Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

2015 ◽  
Vol 18 (4) ◽  
pp. 140 ◽  
Author(s):  
Mehmet Taşar ◽  
Mehmet Kalender ◽  
Okay Güven Karaca ◽  
Ata Niyazi Ecevit ◽  
Salih Salihi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Endarterectomy ◽  
Regional Anesthesia ◽  
Carotid Artery Disease ◽  
Risk Groups ◽  
Cardiac Risk ◽  
Cervical Plexus ◽  
Cardiac Risk Factors ◽  
Significant Difference

Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. <br />Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared.<br />Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P &gt; .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection.<br />Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed. <br /><br />

Cardiovascular risk factor control among cancer survivors: A population-based survey

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6535-6535
Author(s):  
K. Enright ◽  
M. Krzyzanowska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cancer Survivors ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
Significant Difference

6535 Background: Cardiovascular disease is a major cause of morbidity and mortality in long-term survivors of cancer. Whereas the burden of cardiovascular disease has been described in cancer survivors, the control of modifiable cardiovascular risk factors in this population is unknown. Methods: We used the National Health and Nutrition Examination Survey (NHANES 1999–2006) data to examine the rate of control of modifiable cardiac risk factors amongst US cancer survivors compared with propensity matched adult controls with no history of cancer. The modifiable cardiac risk factors (blood pressure, cholesterol, BMI, exercise, smoking) were considered to be controlled if they met the AHA/ACC guideline recommendations. Results: A total of 1,227 cancer survivors and 3,672 age, sex, and comorbidity matched controls were identified, representing 11.9 million cancer survivors and 31.2 million controls. Compared to age, sex and comorbidity matched controls cancer survivors were more likely to be current smokers (34.5% vs. 28.8%, p = 0.021), and more likely to have their BMI at target (32.8% vs. 28.6%, p = 0.034). There was no significant difference in the rate of blood pressure control (69.4% vs. 69.2%, p = 0.88), cholesterol control (47.6% vs. 48.2%, p = 0.80) or adherence to exercise recommendations (24.4% vs. 24.6%, p = 0.89). Younger cancer survivors (age 20–40 y) were 2.8 times more likely to be smokers than controls, whereas older cancer survivors (age 60–80y) were 1.2 times more likely to be smokers than controls. Compared with recent cancer survivors (10 years from diagnosis) were more likely to have optimal blood pressure control (73.3% vs. 65.5%, p = 0.02), however there was no difference in smoking rates, cholesterol, exercise or weight control with duration of cancer survival. Conclusions: Overall the control of modifiable cardiac risk factors was similar between survivors and controls, but was suboptimal in both groups. This study identified smoking cessation, particularly amongst young cancers survivors, as an important area of focus for improvement in survivorship care. No significant financial relationships to disclose.

scholarly journals Determination of Relation of Gender Variation in Age and Cardiac Risk Factors in Unstable Angina in Bangladeshi Population

2012 ◽  
Vol 23 (1) ◽  
pp. 42-45
Author(s):  
SM Suhrawardy ◽  
Momtaz Begum ◽  
Nayeema Akhter ◽  
Jahid Hossain Sharif ◽  
Md Jashim Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Unstable Angina ◽  
Troponin I ◽  
Cardiac Risk ◽  
Cardiac Risk Factor ◽  
Age Difference ◽  
Cardiac Risk Factors ◽  
Medical College ◽  
Case Series Study ◽  
Significant Difference

The incidence of Unstable Angina is increasing. More than 80% of CAD is attributed to different modifiable cardiac risk factors. Evidence of effect of sex on different cardiac risk factor and as well as effect of age in different sex for CAD is still limited and needs evaluation. An observational case series study conducted on 50 consecutive cases following appropriate inclusion and exclusion criteria in the Department of Physiology, Chittagong Medical College in collaboration with CCU of Chittagong Medical College Hospital from September 2006 to July 2008. The cases of unstable angina were diagnosed on the basis of clinical criteria and ECG findings. Serum Troponin I level were estimated to exclude Non-STE MI. There were statistically significant difference of cardiac risk factors (smoking, hypertension and diabetes mellitus) with sex variation (p value<0.05) Smoking habits were less in female, hypertension and diabetes detected more in female. This study concludes that significant difference of cardiac risk factors and age difference in both sexes may explain the outcome of UA in female. JCMCTA 2012; 23(1): 42-45

scholarly journals Association of Cardiovascular Risk Factors in Hypertensive Subjects with Metabolic Syndrome Defined by Three Different Definitions

2011 ◽  
Vol 51 (184) ◽  
Author(s):  
R Shrestha ◽  
SC Jha ◽  
M Khanal ◽  
P Gyawali ◽  
BK Yadav ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Disease Risk ◽  
Oxidized Ldl ◽  
International Diabetes Federation ◽  
High Sensitivity ◽  
Cardiac Risk ◽  
Cardiac Risk Factors

Introduction: Different authorities have put forward their criteria to defi ne metabolic syndrome (MetS). The aim of this study was to fi nd the prevalence of MetS in hypertensive individuals by the available three different defi nitions from National Cholesterol Education Program (NCEP), International diabetes Federation (IDF) and WHO and their association with other cardiac risk factors. Methods: After anthropometric measurements fasting blood was analyzed for glucose, lipids, high sensitivity C-reactive protein (hsCRP) and anti-oxidized LDL antibody in 150 hypertensive individuals. A ten-year coronary heart disease risk was predicted using the Framingham risk score (FRS). Results: The prevalence of MetS was 54.7 % by NCEP, 42.0 % by IDF) and 18.7 % by WHO. As many as 63.4 % had MetS by any defi nition, while only 9.4 % fulfi lled all the criteria of the three definitions. The association of cardiac risk factors also varied according to the defi nition used. hsCRP was signifi cantly elevated in MetS compared to non-MetS. Body mass index, waist circumference and HDL-C were associated in MetS defi ned by NCEP and IDF. FRS was higher in MetS defi ned by Adult Treatment Panel and WHO defi nitions. An increase in urine albumin and a decrease in eGFR were associated with MetS individuals defi ned by WHO only. Conclusions: There is a wide variation in the prevalence of MetS and associated cardiac risk factors according to three different defi nitions used. The different cardiac risk factors among MetS also vary with the defi nitions used. However, hsCRP and emerging risk factor are signifi cantly elevated in hypertensive individuals with MetS as defi ned by all defi nitions. Keywords: cardiovascular risk factors, hypertension,metabolic syndrome.

scholarly journals Early stroke after carotid endarterectomy: A case series during a 5-year period

2018 ◽  
Vol 71 (11-12) ◽  
pp. 389-393
Author(s):  
Vladimir Manojlovic ◽  
Djordje Milosevic ◽  
Nebojsa Budakov ◽  
Vladimir Markovic ◽  
Dragan Nikolic
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Odds Ratio ◽  
Carotid Artery Disease ◽  
Case Series ◽  
Carotid Occlusion ◽  
Significant Difference ◽  
Early Stroke

Introduction. Carotid endarterectomy is an efficient surgical procedure of primary and secondary prevention of ischemic stroke in asymptomatic and symptomatic patients with extracranial carotid artery disease. Material and Methods. In this paper we analyzed incidence, risk factors, potential causes and preventive measures for early stroke after carotid endarterectomy in patients (809) who underwent surgery for carotid artery stenosis at the Clinic of Vascular and Endovascular Surgery of the Clinical Center of Vojvodina in Novi Sad during a five year period (April 2013 - March 2018). Results and Discussion. Early operative stroke was registered in 12 patients with no significant difference between symptomatic (2.8%) and asymptomatic (1.1%) patients (odds ratio - 2,56, 95% confidence interval - 0.8063 to 8.1770 standard deviation 1,596; p = 0,11). Contralateral carotid occlusion (odds ratio - 3.1154, 95% confidence interval - 1.1620 to 8.3522, p = 0.0239) and no dual antiplatelet therapy (odds ratio - 3.1154, 95% confidence interval - 1.8537 to 526.4871; p = 0.0169) were pointed out as risk factors for operative stroke. Most of the perioperative and early postoperative strokes after carotid endarterectomy were due to arterial-arterial thromboembolism, intracerebral hemorrhage and acute carotid occlusion that developed rarely and were associated with severe neurological deficit. Conclusion. Even though our results are in agreement with the literature data, additional measures for surgical quality control would further decrease the incidence of operative stroke.

Abstract P370: Utility of Cardiovascular Risk Algorithms in Prediction of Subclinical Atherosclerosis in the Young

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Alexi Geevarghese ◽  
Michael Garshick ◽  
Eugenia Gianos ◽  
Ricardo Benenstein
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Family History ◽  
Risk Score ◽  
Carotid Plaque ◽  
Cardiac Risk ◽  
Carotid Ultrasound ◽  
Younger Patients ◽  
Cardiac Risk Factors ◽  
History Of

Background: Prediction of cardiovascular risk in younger patients is particularly challenging. Most current risk estimators underestimate risk potentially leading to under-treatment in younger patients with significant risk factors for atherosclerosis. Methods: A retrospective analysis of patients age 20 to 50 (n = 274) referred to a cardiology clinic between 2013 and 2016 and undergoing carotid ultrasound for risk stratification and statin initiation was conducted. A medical history was obtained by chart review at the time of carotid ultrasound. The 2008 Framingham general risk score was used to calculate a 10-year cardiac risk. Carotid plaque was defined using standard definitions as carotid artery focal wall thickening 50% or greater than the surrounding vessel wall or a focal region > 1.5 mm protruding into the lumen. Results: Average age was 41 ± 7.9 years, 60% male, 77% Caucasian, 4% diabetes. Ten percent (n = 27) had carotid plaque noted on ultrasound. Those with plaque compared to those without were older (46 ± 4.3 vs. 41 ± 7.5, p < 0.01), more likely to have hypertension (HTN) (52% vs. 20%, p < 0.01), more likely to be active smokers (19% vs. 6%, p = 0.02) and had higher total cholesterol (222 ± 53 mg/dl vs. 202 ± 45 mg/dl, p = 0.04) and LDL-C (140 ± 40 mg/dl vs. 121 ± 43 mg/dl, p = 0.04). No differences were noted in gender, race, body mass index, diabetes or family history of early heart disease. The average cardiac risk score was 5.9 ± 3.5% for those with plaque and 4.2 ± 3.2% for those without (p < 0.01). When assessing the same population by number of risk factors, 93% (n = 25) of individuals with carotid plaque had ≥ 2 cardiac risk factors (one point each for age 40 to 50, smoking, family history of heart early disease, obesity, LDL > 160 mg/dl, DMII or HTN). This compared to 37% (n=10) who had carotid plaque on imaging and a risk score ≥ 7.5%. Receiver operator curve characteristics to predict plaque were similar for the cardiac risk score (AUC 0.674) and number of cardiac risk factors (AUC 0.674, p = 0.96). Conclusion: In patients 50 years or younger, ≥ 2 cardiac risk factors revealed a higher percentage of carotid plaque than a Framingham cardiac risk score cut off value of ≥ 7.5%. In younger patients with cardiac risk factors, novel algorithms are needed to more accurately guide medication therapy.

The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors

2020 ◽  
pp. 1-9
Author(s):  
Habib Yarizadeh ◽  
Alireza Bahiraee ◽  
Sara Asadi ◽  
Niloofar Sadat Maddahi ◽  
Leila Setayesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Model Assessment ◽  
Iranian Women ◽  
Cvd Risk ◽  
Dash Diet ◽  
Melanocortin 4 Receptor Gene ◽  
Significant Difference ◽  
High Adherence

Abstract. Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25–40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kolossvary ◽  
E.K Fishman ◽  
G Gerstenblith ◽  
D.A Bluemke ◽  
R.N Mandler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Hiv Infection ◽  
Cardiovascular Risk Factors ◽  
Agatston Score ◽  
Funding Source ◽  
Significant Difference ◽  
Ascvd Risk ◽  
Artery Disease

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p&gt;0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p&gt;0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p&gt;0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p&lt;0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p&lt;0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

Conventional cardiac risk factors associated with trastuzumab-induced cardiotoxicity in breast cancer: Systematic review and meta-analysis

2021 ◽  
pp. 100723
Author(s):  
George Koulaouzidis ◽  
Amanda E. Yung ◽  
Diana E. Yung ◽  
Karolina Skonieczna-Żydecka ◽  
Wojciech Marlicz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cardiac Risk ◽  
Factors Associated ◽  
Cardiac Risk Factors
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