Diabetes Incidence: A Two-year Follow-up of 10,000 Men in a Survey of Ischemic Heart Disease in Israel

Diabetes ◽  
1970 ◽  
Vol 19 (12) ◽  
pp. 938-943 ◽  
Author(s):  
J. B. Herman ◽  
J. H. Medalie ◽  
H. A. Kahn ◽  
H. N. Neufeld ◽  
E. Riss ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Diabetes Incidence

scholarly journals Routine Revascularization Versus Initial Medical Therapy for Stable Ischemic Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (9) ◽  
pp. 841-857 ◽  
Author(s):  
Sripal Bangalore ◽  
David J. Maron ◽  
Gregg W. Stone ◽  
Judith S. Hochman
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Unstable Angina ◽  
Medical Therapy ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Cochrane Central Register ◽  
Stable Ischemic Heart Disease

Background: Revascularization is often performed in patients with stable ischemic heart disease. However, whether revascularization reduces death and other cardiovascular outcomes is uncertain. Methods: We conducted PUBMED/EMBASE/Cochrane Central Register of Controlled Trials searches for randomized trials comparing routine revascularization versus an initial conservative strategy in patients with stable ischemic heart disease. The primary outcome was death. Secondary outcomes were cardiovascular death, myocardial infarction (MI), heart failure, stroke, unstable angina, and freedom from angina. Trials were stratified by percent stent use and by percent statin use to evaluate outcomes in contemporary trials. Results: Fourteen randomized clinical trials that enrolled 14 877 patients followed up for a weighted mean of 4.5 years with 64 678 patient-years of follow-up fulfilled our inclusion criteria. Most trials enrolled patients with preserved left ventricular systolic function and low symptom burden, and excluded patients with left main disease. Revascularization compared with medical therapy alone was not associated with a reduced risk of death (relative risk [RR], 0.99 [95% CI, 0.90–1.09]). Trial sequential analysis showed that the cumulative z-curve crossed the futility boundary, indicating firm evidence for lack of a 10% or greater reduction in death. Revascularization was associated with a reduced nonprocedural MI (RR, 0.76 [95% CI, 0.67–0.85]) but also with increased procedural MI (RR, 2.48 [95% CI, 1.86–3.31]) with no difference in overall MI (RR, 0.93 [95% CI, 0.83–1.03]). A significant reduction in unstable angina (RR, 0.64 [95% CI, 0.45–0.92]) and increase in freedom from angina (RR, 1.10 [95% CI, 1.05–1.15]) was also observed with revascularization. There were no treatment-related differences in the risk of heart failure or stroke. Conclusions: In patients with stable ischemic heart disease, routine revascularization was not associated with improved survival but was associated with a lower risk of nonprocedural MI and unstable angina with greater freedom from angina at the expense of higher rates of procedural MI. Longer-term follow-up of trials is needed to assess whether reduction in these nonfatal spontaneous events improves long-term survival.

Symptoms of fatigue and depression in ischemic heart disease are driven by personality characteristics rather than disease stage: a comparison of CAD and CHF patients

2008 ◽  
Vol 15 (5) ◽  
pp. 583-588 ◽  
Author(s):  
Otto R.F. Smith ◽  
Susanne S. Pedersen ◽  
Ron T. Van Domburg ◽  
Johan Denollet
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Early Stage ◽  
Multivariable Analysis ◽  
Type D Personality ◽  
Ischemic Heart ◽  
Disease Stage ◽  
Type D ◽  
The Impact

Background Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (i) the effect of both the IHD stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and (ii) whether the effect of type-D personality on these symptoms is moderated by IHD stage. Methods Two different samples of patients were included to represent IHD stage: 401 percutaneous coronary intervention patients (early-stage IHD) and 105 ischemic chronic heart failure patients (end-stage IHD) completed the DS14 Type-D Scale at baseline. Logistic regression analysis was used to examine the impact of IHD stage and type-D personality on fatigue and depression at follow-up. Results Disease stage was neither associated with symptoms of fatigue ( P = 0.99) nor depression ( P = 0.29) at 12 months. In contrast, type-D personality was shown to predict both symptoms of fatigue [odds ratio (OR) = 2.96; 95% confidence interval (CI): 1.92–4.58, P < 0.001] and depression (OR = 4.91; 95% CI: 3.16–7.65, P < 0.001) at follow-up; the effect of type-D personality on these symptoms was not moderated by disease stage. In multivariable analysis, type-D remained a significant predictor of symptoms of fatigue (OR = 3.14; 95% CI: 1.98–4.99, P < 0.001) and depression (OR = 5.90; 95% CI: 3.60–9.67, P < 0.001), also after controlling for symptom levels at baseline. Conclusion Type-D personality but not disease stage predicted symptoms of fatigue and depression at 12-month follow-up.

scholarly journals The Incidence of Ischemic Heart Disease and Mortality in People with Subclinical Hypothyroidism: Reanalysis of the Whickham Survey Cohort

2010 ◽  
Vol 95 (4) ◽  
pp. 1734-1740 ◽  
Author(s):  
Salman Razvi ◽  
Jola U. Weaver ◽  
Mark P. Vanderpump ◽  
Simon H. S. Pearce
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Subclinical Hypothyroidism ◽  
Subsequent Treatment ◽  
Hazard Ratio ◽  
Community Dwelling ◽  
Ischemic Heart ◽  
Vascular Events ◽  
Thyroid Autoantibody

Abstract Context: The Whickham Survey evaluated vascular events over 20 yr in community-dwelling subjects stratified by thyroid function and thyroid autoantibody status. No association between ischemic heart disease (IHD) and a composite autoimmune thyroid disease group, comprising individuals with subclinical hypothyroidism (SCH), with positive thyroid antibodies or those using levothyroxine, was found. This result appears to be at odds with the findings of other cohort studies. Objective: The objective of the study was to evaluate incident IHD and mortality in participants in relation to their thyroid status. Outcomes, Design, and Participants: Data were reanalyzed assessing incident IHD events and mortality during 20 yr of follow-up in individuals with endogenous SCH (n = 97; TSH 6.0–15 mIU/liter) vs. the euthyroid group (n = 2279), who were IHD free at baseline. Results: Incident IHD was significantly higher in the SCH group [adjusted hazard ratio 1.76 (95% confidence interval 1.15–2.71); P = 0.01]. IHD mortality was also increased in the SCH group [hazard ratio of 1.79 (1.02–3.56); P = 0.05]. These findings lost their significance when subsequent treatment with levothyroxine was excluded from the regression model. There was no difference in all-cause mortality between the groups. Conclusion: In the Whickham Survey, there is an association between incident IHD events and IHD-related mortality with SCH over the 20 yr of follow-up. Furthermore, subsequent treatment of SCH with levothyroxine appears to attenuate IHD-related morbidity and mortality, and this may explain why some other longitudinal studies of SCH have not shown such an association; properly designed controlled trials of treatment of SCH are required to answer this question definitively.

scholarly journals The Pathways to Increase the Efficacy of Drug Therapy in Patients with Ischemic Heart Disease after Coronary Artery Bypass Grafting

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 12-17
Author(s):  
O. L. Barbarash ◽  
V. V. Kashtalap ◽  
M. V. Zykov ◽  
O. N. Hryachkova ◽  
I. A. Shibanova
Keyword(s):  
Heart Disease ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Ischemic Heart Disease ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Ischemic Heart

Purpose: to assess drug therapy and achievement of target parameters of treatment in patients with ischemic heart disease (IHD) during 3–5 years of follow-up aſter coronary bypass surgery.Materials and methods. From the initial sample of the coronary bypass surgery registry (n=680) we selected for this study 111 men (mean age 61 [55; 65] years) hospitalized in 2011 with clinical picture of IHD for coronary artery bypass graſting (CABG).Results. Mean duration of follow-up was 4.2 years. Mortality was 11.7 % (n=13), 11 deaths were cardiovascular, 2 – from unknown causes. End points defined as repeat hospitalizations and IHD progression were registered in 18 of 98 patients (18.4 %). Only in 25 % of patients during 3–5 years of observation aſter CABG there were no clinical signs of angina. Five patients (5.1 %) developed new type 2 diabetes. Drug therapy: 80 patients (81.6 %) received acetylsalicylic acid, 60 (61.2 %) – angiotensin converting enzyme inhibitors, 80 (81.6 %) – β-adrenoblockers. Eighty-one men (82.6 %) received statins, but only 20 of 98 re-examined patients (20.4 %) took high doses. Target levels of low density lipoprotein cholesterolConclusion. Data of clinical practice illustrate insufficient quality of basic and antianginal therapy in patients with IHD aſter CABG. Indicators of control of angina, heart rate, achievement of target levels of parameters of lipid metabolism remain unsatisfactory.

scholarly journals Increased risk of ischemic heart disease after kidney donation

2021 ◽  
Author(s):  
Anders J Haugen ◽  
Stein Hallan ◽  
Nina E Langberg ◽  
Dag Olav Dahle ◽  
Hege Pihlstrøm ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Ischemic Heart ◽  
Kidney Donation ◽  
Baseline Body Mass Index ◽  
Healthy Controls ◽  
Kidney Donors ◽  
Increased Risk

Abstract Background Previous reports suggest increased risk of hypertension and cardiovascular mortality after kidney donation. In this study we investigate occurrence of ischemic heart disease and cerebrovascular disease, diabetes and cancer in live kidney donors compared with healthy controls eligible for donation. Methods Different diagnoses were assessed in 1029 kidney donors and 16084 controls. The diagnoses at follow-up were self-reported for the controls and registered by a physician for the donors. Stratified logistic regression was used to estimate associations with various disease outcomes, adjusted for gender, age at follow up, smoking at baseline, body mass index at baseline, systolic blood pressure at baseline and time since donation. Results The mean (standard deviation) observation time was 11.3 (8.1) years for donors versus 16.4 (5.7) years for controls. Age at follow-up was 56.1 (12.4) years in donors vs 53.5 (11.1) years in controls and 44% of donors were males vs 39.3% in the controls. At follow up 35 (3.5%) of the donors had been diagnosed with ischemic heart disease versus 267 (1.7%) of the controls. Adjusted odds ratio for ischemic heart disease was 1.64 (confidence interval 1.10-2.43, P = 0.01) in donors compared with controls. There were no significant differences for the risks of cerebrovascular disease, diabetes or cancer. Conclusions During long-term follow-up of kidney donors we find an increased risk of ischemic heart disease compared to healthy controls. This information may be important in the follow-up and selection process of living kidney donors.

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