scholarly journals Coronary risk reduction intervention for siblings and offspring of patients with premature coronary heart disease: the CRISO study protocol for a randomised controlled pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Justin Lee Mifsud ◽  
John Stephenson ◽  
Felicity Astin ◽  
Joseph Galea
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Pilot Study ◽  
High Risk ◽  
Control Group ◽  
Preventive Cardiology ◽  
Premature Coronary Heart Disease ◽  
First Degree Relatives ◽  
Increased Risk ◽  
Randomised Controlled

Abstract Background Research has consistently demonstrated that preventive cardiology programs have limited success, and healthy practices among high-risk individuals remain suboptimal. Furthermore, there are no current programmes in Malta that offer support to first-degree relatives of patients with premature coronary heart disease. This internal pilot study will determine the feasibility, acceptability, and potential effectiveness of a preventative intervention. Methods/design We are conducting a 12-month single-centre, two-armed group randomised controlled trial (RCT), recruiting a sample of 100 asymptomatic first-degree relatives of patients with premature coronary heart disease (CHD). The study seeks to test an evidence-based intervention to reduce modifiable risk and determine its feasibility and acceptability. The Intervention will be delivered at an outpatient office based in a large acute academic hospital. It will comprise risk communication using an online risk calculator, a counselling style adapted from motivational interviewing, and 12 weekly telephone goal reinforcement calls (3 months). Control subjects will receive verbal lifestyle advice only. Feasibility will be assessed through recruitment and retention. Qualitative evaluation interviews will be conducted with a subsample of 24 purposefully selected participants at 12 months. Assessment for risk factor changes will be measured at pre-intervention and 6 and 12 months. Associations between variables will also be assessed descriptively. Discussion Preventive cardiology guidelines highlighted the importance of lifestyle interventions, and lifestyle intervention adherence was proven to reduce atherosclerotic cardiovascular disease (ASCVD) risk, regardless of the individual's genetic risk. Preventive cardiology programmes may fail to adequately support persons in modifying risky behaviours, and research demonstrates that healthy practices among high-risk individuals can remain suboptimal. Siblings and offspring of patients with premature CHD are at increased risk of ASCVD. Despite this, there is no process in place for routine screening and support to modify risk. It is hypothesised that participants assigned to the intervention arm will show more cardio-protective lifestyle-related improvement from the baseline than those in the control group. To date, this is the first trial being conducted amongst Maltese first-degree relatives. This study addresses the needed research, and the results will inform a definitive trial. The funding institution is the University of Malta. Trial registration ISRCTN, ISRCTN21559170; Registered 06/08/2020,

Preventive Cardiology

2020 ◽  
Keyword(s):  
Heart Disease ◽  
Treatment Algorithm ◽  
Adult Life ◽  
Heart Association ◽  
Cardiac Risk ◽  
Population Based ◽  
Preventive Cardiology ◽  
Premature Coronary Heart Disease ◽  
Premature Cardiovascular Disease ◽  
Increased Risk

Key Points The etiology of premature cardiovascular disease in children is multifactorial Hypocholesteremia Obesity/lack of physical activity Smoking The goals of preventive cardiology are to Prevent, identify, and treat potential atherosclerotic cardiac risk factors. Educate children and families on preventive strategies. Intervene early to decrease the burden of atherosclerotic heart disease in adult life. The American Heart Association and American Academy of Pediatrics have proposed a risk stratification and treatment algorithm for children at increased risk for premature coronary heart disease. The National Cholesterol Education Program recommends 2 separate approaches to managing hypercholesterolemia in children. Broad, population-based approach Iindividualized patient approach

P639Benefits and safety of exercise training in patients with severe three coronary vessels disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Rojano ◽  
H Ilarraza Lomeli ◽  
M Garcia Saldivia ◽  
M Rius Suarez ◽  
A Lopez Garcia ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Cardiac Rehabilitation ◽  
Cardiopulmonary Exercise Testing ◽  
Rehabilitation Program ◽  
Control Group ◽  
Syntax Score ◽  
Cardiopulmonary Exercise ◽  
Very High

Abstract Background Coronary heart disease is the leading cause of death in the world. Nowadays, there are still patients with untreatable coronary obstructions and exercise therapy could be an option to improve their quality of life and probably diminish mortality. Cardiac rehabilitation programs are recommended worldwide due its effectiveness and safety. However very high risk patients are often not included. Purpose To evaluate the benefit and safety of exercise therapy as a part of a cardiac rehabilitation program in patients with untreatable severe coronary heart disease. Methods A cohort of patients with coronary heart disease included in a cardiac rehabilitation program were studied. Those with severe coronary heart disease (Syntax score ≥33, group A) were identified. Patients were stratified using clinical records and cardiopulmonary exercise testing. They trained for 30 minutes, five times a week of aerobic exercise (cycle ergometer) and this therapy was complemented with general strength, coordination, balance and flexibility maneuvers. After twenty exercise sessions, a second cardiopulmonary exercise test was performed. Symptom limited cardiopulmonary exercise testing was undertaken using a ramp Balke protocol and cardiopulmonary variables were recorded. These patients were compared with their counterparts without severe coronary heart disease (Control group, group B). Studied variables were presented as frequencies (%), mean (SD), median (range) as appropriate. Comparisons between groups were made using chi square or paired T test as needed. All p values <0.05 were considered stochastically significant. Results From a total of 546 patients, seventy-one had severe coronary heart disease (Syntax score ≥33). There were no significant differences between groups on change of METs value and number of sessions assisted. No major adverse cardiovascular outcome was observed. The percentage of exercise induced arrhythmias was 75% in very high risk group vs 76% in control group, (p>0.05). Results are shown in table 1. Table 1. Characteristics between groups Patients Group A (n=75) Group B (n=471) p value Assisted training sessions 15±7 14±6 ns Increment in MET (ml/kg/min) 1.32±1.34 1.35±1.56 ns Arrhythmias, n (%) 56 (75) 370 (76) ns Angor/ST depression, n (%) 11 (15) 15 (3) <0.01 Differences in workload (Watts) 20±13 22±13 ns Conclusion Exercise training could be performed in an effective and safe manner in patients with very high risk untreated coronary heart disease.

scholarly journals Premature coronary heart disease and autosomal dominant hypercholesterolemia: Increased risk in women with LDLR mutations

2016 ◽  
Vol 10 (1) ◽  
pp. 101-108.e3 ◽  
Author(s):  
Zahid Ahmad ◽  
Xilong Li ◽  
Jedrek Wosik ◽  
Preethi Mani ◽  
Joye Petr ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Autosomal Dominant ◽  
Premature Coronary Heart Disease ◽  
Increased Risk

Abstract P290: Stroke and Coronary Heart Disease - Predictive Power of Standard Risk Factors Until Old Age

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Wai Giang Kok ◽  
Lena M Bjorck ◽  
Masuma Novak ◽  
George Lappas ◽  
Annika Rosengren
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Old Age ◽  
Previous History ◽  
Cumulative Risk ◽  
Cumulative Effect ◽  
Risk Groups ◽  
Increased Risk ◽  
Score Model

Introduction and Aim: The SCORE model, based on age, sex, current smoking and systolic blood pressure, and serum cholesterol, was created to identify persons at increased risk for fatal cardiovascular disease (CVD) defined as death from coronary heart disease (CHD) or stroke within 10 years. We aimed to examine the short-term and long-term risk for CHD and stroke separately. Methods and Results: The Primary Prevention cohort study comprising 7174 men free from previous history of CHD, stroke and diabetes and aged 45 to 55 at baseline examination (1970–73) were followed up for 35 years. To estimate the cumulative effect of CHD and stroke, all participants were stratified into one of four risk groups defined by their burden of risk according to the SCORE factors. The 35 year relative risk (RR) for the men with the highest risk compared to those with the lowest was 3.38 (95 % CI 2.84–4.02) for CHD and 1.60 (95% CI 1.28–2.00) for stroke. When adjusted for competing risk the estimated 10 year cumulative risk for high risk individuals was 19.4% for CHD and 3.6% for stroke which increased substantially to 87% and 70% respectively after 35 years. Conclusions: The 10 year risk for CHD and stroke as calculated by the SCORE factors differs which indicates that the cumulative risk in middle age men based on the SCORE model can effectively be used to predict CHD but not stroke to the same extent. However, over an extended follow-up period until old age, the cumulative risk for stroke increased markedly such that high risk individuals developed a high cumulative risk for both CHD and stroke after 35 years.

scholarly journals Ad libitum Mediterranean diet reduces subcutaneous but not visceral fat in patients with coronary heart disease: A randomised controlled pilot study

2019 ◽  
Vol 32 ◽  
pp. 61-69 ◽  
Author(s):  
Hannah L. Mayr ◽  
Catherine Itsiopoulos ◽  
Audrey C. Tierney ◽  
Teagan Kucianski ◽  
Jessica Radcliffe ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Pilot Study ◽  
Mediterranean Diet ◽  
Visceral Fat ◽  
Ad Libitum ◽  
Randomised Controlled

Sex hormones and lipoproteins in adolescent male offspring of parents with premature coronary heart disease and a control group

1998 ◽  
Vol 133 (4) ◽  
pp. 526-532 ◽  
Author(s):  
John A. Morrison ◽  
Dennis L. Sprecher ◽  
Frank M. Biro ◽  
Carolyn Apperson Hansen ◽  
Anne W. Lucky ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Sex Hormones ◽  
Male Offspring ◽  
Adolescent Male ◽  
Control Group ◽  
Premature Coronary Heart Disease

scholarly journals Analysis for interaction between interleukin-35 gene polymorphisms and risk factors on susceptibility to coronary heart disease in the Chinese Han population

2020 ◽  
Author(s):  
Hu LI ◽  
Ying-Xue LIU ◽  
Jin-Yan Huang ◽  
Yu- Feng Zhu ◽  
Kui Wang
Keyword(s):  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Heart Disease ◽  
Cross Validation ◽  
Sign Test ◽  
Control Group ◽  
Environment Interaction ◽  
Current Smoking ◽  
Chd Risk ◽  
Increased Risk

Abstract Objective To explore the effect of single nucleotide polymorphisms (SNPs) of interleukin-35 (IL-35) gene and its relationship with environment on the risk of coronary heart disease (CHD). Methods Prior to the analysis, we performed hardy Weinberg equilibrium test on the control group. The relationship between the four SNPs of IL-35 gene and the risk of coronary heart disease was studied by multivariate logistic regression. The best interaction was identified with generalized multifactor dimensionality reduction (GMDR). Logistic regression was used for investigation on association between four SNPs and CHD risk. Results Logistic regression analysis showed that the C allele of rs428253 and the G allele of rs2243115 were independently correlated with increased risk of CHD, and adjusted ORs (95%CI) were 1.91 (1.28–2.64) and 1.80 (1.30–2.23), respectively. However, there was no significant association between CHD and rs4740 or rs568408. GMDR model, indicated the best model for CHD risk consisted of rs428253 and current smoking, which scored 10/10 for both the sign test and cross-validation consistency (P = 0.010). Therefore, this overall multi-dimensional model had the highest cross-validation consistency, regardless of how the data were divided. This provided an evidence of gene-environment interaction effects. We also found that current smokers with rs428253 - GC/ CC genotype have the highest CHD risk, compared to subjects with never smokers with rs428253 - GG genotype, OR (95%CI) = 3.04 (1.71–4.41), after adjustment for age, gender, hypertension, T2DM and alcohol consumption status. Conclusions In this study, the C allele of rs428253 and the G allele of rs2243115, and the interaction rs428253 and current smoking were correlated with increased risk of CHD.

scholarly journals L162v Polymorphism of Par-Α Gene, A603g Polymorphism of Tissue Factor Gene and Risk of Coronary Heart Disease in Russian Population

2019 ◽  
Vol 1 (4) ◽  
pp. 1-11
Author(s):  
E.G. Sergeeva ◽  
E.G. Sergeeva ◽  
O.A. Berkovich ◽  
Z.I. Ionova ◽  
M.I. Zaraisky ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Tissue Factor ◽  
Restriction Analysis ◽  
Russian Population ◽  
Control Group ◽  
Factor Gene ◽  
Chd Risk ◽  
Increased Risk ◽  
Increase Risk

Purpose The goal of this study is to determine the association of L162V polymorphism of PPAR-alpha gene, A603G polymorphism of tissue factor gene and the risk of coronary heart disease development in Russian population. Materials and Methods A clinical and genetic study of 414 patients with CHD and 220 people of comparable age without CHD which amounted to a control group was performed. L162L and L162V genotypes of L162V polymorphism of PPAR-α gene, A603A, A603G and G603G genotypes of A603G polymorphism of tissue factor gene were determined by polymerase chain reaction followed by restriction analysis. Results A carriage of L162V genotype and V allele of PPAR-α gene was associated with an increase risk of CHD in 2,13 times (L162V genotype) and in 2,21 times (V allele), with an increase in risk of CHD before the age of 45 years in 4,68 times (L162V genotype) and in 3,88 times (V allele). Significantly higher in patients with CHD compared with the general population and in patients with a carriage of G603G genotype and G allele of tissue factor gene was associated with the increase of CHD risk in 2,68 times (G603G genotype) and in 4,37 times (G allele), occurred more frequently in patients with debut of disease at age of 45 years and younger. The level of tissue factor was significantly higher in patients with CHD – carriers G603G genotype compared with carriers A603A genotype (217,9±15,2 pg/ml and 152,6±30,4 pg/ml, respectively, p=0,04). A carriage of the combination of L162V and G603G genotypes was associated with an increased risk of CHD in 3,04 times. Conclusion A carriage of V allele of L162V polymorphism of PPAR-α gene and G allele of A603G polymorphism of tissue factor gene, as well as their pair combination are associated with an increased CHD risk, especially at age 45 years or less.

scholarly journals The importance of stratifying ischemic risk by using the Duke score in women with ischemic heart disease and hypothyroidism before inclusion in cardiovascular rehabilitation programs

2021 ◽  
Vol 12 (3) ◽  
pp. 248-254
Author(s):  
Diana Andrada GURZĂU ◽  
Bogdan CALOIAN ◽  
Horaţiu COMŞA ◽  
Adela SITAR-TĂUT ◽  
Dumitru ZDRENGHEA ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Ischemic Heart Disease ◽  
Thyroid Function ◽  
Ischemic Heart ◽  
Exercise Stress ◽  
Rehabilitation Programs ◽  
Cardiovascular Rehabilitation ◽  
Increased Risk

Introduction: The relationship between abnormal thyroid function and coronary heart disease has been known for a long time, and particularly, hypothyroidism is associated with an increased risk of cardiovascular disease. The aim of this study was to evaluate the ischemic risk by using the Duke score in women with ischemic heart disease and associated hypothyroidism before inclusion in cardiovascular rehabilitation program. Materials and methods: We included in the study 150 female patients admitted to the Cardiology Department of the Clinical Rehabilitation Hospital Cluj-Napoca. All the patients included had ischemic heart disease and performed an exercise stress testing to evaluate the effort capacity and also to stratify the ischemic risk by calculating the Duke Score. After dosing the thyroid stimulating hormone (TSH) we divided the patients in two groups: with hypothyroidism and a control group. Results: Patients with hypothyroidism were more frequently hypertensive, (98% vs 87%, p-0.035), and they had diabetes mellitus in a higher proportion (51% vs 22%, p-0.005). HDL cholesterol was significantly decreased in the group of patients with hypothyroidism: 40.36±10.39mg/dl vs 44.85±10.29mg/dl (p-0.01). Regarding the ischemic risk assessed by the Duke score, the statistically significant differences between the two groups were registered only for the category of high-risk patients, 5.55% vs 18% (p-0.048). Also, the TSH value was higher in the group with high-risk Duke score, 4.21±3.73µIU/ml, compared to the moderate-risk score group, 1.95±1.12µIU/ml(p-0.05). Conclusion: In women with ischemic heart disease, assessing thyroid function can be useful to identify patients at high risk of ischemia. Patients with hypothyroidism tend to have a higher prevalence of cardiovascular risk factors, a higher ischemic risk objectified by the Duke score and more commonly multivascular coronary lesions. For these patients, the inclusion in cardiovascular rehabilitation programs is essential, but it is very important that the programs to be customized for each patient. Keywords: coronary heart disease in women, exercise ECG, Duke score, ischemic risk, hypothyroidism, cardiovascular rehabilitation programs

Sign in / Sign up

Export Citation Format

Share Document