scholarly journals The Risk of Developing Ischemic Stroke in Patients After Exacerbation of Ischemic Heart Disease

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 46-53
Author(s):  
V. A. Brazhnik ◽  
L. O. Minushkina ◽  
N. R. Khasanov ◽  
E. D. Kosmacheva ◽  
M. A. Chichkova ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Roc Curve ◽  
Prognostic Model ◽  
External Validation ◽  
Diagnostic Value ◽  
Ischemic Heart ◽  
Blood Pressure Goal ◽  
Coronary Syndrome

Aim      To develop a model for evaluating the risk of stroke in patients after exacerbation of ischemic heart disease who were admitted to the hospitals included into a vascular program.Materials and methods This study included 1803 patients with acute coronary syndrome (ACS) from four institutions of Moscow, Kazan, Astrakhan, and Krasnodar where the vascular program was established. Mean age of patients was 64.9±12.78 years, 62,1 % of them were men. The patients were followed up for one year after the discharge from the hospital. External validation of the developed prognostic model was performed on a cohort of patients with ACS included into the RECORD-3 study.Results During the follow-up period, 42 cases of ischemic stroke were observed. The risk of ischemic stroke was associated with the presence of atrial fibrillation (odd ratio (OR) 2.640; р=0.037), diabetes mellitus (OR 2.718; р=0.041), and chronic heart failure (OR 7.049; р=0.011). Protective factors were high-density lipoprotein cholesterol >1 mmol/l (OR 0.629; р=0.041), percutaneous coronary intervention during an index hospitalization (OR 0.412; р=0.042), anticoagulant treatment (OR 0.670; р=0.049), and achieving the blood pressure goal (OR 0.604; р=0.023). The prognostic model developed on the basis of regression analysis showed a good predictive value (area under the ROC curve, 0.780), sensitivity of 80 %, and specificity of 64.6 %. The diagnostic value of other scales for risk assessment was somewhat lower. The area under the ROC curve was 0.692±0.0245 for the GRACE scale and 0.708±0.0334 for CHA2DS2‑VASc. In the external validation of the scale based on data of the RECORD-3 study, the diagnostic value was lower although satisfactory as well (area under the ROC curve, 0.651); sensitivity was 78.9 %, and specificity was 52.3 %.Conclusion      The study resulted in development of a simple clinical scale, which will probably allow identifying groups at risk of stroke more precisely than with standard scales. 

scholarly journals Clinical Significance of Thrombin Blockade with Low Doses (2.5 mg) of Rivaroxaban in Ischemic Heart Disease Patients

2020 ◽  
Vol 16 (1) ◽  
pp. 99-107
Author(s):  
A. B. Sumarokov ◽  
L. I. Buryachkovskaya ◽  
Y. V. Docenko ◽  
M. S. Kurochkin ◽  
N. V. Lomakin
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Antiplatelet Therapy ◽  
Ischemic Heart ◽  
Low Doses ◽  
Antithrombotic Effect ◽  
Coronary Syndrome ◽  
Stable Ischemic Heart Disease

Arterial thrombosis is a result of complex interaction between blood cells, soluble coagulation factors in plasma and vessel wall. Antiplatelet drugs do not always provide the necessary antithrombotic effect of sufficient strength, because their influence does not extend to all three factors involved in this process. Low doses of direct oral inhibitors of thrombin are able to potentiate antithrombotic effect of antiplatelet therapy. The combination of rivaroxaban in a dose of 2.5 mg and standard double antiplatelet therapy turned out to be the most promising for clinical use, since studies with dabigatran and apixaban at the II and III stages of the trials were found to be unsuccessful due to the unacceptably high frequency of bleeding. Studies of the combination of rivaroxaban at a dose of 2.5 mg and standard antiplatelet therapy conducted in previous years among patients with acute myocardial infarction showed a decrease in the frequency of complications of atherothrombosis associated with their ischemic nature, while at the same time there was a slight increase in hemorrhagic complications. In the COMPASS study the combination of rivaroxaban (2.5 mg) plus aspirin reduced the risk of the primary endpoint (myocardial infarction, ischemic stroke, cardiovascular death) more significantly than aspirin alone in patients with stable ischemic heart disease and ischemic brain disease. The pathophysiological rationales for the use of low doses of rivaroxaban when added to dual antiplatelet therapy are considered, and the significance of recent studies in patients with acute coronary syndrome, stable ischemic heart disease and in the prevention of ischemic stroke is discussed.

IMPACT OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME, PLATELET ULTRASTRUCTURE, AND ASPIRIN RESISTANCE

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Aspirin Resistance ◽  
Ischemic Heart ◽  
Coronary Syndrome

IMPACT OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME, PLATELET ULTRASTRUCTURE, AND ASPIRIN RESISTANCE

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Aspirin Resistance ◽  
Ischemic Heart ◽  
Coronary Syndrome

Abstract TP197: Countries With an Inverse Ratio of Ischemic Stroke and Ischemic Heart Disease- Analysis of Global Burden of Disease Data

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Talha Jilani ◽  
Iryna Lobanova ◽  
Brandi R French ◽  
Farhan Siddiq ◽  
Camilo R Gomez ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Burden Of Disease ◽  
The United States ◽  
American Samoa ◽  
Marshall Islands ◽  
Ischemic Heart ◽  
Global Burden Of Disease ◽  
Global Burden

Background: Ischemic heart disease is more prevalent than ischemic stroke in most countries, including the United States; however, recent data suggests that ischemic stroke may be more prevalent in some countries. We performed this study to identify the countries with an inverse ratio of ischemic stroke and ischemic heart disease and associated attributes. Methods: We analyzed the data using the Global Burden of Disease (GBD) website; GBD Compare tool published by the Institute for Health Metrics and Evaluation (IHME), Seattle, Washington for the year 2017. We categorized individual 195 countries based on the ratio of ischemic stroke/ischemic heart disease and divided them into ≥1.0, 0,5-99, and <0.5. Gross domestic product (GDP) per capita for each country was calculated using data from Worldometers. Results: There were 51, 125, and 19 countries with the ratio of ischemic stroke/ischemic heart disease and divided them into ≤0.5, 0.5-0.99, and ≥1.0 respectively (see Table). The range of ratio was between 0.24 and 1.86. Countries with inverse ratio included China (1.86), North Korea (1.31), Guam (1.28), Taiwan (1.20), Marshall Islands (1.15), Timor-Leste (1.16), South Korea (1.13), Seychelles (1.11), Northern Mariana Islands (1.10), Cambodia (1.09), Federated States of Micronesia (1.08), American Samoa (1.07), Samoa (1.06), Kiribati (1.04), Solomon Islands (1.03), Fiji (1.02), Indonesia (1.02), Mauritius (1.01), and Vanuatu (1.00). Conclusions: Approximately 1 out of 10 countries have an inverse ratio of ischemic stroke / ischemic heart disease incidences. The inverse ratio is predominantly driven by a lower incidence of ischemic heart disease.

Abstract P88: Risk of Stroke in Hospitalized SARS-Cov-2 Infected Patients a Multinational Population-Based Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Shima Shahjouei ◽  
Soheil Naderi ◽  
Jiang Li ◽  
Durgesh Chaudhary ◽  
Christoph Griessenauer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Associated Factors ◽  
Sinus Thrombosis ◽  
Hospitalized Patients ◽  
Ischemic Heart ◽  
National Study ◽  
Meta Analyses

The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. Data Source: This multicenter, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). Main Outcomes and Measures: The outcome was the risk of subsequent stroke (ischemic stroke, intracranial hemorrhage, cerebral venous/sinus thrombosis). The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined study protocol. Data Extraction and Synthesis: Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Binary logistic regression was used to determine the associated factors with the outcome measure. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. Results: We received data from 18,311 hospitalized SARS-CoV-2 patients from 77 tertiary centers in 46 regions of 11 countries until May 1 st , 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke—123(79%) ischemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centers in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1-3.5, p = 0.03) and the presence of ischemic heart disease (OR: 2.5, 95% CI:1.4-4.7, p =0·006) were predictive of stroke. Conclusion and Relevance: The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5% (pooled risk: 0.9%). The need for mechanical ventilation and the history of ischemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients.

scholarly journals EVALUATION OF THE INTERNAL PICTURE OF HEALTH IN PATIENTS WITH ACUTE CORONARY SYNDROME IN PRESENTING WITHOUT ST-SEGMENT AFTER PERCUTANEOUS CORONARY INTERVENTIONS AND IN THE PROCESS OF REHABILITATION

2019 ◽  
Vol 3 ◽  
pp. 9-17
Author(s):  
Roksolana Nesterak
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Conservative Treatment ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Life Questionnaire ◽  
Actual Problem ◽  
Coronary Syndrome ◽  
St Segment

Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine. One of the forms of ischemic heart disease (IHD) is an acute coronary syndrome (ACS) in patients presenting without persistent ST-segment, the treatment of which involves the use of conservative treatment and reperfusion techniques. An integral part of the management of patients after acute coronary syndrome is rehabilitation and restoration with the search for methods of changing the attitude of the patient to his health. To improve the rehabilitation of patients it is important to assess the internal picture of health with the formation of the correct attitude of the patient to his health. Aim. To study the peculiarities of the components of the internal picture of health in patients with acute coronary syndrome in patients presenting without persistent ST-segment in the process of treatment and rehabilitation. Materials and methods. There were examined 135 patients with ACS presenting without persistent ST-segment, who were divided into the groups depending on the treatment performed; 60 patients with conservative treatment tactics and 75 patients with the performed PCI. The analysis of the internal picture of health was carried out with the help of methods: hospital scale for the detection of anxiety and depression (HADS); patient health questionnaire (PHQ-9); scale for measuring the level of reactive (situational) and personality anxiety of Spielberg-Hanin; SF-36; indicators of the Seattle Quality of Life Questionnaire for Patients with Angine Pectoris (Seattle Angina Questionnaire - SAQ). Results. The study of the internal picture of health in patients with ACS presenting without persistent ST-segment showed low levels of emotional, sensory, cognitive, value-motivational, behavioral components on the appropriate scales, which also depend on the method of treatment used. The revealed peculiarities of patients with ACS presenting without persistent ST-segment need to increase the knowledge of the patient about the disease and the importance of rehabilitation measures. Conclusions. In assessment of the internal picture of health in patients with ACS presenting without persistent ST-segment after transcutaneous coronary intervention and in the process of rehabilitation, it has been determined that the course of ischemic heart disease in patients with ACS presenting without persistent ST-segment, both during conservative treatment and in the course of PCI at the stages of rehabilitation, is accompanied by significant changes of the internal picture of health (IPH); the most significant changes in patients with ACS presenting without persistent ST-segment is the value-motivational and behavioral components of the internal picture of health. In order to increase the effectiveness of rehabilitation after ACS, it is advisable to apply programs that will significantly affect the positive changes in the rehabilitation of patients with ACS.

scholarly journals Peanut Consumption and Risk of Stroke and Ischemic Heart Disease in Japanese Men and Women: The JPHC Study

Stroke ◽  
2021 ◽  
Author(s):  
Satoyo Ikehara ◽  
Hiroyasu Iso ◽  
Yoshihiro Kokubo ◽  
Kazumasa Yamagishi ◽  
Isao Saito ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Japanese Men ◽  
Food Frequency ◽  
Men And Women ◽  
History Of

Background and Purpose: Several prospective cohort studies and a randomized clinical trial have shown the beneficial effects of peanut consumption on cardiovascular disease and its risk factors. We examined the association between peanut consumption and risk of cardiovascular disease in Japanese men and women. Methods: We analyzed data of 74 793 participants aged 45 to 74 years who completed a lifestyle questionnaire including the validated food frequency questionnaire in the Japan Public Health Center–based Prospective Study. They were followed up from 1995 to 2009 for cohort I and from 1998 to 1999 to 2012 for cohort II. Peanut consumption was calculated from the food frequency questionnaire, and the end points were incidence of stroke, ischemic heart disease, and cardiovascular disease (stroke and ischemic heart disease). Results: During a median follow-up of 14.8 years, 3,599 strokes and 849 ischemic heart diseases were reported. Higher peanut consumption was associated with reduced risks of total stroke, ischemic stroke, and cardiovascular disease among men and women. The multivariable hazard ratios (95% CIs) for the highest versus lowest quartiles of peanut consumption after adjustment for age, sex, public health center, smoking, alcohol consumption, perceived stress level, physical activity, vegetable, fruit, fish, soy, sodium and total energy intakes, body mass index, history of hypertension, history of diabetes, and cholesterol-lowering drug were 0.84 (0.77–0.93, P for trend=0.002) for total stroke, 0.80 (0.71–0.90, P for trend=0.002) for ischemic stroke, 0.93 (0.79–1.08, P for trend=0.27) for hemorrhagic stroke, 0.97 (0.80–1.17, P for trend=0.81) for ischemic heart disease and 0.87 (0.80–0.94, P for trend=0.004) for cardiovascular disease, and these associations were similarly observed in both sexes. Conclusions: Higher peanut consumption was associated with reduced risk of stroke, especially ischemic stroke, but not ischemic heart disease in Japanese men and women.

Immature Platelets and Risk of Cardiovascular Events among Patients with Ischemic Heart Disease: A Systematic Review

2020 ◽  
Author(s):  
Julie Faber ◽  
Anne-Mette Hvas ◽  
Steen Dalby Kristensen ◽  
Erik Lerkevang Grove ◽  
Kasper Adelborg
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiovascular Events ◽  
Ischemic Heart ◽  
Cochrane Library ◽  
Coronary Syndrome ◽  
Immature Platelet Fraction ◽  
Immature Platelets ◽  
Stable Cad

Abstract Background Immature platelets are larger and may be more thrombogenic than mature platelets. This systematic review included studies on the association between mean platelet volume (MPV), immature platelet count (IPC), and immature platelet fraction (IPF) and the risk of major cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) or stable coronary artery disease (CAD). Methods The literature search included studies in PubMed, Embase, Web of Science, and Cochrane Library. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Effect estimates that included multivariate adjusted odds ratios, relative risks, or hazard ratios were extracted. Results Forty-two studies were identified. High MPV was positively associated with MACE in 20 of 26 studies of patients with ACS, four of five studies in patients with stable CAD, and in all six studies comprising a combined population with ACS and stable CAD. Using continuous models of MPV in patients with ACS, effect estimates varied from 0.90 (95% confidence interval [CI]: 0.95–1.03) to 1.66 (95% CI: 1.32–2.09). The strength of these associations was broadly similar among patients with stable CAD and in combined populations. Five studies investigated IPC or IPF as exposures and all reported positive associations with MACE among patients with ACS, stable CAD, or in combined populations. Conclusion This review demonstrated clear evidence for positive associations between measures of immature platelets and subsequent risk of MACE in acute and stable ischemic heart disease patients.

Nonthyroidal Illness Syndrome and Hypothyroidism in Ischemic Heart Disease Population: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 105 (8) ◽  
pp. 2830-2845
Author(s):  
Chun-Yu Chang ◽  
Yung-Jiun Chien ◽  
Po-Chen Lin ◽  
Chien-Sheng Chen ◽  
Meng-Yu Wu
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Meta Analysis ◽  
Ischemic Heart ◽  
Cochrane Library ◽  
Future Research ◽  
Sufficient Information ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
All Cause Mortality

Abstract Context The association of non-thyroidal illness syndrome (NTIS) and hypothyroidism with the prognosis in ischemic heart disease (IHD) population is inconclusive. Objective We aimed to evaluate the influence of NTIS and hypothyroidism on all-cause mortality and major adverse cardiac events (MACE) in IHD population. Data Sources We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from inception through February 17, 2020. Study Selection Original articles enrolling IHD patients, comparing all-cause mortality and MACE of NTIS and hypothyroidism with those of euthyroidism, and providing sufficient information for meta-analysis were considered eligible. Data Extraction Relevant information and numerical data were extracted for methodological assessment and meta-analysis. Data Synthesis Twenty-three studies were included. The IHD population with NTIS was associated with higher risk of all-cause mortality (hazard ratio [HR] = 2.61; 95% confidence interval [CI] = 1.89-3.59) and MACE (HR = 2.22; 95% CI = 1.71-2.89) than that without. In addition, the IHD population with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10-1.97) and MACE (HR = 1.53; 95% CI = 1.19-1.97) than that without. In the subgroup analysis, the acute coronary syndrome (ACS) subpopulation with NTIS was associated with higher risk of all-cause mortality (HR = 3.30; 95% CI = 2.43-4.48) and MACE (HR = 2.19; 95% CI = 1.45-3.30). The ACS subpopulation with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.67; 95% CI = 1.17-2.39). Conclusions The IHD population with concomitant NTIS or hypothyroidism was associated with higher risk of all-cause mortality and MACE. Future research is required to provide evidence of the causal relationship and to elucidate whether normalizing thyroid function parameters can improve prognosis.

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