Abstract P347: The Impact of the Length of the Follow-up on the the Strengths of the Associations Between Cardiovascular Risk Factors and Future Myocardial Infarction, Stroke and Heart Failure

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Lars Lind ◽  
Erik Ingelsson ◽  
Johan Sundström ◽  
Johan ärnlöv
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Outcomes ◽  
Rapid Decline ◽  
The Impact ◽  
Over Time

Objective: The aim of this study was to investigate how the length of the follow-up period influences the strength of the associations between major cardiovascular risk factors and different cardiovascular outcomes (myocardial infarction [MI], stroke and heart failure). Methods: We examined 1826 men aged 50 regarding cardiovascular risk factors in 1970-74. The follow-up time was 33 years. The hazard ratio (HR) was calculated yearly for each risk factor and outcome. During follow-up, 571 cases of MI, 381 cases of stroke and 384 cases of heart failure occurred. Results: Two major patterns were found regarding influence of the follow-up time on the associations between risk factors and the different cardiovascular outcomes. First, a gradual decline in the HR over time was seen for blood pressure in relation to all three outcomes, with the most rapid decline for heart failure and stroke. This pattern was also seen for BMI in relation to MI and heart failure, and for smoking regarding MI and stroke. Second, we observed a gradual increase in HRs to a maximum at 20-25 years, and thereafter a slight decline. This pattern was seen for the apoB/A1 ratio, HDL, and triglycerides, mainly in relation to MI and heart failure. Conclusion: The length of follow-up influenced the associations between traditional risk factors and cardiovascular outcomes in different ways. The collective influence of the risk factors did however show a substantial decline in discrimination over time for the outcomes stroke and heart failure, but not regarding myocardial infarction.

Factor XIII Val34Leu polymorphism and the risk of myocardial infarction under the age of 36 years

2008 ◽  
Vol 99 (06) ◽  
pp. 1085-1089 ◽  
Author(s):  
Marianna Politou ◽  
Christoforos Komporozos ◽  
Demosthenes Panagiotakos ◽  
Chrisoula Belessi ◽  
Anthi Travlou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Factor Xiii ◽  
Control Group ◽  
Lower Prevalence ◽  
Premature Coronary Heart Disease ◽  
Acute Mi ◽  
The Impact

SummaryThere are limited and controversial data regarding the impact of factor XIII (FXIII) Val34Leu polymorphism in the pathogenesis of premature myocardial infarction (MI). We examined whether FXIII Val34Leu polymorphism is associated with the development of early MI.We recruited 159 consecutive patients who had survived their first acute MI under the age of 36 years (mean age=32.1 ± 3.6 years, 138 were men). The control group consisted of 121 healthy individuals matched with cases for age and sex, without a family history of premature coronary heart disease (CHD). FXIII Val34Leu polymorphism was tested with polymerase chain reaction and reverse hybridization. There was a lower prevalence of carriers of the Leu34 allele in patients than in controls (30.2 vs. 47.1%, p=0.006). FXIII Val34Leu polymorphism was associated with lower risk for acute MI after adjusting for major cardiovascular risk factors (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.27–0.95, p=0.03). Subgroup analysis according to angiographic findings (“normal” coronary arteries [n=29] or significant CHD [n=130]) showed that only patients with MI and significant CHD had lower prevalence of carriers of the Leu34 allele compared to controls after adjusting for major cardiovascular risk factors (OR = 0.42, 95% CI 0.22–0.83, p=0.01). Our data indicate that FXIII Val34Leu polymorphism has a protective effect against the development of MI under the age of 36 years, particularly in the setting of significant CHD.

Has brief counselling an impact on the risk factors for cardiovascular disease in 40-year-old men. A three-year follow-up study

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 300-307 ◽  
Author(s):  
Anita Näslindh-Ylispangar ◽  
Marja Sihvonen ◽  
Seppo Sarna ◽  
Hannu Vanhanen ◽  
Pertti Kekki
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Repeated Measures ◽  
Follow Up Study ◽  
The Metabolic Syndrome ◽  
Old Men ◽  
The Impact

AbstractThe metabolic syndrome presents a serious challenge to health professionals. The aim of the present study is to analyze the impact of a brief counselling on cardiovascular risk factors among 40-year-old men. Forty-six males living in north-eastern Helsinki voluntarily completed the follow-up study between 2001 and 2004, and were assessed for clinical risk factors. The mean differences were determined by a paired t-test, and the interaction between groups and time by the F-test with repeated measures ANOVA. After baseline assessment and in 2002, males received a 45 minute nurse-delivered counselling session with self-administered protocol. Cardiovascular risk factors improved significantly (p<0.05) from baseline within months. However, the final measurements obtained after three years showed that almost all risk factors, except the low and high density lipoprotein, tended to revert back to baseline. The profiles were similar in all predictor groups. Brief counselling had an impact on risk factors measured in 2002, but only a partial effect on them in 2004. Conclusive results lead to the idea thatmore collaboration is needed between private health care agencies and official primary health care for ensuring the continuity of improved health habits among middle-aged males.

scholarly journals Mobile App and Digital System for Patients After Myocardial Infarction (AfterAMI); Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Michał Peller ◽  
Maria Boszko ◽  
Paulina Hoffman ◽  
Natalia Żurawska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Risk Factors ◽  
Controlled Trial ◽  
Mobile App ◽  
Clinical Practices ◽  
Open Label ◽  
The Impact

Abstract Background: Treatment of acute myocardial infarction has been studied and improved over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient's prognosis. It is extremely important to take care of all cardiovascular risk factors.Mobile application ‘afterAMI’ supported by a web system is a novel telemedical tool developed to support patients and physicians during cardiac rehabilitation. The application has an educational model with a focus on cardiovascular risk factors and lifestyle after myocardial infarction. Moreover, it offers a module that controls vital signs like blood pressure, heart rate, weight, and many others. Additionally, the application will send reminders for better drug adherence.Methods: A group of 100 patients with myocardial infarction on admission at the 1st Chair and Department and of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analysed, along with issues like rehospitalizations, patients' knowledge of risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1- and 6-months after inclusion into the study.Discussion: This project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registration: ClinicalTrials.gov, NCT04793425, registered 11 March 2021.

scholarly journals CLINICAL FEATURES OF THE REHABILITATION PERIOD AFTER THE PREVIOS MYOCARDIAL INFARCTION AND DECOMPENSATED HEART FAILURE WITH ACCOUNT OF CARDIOVASCULAR RISK FACTORS

2021 ◽  
pp. 26-31
Author(s):  
І. P. Vakaliuk ◽  
K. V. Levandovska ◽  
N. B. Tymochko
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Cardiovascular Risk Factors ◽  
Exercise Tolerance ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Study Groups

Cardiovascular diseases (CVD) are known to account for one-third of all deaths worldwide. According to the American Heart Association, 18% of men and 35% of women with prior acute myocardial infarction (AMI) developed recurrent AMI within 6 years after initial MI; 22% of men and 46% of women were disabled due to the development of chronic heart failure (CHF). The purpose of the research: to analyse clinical features of recovering period after myocardial infarction taking into account cardiovascular risk factors. Materials and methods of the research. 175 persons with myocardial infarction and related risk factors were examined. Study groups were homogenous by age, gender, disease severity, clinical signs of decompensation, that served as a basis for inclusion of the patients in the research. All patients underwent the general-clinical examination (pain syndrome analysis, medical history, objective signs), clinical and instrumental (electrocardiography, echocardioscopy, 6-minute walk test, in a quiet 30-50-m long hospital corridor in the morning) and laboratory tests (lipidogram, leptin level). Study groups were homogenous by age, gender, disease severity, duration of the post-infarction period, clinical signs of decompensation. All patients were divided into groups according to the presence of risk factors: group 1 of MI with HF (74 patients), group 2 – MI with AH (76 patients), group 3 – MI and obesity (72 patients); group 4 consisted of patients with all risk factors (78 patients) together. The obtained results were statistically processed on the personal computer by means of an advanced analytics software package STATISTICA-7 and a statistical software package “Microsoft-Excel” using the statistical variation analysis. Research results and their discussion. The most important cardiovascular risk factors, which aggravate the post infarction period are age, arterial hypertension, diabetes mellitus, heart failure, congenital and acquired valvular defects, obesity. In patients with heart failure, recovering period is characterized by stabile heartbeat, reduced exercise tolerance combined with progressing dilatation of left ventricular chambers in 83.78% of patients. Patients with arterial hypertension have stable anginal pain syndrome and reduced exercise tolerance (89.47% of cases). In obese patients, consistent fatigue, general weakness, dyspnoea, high levels of total cholesterol and leptin in blood serum (81.94% of patients) are mostly observed. In patients with combined heart failure, arterial hypertension, obesity, the recovery period clinics after myocardial infarction is characterized by significantly reduce of exercise tolerance (92.30% of patients). Shortness of breath, which was accompanied by heart palpitations, was prevalent in the group of patients with HF (89.1%) and was the least manifested in the group of patients with obesity (52.7%). Conclusions. Changes in cardiac hemodynamics in patients who had undergone the myocardial infarction with concomitant heart failure and with a combination of risk factors were accompanied by the eccentric hypertrophy onset, characterized by a combination of the left venricle cavities dilation with hypertrophy of its walls and the decreased contractility. The presence of decompensated heart failure significantly degrades the performance of six-minute walk test.

The Effects of Cardiovascular Risk Factors on Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Performance in Cognitively Healthy Older Adults

2019 ◽  
Author(s):  
Alyssa N De Vito ◽  
John P K Bernstein ◽  
Daniel Weitzner ◽  
Matthew Calamia ◽  
Jeffrey N Keller
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Depression Scale ◽  
Aging Research ◽  
Data Set ◽  
Neuropsychological Status ◽  
Repeatable Battery ◽  
The Impact ◽  
Over Time

Abstract Objective The current study investigated the differential impact cardiovascular risk factors (CVRFs) on Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) performance in a large, cognitively healthy, older adult sample across 4 years. Method Participants were 486 individuals recruited through a longitudinal aging research study in the southeastern United States. Participants were 69.3% female, an average of 69.96 years old (SD = 6.58), 16.32 years of education (SD = 2.27), and Mini-Mental Status Exam score of 29.12 (SD = 1.16). Participants completed the RBANS at baseline and yearly thereafter, as well as the Uniform Data Set demographic and health questionnaires and the Geriatric Depression Scale. Results Multilevel modeling was conducted using standardized RBANS index scores. Overall, across indices, performance generally improved across time consistent with practice effects from repeated testing. Some CVRFs were associated with worse performance over time. For example, individuals with hypertension performed more poorly on immediate memory over time (t = −2.06, p < .05). Other CVRFs (e.g., BMI) were not associated with baseline performance or performance over time. (p > .05). Conclusions CVRFs differentially affect RBANS performance over time. These results extend previous cross-sectional findings regarding the impact of different cardiovascular health risks to a large, cognitively healthy, longitudinal sample.

Abstract MP05: Impact of Gentrification on Cardiovascular Risk Factors and Outcomes in England: 2004-2018

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nrupen A Bhavsar ◽  
Danying Li ◽  
Miguel Ramos ◽  
Laura Richman
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
The United States ◽  
Living Environment ◽  
Length Of Residence ◽  
Lower Odds ◽  
Significant Difference ◽  
The Impact

Introduction: Dynamic changes to neighborhoods due to forces such as gentrification impact the health of residents. Much of this research has been conducted within the United States, where racial disparities and access to healthcare impact risk for health outcomes. Internationally, other factors may play a more prominent role in the association between gentrification and cardiovascular risk factors and outcomes. Hypothesis: Residents living in gentrified vs. non-gentrified neighborhoods will have lower odds of diabetes (DM), hypertension (HTN), depression and cardiovascular disease (CVD). Methods: We defined gentrification using changes in domains of the Index of Multiple Deprivation (IMD) at the level of the Lower Layer Super Output Areas (LSOA) in England from 2004-2010. We used all IMD domains (income, employment, education, crime, barriers to housing, and living environment), except the health domain, from 2004 and 2010 to define LSOA deprivation. The IMD for each LSOA was standardized to the mean IMD of England using z-scores. LSOAs were eligible to be gentrified if they had a positive z-score in 2004 and were considered to gentrify if they had a negative change in the transformed IMD from 2004 to 2010. We linked these data to individual participants in the Understanding Society Study (USS). The USS is a nationally representative cohort study of 60,000 United Kingdom residents started in 2009 with follow-up ongoing. We limited the analysis to residents in England who lived in top and bottom 25% deprived LSOAs (n=8782). We used multivariable logistic regression to calculate the odds ratio for self-reported DM, HTN, depression, and CVD in residents in neighborhoods that did and did not gentrify, adjusting for race, sex, length of residence (LOR), baseline IMD score, and baseline prevalence of health conditions. Results were stratified by age (<65 & >=65 years) and median LOR (<13 & >=13 years). Results: At baseline, 8782 participants had a median age of 43 years, 4% were black and 55% were female. There was no significant difference in the prevalence of DM, HTN, depression, or CVD at baseline. At follow-up, overall, there were no significant difference in the odds of DM, HTN, or CVD between residents living in gentrified vs. non-gentrified neighborhoods. Residents in neighborhoods that gentrified had a 39% lower odds of depression as compared to participants living in neighborhoods that did not gentrify (p=0.01). Results were not significantly modified by age or length of residence. Conclusions: Residents living in gentrified neighborhoods did not have differential risk for most CVD risk factors and outcomes as compared to residents living in neighborhoods that did not gentrify. However, the impact of gentrification on health is not uniform across all conditions. The positive health impact seen may suggest gentrification increases access to resources not present prior to gentrification.

scholarly journals Hypothetical interventions and risk of myocardial infarction in a general population: application of the parametric g-formula in a longitudinal cohort study—the Tromsø Study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035584
Author(s):  
Tom Wilsgaard ◽  
Anne Merete Vangen-Lønne ◽  
Ellisiv Mathiesen ◽  
Maja-Lisa Løchen ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Reduction ◽  
Absolute Risk

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Lechner ◽  
M Reindl ◽  
C Tiller ◽  
M Holzknecht ◽  
A Mayr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Aortic Stiffness ◽  
Prognostic Significance ◽  
St Elevation Myocardial Infarction ◽  
Adjusted Analysis ◽  
St Elevation ◽  
The Impact

Abstract Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regressionand logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p&lt;0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p&lt;0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p&gt;0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p=0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Austrian Science Fund (FWF)Austrian Society of Cardiology Figure 1. Biorender.com

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