scholarly journals Impact of Elevated Cystatin C Level on Cardiovascular Disease Risk in Predominantly High Cardiovascular Risk Populations

2010 ◽  
Vol 3 (6) ◽  
pp. 675-683 ◽  
Author(s):  
Meng Lee ◽  
Jeffrey L. Saver ◽  
Wen-Hung Huang ◽  
Jessica Chow ◽  
Kuo-Hsuan Chang ◽  
...  
2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.


2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.


Author(s):  
Denis Fabrício Valério ◽  
Arthur Fernandes Gáspari ◽  
Giovana Vergínea de Souza ◽  
Cleiton Augusto Libardi ◽  
Claudia Regina Cavaglieri ◽  
...  

Introduction: Physical inactivity is considered as one of the factors to increase the risk of developing cardiovascular diseases (CVDs) and decrease aerobic fitness mainly in middle-age. Increased habitual physical activity (HPA) is one of the strategies recommended to reduce physical inactivity. However, it is not known whether middle-age individuals who exclusively perform greater amount of HPA have greater aerobic fitness and / or a lower risk of CVDs. Objective: Verify the association between HPA with the risk of CVDs and aerobic fitness in individuals who only perform HPA. Method: We selected 89 male volunteers, age: 47.4 ± 5.06 years, who did not practice systemized physical training. Our measurements were: HPA by the International Physical Activity Questionnaire and Baecke questionnaires, the aerobic fitness by direct assessment of maximal oxygen consumption (VO2 máx) and the risk of developing cardiovascular disease by the score calculation of General Cardiovascular Risk Profile from Framingham Study. Results: There was no correlation of the HPA level with cardiovascular risk factors, general cardiovascular disease risk and VO2 máx. Moreover, no difference was found between the categorical groups of the IPAQ questionnaire and between the groups, “clusters”, calculated from the Baecke questionnaire scores for the variables of cardiovascular risk, general cardiovascular disease risk and VO2 máx. Conclusion: This study have found that the HPA level of middle-aged men is not associated with lower cardiovascular risk profile or higher aerobic fitness, suggesting that only increase HPA may not be enough to promote beneficial adaptations in aerobic fitness and improve risk profile for CVDs. These results may be related to low volume and intensity of HPA, which reinforces the importance of performing physical training with control of these variables for health promotion.


2021 ◽  
Vol 16 ◽  
Author(s):  
Esmee ME Bovee ◽  
Martha Gulati ◽  
Angela HEM Maas

Evidence has shown that women with a history of preeclampsia or haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome have an increased risk of cardiovascular disease later in life. Recommendations for screening, prevention and management after such pregnancies are not yet defined. The identification of promising non-traditional cardiovascular biomarkers might be useful to predict which women are at greatest risk. Many studies are inconsistent and an overview of the most promising biomarkers is currently lacking. This narrative review provides an update of the current literature on circulating cardiovascular biomarkers that may be associated with an increased cardiovascular disease risk in women after previous preeclampsia/HELLP syndrome. Fifty-six studies on 53 biomarkers were included. From the summary of evidence, soluble fms-like tyrosine kinase-1, placental growth factor, interleukin (IL)-6, IL-6/IL-10 ratio, high-sensitivity cardiac troponin I, activin A, soluble human leukocyte antigen G, pregnancy-associated plasma protein A and norepinephrine show potential and are interesting candidate biomarkers to further explore. These biomarkers might be potentially eligible for cardiovascular risk stratification after preeclampsia/HELLP syndrome and may contribute to the development of adequate strategies for prevention of hypertension and adverse events in this population.


2021 ◽  
Vol 8 ◽  
Author(s):  
Guan Wang ◽  
Yanbo Zhang ◽  
Sijin Li ◽  
Jun Zhang ◽  
Dongkui Jiang ◽  
...  

Objective: Preeclampsia affects 2–8% of women and doubles the risk of cardiovascular disease in women after preeclampsia. This study aimed to develop a model based on machine learning to predict postpartum cardiovascular risk in preeclamptic women.Methods: Collecting demographic characteristics and clinical serum markers associated with preeclampsia during pregnancy of 907 preeclamptic women retrospectively, we predicted the cardiovascular risk (ischemic heart disease, ischemic cerebrovascular disease, peripheral vascular disease, chronic kidney disease, metabolic system disease or arterial hypertension). The study samples were divided into training sets and test sets randomly in the ratio of 8:2. The prediction model was developed by 5 different machine learning algorithms, including Random Forest. 10-fold cross-validation was performed on the training set, and the performance of the model was evaluated on the test set.Results: Cardiovascular disease risk occurred in 186 (20.5%) of these women. By weighing area under the curve (AUC), the Random Forest algorithm presented the best performance (AUC = 0.711[95%CI: 0.697–0.726]) and was adopted in the feature selection and the establishment of the prediction model. The most important variables in Random Forest algorithm included the systolic blood pressure, Urea nitrogen, neutrophil count, glucose, and D-Dimer. Random Forest algorithm was well calibrated (Brier score = 0.133) in the test group, and obtained the highest net benefit in the decision curve analysis.Conclusion: Based on the general situation of patients and clinical variables, a new machine learning algorithm was developed and verified for the individualized prediction of cardiovascular risk in post-preeclamptic women.


2019 ◽  
Vol 104 (12) ◽  
pp. 6033-6039 ◽  
Author(s):  
David S Schade ◽  
R Philip Eaton

Abstract Context Cardiovascular disease remains the number one cause of morbidity and mortality in the United States, despite major advances in our understanding of its pathogenesis and prevention. One reason for this continued epidemic is the poor adherence to treatment guidelines by caregivers and the lack of understanding by patients relative to its reversibility with treatment. Current guidelines are complex and often contradictory; there are at least 21 organizations publishing guidelines. Objective This article proposes a simplified approach that is based on the low-density lipoprotein (LDL) hypothesis stating that the lower the LDL cholesterol (LDL-C), the less the cardiovascular disease. This goal focuses on obtaining a plasma LDL-C <50 mg/dL. Design A positive coronary artery calcium scan in conjunction with an intermediate online cardiovascular risk score will identify individuals with substantial cardiovascular disease risk. With lifestyle improvements (including a low cholesterol diet) and low-dose hypolipemic generic oral medications, this LDL-C concentration is readily achievable in the majority of asymptomatic patients at risk for atherosclerosis. Conclusion Controlling the cardiovascular epidemic will require participation of both the patient and the physician caregiver. By simplifying the therapeutic regimen, patient compliance will increase, and an important reduction in cardiovascular morbidity and mortality will follow.


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