scholarly journals Risk of cardiovascular disease among patients with sarcoidosis: a population-based retrospective cohort study, 1976–2013

2016 ◽  
Vol 49 (2) ◽  
pp. 1601290 ◽  
Author(s):  
Patompong Ungprasert ◽  
Cynthia S. Crowson ◽  
Eric L. Matteson
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Cerebrovascular Accident ◽  
Index Date ◽  
Population Based ◽  
Artery Disease

A higher incidence of cardiovascular disease (CVD) has been observed in several chronic inflammatory diseases. However, data on sarcoidosis are limited.In this study, 345 patients with incident sarcoidosis in Olmsted County (Minnesota, USA) during 1976–2013 were identified based on comprehensive medical record review. 345 sex- and age-matched comparators were also identified from the same underlying population. Medical records were individually reviewed for CVD, including coronary artery disease, congestive heart failure, atrial fibrillation, cerebrovascular accident, transient ischaemic attack, peripheral arterial disease and abdominal aortic aneurysm. Cox proportional hazards models with adjustment for age, sex, calendar year and cardiovascular risk factors were used to compare the rate of development of CVD between cases and comparators.The prevalence of CVD before the index date was not significantly different between the two groups. Adjusting for age, sex and calendar year, the risk of incident CVD after the index date was significantly elevated among patients with sarcoidosis with an adjusted hazard ratio of 1.57 (95% CI 1.15–2.16). Adjustment for cardiovascular risk factors yielded an adjusted hazard ratio of 1.65 (95% CI 1.08–2.53). Significantly increased risk was also observed for several types of CVD, including coronary artery disease, congestive heart failure, atrial fibrillation and cerebrovascular accident.Increased incidence of CVD among patients with sarcoidosis was demonstrated in this population-based cohort, even after controlling for baseline traditional atherosclerotic risk factors.

scholarly journals Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Tiffany M. Powell-Wiley ◽  
Paul Poirier ◽  
Lora E. Burke ◽  
Jean-Pierre Després ◽  
Penny Gordon-Larsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Weight Loss ◽  
Coronary Artery ◽  
Disease Risk ◽  
Artery Disease ◽  
The Impact

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.

Abstract P108: Comorbidity Burden in Atrial Fibrillation: A Population-Based Case-Control Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Alanna M Chamberlain ◽  
Margaret C Byrne ◽  
Alvaro Alonso ◽  
Bernard J Gersh ◽  
Sheila M Manemann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Coronary Artery ◽  
Chronic Conditions ◽  
Diagnostic Code ◽  
Comorbidity Burden ◽  
Artery Disease ◽  
Population Controls

Background: Differences in the prevalence and duration of co-morbid conditions in atrial fibrillation (AF) patients compared to population controls have not been well documented. Methods: The prevalence and duration of 17 chronic conditions defined by the US Department of Health and Human Services, as well as anxiety, obesity, and smoking status, was obtained in a random sample of 1430 patients with incident AF from 2000-2010 and 1430 controls from Olmsted County, MN. Controls were matched to cases 1:1 on sex and age (within 5 years). Chronic conditions were ascertained electronically requiring 2 occurrences of a diagnostic code; the duration of each condition (up to 25 years) was calculated. Logistic regression determined associations of each condition with AF after adjustment for all other conditions. Results: Among the 1430 matched pairs (median age 76 years, 48.6% men), the prevalence of chronic conditions was higher in AF cases compared to controls for all conditions except asthma, dementia, depression, hepatitis, and osteoporosis (figure). However, the duration of the conditions were similar in AF compared to controls, except for hypertension (median duration 12.3 and 9.9 years in AF cases and controls, respectively; p=0.002). After adjusting for all other conditions, obesity, hypertension, congestive heart failure, coronary artery disease, chronic kidney disease, and chronic obstructive pulmonary disease remained significantly more common in AF compared to controls (figure). Conditions with the largest attributable risk of AF were hypertension (25.4%), coronary artery disease (17.7%), and congestive heart failure (12.3%). Conclusions: AF patients have a higher prevalence of many chronic conditions compared to population controls. However, besides hypertension, these comorbidities do not develop earlier in AF. Nevertheless, the excess comorbidity burden in AF is important to characterize and understand as it may partly explain the excess mortality and healthcare utilization experienced by AF patients.

Impact of stroke on heart function

ESC CardioMed ◽  
2018 ◽  
pp. 954-957
Author(s):  
Christoph Kleinschnitz
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Neurological Disease ◽  
Heart Function ◽  
Population Based ◽  
Cardiac Diseases ◽  
Possible Cause

Much emphasis has been placed on the heart as a possible cause of neurological disease. Cardiac diseases, such as atrial fibrillation, valvular heart disease, or congestive heart failure are well-established, important risk factors for ischaemic stroke. Within population-based studies, about 30% of ischaemic strokes are caused by cardiac diseases.

scholarly journals Risk Factors and Comorbidities Associated with Diabetic Kidney Disease

2021 ◽  
Vol 12 ◽  
pp. 215013272110485
Author(s):  
Satyajeet Roy ◽  
Olga Schweiker-Kahn ◽  
Behjath Jafry ◽  
Rachel Masel-Miller ◽  
Riya Sam Raju ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Peripheral Artery ◽  
Cerebrovascular Accidents ◽  
Patients With Diabetes ◽  
Artery Disease

Introduction/objectives: Diabetic Kidney Disease (DKD) is the leading cause of end-stage kidney disease. Despite optimal glycemic control and blood pressure management, progression to DKD cannot be halted in some patients. We aimed to find the association of modifiable and non-modifiable risk factors and comorbid conditions in patients with DKD. Methods: Retrospective medical record review of adult patients with diabetes mellitus (DM) was performed who visited our internal medicine office between January 1, 2020 and December 31, 2020. Results: Among 728 patients with DM, 471 (64.7%) patients had DKD, and 257 (35.3%) patients were without DKD. Among the group of patients with DKD, the majority were in CKD stage G1A2 (34.6%), followed equally by G2A2 and G3aA1 (16.8% each). Mean age of the patients with DKD was significantly greater than the patients without DKD (69.4 years vs 62.2 years; P < .001). For each unit increase in age, there was a 7.8% increase in the odds of DKD (95% CI 5.3-10.4; P < .001). Women had 2.32 times greater odds of DKD (95% CI, 1.41-3.81; P = .001). We found decreased odds of DKD for those who consumed alcohol moderately (OR 0.612, 95% CI 0.377-0.994; P < .05). Significantly higher frequencies of associations of several comorbid medical conditions were seen in patients with DKD compared to the patients without DKD, such as hypertension (91.9% vs 75.6%), hyperlipidemia (86.6% vs 78.2%), coronary artery disease (39.3% vs 16.8%), cerebrovascular accidents (13.4% vs 7.4%), congestive heart failure (12.9% vs 4.1%), carotid artery stenosis (11.3% vs 2.6%), aortic aneurysm (5.4% vs 2.0%), peripheral artery disease (10.8% vs 3.5%), gout (12.4% vs 5.5%), and osteoarthritis (41.4% vs 31.2%). Conclusions: In patients with diabetes, increasing age, female sex, and lack of moderate alcohol consumption were associated with increased odds of DKD. Higher frequencies of association of hypertension, hyperlipidemia, coronary artery disease, cerebrovascular accidents, congestive heart failure, carotid artery stenosis, aortic aneurysm, peripheral artery disease, gout, and osteoarthritis were also seen in patients with DKD.

scholarly journals Predictors and risk model for heart failure hospitalization in atrial fibrillation patients without pre-existing heart failure: the Fushimi AF Registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y Hamatani ◽  
M Iguchi ◽  
K Minami ◽  
K Ishigami ◽  
S Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Risk Model ◽  
The Mean ◽  
Artery Disease

Abstract Background Atrial fibrillation (AF) increases the risk of hospitalization for heart failure (HF), as well as that of thromboembolism. The strategy for prediction of thromboembolism has been well-established; however, little focus has been placed on the risk stratification for and prevention of HF hospitalization in AF patients. Purpose The aim of this study is to investigate the predictors and risk model of HF hospitalization in non-valvular AF patients without pre-existing HF. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,472 patients by the end of October 2020. From the registry, we excluded patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction [LVEF] &lt;40%), and those with valvular AF (mitral stenosis or prosthetic heart valve). Among 3,188 non-valvular AF patients without pre-existing HF, we explored the risk factors for the HF hospitalization during follow-up period. The risk model for predicting HF hospitalization was determined by the cumulative numbers of risk factors which were significant on multivariate analysis. Results The mean age was 72.4±10.8 years, 1197 were female and 1787 were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc scores were 1.7±1.2 and 2.9±1.6, respectively. During the median follow-up period of 5.1 years, HF hospitalization occurred in 285 (8.9%), corresponding to an annual incidence of 1.8 events per 100 person-years. In multivariable Cox regression analysis, advanced age (≥75 years), valvular heart disease, coronary artery disease, reduced LVEF (&lt;60%), chronic obstructive pulmonary disease (COPD) and anemia were independently associated with the higher incidence of HF hospitalization (all P&lt;0.001) (Picture 1). A risk model based on these 6 variables could stratify the incidence of HF hospitalization during follow-up period (log-rank; P&lt;0.001) (Picture 2). Patients with ≥3 risk factors had an 11-fold higher incidence of HF hospitalization compared with those not having any of these risk factors (hazard ratio: 11.3, 95% confidence interval: 7.0–18.4; P&lt;0.001). Conclusions Advanced age, coronary artery disease, valvular heart disease, reduced LVEF, COPD and anemia were independently associated with the risk of HF hospitalization in AF patients without pre-existing HF. There was good prediction for endpoint of HF hospitalization using these 6 variables, providing the opportunities for the implementation of strategies to reduce the incidence of HF among AF patients. FUNDunding Acknowledgement Type of funding sources: None.

Antithrombotic therapy in acute coronary syndrome and stable coronary artery disease patients with atrial fibrillation: a 3-year retrospective cohort study

2019 ◽  
Vol 16 (5) ◽  
pp. 399-407
Author(s):  
Jun Wu ◽  
Shenglan Lin ◽  
Chen Men ◽  
Xiangming Wang ◽  
Sen Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Coronary Artery ◽  
Dual Antiplatelet Therapy ◽  
Stable Coronary Artery Disease ◽  
Anticoagulation Therapy ◽  
Coronary Syndrome ◽  
Artery Disease

Aim: Acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) occur frequently in patients with atrial fibrillation (AF). However, the optimal antithrombotic therapy is still debated. Methods & results: We analyzed 976 coronary artery disease patients with AF from 2013 to 2014. ACS+AF patients tend to take dual antiplatelet therapy (p < 0.001), whereas SCAD+AF patients prefer anticoagulation therapy (warfarin: p < 0.001, dabigatran: p < 0.05). Ventricular arrhythmia, congestive heart failure and ACS were the top three reasons for SCAD group patients’ readmission, while reinfarction and congestive heart failure were two major factors in readmission of ACS group. Conclusion: ACS+AF group patients more likely choose dual antiplatelet therapy, whereas SCAD+AF group patients prefer anticoagulation therapy. Compared with ACS group, SCAD group had a higher rate of readmission.

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