scholarly journals Lipid profile in a group of patients with Turner’s syndrome at Clínica Universitaria Bolivariana in the Medellín city between 2000 and 2009*

2011 ◽  
pp. 54-60
Author(s):  
Eduar Valencia ◽  
Lina María Serna ◽  
Carlos Mauricio Medina ◽  
Álvaro Arango
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Turner Syndrome ◽  
Coronary Disease ◽  
Cholesterol Levels ◽  
Profile Control ◽  
Clinical Records

Introduction: Turner syndrome patients can present lipid profile alterations, which associated with obesity, frequent in these patients, causes increased cardiovascular risk, lowering their life expectancy. This research evaluates lipid profiles of patients with Turner syndrome between 2000 and 2009 and these are associated to the karyotype and other risk factors for coronary disease. Objective: To describe the lipid profile and other cardiovascular risk factors in a group of girls with Turner syndrome. Methods: This is a descriptive and retrospective study, which evaluated the clinical records of 21 girls with Turner syndrome. We sought metabolic risk factors for coronary disease such as lipid profile, weight, body mass index, and blood pressure. Results: Age at time of diagnostics ranged between 8 months to 17 years, four patients were below 10 years of age and 17 patients were over 11 years of age. The karyotype revealed: 57.3% with 45x monosomy, 33% with 46xx-45x mosaicism, and 9.5% with 46x-qx mosaicism. None of the patients was obese; the total cholesterol levels ranged from 116 mg/dl to 225 mg/dl with a mean of 168.7. When these patients were grouped by age, we found that 25% of those younger than 10 years of age had high levels of cholesterol vs. 58.8% for those over 10 years of age. Regarding the karyotype of the six patients with 46xx-45x karyotype, five (71.4%) presented hypercholesterolemia; 95.2% of the patients were normotensive. Discussion: This research revealed Turner syndrome patients present lipid profile alterations at early ages. Conclusion: It is important to include in the follow up protocol in these patients the lipid profile control and, thus, be able to conduct early interventions to improve their quality of life.

scholarly journals Type 2 diabetes therapy’s quality based on gender. Monographs of AMD Annals 2018

2019 ◽  
Vol 22 (4) ◽  
pp. 197
Author(s):  
Tonutti, L.
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Glycosylated Hemoglobin ◽  
Analysis Data ◽  
Slight Reduction ◽  
Gender Perspective

OBJECTIVE OF THE STUDY Evaluate the evolution of the therapy’s quality by gender in type 2 diabetes (DM2) in Italy, from 2011 to 2016, considering the new AMD Indicators in a gender perspective and the possible disparity in the drug treatment. DESIGN AND METHODS For the purpose of this analysis, data from the AMD Annals 2018 were used. They refer to patients with DM2, treated in 2016 in 222 diabetology services. This report is based on the analysis of the new 2015 AMD indicators (Audit 2, January 23rd, 2018). The characteristics of the study population and the analysis of the indicators are reported separately for men and women affected by DM2. RESULTS The data of 242,422 men and 184,696 women with DM2 were evaluated. The patients were treated by 222 diabetology services in 2016. The distribution by gender shows the prevalence of males and the one by age shows a general aging of the population and an increased survival, mainly in women (3.6% of men and 6.6% of women with DM2 have an age >85 years). The average number of visits per treatment group was comparable between sexes. Compared to the 2011 evaluation, an improvement was achieved in all the process indicators in both genders, although still slightly better in males. In particular, the evaluation of metabolic control through the monitoring of glycated hemoglobin affects almost all male and female patients (96.9% vs 97%). The percentage of patients monitored for lipid profile, renal function, retinopathy and foot screening is lower. Some parameters were considered intermediate outcome indicators as they predict cardiovascular (CV) risk: the achievement of targets for the main CV risk factors is systematically unfavorable for women with DM2. In particular, women are more obese, have a worse diabetes compensation (especially a worse lipid profile) and a greater frequency of glomerularfiltrate reduction. The average levels of glycosylated hemoglobin were slightly higher in women than in men (7,3% ± 1,3 vs 7,2% ± 1,2), also the average levels of LDL cholesterol (100,2 mg/dl ± 33,4 vs 92,5 mg/dl ± 32,3) and average BMI levels (30,1 kg/m2 ± 6.1 vs 29,2 kg / m2 ± 4,9). In comparison with 2011 data, is noticeable a slight reduction in smokers among males and a slight increase among women (20,5% vs 21,5% in men, 12,2% vs 11,8% in women). Overall, the quality of the therapy (assessed with Q score) has improved over the years, in a similar way for both sexes. About half of the patients, in both sexes, have a Q score >25, therefore adequate levels of therapy. The use of drugs for the control of glycaemia in both genders is similar also for innovative drugs. The use of statins is high in both sexes, slightly in favor of women. The intensity of the therapy for hypertension has improved in both sexes. Hence, the available data does not highlight a problem of under-treatment of women, despite their worst results. Gender data related to micro and macroangiopathic complications show differences in the two sexes, but the quality of the data recording on final outcomes, especially cardiovascular, is still modest. CONCLUSIONS Data analysis shows a significant improvement in the quality of specialistic health care, with greater attention in monitoring CV risk factors and complications, an increase in the percentage of subjects in target and a more intensive use of drugs in both sexes. However, some gaps are still present. The examined data confirm that the cardiovascular risk profile is decidedly unfavorable for women and that the main cardiovascular risk factors control, although improved over the years, remains sub-optimal in women and men. Greater efforts are needed to optimize CV risk factors management in both sexes and to reduce, or better eliminate, differences between genders. These data offer important insights for research, clinical practice and review of guidelines in a gender perspective, taking into account that various factors related to gender, such as genetic/biological aspects, lifestyle, adherence to therapies, psycho-social aspects, in addition to prescriptive differences, can affect the achievement of the various outcomes. KEYWORDS gender; DM2; AMD indicators.

Assessing the correlation between diabetes mellitus cardiovascular risk factors and coronary disease

2007 ◽  
Vol 2 (04) ◽  
Author(s):  
P Akritopoulos ◽  
K Akritopoulou ◽  
E Fotiadis ◽  
S Patiakas ◽  
I Kontogiannis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Coronary Disease

scholarly journals Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

2021 ◽  
Vol 10 (6) ◽  
pp. 1314
Author(s):  
Rebeca Lorca ◽  
Isaac Pascual ◽  
Andrea Aparicio ◽  
Alejandro Junco-Vicente ◽  
Rut Alvarez-Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Young Women ◽  
Artery Dissection ◽  
Men And Women ◽  
High Prevalence

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

scholarly journals Impact of switching to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG on cardiovascular risk and lipid profile in people living with HIV: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Giacomelli ◽  
Federico Conti ◽  
Laura Pezzati ◽  
Letizia Oreni ◽  
Anna Lisa Ridolfo ◽  
...  
Keyword(s):  
Body Weight ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Risk Score ◽  
Rank Test ◽  
People Living With Hiv ◽  
Cholesterol Levels ◽  
Signed Rank Test ◽  
Living With Hiv

Abstract Background We aimed to assess the overall cardiovascular and metabolic effect of the switch to three different single tablet regimens (STRs) [tenofovir alafenamide/emtricitabine/rilpivirine (TAF/FTC/RPV), TAF/FTC/elvitegravir/cobi (TAF/FTC/EVG/cobi) and ABC/lamivudine/dolutegravir (ABC/3TC/DTG)] in a cohort of people living with HIV/AIDS (PLWH) under effective ART. Methods All PLWH aged above 18 years on antiretroviral treatment with an HIV-RNA < 50 cp/mL at the time of the switch to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG were retrospectively included in the analysis. Framingham risk score modification after 12 months from the switch such as lipid profile and body weight modification were assessed. The change from baseline to 12 months in mean cardiovascular risk and body weight in each of the STR’s group were assessed by means of Wilcoxon signed-rank test whereas a mixed regression model was used to assess variation in lipid levels. Results Five-hundred and sixty PLWH were switched to an STR regimen of whom 170 (30.4%) to TAF/FTC/EVG/cobi, 191 (34.1%) to TAF/FTC/RPV and 199 (35.5%) to ABC/3TC/DTG. No difference in the Framingham cardiovascular risk score was observed after 12 months from the switch in each of the STR’s groups. No significant overtime variation in mean total cholesterol levels from baseline to 12 months was observed for PLWH switched to ABC/3TC/DTG [200 (SD 38) mg/dl vs 201 (SD 35) mg/dl; p = 0.610] whereas a significant increment was observed in PLWH switched to TAF/FTC/EVG/cobi [192 (SD 34) mg/dl vs 208 (SD 40) mg/dl; p < 0.0001] and TAF/FTC/RPV [187 (SD 34) mg/dl vs 195 (SD 35) mg/dl; p = 0.027]. In addition, a significant variation in the mean body weight from baseline to 12 months was observed in PLWH switched to TAF/FTC/EVG/cobi [72.2 (SD 13.5) kilograms vs 74.6 (SD 14.3) kilograms; p < 0.0001] and TAF/FTC/RPV [73.4 (SD 11.6) kilograms vs 75.6 (SD 11.8) kilograms; p < 0.0001] whereas no difference was observed in those switched to ABC/3TC/DTG [71.5 (SD 12.8) kilograms vs 72.1 (SD 12.6) kilograms; p = 0.478]. Conclusion No difference in the cardiovascular risk after 1 year from the switch to these STRs were observed. PLWH switched to TAF/FTC/EVG/cobi and TAF/FTC/RPV showed an increase in total cholesterol levels and body weight 12 months after the switch.

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 Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Caro Codon ◽  
T Lopez-Fernandez ◽  
C Alvarez-Ortega ◽  
P Zamora Aunon ◽  
I Rodriguez Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Individual Risk ◽  
Funding Source ◽  
Number Of Patients ◽  
All Cause Mortality

Abstract Background The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Design Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk. Methods A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years and 2 years after initiation of cancer therapy. Results At baseline, 893 patients (67.4%) presented at least 1 risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity and all-cause mortality [HR 1.79 (95% CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)]. Conclusions This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)

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