scholarly journals CARDIOVASCULAR HEALTH KNOWLEDGE OF PATIENT ATTENDANTS IN SOUTHERN OF IRAN, SHIRAZ

2012 ◽  
Vol 19 (05) ◽  
pp. 604-610
Author(s):  
ABDUL HAMEED CHOHEDRI ◽  
MANSOUR MASJEDI ◽  
MOHAMMAD HOSSEIN EGHBAL

Background : Knowledge about coronary artery disease and it’s risk factors is a very important factor in prevention of ischemicheart disease. The aim of this study was to investigate knowledge of patient attendants about coronary artery disease and its risk factors insouthern of Iran; Shiraz. Design: Cross sectional study. Setting: Shiraz University of Medical Sciences. Materials and Methods: 800 patientattendants (persons accompanying patients) selected randomly and divided into two groups (study and control) each including 400 patientattendants. Face to face interview was done and knowledge was measured by correct answers to our standard questionnaire. Results: Themedian knowledge score was 6.89 for study group and was 2.82 for control group out of a possible maximum of 15. Majority of respondents instudy group could identify up to three risk factors for coronary artery disease, but in control group could identify only one risk factor. About 5.8%in study group and 37.5% in control group were not able to identify even a single risk factor for coronary artery disease. Conclusions:According to our results there is a big gap in knowledge about coronary artery disease and it’s risk factors in our population. It means that moreeducational programs are needed to prevent the increasing rate of coronary artery disease.

Author(s):  
Fu-Hsuan Kuo ◽  
Chia-Yi Lee ◽  
Ju-Pi Li ◽  
Jui-Fu Chung ◽  
Yu-Hsun Wang ◽  
...  

We aim to evaluate the development of peripheral occlusive artery disease (PAOD) in patients with migraine by using the National Health Insurance Research Database in Taiwan. A retrospective cohort study was conducted and individuals with diagnostic codes of migraine were enrolled in the study group after excluding those diagnosed with PAOD before the index date. Each subject with migraine was propensity-score matched to another non-migraine patient and the latter served as the control group. A total of 37,288 patients were finally enrolled in the groups. The primary outcome was set as the development of PAOD between the two groups while multiple possible risk factors, including demographic data and comorbidities, were analyzed via the Cox proportional hazards regression. There were 885 and 530 PAOD events in the study and control groups, and the study group had a significantly higher adjusted hazard ratio (1.65, 95% confidential interval: 1.48–1.84, p < 0.001), and the cumulative incidence also revealed a correlation between migraine and PAOD. Other potential risk factors related to the existence of PAOD include age, hypertension, chronic kidney disease, diabetes mellitus, coronary artery disease, stroke, and asthma. For individuals without certain systemic diseases including hypertension, chronic liver disease, chronic kidney disease, coronary artery disease, stroke, asthma, or heart failure, the hazard ratio of subsequent PAOD was significantly higher in the migraine patients than that in the non-migraine individuals (all p < 0.001). In conclusion, the presence of migraine is a significant risk factor for the development of subsequent PAOD.


2013 ◽  
Vol 131 (5) ◽  
pp. 296-300 ◽  
Author(s):  
Antonio Ivo Moritz Neto ◽  
Joel Rolim de Moura Junior ◽  
Darlene Camati Persuhn

CONTEXT AND OBJECTIVE: Atherosclerotic disease is the leading cause of death in Brazil. It is a complex disease and its prevention involves identification and control of risk factors. Moderately increased plasma homocysteine concentration (hyperhomocysteinemia) has been considered to be a risk factor for several vascular diseases. Mutations in the methylenetetrahydrofolate reductase (MTHFR) enzyme, which is involved in homocysteine metabolism, have been investigated as potential vascular disease risk factors. G1793A polymorphism was described in 2002 and there are few studies analyzing its involvement in diseases. The objective of this study was to investigate the prevalence of G1793A polymorphism in subjects with early coronary artery disease (CAD). DESIGN AND SETTING: Cross-sectional study with control group conducted at a private cardiology clinic and a molecular biology laboratory (Universidade do Vale do Itajaí). METHODS: We studied 74 early-onset CAD+ patients and 40 CAD- individuals with normal angiography results. DNA was extracted from blood samples. Molecular data were obtained via PCR/RFLP and agarose gel electrophoresis. RESULTS: The occurrence of G1793A heterozygotes was similar in the control (5%) and test (6.25%) groups, thus showing that in the population studied there was no correlation between the marker and occurrences of early CAD. There was also no association between the polymorphism and the risk factors for atherosclerosis. CONCLUSIONS: The frequency of the 1793A allele in the test group (3.4%) was similar to what was found in the control individuals (2.5%). There was no correlation between G1793A polymorphism and occurrences of early CAD in this population.


2019 ◽  
Vol 8 (5) ◽  
pp. 677-685
Author(s):  
Til Bahadur Basnet ◽  
Cheng Xu ◽  
Manthar Ali Mallah ◽  
Wiwik Indayati ◽  
Cheng Shi ◽  
...  

Abstract There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case–control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21–2.7) and OR: 5.2 (CI: 3.4–7.97)), with p-values less than 0.004 and &lt;0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64–12.12, p &lt; 0.00001; OR: 1.89, 95% CI: 1.08–3.31, p &lt; 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.


2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
Pradyumna Agasthi ◽  
Sivakanth Aloor ◽  
Avantika Chenna ◽  
Anekwe Onwuanyi

Background: Ghrelin (GH) is a gastrointestinal endocrine peptide regulating multiple biological processes including adipogenesis, glucose metabolism, cell differentiation and proliferation. Recent studies demonstrated that GH inhibits pro-atherogenic changes in vessel wall via inhibition of nuclear factor - B activity, a transcriptional factor mediating production pro-inflammatory cytokines and adhesion molecule expression in the endothelium. The aim of the current study is to conduct a meta-analysis to evaluate the relationship between serum GH levels and coronary artery disease (CAD). Methods: We searched MEDLINE, CINHAL and COCHRANE databases for studies reporting serum GH levels in the CAD and non CAD study population. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum GH levels between the CAD and control groups. Results: Our search strategy yielded 285 articles and we included 10 studies enrolling 1855 participants. The median age of the CAD group was 62 yrs. (IQR 60 - 63) compared to 61 yrs. (IQR 58 - 65) in the control group. The median body mass index in the CAD group was 28 kg/m2 (IQR 27.9 - 28) compared to 27 kg/m2 (IQR 26 - 27) in the control group. The unweighted median serum GH levels in the CAD group were 0.66 ng/ml (IQR 0.3 - 1.6) compared to 0.76 ng/ml (IQR 0.38 - 4.9) in the control group. The SMD of GH level was -0.44 (95% CI -0.56,-0.31) p<0.001 comparing those in the CAD group and control group. Conclusion: Serum GH levels are significantly and inversely associated with CAD. Current findings warrant the need to further investigate the role of GH in the pathogenesis of CAD.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Gaudel ◽  
M Kaunonen ◽  
S Neupane ◽  
K Joronen ◽  
A M Koivisto ◽  
...  

Abstract Background Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality and serious health problem worldwide. It is important to observe lifestyle related risk factors in patients with CAD for effective planning and implementation of secondary prevention strategies. The aim of this study is to describe the prevalence of lifestyle related risk factor habits among the patients with CAD. Methods A cross-sectional study was conducted among CAD patients in a tertiary care national heart center in Kathmandu, Nepal. Six lifestyle related factors (dietary habit, smoking, alcohol consumption, stress, physical activity and adherence to medication) and Body Mass Index were used as the risk factors of CAD in this study. Individual face-to-face structured interview was conducted using culturally validated standard instruments. The descriptive characteristics were presented as frequencies and percentages for categorical variables and as mean ± standard deviation (SD) or median and interquartile range (IQR) otherwise. Results In total study population, the mean age of the patients was 59.9 years and 76% were male. Patients having any three risk factors out of seven were the most common (36%) followed by two risk factors (25%) and four risk factors (22%). About 32% of study population were current smokers, whereas 29% were former smokers. Likewise, 31% of the total were physically inactive. Majority of the patients 95% had perceived moderate stress. Conclusions The prevalence of lifestyle related risk factors is high among CAD patients in study population. Combination of any three lifestyle related risk factors were the most common among patients. Therefore, studies focusing on lifestyle risk factor modification intervention on particular groups is recommended. Key messages Need to improve awareness about lifestyle related risk factors among CAD patients. Highlight the importance of lifestyle counselling.


2010 ◽  
Vol 95 (5) ◽  
pp. 2376-2383 ◽  
Author(s):  
Erdembileg Anuurad ◽  
Zeynep Ozturk ◽  
Byambaa Enkhmaa ◽  
Thomas A. Pearson ◽  
Lars Berglund

Abstract Context: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD). Objective: We investigated the association between Lp-PLA2 and CAD in a biethnic African-American and Caucasian population. Design: Lp-PLA2 mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography. Main Outcome Measures: We assessed the distribution of Lp-PLA2 levels and determined the predictive role of Lp-PLA2 as a risk factor for CAD. Results: Levels of Lp-PLA2 mass and activity were higher among Caucasians compared with African-Americans (293 ± 75 vs. 232 ± 76 ng/ml, P &lt; 0.001 for mass and 173 ± 41 vs. 141 ± 39 nmol/min/ml, P &lt; 0.001 for activity, respectively). However, Lp-PLA2 index was similar in the two groups (0.61 ± 0.17 vs. 0.64 ± 0.19, P = NS). In both ethnic groups, Lp-PLA2 activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA2 index than corresponding Caucasian subjects (0.69 ± 0.20 vs. 0.63 ± 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA2 index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians. Conclusions: Lp-PLA2 activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA2 as a cardiovascular risk factor.


1993 ◽  
Vol 39 (2) ◽  
pp. 209-212 ◽  
Author(s):  
J H Wu ◽  
J T Kao ◽  
M S Wen ◽  
D Wu

Abstract We measured lipid and lipoprotein concentrations in blood samples from control subjects and patients with coronary artery disease (CAD) in Taiwan. We found significant differences (P &lt; 0.01) in the concentrations of high-density lipoprotein cholesterol (HDLC), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB), and lipoprotein(a) [Lp(a)]. Concentrations of HDLC &lt; 350 mg/L, ApoAI &lt; 900 mg/L, ApoB &gt; 800 mg/L, and Lp(a) &gt; 200 mg/L occurred, respectively, 2.8, 5.2, 1.7, and 2.3 times more frequently in the patients than in the control group. If one considers HDLC at &lt; 350 mg/L, ApoAI at &lt; 900 mg/L, ApoB at &gt; 800 mg/L, and Lp(a) at &gt; 200 mg/L as separate risk factors for CAD, the ratio of individual patients to control subjects having 4, 3, 2, 1, or 0 risk factors was [symbol: see text] 9.4, 2.1, 0.2, 0.2, respectively. Individuals displaying three or more risk factors were found 15 times more frequently in the CAD group than in the control group. These risk factors may be used clinically for the prediction and prevention of CAD in the general population.


2009 ◽  
Vol 36 (11) ◽  
pp. 2454-2461 ◽  
Author(s):  
ROBERT J. GOLDBERG ◽  
MURRAY B. UROWITZ ◽  
DOMINIQUE IBAÑEZ ◽  
MANDANA NIKPOUR ◽  
DAFNA D. GLADMAN

Objective.To ascertain coronary artery disease (CAD) outcomes and predictive factors in a prospective study of patients with systemic lupus erythematosus (SLE) and matched healthy controls.Methods.SLE patients and non-SLE age-matched controls without a history of CAD were recruited into a prospective study between 1997 and 1999. CAD events were assessed at clinic visit for SLE patients and through telephone interview and chart review for controls. All events were verified with patient medical records.Results.Followup information was available on 237 controls and 241 SLE patients. The mean followup time was 7.2 years. Univariate analyses identified age and postmenopausal status as predictors of CAD in both the groups. Sedentary lifestyle, hypertension, the presence of metabolic syndrome, and the number of Framingham risk factors were predictive in the control group only. The 10-year risk of CAD score was predictive in both groups but was not as marked in the SLE group as in the controls. None of the lipid subfractions were predictive for CAD in the SLE group, whereas in the controls, a high triglyceride level ≥ 2.8 was predictive. Time-to-event multivariate analysis for CAD in all subjects revealed SLE itself, older age, and triglycerides ≥ 2.8 to be highly predictive for CAD.Conclusion.In a prospective study of patients with SLE and matched controls followed over a median of 8 years, patients with SLE developed significantly more CAD events than controls. Accounting for demographic variability, CAD risk factors, and lipid factors, SLE is an independent risk factor for the development of CAD.


2012 ◽  
Vol 58 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Robert Roberts ◽  
Alexandre F R Stewart

Abstract BACKGROUND It has long been recognized that 50% of the susceptibility for coronary artery disease (CAD) is due to predisposing genetic factors. Comprehensive prevention is likely to require knowledge of these genetic factors. CONTENT Using a genomewide association study (GWAS), the Ottawa Heart Genomic Study and the deCODE group simultaneously identified the first genetic risk variant, at chromosome 9p21. The 9p21 variant became the first risk factor to be identified since 1964. 9p21 occurs in 75% of the population except for African Americans and is associated with a 25% increased risk for CAD with 1 copy and a 50% increased risk with 2 copies. Perhaps the most remarkable finding is that 9p21 is independent of all known risk factors, indicating there are factors contributing to the pathogenesis of CAD that are yet unknown. 9p21 in individuals with premature CAD is associated with a 2-fold increase in risk, similar to that of smoking and cholesterol. Routine genetic testing will probably remain controversial until a specific treatment is developed. Over a period of 5 years, however, GWASs have identified 30 genetic variants for CAD risk, of which only 6 act through the known risk factors. SUMMARY The 9p21 variant has now been established as an independent risk factor for CAD and, along with the additional 29 risk genetic variants recently identified, is likely to provide the thrust for genetic testing and personalized medicine in the near future.


2016 ◽  
Vol 64 (4) ◽  
pp. 940-941
Author(s):  
N Vyas ◽  
H Alkhawam ◽  
E Saker ◽  
R Sogomonian ◽  
RA Ching Companioni ◽  
...  

IntroductionHelicobacter pylori (HP) infection is known to target the gastrointestinal system and is associated with extra gastrointestinal manifestations, but there is limited literature on cardiac associations. The most supported pathogenesis uses chronic inflammation as a risk factor causing atherosclerosis resulting in cardiovascular disease. Our aim is to evaluate whether there is an association between HP infection and acute myocardial infarction (AMI) and coronary artery disease (CAD).MethodWe performed a retrospective single center study at our medical center from 2005 to 2014 consisting of 1,671 patients who underwent Coronary Angiography (CA). We divided these patients into two groups based on CA reports. Patients with CAD defined as left main stenosis of ≥50% or any stenosis of ≥70% versus normal coronaries. We reviewed each patient chart to determine the prevalence of positive serum HP IgG antibody. Smoking, hypertension, dyslipidemia and obesity were also considered in each group.ResultsOf 1,671 patients, 1,237 had evidence of CAD vs 434 with normal coronary arteries. Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001) as depicted in figure 1. When we looked at the CAD group and compared SPHP patients to seronegative HP (SNHP) patients we found a greater amount of multiple coronary vessels disease in the SPHP group (OR: 1.4, 95% CI: 1.1–2, P=0.04). With regards to AMI, 30% of the SPHP group presented with AMI versus 10% seen in the SNHP group (OR: 4.3, 95% CI: 3–6.5, p<0.0001). In the CAD group with SPHP there was more hyperlipidemia and a higher BMI than in the CAD SNHP group (p<0.0001 and <0.0001, respectively), but there was no statistical difference between the two groups for the risk factors of smoking, hypertension and diabetes.ConclusionAccording to this study, the results showed a correlation with SPHP patients and CAD. Patients with HP seropositivity also tend to have multiple coronary artery vessel disease. In addition, our results also confirmed that there is an association between with HP infection and AMI. We hypothesize that the associated maybe secondary to inflammatory reaction associated with HP. Additional studies with larger sample groups are needed to investigate the possible role of this pathogen as a risk factor for heart disease.Abstract ID: 35 Figure 1Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001).


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