Cardiac risk factors and events in patients with prostate cancer commencing androgen deprivation therapy: Analysis from a tertiary care center in the Middle East.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 73-73
Author(s):  
Mona Hassan ◽  
Talar Telvizian ◽  
Mostafa Abohelwa ◽  
Hadi Skouri ◽  
Deborah Mukherji
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Middle East ◽  
Cardiovascular Events ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Cardiac Events ◽  
Artery Disease

73 Background: Androgen deprivation therapy (ADT) is the mainstay of treatment for advanced prostate cancer, improving symptoms and prolonging survival. There is an association between ADT use and cardiovascular events, particularly in men with pre-existing risk factors. There are no definite guidelines to stratify patients based on cardiovascular risk prior to ADT initiation. This is the first study on cardiac risks and events in patients on ADT from Lebanon and the Middle East region, a population known to have a high prevalence of cardiovascular risk factors. Methods: A retrospective chart review of 236 patients with prostate cancer who received ADT therapy at a tertiary care center in Lebanon was performed. 167 had a full set of data and were included in analysis. Cardiovascular risk factors at baseline and cardiovascular events on ADT were reviewed. Results: The median age of our cohort was 68, range 48-92 years. The majority of patients had stage 4 diseases at diagnosis (49.8%) with a median duration of 12 months on ADT. In our cohort 24.4% had body mass index > 30, 52.1% had smoking history, 27.4% were diabetic, 28.8 % had history of coronary artery disease, 10.6% had heart failure history and 54.6% had hypertension. Less than half of the patients had a documented lipid profile at baseline. Twenty two patients (9.5%) had documented cardiac events following ADT initiation. Conclusions: In this cohort of patients from the Middle East we found that one third of the population had established coronary artery disease at baseline and 9.5% had documented cardiac events on ADT initiation. Our study highlights the gaps in cardiovascular risk assessment for this high risk group of patients with prostate cancer. Risk and resource-stratified algorithms are needed before starting ADT therapy for optimal cardiovascular health. Increased awareness, collaboration and referral mechanisms between oncologists, urologist and cardiologists are also needed.

scholarly journals High rates of advanced prostate cancer in the Middle East: Analysis from a tertiary care center

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Deborah Mukherji ◽  
Marilyne Daher ◽  
Talar Telvizian ◽  
Christelle Dagher ◽  
Zahi Abdul-Sater ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Middle East ◽  
Advanced Prostate Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Prevalence of Cardiovascular Risk Factors among Chronic Kidney Disease Patients Undergoing Hemodialysis in a Tertiary Care Center, Kathmandu, Nepal

2019 ◽  
Vol 21 (4) ◽  
pp. 313-318
Author(s):  
A Pokhrel ◽  
P. Gyawali ◽  
BR Pokhrel ◽  
M P Khanal ◽  
D N Manandhar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Maintenance Hemodialysis ◽  
Tertiary Care Center ◽  
Phosphate Product

The risk of cardiovascular disease is higher in chronic kidney disease patients compared to the general population and its impact is higher in developing countries compared to the developed countries. With this background in mind, we aimed to evaluate the prevalence of different cardiovascular risk factors in patients on maintenance hemodialysis in a tertiary care center. Chronic kidney disease patients aged 18 years and above who were under maintenance hemodialysis in the hemodialysis unit of Nepal Medical College were included in the study. Pre-dialysis venous blood samples from the participants were collected and analyzed for serum calcium, phosphorus, total protein, albumin and hemoglobin. Calcium phosphate product was calculated. Out of 100 study participants, 52% were male and 48% were female. Age-wise distribution showed 38% of the participants were below 40 years. The mean age of the participants was 45.86 ± 14.4 years. Ninety-three percent had hypertension and 29% had diabetes mellitus. Hypocalcemia was present in 80%, hyperphosphatemia was seen among 81% and high calcium phosphate product was present in 33% of the participants. Low hemoglobin (< 10gm/dL) was found in 86%. The cardiovascular risk trend in the Nepalese chronic kidney disease population is fairly different compared to the western population. Participants were younger. Prevalence of hypertension and diabetes was high. The high prevalence of anemia might be due to unaffordability of the participants for regular erythropoietin therapy. Inadequately managed hyperphosphatemia despite the widespread use of phosphorus binders, is still a major clinical challenge in patients on hemodialysis.

Study of risk factors of eclampsia in a tertiary care center

2019 ◽  
Vol 12 (2) ◽  
pp. 31-35
Author(s):  
Padma Chandavathu ◽  
◽  
Akurathi Krishna Rao ◽  
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

2015 ◽  
Vol 16 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Cuneyt Eftal Taner ◽  
Atalay Ekin ◽  
Ulas Solmaz ◽  
Cenk Gezer ◽  
Birgul Cetin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
High Volume ◽  
Tertiary Care Center

scholarly journals Real-world data on metabolic effects of PCSK9 inhibitors in a tertiary care center in patients with and without diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Laurenz T. Fischer ◽  
Daniel A. Hochfellner ◽  
Lisa Knoll ◽  
Tina Pöttler ◽  
Julia K. Mader ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Real World ◽  
Cardiovascular Events ◽  
Care Center ◽  
Tertiary Care ◽  
Lipid Lowering ◽  
Tertiary Care Center ◽  
Pcsk9 Inhibitors ◽  
Real World Data ◽  
Pcsk9 Inhibitor

Abstract Background The lipid-lowering and positive cardiovascular effect of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors was shown in several studies, hence, they are more widely used in the lipid-lowering management of individuals with high cardiovascular risk. As real-world data are still scarce, specifically in patients with type 2 diabetes (T2D), the aim of this retrospective analysis was to investigate the efficacy of PCSK9 inhibitors in lowering low-density lipoprotein cholesterol (LDL-C) in an outpatient clinic of a tertiary care center in routine care. Methods A retrospective analysis of data extracted from the electronic patient record was performed. Patients who were routinely prescribed with PCSK9 inhibitor therapy (alirocumab or evolocumab) during the years 2016 and 2019 were included in the analysis. Characteristics of the patient population, the effects on LDL-C and HbA1c levels as well as subsequent cardiovascular events were assessed over an observation period of 18 months. Results We identified 237 patients treated with PCSK9 inhibitors between January 2016 and September 2019. Almost all patients (97.5%) received PCSK9 inhibitors for secondary prevention. 26.2% of the population had a concomitant diabetes diagnosis. Intolerance to statins (83.1%), ezetimibe (44.7%) or both agents (42.6%) was reported frequently. Three months after initiation of PCSK9 inhibitor therapy, 61.2% of the patients achieved LDL-C levels < 70 mg/dl, and 44.1% LDL-C levels < 55 mg/dl. The median LDL-C was lowered from 141 mg/dl at baseline, to 60 mg/dl after 3 months and 66 mg/dl after 12 months indicating a reduction of LDL-C as follows: 57.5% after 3 months and 53.6% after 12 months. After 3 months of observation, target achievement of LDL-C was higher in patients with T2D compared to non-diabetes patients; < 55 mg/dl: 51% vs. 41.5%; < 70 mg/dl 69.4 vs. 58.5%. After 12 months even more pronounced target LDL achievement in T2D was demonstrated < 55 mg/dl: 58.8% vs. 30.1%; < 70 mg/dl 70.6 vs. 49.6%. Patients with insufficiently controlled T2D (HbA1c > 54 mmol/mol) had a higher reduction in LDL-C but still were more likely to subsequent cardiovascular events. Conclusions Significant reductions in LDL-C and a high percentage of patients achieving recommended treatment targets were observed. The percentage of patients with T2D meeting recommended LDL-C targets was higher than in those without T2D. Still some patients did not achieve LDL-C levels as recommended in current guidelines. Special attention to the characteristics of these patients is required in the future to enable achievement of treatment goals and avoid adverse cardiovascular outcomes.

scholarly journals Risk factors associated with birth defects at a tertiary care center in Pakistan

2012 ◽  
Vol 38 (1) ◽  
pp. 68 ◽  
Author(s):  
Mohammad Zeeshan Raza ◽  
Asfandyar Sheikh ◽  
Syed Salman Ahmed ◽  
Sajid Ali ◽  
Syed Mumtaz Ali Naqvi
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Factors Associated

GASTRIC CANCER: A 5 YEAR RETROSPECTIVE ANALYSIS OF CLINICAL, PATHOLOGICAL AND TREATMENT ASPECTS FROM A TERTIARY CARE CENTER IN SOUTH INDIA.

2021 ◽  
pp. 129-132
Author(s):  
B. Ramkumar ◽  
J. Kannan ◽  
Ingersal. N ◽  
Srigopal mohanty ◽  
Amit saklani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Location ◽  
Advanced Stage ◽  
Tertiary Care Center ◽  
Nodal Disease ◽  
Female Ratio

Context: Gastric cancer(GC) is fth most common cancer worldwide. Mostly presents with advanced stage and poor overall survival. Methods: Retrospective study on clinical, pathological, pattern of distant metastasis(DM) , treatment aspect of GC treated between January 2014 to December 2018 in a tertiary care center in south India. Statistical analysis : Chi square test and multivariate analysis (MVA) were used for analysis. P <0.05 was considered signicant. Results: Median age at diagnosis is 57 years. Higher male : female ratio. Most common presentation was abdominal pain followed vomiting. Malignant Gastric outlet obstruction(MGOO) was present in 22.7%. Histologically , all patients had adenocarcinoma with predominantly moderate differentiation (51.1%). Liver (19.1%)was most common site of metastasis . Curative surgery was done in 35.5% of patients. D2 lymph node dissection was performed in 12.4% of patient. Patients were given perioperative /preoperative/ adjuvant / palliative chemotherapy. MVA revealed history of tobacco use, body of stomach tumor location, nodal disease were risk factors for DM. Conclusion : The present analysis revealed use of tobacco, alcohol intake were main risk factors for GC. Most of the patients present in advanced stage , so prevention by avoiding risk factors and early detection by signs , symptoms and endoscopy are necessary. Use of tobacco,site of tumor location, nodal disease were factors associated with DM. Aggressive management with both surgery and chemotherapy is warranted for locally advanced disease.

Sign in / Sign up

Export Citation Format

Share Document