Evaluation of Ischemic Heart Disease Factors in Hemophilia Patients in Khorramabad

Author(s):  
Alireza Nezami ◽  
Fariba Tarhani ◽  
Sina Elahi

Background: Evaluation of risk factors associated with coronary artery disease and cardiac health in hemophilia patients is necessary to prevent the onset of ischemic heart disease. In this study, we evaluated the cardiovascular status of hemophilic patients in Lorestan province for the early onset of ischemic heart disease. Methods: In this cross-sectional descriptive study, a total of 80 patients presenting severe hemophilia, the detailed questionnaire-based investigation was conducted to analyze the prevalence of cardiovascular risk factors in severe hemophilic patients. In patients with hemophilia, body mass index (BMI), blood pressure, diabetes, LDL, cholesterol and HDL, the risk of cardiovascular death was estimated using a predictive risk predictor algorithm of Europe SCORE. Results: The mean age of the patients was 25 years where all the patients were non-diabetic. Echocardiography did not show any wall motion abnormality and changes in the T wave and dysrhythmia was also not seen by ECG. 7 patients had high blood pressure, 11 had abnormal HDL, and 1 had abnormal LDL. In this study, serum LDL and HDL levels were not significantly correlated with age and BMI. Conversely, age and BMI were significantly associated with hypertension. Hypertension was observed in people over the age of 25 years and in overweighed individuals.78.8% had normal BMI and 21.3% were overweighed. There was no significant correlation between serum LDL, serum HDL, and blood pressure and sex. The levels of abnormal LDL and HDL were higher in men than in women. Conclusion: ECG findings from our study did not report any significant cardiac abnormalities among hemophilic patients. Cardiovascular risk factors were not significantly correlated in these paitents.

2015 ◽  
Vol 53 (2) ◽  
pp. 146-152
Author(s):  
Alexandra Dǎdârlat ◽  
D. Zdrenghea ◽  
Dana Pop

Abstract Ischemic heart disease is underdiagnosed in women due to atypical symptomatology as well as to the lower specificity of several paraclinical tests, such as exercise stress testing. The aim of the study was to ascertain whether the Duke treadmill score (DTS) could be an efficient parameter in the diagnosis of ischemic heart disease in women. Material and method. 105 patients were enrolled in the study, 45.71% women with average age ranged between 20 and 70 years, investigated in the Rehabilitation Hospital, Cardiology-Departament, Cluj-Napoca, Romania. All the patients were clinically assessed as concerns the presence of cardiovascular risk factors, and they underwent electrocardiographic, echocardiographic and treadmill stress tests. DST was calculated according to the formula: exercise time – 5 x (ST deviation expressed in mm–4 x Angina Index). Results. DTS was lower in women as compared to men: 2.54±5.36 vs. 6±4.69, p=0.0006. 54.28% of the patients were ranged with a low DTS risk category, whereas 45.71% belonged to a moderate and high risk category. DTS was significantly lower in women than in men with high blood pressure (2.03±4.8 vs. 5.8±4.28), hypercholesterolemia (1.14±4.51 vs. 6.24±4.13), diabetes mellitus (1.83 ± 3.73 vs. 6.13±4.8), and obesity (2.42±5.35 vs. 5.81±4.64). By analyzing the presence of cardiovascular risk factors only in women, we noticed that only those with high blood pressure (2.03±4.89 vs. 8.13 ±7.85) and hypercholesterolemia (2.31±4.76 vs. 3.89±5.95) had a statistically significant low DTS (p<0.05). In conclusion, our research, which showed differences in DTS between women and men, raises concerns about the early diagnosis of ischemic heart disease in women.


2014 ◽  
Vol 32 (3) ◽  
pp. 191-198 ◽  
Author(s):  
Eric J. Chow ◽  
K. Scott Baker ◽  
Stephanie J. Lee ◽  
Mary E.D. Flowers ◽  
Kara L. Cushing-Haugen ◽  
...  

Purpose To determine the influence of modifiable lifestyle factors on the risk of cardiovascular disease after hematopoietic cell transplantation (HCT). Patients and Methods HCT survivors of ≥ 1 year treated from 1970 to 2010 (n = 3,833) were surveyed from 2010 to 2011 on current cardiovascular health and related lifestyle factors (smoking, diet, recreational physical activity). Responses (n = 2,362) were compared with those from a matched general population sample (National Health and Nutrition Examination Survey [NHANES]; n = 1,192). Results Compared with NHANES participants, HCT survivors (median age, 55.9 years; median 10.8 years since HCT; 71.3% allogeneic) had higher rates of cardiomyopathy (4.0% v 2.6%), stroke (4.8% v 3.3%), dyslipidemia (33.9% v 22.3%), and diabetes (14.3% v 11.7%; P < .05 for all comparisons). Prevalence of hypertension was similar (27.9% v 30.0%), and survivors were less likely to have ischemic heart disease (6.1% v 8.9%; P < .01). Among HCT survivors, hypertension, dyslipidemia, and diabetes were independent risk factors for ischemic heart disease and cardiomyopathy, and smoking was associated with ischemic heart disease and diabetes (odds ratios [ORs], 1.8 to 2.1; P = .02). Obesity was a risk factor for post-transplantation hypertension, dyslipidemia, and diabetes (ORs ≥ 2.0; P < .001). In contrast, lower fruit/vegetable intake was associated with greater risk of dyslipidemia and diabetes (ORs, 1.4 to 1.8; P ≤ .01), and lower physical activity level was associated with greater risk of hypertension and diabetes (ORs, 1.4 to 1.5; P < .05). Healthier lifestyle characteristics among HCT survivors attenuated risk of all cardiovascular conditions assessed. Conclusion Attention of clinicians to conventional cardiovascular risk factors and modifiable lifestyle characteristics offers hope of reducing serious cardiovascular morbidity after HCT.


2005 ◽  
Vol 52 (10) ◽  
pp. 3039-3044 ◽  
Author(s):  
Cynthia S. Crowson ◽  
Paulo J. Nicola ◽  
Hilal Maradit Kremers ◽  
W. Michael O'Fallon ◽  
Terry M. Therneau ◽  
...  

1999 ◽  
Vol 144 ◽  
pp. 135
Author(s):  
C. Morillas ◽  
C. Riera ◽  
C. Meliá ◽  
E. Solá ◽  
J. Sanchez ◽  
...  

Urology ◽  
2013 ◽  
Vol 82 (2) ◽  
pp. 377-381 ◽  
Author(s):  
Yael Pauker-Sharon ◽  
Yaron Arbel ◽  
Ariel Finkelstein ◽  
Amir Halkin ◽  
Itzhak Herz ◽  
...  

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1811-1811 ◽  
Author(s):  
Hesam Hekmatjou ◽  
Gail J. Roboz ◽  
Ellen K. Ritchie ◽  
Sangmin Lee ◽  
Pinkal Desai ◽  
...  

Abstract Arterial thrombosis (AT), including ischemic heart disease, stroke, and peripheral artery occlusive disease (PAOD), have been observed in several studies of CML patients treated with tyrosine kinase inhibitors (TKI’s), most often in patients treated with ponatinib. Reports of AT in patients treated with other TKI’s are based on anecdotal observations and/or studies with relatively short follow-up times and limited data on underlying risk factors. From 1999 to 2014, 408 patients with CML were seen at Weill-Cornell/New York Presbyterian Hospital. Of these, a cohort of 224 patients in chronic phase received ongoing therapy with TKI’s with continuous clinical observation with a median follow-up of 7 years (range 1-15 years). There were 124 (55.4%) men and 100 (44.6%) women with a median age of 52 years (range 21-75 years). Initial therapy with a TKI occurred in 86% whereas 14% had received prior therapy with interferon-alpha and 2% had a prior allogeneic transplant. The initial TKI therapy was imatinib in 82%, nilotinib in 14% and dasatinib in 4%. 49% of patients were treated with only 1 TKI, 21% with 2 TKI’s and 30% with > 2 TKI’s. Over the course of therapy, overall 82% of patients were exposed to imatinib, 33.9% to nilotinib, 25% to dasatinib and 2.2% to ponatinib. Information on pre-treatment cardiovascular risk factors which included; a history of a prior AT, diabetes, hyperlipidemia, hypertension and smoking, were available on all patients. Prior AT occurred in 7.5%; 25% had 1 risk factor and 20.6% had 2 or more risk factors. Overall AT was observed in 7.1% (95% CI = 3.8%, 10.5%) of all patients and there were no deaths associated with AT. Ischemic heart disease occurred in 4.9%, a stroke in 0.4% and PAOD in 1.8%. The median time from start of TKI therapy to development of AT was 7 years (range 4-14). The median age of patients who developed AT was 68 years (range 47-80). AT occurred predominantly in patients with pre-existing risk factors; the incidence was 14.6% in patients with prior risk factors whereas only 1.6% of patients without risk factors developed this complication (p<0.0001). In 16 /224 patients, 17 AT’s occurred; 10 while on treatment with imatinib, 5 on nilotinib, 1 on dasatinib and 2 on ponatinib. By overall TKI exposure, AT occurred in 5.4 % of patients exposed to imatinib 6.6% exposed to nilotinib and 1.8% exposed to dasatinib (p=not significant). Apart from ponatinib, neither the initial TKI used, the overall exposure or length of exposure to TKI’s, or the number of TKI’s administered were associated with an increased risk of AT. These data would suggest that the development of AT is uncommon in patients without prior risk factors and occurs with equal frequency in patients exposed to either imatinib or nilotinib. Additional data are needed to conclusively determine whether treatment with a TKI (excluding ponatinib) is an independent risk factor for the development of AT in CML patients. Importantly, identification of the mechanism(s) associated with TKI-related AT in CML patients are needed to plan preventive measures, particularly in patients with preexisting risk factors. Disclosures Roboz: Novartis: Consultancy; Agios: Consultancy; Celgene: Consultancy; Glaxo SmithKline: Consultancy; Astra Zeneca: Consultancy; Sunesis: Consultancy; Novartis: Consultancy; Teva Oncology: Consultancy; Astex: Consultancy. Allen-Bard:Novartis: Speakers Bureau. Feldman:Novartis: Honoraria, Research Funding, Speakers Bureau; Ariad: Honoraria, Speakers Bureau.


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