients bearing the -1208 insertion allele of tissue factor (TF) and longer glycoprotein Ib-alpha (GpIbalpha) variants may come to surgical attention sooner and undergo coronary artery bypass grafting (CABG) at a younger age. The authors tested this hypothesis in a cardiac surgery population. Methods The impact of the number of TF -1208 insertion alleles and the number of GpIbalpha repeats on age at first CABG were tested in 424 elective coronary bypass patients. Multivariate regression included traditional risk factors of sex, hypertension, diabetes, hyperlipidemia, and smoking. The authors also tested the hypothesis that these alleles are correlated with age at first noncoronary cardiac surgery in a group of 143 patients undergoing noncoronary cardiac operations. Result Both the number of TF -1208 insertion alleles and total number of GpIbalpha repeats were associated with younger age at first CABG in a univariate analysis. In multivariate regression in which traditional risk factors were included, the number of TF -1208 insertion alleles and the total number of GpIbalpha repeats were independent contributors toward age at first CABG. Neither polymorphism had a significant impact on age at first noncoronary cardiac surgery. Conclusions Genetic variants in TF and GpIbalpha are associated with younger age at first CABG, indicating that the younger and older first-time CABG populations are different on the genetic level. How these genetic differences may account for age-associated differences in perioperative risk will be the subject of future investigations.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

‘Genetics load the gun, but the environment pulls the trigger’: novel, emerging and non-traditional risk factors in cardiovascular disease

2021 ◽  
pp. 1-3
Author(s):  
Andrew Richardson
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Environmental Factors ◽  
Individual Risk ◽  
Traditional Risk Factors ◽  
Individual Risk Factors ◽  
The Impact

In this article, Andy Richardson, BANCC Educational Advisor, examines several important environmental and individual risk factors for cardiovascular disease. Following on from the meeting of Global Leaders at COP26 in Glasgow, he considers the impact of, and exposure to, environmental factors, including pollution and noise.

scholarly journals The Impact of Air Pollution (PM2.5) on Atherogenesis in Modernizing Southern versus Northern China

Atmosphere ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1552
Author(s):  
Kamsang Woo ◽  
Changqing Lin ◽  
Yuehui Yin ◽  
Dongshuang Guo ◽  
Ping Chook ◽  
...  
Keyword(s):  
Risk Factors ◽  
Air Pollution ◽  
Northern China ◽  
Age And Gender ◽  
Carotid Imt ◽  
Southern Chinese ◽  
Northern Chinese ◽  
Traditional Risk Factors ◽  
And Gender ◽  
The Impact

To evaluate the impact of PM2.5 air pollution on atherogenic processes in modernizing Southern versus Northern China, we studied 1323 asymptomatic Chinese in Southern and Northern China in 1996–2007. PM2.5 exposure and metabolic syndrome (MS) were noted. Brachial flow-mediated dilation (endothelial function FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. Although age and gender were similar, PM2.5 was higher in Northern China than in Southern China. The Northern Chinese were characterized by lower lipids, folate and vitamin B12, but higher age, blood pressures, MS and homocysteine (HC) (p = 0.0015). Brachial FMD was significantly lower and carotid IMT was significantly greater (0.68±0.13) in Northern Chinese, compared with FMD and IMT (0.57 ± 0.13, p < 0.0001) in Southern Chinese. On multivariate regression, for the overall cohort, carotid IMT was significantly related to PM2.5, independent of location and traditional risk factors (Model R2 = 0.352, F = 27.1, p < 0.0001), while FMD was inversely related to gender, age, and northern location, but not to PM2.5. In Southern Chinese, brachial FMD was inversely correlated to PM2.5, independent of age, whereas carotid IMT was significantly related to PM2.5, independent of age and gender. In Northern Chinese, brachial FMD was inversely related to gender only, but not to PM2.5, while carotid IMT was related to traditional risk factors. Despite a higher PM2.5 pollution in Northern China, PM2.5 pollution was more significantly associated with atherogenic surrogates in Southern compared to Northern Chinese. This has potential implications for atherosclerosis prevention.

Extracorporeal Life Support in Postcardiotomy Cardiogenic Shock: A View on Scenario, Outcome, and Risk Factors in 261 Patients

2020 ◽  
Author(s):  
Zdenek Provaznik ◽  
Alois Philipp ◽  
Florian Zeman ◽  
Daniele Camboni ◽  
Christof Schmid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Multivariate Regression ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Multivariate Regression Analysis ◽  
Weaning Failure

Abstract Background Weaning failure from cardiopulmonary bypass, postoperative low cardiac output (LCO), and cardiopulmonary resuscitation (CPR) are common scenarios preceding extracorporeal life support (ECLS) implantation after cardiac surgery. The impact of these scenarios on short- and long-term outcome are not well described. Methods Between March 2006 and December 2018, 261 patients received ECLS support after cardiac surgery. Data of patients with weaning failure (NW), postoperative LCO, and CPR leading to ECLS implantation were retrospectively analyzed regarding outcome. Risk factors for outcome after postcardiotomy ECLS were assessed by uni- or multivariate regression analysis. Results Median duration of extracorporeal support was 5.5 ± 8.5 days. Overall mortality on ECLS was 39.1%. Scenario analysis revealed weaning failure from cardiopulmonary bypass in 40.6%, postoperative LCO in 24.5%, and postoperative CPR in 34.9% leading to initiation of ECLS. Most common cause of death was refractory LCO (25.3%). Overall follow-up survival was 23.7%. Survival after weaning and during follow-up in all subgroups was 9.2% (CPR), 5.0% (LCO), and 9.6% (NW), respectively. Uni- or multivariate regression analysis revealed age, aortic surgery, and vasopressor medication level on day 1 as risk for death on support, as well as postoperative renal failure, and body mass index (BMI) as risk factors for death during follow-up. Conclusion Mortality after postcardiotomy ECLS is high. Overall, outcome after CPR, NW, weaning failure and LCO is comparable. Postoperative resuscitation does not negatively affect outcome after postcardiotomy ECLS. Neurological status of ECLS survivors is good.

P1395The role of hyponatremia in the development of atrial fibrillation after cardiac surgery

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Pavlikova ◽  
A Shevelyok ◽  
N Vatutin
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Serum Sodium ◽  
Sodium Level ◽  
Cox Regression ◽  
Serum Sodium Level ◽  
History Of ◽  
The Impact

Abstract Background. Atrial fibrillation (AF) is one of the most common complication after cardiac surgeries. Age, valvular heart disease, heart failure, chronic obstructive pulmonary disease and a history of AF are well known risk factors for postoperative AF. On the other hand, hyponatremia is also a frequent disorder in patients undergoing cardiac surgery but its relationship with AF has not been studied. Purpose. We evaluated the impact of hyponatremia on the incidence of postoperative AF in patients undergoing cardiac surgery with cardiopulmonary bypass. Methods. The retrospective study included case history of 222 patients (174 men and 48 women, median age 64.5 [range 58.0; 69.0] years) who underwent cardiac surgery with cardiopulmonary bypass between January 2015 and December 2018.  In all patients intraoperative sodium level was analyzed. Hyponatremia was defined as serum sodium level &lt; 135 mmol/l. Primary outcome was the episode of AF in postoperative period. Results. The incidence of postoperative AF was 18.9% (95% confidence interval (CI) 14.1-24.3 P = 0.05). Patients with AF more often had obesity, diabetes mellitus and a history of myocardial infarction and were more likely to perform combined surgery compared to non-AF patients (all Ps &lt; 0.05). The prevalence of hyponatremia was significantly higher among AF group compared with non-AF (95.2% versus 77.8%, P = 0.017). Hyponatremia was the independent risk factors of postoperative AF in Cox regression models adjusted for covariates (odds ratio 5.31; 95% CI 1.42-18.7; P = 0.017). Conclusion.  In this analysis serum sodium level was closely associated with the risk of AF. These findings suggest that hyponatremia may cause the development of postoperative AF in patients undergoing cardiac surgery with cardiopulmonary bypass.

Warfarin-Induced Rapid Rise in INR Post–Cardiac Surgery Is Not Associated With Increased Bleeding Risk

2019 ◽  
Vol 53 (12) ◽  
pp. 1184-1191 ◽  
Author(s):  
Logan M. Olson ◽  
Andrea M. Nei ◽  
Ross A. Dierkhising ◽  
David L. Joyce ◽  
Scott D. Nei
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Warfarin Dose ◽  
Retrospective Chart Review ◽  
Female Gender ◽  
Bleeding Risk ◽  
Hospital Length Of Stay ◽  
Rapid Rise ◽  
The Impact ◽  
Post Cardiac Surgery

Background: Post–cardiac surgery bleeding can have devastating consequences, and it is unknown if warfarin-induced rapid international normalized ratio (INR) rise during the immediate postoperative period increases bleed risk. Objective: To determine the impact of warfarin-induced rapid-rise INR on post–cardiac surgery bleeding. Methods: This was a single-center, retrospective chart review of post–cardiac surgery patients initiated on warfarin at Mayo Clinic Hospital, Rochester. Patients were grouped based on occurrence or absence of rapid-rise INR (increase ≥1.0 within 24 hours). The primary outcome compared bleed events between groups. Secondary outcomes assessed hospital length of stay (LOS) and identified risk factors associated with bleed events and rapid rise in INR. Results: During the study period, 2342 patients were included, and 56 bleed events were evaluated. Bleed events were similar between rapid-rise (n = 752) and non–rapid-rise (n = 1590) groups in both univariate (hazard ratio [HR] = 1.22; P = 0.594) and multivariable models (HR = 1.24; P = 0.561). Those with rapid-rise INR had longer LOS after warfarin administration (discharge HR = 0.84; P = 0.0002). The most common warfarin dose immediately prior to rapid rise was 5 mg. Risk factors for rapid-rise INR were low body mass index, female gender, and cross-clamp time. Conclusion and Relevance: This represents the first report to assess warfarin-related rapid-rise INR in post–cardiac surgery patients and found correlation to hospital LOS but not bleed events. Conservative warfarin dosing may be warranted until further research can be conducted.

Abstract 97: The Impact of “Traditional” Risk Factors for Incident Versus Recurrent Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Brett Kissela ◽  
Dawn O Kleindorfer ◽  
Monika M Safford ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards ◽  
Recurrent Stroke ◽  
Absolute Risk ◽  
Stroke Risk Factors ◽  
Increased Risk ◽  
Traditional Risk Factors ◽  
Age Range ◽  
The Impact

Introduction: Risk factors for incident stroke have been shown to also be associated with risk for recurrent stroke; however, to our knowledge there has not been a cohort with risk factors measured in a sufficient number of stroke-free and prevalent stroke cases to contrast the impact of the risk factors between incident and recurrent stroke. Methods: REGARDS recruited 30,239 participants between 2003 and 2007. Participants were stratified into those reporting and not reporting a physician-diagnosed stroke at baseline. Proportional hazards analysis was used to assess the role of risk factors for stroke. Results: Over 6.2 years of follow-up, there were 825 strokes among 25,849 (3.2%) participants without stroke/TIA at baseline, and 310 strokes among 3,101 (10.0%) with stroke/TIA at baseline. In those stroke-free at baseline, there was an age-by-race interaction (p = 0.0003) with a substantially higher risk among blacks than whites at age 45 (HR = 2.69; 95% CI: 1.85 - 3.91), but with increasing age to age 85 this disparity disappeared (HR = 0.95; 95% CI: 0.74 - 1.23). However, there was a constant (p = 0.98) 21% non-significantly higher risk among blacks over the entire age range. For both blacks and whites, the impact of increasing age had a substantially smaller impact on recurrent than incident stroke. The traditional risk factors had a generally smaller impact for recurrent than incident stroke (significantly for atrial fibrillation and heart disease), however, they remained significantly associated with increased risk for recurrent stroke (see table). Discussion: The role of race and age differed for incident versus recurrent stroke, while the traditional risk factors persisted as indicators of higher risk for recurrent stroke. The smaller impact of stroke risk factors on recurrent stroke should be interpreted with caution, as the higher event rate in this group could imply that the risk factors still have a powerful effect on absolute risk.

scholarly journals Does coronary calcium scoring adds value to cardiovascular risk prediction in asymptomatic population?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Serrao ◽  
M Temtem ◽  
A Pereira ◽  
J Monteiro ◽  
M Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Risk Prediction ◽  
Cardiovascular Events ◽  
Cardiovascular Risk Prediction ◽  
Traditional Risk Factors ◽  
The Impact

Abstract Background Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction, in asymptomatic population. The inclusion of CAC scoring in traditional risk models may help in decision-make providing better cardiovascular risk stratification. Purpose The aim of our study is to estimate the impact of CAC scoring in cardiovascular events risk prediction in a model based on traditional risk factors (TRFs). Methods and results The study consisted of 1052 asymptomatic individuals free of known coronary heart disease, enrolled from GENEMACOR study and referred for computed tomography for the CAC scoring assessment. A cohort of 952 was followed for a mean of 5.2±3.2 years for the primary endpoint of all-cause of cardiovascular events. The following traditional risk factors were considered: (1) current cigarette smoking, (2) dyslipidemia, (3) diabetes mellitus, (4) hypertension and (5) family history of coronary heart disease. Among this population, the extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done by using the Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC&lt;100 and P&lt;50); moderate CAC (100≤CAC&lt;400 or P50–75) and high CAC (CAC≥400 or P&gt;75). Two Cox regression models were created, the first only with TRFs and the second adding the CAC severity categories. When including CAC categories to the TRFs, the higher severity level presented a significant risk of MACE occurrence with an HR of 4.39 (95% CI 1.83–10.52; p=0.001). Conclusion Our results point to the importance of the inclusion of CAC in both primary and secondary prevention to an improved risk stratification. Larger prospective multicentre cohorts with longer follow-up should reproduce and validate these findings. Funding Acknowledgement Type of funding source: None

scholarly journals The impact of traditional and non-traditional risk factors on coronary calcification in pre-dialysis patients

2006 ◽  
Vol 21 (9) ◽  
pp. 2464-2471 ◽  
Author(s):  
Cristianne Tomiyama ◽  
Andrea Higa ◽  
Maria A. Dalboni ◽  
Miguel Cendoroglo ◽  
Sergio A. Draibe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Calcification ◽  
Dialysis Patients ◽  
Traditional Risk Factors ◽  
The Impact
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