scholarly journals Why we should be looking for ear lobe creases. A systematic review and meta-analysis of diagonal ear lobe crease and coronary artery disease.

2020 ◽  
Author(s):  
Jonathan Curtis ◽  
Sophie Walford
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Meta Analysis ◽  
Risk Marker ◽  
Artery Disease ◽  
Sensitivity Specificity ◽  
Insufficient Sensitivity

Objectives The association between diagonal ear lobe crease (DELC) and cardiovascular disease was first suggested in 1973 although some studies have attributed this to confounding cardiovascular factors. This review looked to see if there is a significant association between DELC and angiography-confirmed coronary artery disease (CAD) independent of other risk factors. Design Systematic review and meta-analysis of selected studies using the PRISMA checklist. Setting 12 different hospitals with angiography in eight countries. Participants 4960 adult patients undergoing coronary angiography. Main Outcome Measures • Presence/absence of diagonal ear lobe crease • Diagnostic Odds Ratio • Sensitivity/Specificity Results 12 studies were included in the meta-analysis. Findings from our study suggest: • Patients with DELC have a 4x increased likelihood of having CAD (OR 4.61 P<0.00001). • The relationship between DELC and CAD was independent of age and all other conventional cardiovascular risk factors. • Bilateral DELC has a stronger association with CAD than unilateral DELC. • Presence of DELC has insufficient sensitivity / specificity to be used as a diagnostic test for cardiovascular disease but instead should be used as a risk marker. Conclusions We found that DELC is associated with CAD independently of other known cardiovascular risk factors including age. Histology studies indicate that atherosclerosis is causing DELC and patients with DELC appear to have an increased risk of CAD. It has insufficient sensitivity or specificity to be used as a diagnostic test but should be used as a valuable risk marker to be aware of whilst examining ears.

scholarly journals Risk factors of premature coronary artery disease in Iran: A systematic review and meta‐analysis

2019 ◽  
Vol 49 (7) ◽  
Author(s):  
Hoorak Poorzand ◽  
Konstantinos Tsarouhas ◽  
Seyyed Amin Hozhabrossadati ◽  
Nastaran Khorrampazhouh ◽  
Yones Bondarsahebi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Meta Analysis ◽  
Premature Coronary Artery Disease ◽  
Artery Disease

scholarly journals Circulating Oxidized LDL is a Useful Marker for Cardiovascular Risk Assessment

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1350-1350
Author(s):  
Ann Mertens ◽  
Peter P Verhamme ◽  
Raymond Verhaeghe ◽  
Erik Muls ◽  
Desire Collen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Oxidized Ldl ◽  
Global Risk ◽  
Artery Disease

0032 BACKGROUND: Coronary artery disease is associated with an increase in circulating oxidized (Ox)LDL (Circulation 1998; 98:1487-1494). OBJECTIVES: 1) To determine the usefulness of OxLDL for identifying cardiovascular disease patients and 2) to study the relation of OxLDL with cardiovascular risk factors. METHODS: 1) To determine the diagnostic value of OxLDL 308 subjects were studied: 178 patients with angiographically proven coronary artery disease and 130 age-matched subjects without cardiovascular disease (controls) confirmed by B mode ultrasonography of their carotid arteries. 2) Additional 307 patients without cardiovascular disease were studied to determine the relation of OxLDL with cardiovascular risk factors. Levels of OxLDL were directly measured in plasma using a mAb-4E6 based competition ELISA. RESULTS: Compared with controls, patients had 2.3-fold higher levels of circulating OxLDL. At a cutoff value of 2.30 mg/dL, the sensitivity of OxLDL for cardiovascular disease was 73% with a specificity of 90%. The Global Risk Assessment Score (GRAS) was calculated using age, total and HDL cholesterol, systolic blood pressure, diabetes mellitus and smoking. GRAS was 8.65±3.41 for patients versus 6.09±5.10 (p≤0.001) for controls. Compared with subjects with low OxLDL (≤2.30 mg/dL) and low GRAS (≤12), risk of having cardiovascular disease was 3.2 times higher for subjects with low OxLDL and high GRAS, 6.4 times higher for subjects with high OxLDL and low GRAS and 27 times higher for subjects with both high OxLDL and high GRAS. Among patients without cardiovascular disease, stepwise multivariate analysis showed that Body Mass Index (p<0.001), LDL cholesterol (p<0.001), diabetes type 2 (p=0.003), triglycerides (p=0.017) and smoking (p=0.046) were the strongest predictors of OxLDL. Conclusion: Circulating OxLDL is a sensitive marker of cardiovascular disease. Circulating oxidized LDL correlates with obesity, hypercholesterolemia, diabetes and smoking. Addition of OxLDL to the established risk factors may improve cardiovascular risk prediction. Inclusion of OxLDL in prospective studies of risk factors of cardiovascular disease seems to be warranted.

Coronary artery disease--ignored in women or inherently more lethal in women?

1998 ◽  
Vol 7 (1) ◽  
pp. 77-79 ◽  
Author(s):  
KB Keller ◽  
L Lemberg
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Coronary Artery ◽  
Noninvasive Testing ◽  
Atypical Chest Pain ◽  
Artery Disease

The leading cause of death in women is cardiovascular disease. The major cardiovascular risk factors have a greater impact on women. The prognosis for women with CAD is worse than for men. Women frequently present with symptoms of heart disease at a much later age and have a greater frequency of atypical chest pain. Noninvasive testing is less reliable in women. Do these facts indicate that CAD is inherently a more lethal disease in women? Or is CAD, as some would suggest, traditionally ignored in women? Stay tuned!

scholarly journals Radiation‐Induced Cardiovascular Disease: Review of an Underrecognized Pathology

2021 ◽  
Author(s):  
Eve Belzile‐Dugas ◽  
Mark J. Eisenberg
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Radiation Therapy ◽  
Cardiovascular Risk ◽  
Survival Benefit ◽  
Surgical Approaches ◽  
Pericardial Disease ◽  
Radiation Induced ◽  
Artery Disease

Abstract Radiation therapy demonstrates a clear survival benefit in the treatment of several malignancies. However, cancer survivors can develop a wide array of cardiotoxic complications related to radiation. This pathology is often underrecognized by clinicians and there is little known on how to manage this population. Radiation causes fibrosis of all components of the heart and significantly increases the risk of coronary artery disease, cardiomyopathy, valvulopathy, arrhythmias, and pericardial disease. Physicians should treat other cardiovascular risk factors aggressively in this population and guidelines suggest obtaining regular imaging once symptomatology is established. Patients with radiation‐induced cardiovascular disease tend to do worse than their traditional counterparts for the same interventions. However, there is a trend toward fewer complications and lower mortality with catheter‐based rather than surgical approaches, likely because radiation makes these patients poor surgical candidates. When appropriate, these patients should be referred for percutaneous management of valvulopathy and coronary disease.

Exercise test with constant workload versus incremental test in individuals with cardiovascular disease: systematic review and meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Karsten ◽  
FM Mortimer ◽  
LS Silveira ◽  
GS Ribeiro
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Drug Therapy ◽  
Oxygen Uptake ◽  
Exercise Test ◽  
Meta Analysis ◽  
Incremental Test ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf Research Group on Cardiovascular Health and Exercise - gepCARDIO Introduction Cardiovascular disease is the main cause of morbidity and mortality worldwide, accounting for about 31% of deaths, in addition to leading to disabilities and worsening quality of life. The diagnosis of the disease and the response to treatments can be evaluated with functional tests. The most used are the incremental tests, such as the cardiopulmonary exercise test, a reference standard for diagnostic evaluation and exercise prescription. Constant workload tests or endurance tests report the efforts in daily activities and are especially applied to assess the effects of therapeutic procedures, such as physical training and drug therapy. Porpuse: Compare incremental exercise tests with constant workload tests for the assessment of functional performance in response to therapeutic interventions in individuals with cardiovascular disease. Methods: The systematic review was registered on the PROSPERO (CRD42020190214). The search was conducted in July 2020, in ten databases (PubMed, Scopus, Web of Science, Embase, CINAHL, LILACS, PEDro, SPORTDiscus, Livivo and Cochrane Library), and the Google Scholar search. Combinations of terms of related to the PECO strategy were used: (P) individuals with cardiovascular disease undergoing therapeutic procedure; (E) who were exposed to the evaluation with constant workload test; (C) compared to an incremental exercise test; (O) to assess functional capacity outcomes.  Results: 9.453 studies were identified, of which 24 were included in the qualitative analysis and 19 in the meta-analysis. The interventions found were exercise training (71%) and drug therapy (29%). Heart failure was the prevalent diagnosis (54%), followed by coronary artery disease (17%). The constant workload test showing an improvement of 83% (MD 8.62, 95% CI 5.85–11.38) in test duration. The incremental tests showed changes of 12% (MD 1.98, 95% CI 5.85–11.38) for oxygen uptake, and 23% (MD 2.15, 95% CI 1.60–2.71) in oxygen uptake at the anaerobic threshold. In the comparisons between the tests performed in the meta-analysis, the duration of the constant workload test was more responsive than the oxygen uptake in the incremental test (SMD 1.59, 95% CI 0.88 - 2.29). In the analysis of subgroups of clinical diagnosis, the constant workload test was more responsive in the groups of heart failure, coronary artery disease and peripheral arterial disease. In the analysis by type of intervention, the studies with constant workload test also showed superior results. Conclusion: Tests with constant workload are more responsive in detecting changes in functional capacity in individuals with cardiovascular disease after a therapeutic intervention. Future studies with better methodological quality are recommended to increase the certainty of the evaluated evidence. Constant workload tests may have more use in clinical practice, facilitating the assessment of functional outcomes for cardiac patients.

Opioid dependency and myocardial infarction: A systematic review and meta-analysis.

2021 ◽  
Vol 16 ◽  
Author(s):  
Farahnaz Rohani ◽  
Arash Akhavan Rezayat ◽  
Ahmadreza Zarifian ◽  
Mohammad Ghasemi Nour ◽  
Farveh Vakilian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Coronary Artery Disease ◽  
Developing Countries ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Health Concern ◽  
Artery Disease

Background: Coronary artery disease is a major cause of morbidity and mortality worldwide. A major health concern in developing countries is opioid addiction, which has controversial cardiovascular side effects. We aimed to investigate whether myocardial infarction (MI) and its risk factors are associated with morphine dependency in the Iranian population. Methods: Electronic databases, including PubMed, Medline, Scopus, SID, Elmnet, and Magiran were searched to find published articles including the keywords morphine, coronary artery disease, hypertension, hyperlipidemia, and diabetes mellitus. Results: Twelve studies involving 25,800 people were included in the systematic review and meta-analysis. Morphine dependency was significantly associated with MI with an adjusted odds ratio (AOR) of 2.28 (95%CI=1.26-4.11). It didn’t have significant associations with hypertension (AOR=0.952; 95%CI=0.696-1.301) nor diabetes (AOR=0.895; 95%CI=0.644-1.246). Morphine dependency also had no significant association with hyperlipidemia with a crude odds ratio (COR) of 0.906 (95%CI=0.786-1.045). Conclusion: Morphine dependency was significantly related to MI, but its risk factors were not significantly associated with morphine dependency. The increasing prevalence of opioid abuse in developing countries may be a reason for the growing incidence of MI in younger ages and individuals with no risk factors. Besides, physicians should consider the presence of impurities in morphine-based opioids and its possible effects on health.

scholarly journals Cardiovascular health and risk of hospitalization with COVID-19: A Mendelian Randomization study

2021 ◽  
Vol 10 ◽  
pp. 204800402110593
Author(s):  
Marina Cecelja ◽  
Cathryn M. Lewis ◽  
Ajay M. Shah ◽  
Phil Chowienczyk
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Health ◽  
Mendelian Randomization ◽  
Meta Analysis ◽  
Reverse Causality ◽  
Inverse Variance ◽  
Artery Disease

Background Susceptibility to and severity of COVID-19 is associated with risk factors for and presence of cardiovascular disease. Methods We performed a 2-sample Mendelian randomization to determine whether blood pressure (BP), body mass index (BMI), presence of type 2 diabetes (T2DM) and coronary artery disease (CAD) are causally related to presentation with severe COVID-19. Variant-exposure instrumental variable associations were determined from most recently published genome-wide association and meta-analysis studies (GWAS) with publicly available summary-level GWAS data. Variant-outcome associations were obtained from a recent GWAS meta-analysis of laboratory confirmed diagnosis of COVID-19 with severity determined according to need for hospitalization/death. We also examined reverse causality using exposure as diagnosis of severe COVID-19 causing cardiovascular disease. Results We found no evidence for a causal association of cardiovascular risk factors/disease with severe COVID-19 (compared to population controls), nor evidence of reverse causality. Causal odds ratios (OR, by inverse variance weighted regression) for BP (OR for COVID-19 diagnosis 1.00 [95% confidence interval (CI): 0.99–1.01, P = 0.604] per genetically predicted increase in BP) and T2DM (OR for COVID-19 diagnosis to that of genetically predicted T2DM 1.02 [95% CI: 0.9–1.05, P = 0.927], in particular, were close to unity with relatively narrow confidence intervals. Conclusion The association between cardiovascular risk factors/disease with that of hospitalization with COVID-19 reported in observational studies could be due to residual confounding by socioeconomic factors and /or those that influence the indication for hospital admission.

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