scholarly journals Cardiovascular Disease Events and Mortality After Myocardial Infarction Among Black and White Adults

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
J. Walker Blackston ◽  
Monika M. Safford ◽  
Matthew T. Mefford ◽  
Elizabeth Freeze ◽  
George Howard ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Health Status ◽  
Racial Differences ◽  
Treatment Strategies ◽  
Primordial Prevention ◽  
Black And White ◽  
White Adults

Background: Despite improvements in prognosis following myocardial infarction (MI), racial disparities persist. The objective of this study was to examine disparities between Black and White adults in cardiovascular disease (CVD), coronary heart disease, stroke, heart failure (HF), and mortality after MI and characteristics that may explain the disparities. Methods: This prospective cohort study included 1122 REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants with incident MI between 2003 and 2016. We followed participants for subsequent CVD events (MI, stroke, HF hospitalization, or death from CVD; n=431), coronary heart disease events (MI or death from coronary heart disease; (n=277), stroke (n=68), HF events (HF hospitalization or death from HF; n=191), and all-cause mortality (n=527; 3-year median follow-up after MI). Results: Among 1122 participants with incident MI, 37.5% were Black participants, 45.4% were women, and mean age was 73.2 (SD, 9.5) years. The unadjusted hazard ratio for CVD events comparing Black to White participants was 1.42 (95% CI, 1.17–1.71). Adjusting for sociodemographic characteristics did not attenuate the association (1.41 [95% CI, 1.14–1.73]), but further adjusting for pre-MI health status (1.25 [95% CI, 1.00–1.56]) and characteristics of the MI (1.01 [95% CI, 0.80–1.27]) resulted in substantial attenuation. Similar patterns were observed for the other outcomes, although the number of strokes was small. Conclusions: Black individuals had a higher risk of CVD events and mortality after MI than White individuals. The disparities were explained by health status before MI and characteristics of the MI. These findings suggest that both primordial prevention of risk factors and improved acute treatment strategies are needed to reduce disparities in post-MI outcomes.

scholarly journals PROFIL PENYAKIT JANTUNG KORONER DI IRINA F JANTUNG RSUP PROF. Dr. R. D. KANDOU MANADO

e-CliniC ◽  
2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Andi Eka Dharma Putra Syukri
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Arteries ◽  
Communicable Disease ◽  
Cardiovascular Disorder ◽  
Industrial Country ◽  
Unhealthy Lifestyle ◽  
Old Myocardial Infarction

Abstract: Heart and Blood Vessels Disease is the leading cause of cardiovascular disorder that mostly happened in developed or industrial country, related to new communicable disease or “infection” caused by imitation of unhealthy lifestyle.1 The cardiovascular disease divided into several type of heart disease such as; coronary heart disease (CHD) that caused by narrowing of of the coronary arteries due to deposition of fat gathering in and around the cells lining the walls of the coronary arteries and blocking of the blood flow. This research aimed to know the  CHD Profile in Irina F Jantung of RSUP Prof.Dr. R.D Kandou Manado in period of January-December 2010. This was retrospective-descriptive study that used medical records in Irina F Jantung of RSUP. Prof. Dr. R.D Kandou Manado. During this period of this research reported 230 cases of CHD; 69 cases (30%) byage groups 61-70 years old, 159 cases (69,13%) by gender and 86 cases were accompanied disease with the greatest proportion of Hypertension 52 cases (55,32%), and Old Myocardial Infarction (OMI) 71 cases (30,87%) as being the most clinical symptom. The frequency of Cardiovascular disease will be increasing every year if there’s no change of diet and unhealthy lifestyle by people in both urban and rural environments and other degenerative diseases are caused. Key words: Heart Disease, Coronary Heart Disease, Old Myocardial Infarction   ABSTRAK : Penyakit Jantung dan Pembuluh Darah (PJPD) adalah penyakit yang mengakibatkan gangguan jantung dan pembuluh darah, paling sering terjadi di negara maju atau negara industri akibat ‘penularan’ yang disebabkan peniruan gaya hidup kurang sehat.1 Penyakit Jantung ini terbagi dalam beberapa jenis penyakit jantung lainnya diantaranya adalah Penyakit Jantung Koroner (PJK) penyakit jantung yang disebabkan oleh penyempitan arteri koroner akibat dari berkumpulnya endapan lemak di dalam dan sekitar sel yang melapisi dinding arteri koroner sehingga menyumbat aliran darah. Tujuan penelitian ini adalah untuk mengetahui Profil PJK di Irina F Jantung Rsup Prof. Dr. R. D Kandou Manado Periode Januari 2010 - Desember 2010. Penelitian ini bersifat deskriptif dengan metoderetrospektif menggunakan buku register di Irina F Jantung RSUP. Prof. Dr. R.D Kandou Manado periode Januari 2010 sampai Desember 2010. Selama periode Januari 2010 sampai Desember 2010 di Irina F Jantung Rsup Prof. Dr. R. D Kandou Manado tercatat 230 kasus PJK. Berdasarkan kelompok Umur 61-70 tahun sebanyak 69 kasus (30%), Jenis Kelamin sebanyak 159 kasus (69,13%), 86 kasus disertai penyakit penyerta yang terbanyak diantaranya Hipertensi 52 kasus (55,32%), dan manifestasi klinis yang didapat adalah Old Myocardial Infarction (OMI) sebanyak 71 kasus (30,87%). Setiap tahun frekuensi penyakit ini akan terus meningkat jika tidak di atur pola makan atau gaya hidup masyarakat yang kurang sehat, baik di lingkungan urban maupun rural dan disebabkan penyakit degeneratif lainnya. Kata kunci: Penyakit Jantung, Jantung Koroner, Old infark miokard

scholarly journals Comparative Effect of Statins and Omega-3 Supplementation on Cardiovascular Events: Meta-Analysis and Network Meta-Analysis of 63 Randomized Controlled Trials Including 264,516 Participants

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2218 ◽  
Author(s):  
Tung Hoang ◽  
Jeongseon Kim
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Omega 3 ◽  
Randomized Controlled

Statins and omega-3 supplementation have been recommended for cardiovascular disease prevention, but comparative effects have not been investigated. This study aimed to summarize current evidence of the effect of statins and omega-3 supplementation on cardiovascular events. A meta-analysis and a network meta-analysis of 63 randomized controlled trials were used to calculate pooled relative risks (RRs) and 95% confidence intervals (CIs) for the effects of specific statins and omega-3 supplementation compared with controls. Overall, the statin group showed significant risk reductions in total cardiovascular disease, coronary heart disease, myocardial infarction, and stroke; however, omega-3 supplementation significantly decreased the risks of coronary heart disease and myocardial infarction only, in the comparison with the control group. In comparison with omega-3 supplementation, pravastatin significantly reduced the risks of total cardiovascular disease (RR = 0.81, 95% CI = 0.72–0.91), coronary heart disease (RR = 0.75, 95% CI = 0.60–0.94), and myocardial infarction (RR = 0.71, 95% CI = 0.55–0.94). Risks of total cardiovascular disease, coronary heart disease, myocardial infarction, and stroke in the atorvastatin group were statistically lower than those in the omega-3 group, with RRs (95% CIs) of 0.80 (0.73–0.88), 0.64 (0.50–0.82), 0.75 (0.60–0.93), and 0.81 (0.66–0.99), respectively. The findings of this study suggest that pravastatin and atorvastatin may be more beneficial than omega-3 supplementation in reducing the risk of total cardiovascular disease, coronary heart disease, and myocardial infarction.

A comparison of the associations between risk factors and cardiovascular disease in Asia and Australasia

2005 ◽  
Vol 12 (5) ◽  
pp. 484-491 ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
New Zealand ◽  
Treatment Strategies ◽  
Haemorrhagic Stroke ◽  
Vascular Risk ◽  
Prevention And Treatment

Background Cardiovascular disease is already the leading cause of death in many Asian populations. Relationships between vascular risk factors and cardiovascular disease may differ in Asian and western populations. Previously, a lack of prospective data has prevented the reliable quantification of such differences, which, if they were shown to exist, would suggest that novel cardiovascular prevention and treatment strategies are required for Asia. Design An individual participant data meta-analysis of 32 studies from the Asia-Pacific region involving 331 100 subjects (75% from Asia; 25% from the predominantly Caucasian populations of Australia and New Zealand). Methods Outcomes were death from coronary heart disease, ischaemic and haemorrhagic stroke. Hazard ratios were estimated from Cox models for systolic blood pressure (SBP), total cholesterol, triglycerides, body mass index, diabetes and current cigarette smoking, stratified by study and sex and adjusted for age, the other risk factors and regression dilution. Results After an average period of follow-up of 4 years there were 2082 deaths from coronary heart disease, 600 from haemorrhagic stroke and 420 from ischaemic stroke. The direction and strength of the associations between risk factors and cardiovascular outcomes were similar in the two regions, although in two cases there were significant differences. Triglycerides were more strongly associated with coronary heart disease in Australia and New Zealand ( P = 0.03), whereas SBP showed a stronger relationship with haemorrhagic stroke in Asia ( P = 0.04). Conclusions Classical vascular risk factors act similarly in Asian and Caucasian populations; prevention and treatment strategies should thus be similar. Blood pressure reduction should be particularly effective in Asia.

scholarly journals Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study

BMJ ◽  
2019 ◽  
pp. l1855 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
Taavi Tillmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Odds Ratio ◽  
Lower Risk ◽  
Smoking Behaviour ◽  
Mendelian Randomisation

AbstractObjectivesTo investigate the role of body mass index (BMI), systolic blood pressure, and smoking behaviour in explaining the effect of education on the risk of cardiovascular disease outcomes.DesignMendelian randomisation study.SettingUK Biobank and international genome-wide association study data.ParticipantsPredominantly participants of European ancestry.ExposureEducational attainment, BMI, systolic blood pressure, and smoking behaviour in observational analysis, and randomly allocated genetic variants to instrument these traits in mendelian randomisation.Main outcomes measureThe risk of coronary heart disease, stroke, myocardial infarction, and cardiovascular disease (all subtypes; all measured in odds ratio), and the degree to which this is mediated through BMI, systolic blood pressure, and smoking behaviour respectively.ResultsEach additional standard deviation of education (3.6 years) was associated with a 13% lower risk of coronary heart disease (odds ratio 0.86, 95% confidence interval 0.84 to 0.89) in observational analysis and a 37% lower risk (0.63, 0.60 to 0.67) in mendelian randomisation analysis. As a proportion of the total risk reduction, BMI was estimated to mediate 15% (95% confidence interval 13% to 17%) and 18% (14% to 23%) in the observational and mendelian randomisation estimates, respectively. Corresponding estimates were 11% (9% to 13%) and 21% (15% to 27%) for systolic blood pressure and 19% (15% to 22%) and 34% (17% to 50%) for smoking behaviour. All three risk factors combined were estimated to mediate 42% (36% to 48%) and 36% (5% to 68%) of the effect of education on coronary heart disease in observational and mendelian randomisation analyses, respectively. Similar results were obtained when investigating the risk of stroke, myocardial infarction, and cardiovascular disease.ConclusionsBMI, systolic blood pressure, and smoking behaviour mediate a substantial proportion of the protective effect of education on the risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of cardiovascular disease attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation.

scholarly journals APOL1 Kidney Risk Variants and Cardiovascular Disease: An Individual Participant Data Meta-Analysis

2019 ◽  
Vol 30 (10) ◽  
pp. 2027-2036 ◽  
Author(s):  
Morgan E. Grams ◽  
Aditya Surapaneni ◽  
Shoshana H. Ballew ◽  
Lawrence J. Appel ◽  
Eric Boerwinkle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Risk Variants ◽  
Individual Participant ◽  
Incident Cardiovascular Disease

BackgroundTwo coding variants in the apo L1 gene (APOL1) are strongly associated with kidney disease in blacks. Kidney disease itself increases the risk of cardiovascular disease, but whether these variants have an independent direct effect on the risk of cardiovascular disease is unclear. Previous studies have had inconsistent results.MethodsWe conducted a two-stage individual participant data meta-analysis to assess the association of APOL1 kidney-risk variants with adjudicated cardiovascular disease events and death, independent of kidney measures. The analysis included 21,305 blacks from eight large cohorts.ResultsOver 8.9±5.0 years of follow-up, 2076 incident cardiovascular disease events occurred in the 16,216 participants who did not have cardiovascular disease at study enrollment. In fully-adjusted analyses, individuals possessing two APOL1 kidney-risk variants had similar risk of incident cardiovascular disease (coronary heart disease, myocardial infarction, stroke and heart failure; hazard ratio 1.11, 95% confidence interval, 0.96 to 1.28) compared to individuals with zero or one kidney-risk variant. The risk of coronary heart disease, myocardial infarction, stroke and heart failure considered individually was also comparable by APOL1 genotype. APOL1 genotype was also not associated with death. There was no difference in adjusted associations by level of kidney function, age, diabetes status, or body-mass index.ConclusionsIn this large, two-stage individual participant data meta-analysis, APOL1 kidney-risk variants were not associated with incident cardiovascular disease or death independent of kidney measures.

scholarly journals Association of Nonacute Opioid Use and Cardiovascular Diseases: A Scoping Review of the Literature

2021 ◽  
Author(s):  
Jade H. Singleton ◽  
Erin L. Abner ◽  
Peter D. Akpunonu ◽  
Anna M. Kucharska‐Newton
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Scoping Review ◽  
Opioid Use ◽  
The Relationship

BACKGROUND In this scoping review, we identified and reviewed 23 original articles from the PubMed database that investigated the relationship between nonacute opioid use (NOU) and cardiovascular outcomes. METHODS AND RESULTS We defined NOU to include both long‐term opioid therapy and opioid use disorder. We summarized the association between NOU and 5 classes of cardiovascular disease, including infective endocarditis, coronary heart disease (including myocardial infarction), congestive heart failure, cardiac arrythmia (including cardiac arrest), and stroke. The most commonly studied outcomes were coronary heart disease and infective endocarditis. There was generally consistent evidence of a positive association between community prevalence of injection drug use (with opioids being the most commonly injected type of drug) and community prevalence of infective endocarditis, and between (primarily medically indicated) NOU and myocardial infarction. There was less consensus about the relationship between NOU and congestive heart failure, cardiac arrhythmia, and stroke. CONCLUSIONS There is a dearth of high‐quality evidence on the relationship between NOU and cardiovascular disease. Innovative approaches to the assessment of opioid exposure over extended periods of time will be required to address this need.

scholarly journals Depressive Symptoms and Complications Early after Acute Myocardial Infarction: Gender Differences

2018 ◽  
Vol 12 (1) ◽  
pp. 205-214 ◽  
Author(s):  
Mohannad Eid AbuRuz ◽  
Ghadeer Al-Dweik
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Gender Differences ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Assessment Tools ◽  
Male Patients

Background:Cardiovascular disease is the first leading cause of death worldwide. Coronary heart disease is the most common manifestation of cardiovascular disease. Acute myocardial infarction is the primary manifestation of coronary heart disease. Depression is a common and predicted complication after acute myocardial infarction. Limited studies evaluated gender differences in depressive symptoms after acute myocardial infarction especially in developing countries.Objective:The study aimed to determine whether there was a difference in depression levels and rate of complications based on gender early after acute myocardial infarction.Method:This was a prospective comparative study on 230 patients (150 men and 80 women) with a confirmed diagnosis of acute myocardial infarction. All participants signed an informed consent, filled sociodemographic and clinical questionnaire and the Depression Subscale of the Hospital Anxiety and Depression Scale. Clinical data were abstracted from the participants’ medical record after discharge.Results:Eighty-six participants (37.4%), 54 men and 32 women, developed 1 or more complications during hospitalization. Female patients were more depressed (14.4±3.5vs.8.3 ± 2.6) and developed more complications (1.9 ± 0.9vs.0.8 ± 0.5) than male patients did. Depressive symptoms increased the occurrence of complication by 40% and 33% for female and male patients respectively after controlling for sociodemographic and clinical variables.Conclusion:Depressive symptoms independently predicted complications after acute myocardial infarction in both men and women. The inclusion of depression assessment tools in acute myocardial infarction treatment protocols is highly recommended.

Diabetes and Cardiovascular Disease During Androgen Deprivation Therapy for Prostate Cancer

2006 ◽  
Vol 24 (27) ◽  
pp. 4448-4456 ◽  
Author(s):  
Nancy L. Keating ◽  
A. James O'Malley ◽  
Matthew R. Smith
Keyword(s):  
Prostate Cancer ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Androgen Deprivation Therapy ◽  
Gnrh Agonist ◽  
Cardiac Death ◽  
Androgen Deprivation

Purpose Androgen deprivation therapy with a gonadotropin-releasing hormone (GnRH) agonist is associated with increased fat mass and insulin resistance in men with prostate cancer, but the risk of obesity-related disease during treatment has not been well studied. We assessed whether androgen deprivation therapy is associated with an increased incidence of diabetes and cardiovascular disease. Patients and Methods Observational study of a population-based cohort of 73,196 fee-for-service Medicare enrollees age 66 years or older who were diagnosed with locoregional prostate cancer during 1992 to 1999 and observed through 2001. We used Cox proportional hazards models to assess whether treatment with GnRH agonists or orchiectomy was associated with diabetes, coronary heart disease, myocardial infarction, and sudden cardiac death. Results More than one third of men received a GnRH agonist during follow-up. GnRH agonist use was associated with increased risk of incident diabetes (adjusted hazard ratio [HR], 1.44; P < .001), coronary heart disease (adjusted HR, 1.16; P < .001), myocardial infarction (adjusted HR, 1.11; P = .03), and sudden cardiac death (adjusted HR, 1.16; P = .004). Men treated with orchiectomy were more likely to develop diabetes (adjusted HR, 1.34; P < .001) but not coronary heart disease, myocardial infarction, or sudden cardiac death (all P > .20). Conclusion GnRH agonist treatment for men with locoregional prostate cancer may be associated with an increased risk of incident diabetes and cardiovascular disease. The benefits of GnRH agonist treatment should be weighed against these potential risks. Additional research is needed to identify populations of men at highest risk of treatment-related complications and to develop strategies to prevent treatment-related diabetes and cardiovascular disease.

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