scholarly journals Associations of Serum Cortisol with Cardiovascular Risk and Mortality in Patients Referred to Coronary Angiography

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Stefan Pilz ◽  
Verena Theiler-Schwetz ◽  
Christian Trummer ◽  
Martin H Keppel ◽  
Martin R Grübler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Natural Killer Cells ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Natural Killer ◽  
Cardiovascular Mortality ◽  
Serum Cortisol ◽  
Killer Cells ◽  
Coronary Syndrome

Abstract Context Serum cortisol may be associated with cardiovascular risk factors and mortality in patients undergoing coronary angiography, but previous data on this topic are limited and controversial. Objective We evaluated whether morning serum cortisol is associated with cardiovascular risk factors, lymphocyte subtypes, and mortality. Methods This is a prospective cohort study performed at a tertiary care centre in south-west Germany between 1997 and 2000. We included 3052 study participants who underwent coronary angiography. The primary outcome measures were cardiovascular risk factors, lymphocyte subtypes, and all-cause and cardiovascular mortality. Results Serum cortisol was associated with an adverse cardiovascular risk profile, but there was no significant association with coronary artery disease or acute coronary syndrome. In a subsample of 2107 participants, serum cortisol was positively associated with certain lymphocyte subsets, including CD16+CD56+ (natural killer) cells (P < 0.001). Comparing the fourth versus the first serum cortisol quartile, the crude Cox proportional hazard ratios (with 95% CIs) were 1.22 (1.00-1.47) for all-cause and 1.32 (1.04-1.67) for cardiovascular mortality, respectively. After adjustments for various cardiovascular risk factors, these associations were attenuated to 0.93 (0.76-1.14) for all-cause, and 0.97 (0.76-1.25) for cardiovascular mortality, respectively. Conclusions Despite significant associations with classic cardiovascular risk factors and natural killer cells, serum cortisol was not a significant and independent predictor of mortality in patients referred to coronary angiography. These findings might reflect that adverse cardiovascular effects of cortisol could be counterbalanced by some cardiovascular protective actions.

scholarly journals Symmetrical and Asymmetrical Dimethylarginine as Predictors for Mortality in Patients Referred for Coronary Angiography: The Ludwigshafen Risk and Cardiovascular Health Study

2011 ◽  
Vol 57 (1) ◽  
pp. 112-121 ◽  
Author(s):  
Andreas Meinitzer ◽  
Jan T Kielstein ◽  
Stefan Pilz ◽  
Christiane Drechsler ◽  
Eberhard Ritz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Health Study ◽  
Structural Isomer ◽  
Cardiovascular Health Study ◽  
Asymmetrical Dimethylarginine

BACKGROUND Asymmetrical dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, has been linked to cardiovascular risk. The clinical role of its structural isomer symmetrical dimethylarginine (SDMA) remains largely unclear. METHODS We measured SDMA and ADMA in 3229 patients undergoing coronary angiography at baseline (1997–2000) and recorded total and cardiovascular mortality during a median follow-up time of 7.7 years. We investigated associations of SDMA with cardiovascular risk factors and mortality and compared its role as a cardiovascular risk factor with ADMA, which predicted mortality in previous analyses of our study. RESULTS In linear regression analyses including common cardiovascular risk factors as covariates, SDMA and ADMA were significantly associated with cystatin C, N-terminal pro-B–type natriuretic peptide, New York Heart Association classification, and homocysteine. The regression coefficients were higher for SDMA than for ADMA. In Cox proportional-hazards models adjusted for cardiovascular risk factors, the hazard ratios (HRs) (with 95% CI) in the second, third, and fourth SDMA quartile compared to the lowest quartile were 0.77 (0.60–0.99), 0.99 (0.78–1.25), and 1.51 (1.20–1.91) for total mortality and 0.92 (0.68–1.25), 0.93 (0.68–1.26), and 1.54 (1.14–2.01) for cardiovascular mortality. The same calculations for ADMA quartiles revealed HRs of 1.05 (0.83–1.32), 1.19 (0.95–1.50), and 1.61 (1.30–1.99) for total mortality and HR of 1.00 (0.74–1.34), 1.26 (0.95–1.68), and 1.54 (1.18–2.02) for cardiovascular mortality. CONCLUSIONS Serum concentrations of SDMA are independently associated with increased cardiovascular and all-cause mortality in patients undergoing coronary angiography. The pattern of risk linked to SDMA is different from that linked to ADMA, suggesting different pathophysiological roles of these 2 methylarginine metabolites.

Impact of Metabolic Surgery on Type 2 Diabetes Mellitus, Cardiovascular Risk Factors, and Mortality. Review article.

2020 ◽  
Vol 16 ◽  
Author(s):  
Ricardo Cohen ◽  
Noelia S Sforza ◽  
Romina G Clemente
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Bariatric Surgery ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Mortality ◽  
Review Article ◽  
Controlled Trials ◽  
Randomized Controlled

Background: The association between obesity and a reduction in life expectancy is well established, and cardiovascular disease is a leading cause of mortality. Bariatric surgery has long been established as the most effective and durable intervention for obesity, and is the only intervention for obesity that consistently improves multiple comorbidities, reduces cardiovascular disease and long-term mortality. The purpose of this review article is to describe the impact of metabolic/bariatric surgery on type 2 diabetes mellitus and cardiometabolic parameters, including cardiovascular mortality. Methods: A systematic literature search of Pubmed, MEDLINE, and Cochrane Central Register was performed. We included randomized controlled trials, metanalysis, case-control trials, and cohort studies that contain data on reductions in cardiovascular risk factors and cardiovascular mortality in subjects who underwent metabolic/bariatric surgery from January 1, 2005, to June 1, 2020. Conclusion: There is sufficient evidence of randomized controlled trials that metabolic/bariatric surgery is associated with a significant improvement of all cardiovascular risk factors. Although studies are showing a reduction of macrovascular events and cardiovascular mortality, these findings come from observational studies and should be confirmed in randomized clinical trials.

Sensitivity, specificity of pre-test probability and their use in the relation to syntax score and cardiovascular risk factors

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Syntax Score ◽  
Model Group ◽  
European Society Of Cardiology ◽  
Test Probability

Overview: Coronary angiography is the gold standard for definitive diagnosis of obstructive ischemic coronary disease. However, this is an invasive, expensive test, and may have a number of complications. Models of pre-test probability (PTP) in the guideline of the European Society of Cardiology 2013 and 2019 are easy to use and apply even to doctors who are not cardiologists, and can be implemented at the medical facilities. We aim to assess the sensitivity and specificity of different PTP stratification models follow ESC2013 and 2019; and their use in the relation to SYNTAX score and cardiovascular risk factors. Materials and Methods: Patients (n=108) with chest pain had been treated at Ninh Thuan Provincial Hospital from January 2019 to May 2020. The PTP stratification models were calculated according to the recommendations of the European Society of Cardiology (ESC) 2013 and 2019. Coronary angiography was enrolled for the diagnosis, Quantitative coronary analyzed (QCA) - based stenosis assessment was used with a cut-off of ≥ 50% diameter reduction for significant lesions of coronary artery and SYNTAX score were calculated.Diagnostic accuracy was calculated by usingsensitivity, specificitywhich were analyzed by using statistical software SPSS version 20.0. Results: In the 2013 pre-test probability model,group withmedium PTP andhigh PTPhad the sensitivity of 57.14%, 100% respectively; the overall sensitivity for both groups (the medium and high pre-test) was 59.36%; and the specificity was 58.33%. In the 2019PTP model, group withmedium PTP and high PTP had the sensitivity of 41.67%, of 67.57% respectively;the overall sensitivity for both groups (the medium and high scores PTP) was 61.22%; and the specificity was 80%. The group of low SYNTAXscore (<23) had at most 93 cases, accounting for 86.1%; the lowest was the group of high SYNTAX score (≥ 33 points) accounting for 2.8%. There were statistically significant differences in patients with and without smoking, history of hypertension for both PTP model 2013 and 2019. Conclusion: Sensitivity and specificity of the 2013 and 2019 PTP were quite high in the relation to the severity of coronary artery which were evaluated by SYNTAX score.

Control of cardiovascular risk factors in recurrent Acute Coronary Syndrome

2017 ◽  
Vol 27 (1) ◽  
pp. e16-e17
Author(s):  
L. De Biase ◽  
E. Mencarelli ◽  
F. Simonelli ◽  
C. Miotti ◽  
G. Gallo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Syndrome

Screening for cardiovascular risk factors in patients admitted for acute coronary syndrome

2014 ◽  
Vol 68 (7) ◽  
pp. 929-930
Author(s):  
M. Banerjee ◽  
A. White ◽  
R. Pearson ◽  
T. Balafsan ◽  
S. Hama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Syndrome
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