scholarly journals A Comparison Between Bayesian and Frequentist Approach in the Analysis of Risk Factors for Female Cardiovascular Disease Patients in Malaysia

2020 ◽  
pp. 1-7
Author(s):  
Nurliyana Juhan ◽  
Yong Zulina Zubairi ◽  
Zarina Mohd Khalid ◽  
Ahmad Syadi Mahmood Zuhdi
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Multivariate Analysis ◽  
Bayesian Approach ◽  
Killip Class ◽  
Female Patients ◽  
Coronary Syndrome ◽  
Frequentist Approach ◽  
The Bayesian Approach

Cardiovascular disease (CVD) is the number one killer among women in Malaysia and globally, with over two million deaths each year. In this study, two modelling approaches namely Bayesian approach and frequentist approach were considered to identify associated risk factors in CVD among female patients presenting with ST Elevation Myocardial Infarction (STEMI) and to obtain feasible model to fit the data. Comparisons were made to find the best model. A total of 874 STEMI female patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate and multivariate analysis were performed for both Bayesian and frequentist approaches. Six variables namely smoking, dyslipidaemia, myocardial infarction (MI), renal disease, Killip class and age group were found to be significant at the multivariate analysis. The standard errors obtained from the Bayesian approach were much smaller than the frequentist approach. Also, the model fit using Bayesian approach was much better than the frequentist as the deviance value produced by the Bayesian approach was smaller. The Bayesian analysis provides a better alternative to the frequentist approach in the analysis of the risk factors associated with mortality among female CVD patients.

scholarly journals Identifying Risk Factors for Female Cardiovascular Disease Patients in Malaysia: A Bayesian Approach

MATEMATIKA ◽  
2018 ◽  
Vol 34 (3) ◽  
pp. 15-23
Author(s):  
Nurliyana Juhan ◽  
Yong Zulina Zubairi ◽  
Zarina Mohd Khalid ◽  
Ahmad Syadi And Mahmood Zuhdi
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Renal Disease ◽  
Bayesian Approach ◽  
Model Performance ◽  
Killip Class ◽  
Female Patients ◽  
Increased Risk ◽  
Associated Risk Factors

Cardiovascular disease (CVD) includes coronary heart disease, cerebrovasculardisease (stroke), peripheral artery disease, and atherosclerosis of the aorta. All femalesface the threat of CVD. But becoming aware of symptoms and signs is a great challengesince most adults at increased risk of cardiovascular disease (CVD) have no symptoms orobvious signs especially in females. The symptoms may be identified by the assessmentof their risk factors. The Bayesian approach is a specific way in dealing with this kindof problem by formalizing a priori beliefs and of combining them with the available ob-servations. This study aimed to identify associated risk factors in CVD among femalepatients presenting with ST Elevation Myocardial Infarction (STEMI) using Bayesian lo-gistic regression and obtain a feasible model to describe the data. A total of 874 STEMIfemale patients in the National Cardiovascular Disease Database-Acute Coronary Syn-drome (NCVD-ACS) registry year 2006-2013 were analysed. Bayesian Markov ChainMonte Carlo (MCMC) simulation approach was applied in the univariate and multivariateanalysis. Model performance was assessed through the model calibration and discrimina-tion. The final multivariate model of STEMI female patients consisted of six significantvariables namely smoking, dyslipidaemia, myocardial infarction (MI), renal disease, Killipclass and age group. Females aged 65 years and above have higher incidence of CVD andmortality is high among female patients with Killip class IV. Also, renal disease was astrong predictor of CVD mortality. Besides, performance measures for the model wasconsidered good. Bayesian logistic regression model provided a better understanding onthe associated risk factors of CVD for female patients which may help tailor preventionor treatment plans more effectively.

scholarly journals Caronary Artery Disease in Women

2014 ◽  
Vol 15 (2) ◽  
pp. 135-140
Author(s):  
NS Neki
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Disease ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Prevalent Form

Coronary artery disease (CAD) - which includes coronary atherosclerotic disease, myocardial infarction (MI), acute coronary syndrome and angina - is the most prevalent form of cardiovascular disease and is the largest subset of this mortality. Coronary artery disease (CAD) is a leading cause of death of women and men  worldwide. CAD’s impact on women traditionally has been underappreciated due to higher rates at younger ages in men. Microvascular coronary disease disproportionately affects women. Women have unique risk factors for CAD, including those related to pregnancy and autoimmune disease.DOI: http://dx.doi.org/10.3329/jom.v15i2.20687 J MEDICINE 2014; 15 : 135-140

scholarly journals Risk Factors of Mortality among Male Patients with Cardiovascular Disease in Malaysia Using Bayesian Analysis

2020 ◽  
Author(s):  
Nurliyana JUHAN ◽  
Yong Zulina ZUBAIRI ◽  
Zarina Mohd KHALID ◽  
Ahmad Syadi MAHMOOD ZUHDI
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Renal Disease ◽  
Bayesian Approach ◽  
Model Calibration ◽  
Model Fit ◽  
Model Parameters ◽  
Killip Class ◽  
Factors Associated ◽  
Male Patients

Background: Identifying risk factors associated with mortality is important in providing better prognosis to patients. Consistent with that, Bayesian approach offers a great advantage where it rests on the assumption that all model parameters are random quantities and hence can incorporate prior knowledge. Therefore, we aimed to develop a reliable model to identify risk factors associated with mortality among ST-Elevation Myocardial Infarction (STEMI) male patients using Bayesian approach. Methods: A total of 7180 STEMI male patients from the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry for the years 2006-2013 were enrolled. In the development of univariate and multivariate logistic regression model for the STEMI patients, Bayesian Markov Chain Monte Carlo (MCMC) simulation approach was applied. The performance of the model was assessed through convergence diagnostics, overall model fit, model calibration and discrimination. Results: A set of six risk factors for cardiovascular death among STEMI male patients were identified from the Bayesian multivariate logistic model namely age, diabetes mellitus, family history of CVD, Killip class, chronic lung disease and renal disease respectively. Overall model fit, model calibration and discrimination were considered good for the proposed model. Conclusion: Bayesian risk prediction model for CVD male patients identified six risk factors associated with mortality. Among the highest risks were Killip class (OR=18.0), renal disease (2.46) and age group (OR=2.43) respectively.

scholarly journals Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001322
Author(s):  
Emily S Bartlett ◽  
Luisa S Flor ◽  
Danielle Souto Medeiros ◽  
Danny V Colombara ◽  
Casey K Johanns ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factors ◽  
Public Knowledge ◽  
Significant Heterogeneity ◽  
Coronary Syndrome ◽  
Eastern Brazil

ObjectiveTo conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.MethodsA cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.Results3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.ConclusionsIn three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.

scholarly journals RISK FACTORS OF CARDIOVASCULAR DISEASE AMONG ST-ELEVATION MYOCARDIAL INFARCTION MALE PATIENTS IN MALAYSIA FROM 2006 TO 2013

2019 ◽  
Vol 81 (3) ◽  
Author(s):  
Nurliyana Juhan ◽  
Zarina Mohd Khalid ◽  
Yong Zulina Zubairi ◽  
Ahmad Syadi Mahmood Zuhdi ◽  
Wan Azman Wan Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Univariate Analysis ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Male Patients

Cardiovascular disease is the leading cause of death in Malaysia and globally. This study aimed to identify associated risk factors in cardiovascular disease among ST elevation myocardial infarction (STEMI) male patients and obtain a feasible model to describe the data. A total of 16,673 STEMI male patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate analysis was conducted. Significant variables from the univariate analysis were further analysed by a multivariate logistic analysis to identify the prognostic factors. The most prevalent risk factor for male patients was smoking (79.3%), followed by hypertension (54.9%) and diabetes mellitus (40.4%). At univariate level, this study is consistent with the findings from the Malaysian National Health and Morbidity Survey (NHMS) where smoking is a significant risk factor. After adjustment in multivariate logistic model, the risk factors for cardiovascular death among male patients are related to age, premorbid condition such as diabetes mellitus, hypertension, family history of CVD, Killip class, type of treatment such as percutaneous coronary intervention (PCI) and relevant comorbidity such as renal disease. Drastic efforts in the management of all risk factors in males is needed to improve adherence outcomes.

scholarly journals Haemorrhagic risk of oncology patients with myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Branco Mano ◽  
A.T Timoteo ◽  
S Aguiar Rosa ◽  
R Cruz Ferreira
Keyword(s):  
Myocardial Infarction ◽  
Multivariate Analysis ◽  
Antiplatelet Therapy ◽  
Invasive Coronary Angiography ◽  
Oncology Patients ◽  
Killip Class ◽  
Coronary Syndrome ◽  
Safety Endpoint ◽  
Diagnosis Of Cancer ◽  
St Elevation

Abstract   The approach of acute coronary syndrome (ACS) in oncology patients (pts) is challenging due to higher haemorrhagic risk. Objectives and methods Retrospective analysis of pts included in an ACS registry between October 2010 and September 2019 with cancer (active or diagnosed in <5 years). Aim: evaluate safety and efficacy of single vs dual antiplatelet therapy (DAPT), anticoagulation and revascularization strategy. Primary safety endpoint: major haemorrhagic events (MHE). Secondary efficacy endpoints: ischemic events, intra-hospital (IH) mortality; combined efficacy endpoint of IH mortality, reinfarction and ischemic stroke. Results 934 pts (5%) of a total of 18845 pts with ACS had diagnosis of cancer. Compare to pts without malignancy, oncology pts were older, had more atrial fibrillation (AF), lower left ventricle ejection fraction (LVEF), underwent invasive coronary angiography (ICA) and angioplasty less often. Oncology pts had more events: MHE (2.9% vs 1.5%, p<0.001), mortality (5.8% vs 3.4%, p<0.001) and combined endpoint (7.4% vs 4.9%, p<0.001). Oncology population: pts with MHE (N=27) had more previous haemorrhagic events, AF, higher creatinine level, ST-Elevation Myocardial Infarction (STEMI), more use of anticoagulation, less use of DAPT or acetylsalicylic acid (ASA) and higher IHmortality. In multivariate analysis, previous haemorrhagic events, AF, STEMI and no ASA were independent predictors of MHE. Pts who reached combined endpoint (N=69) were older, had more renal impairment, thrombocytopenia, STEMI, Killip class > I, lower LVEF, less prescribe with antiplatelet therapy and neurohormonal therapy, less submitted to ICA and a trend to less angioplasty. In multivariate analysis, STEMI, Killip >I, creatinine >2mg/dL, thrombocytopenia, LVEF<40%, no ACEi therapy and no ICA were independent predictors of the combined endpoint (Table 1). Conclusion Oncology pts had worse prognosis than general population with ACS. MHE were mainly related to previous haemorrhagic event and AF, associated with anticoagulation strategy. On the other hand, IH mortality, reinfarction and ischaemic stroke were associated with lower use of antiplatelet and neurohormonal therapy and ICA. Funding Acknowledgement Type of funding source: None

IDENTIFICATION AND ASSESSMENT OF RISK FACTORS ROLE IN MYOCARDIAL INFARCTION DEVELOPMENT

2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Control Group ◽  
Biological Factors ◽  
Prevention And Treatment ◽  
High Level ◽  
Social Importance ◽  
The Impact

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.

scholarly journals Analysis of risk factors for different subtypes of acute coronary syndrome

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110083
Author(s):  
Lei Zhang ◽  
Juledezi Hailati ◽  
Xiaoyun Ma ◽  
Jiangping Liu ◽  
Zhiqiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Amino Terminal ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

ACUTE CORONARY SYNDROME FOLLOWING INTRAVENOUS IMMUNOGLOBULIN THERAPY : A HIDDEN RISK

2021 ◽  
pp. 78-79
Author(s):  
Karthikkeyan Rajachandran ◽  
Giphy Susan Varghese
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
Immunoglobulin Therapy ◽  
Left Ventricular ◽  
Intravenous Immunoglobulin Therapy ◽  
Severe Left Ventricular Dysfunction ◽  
St Segment Elevation ◽  
Coronary Syndrome

Intravenous immunoglobulin (IVIG) is one of the main line modalities of therapy for chronic inammatory demyelinating polyneuropathy (CIDP). We hereby, report an incidence of acute myocardial infarction probably induced by IVIG during the treatment of CIDP. A 76 year old female with no history suggestive of cardiovascular disease, developed an acute Non ST Segment Elevation Myocardial Infarction (NSTEMI) and severe left ventricular dysfunction after receiving three doses of IVIG. Since hypercoagulability is a concern with IVIG therapy, it was discontinued. Hence, we highlight the importance of cardiac evaluation before initiation and during the course of IVIG therapy in elderly patients as well as in patients with known risk factors for cardiovascular disease and thrombotic events.

scholarly journals Acute Myocardial Infarction In Systemic Mastocytosis: Case Report With Literature Review Of The Role Of Inflammatory Process In Acute Coronary Syndrome

2020 ◽  
Vol 16 ◽  
Author(s):  
Ayman Battisha ◽  
Khalid Sawalha ◽  
Bader Madoukh ◽  
Omar Sheikh ◽  
Karim Doughem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Plasma Lipids ◽  
Plaque Rupture ◽  
Systemic Mastocytosis ◽  
Cardiac Risk ◽  
Control Group ◽  
Coronary Syndrome

: Systemic Mastocytosis (SM) is a disorder of excessive mast cell infiltration in multiple organ tissues. Atherosclerosis is a major risk factor for developing acute coronary syndrome [1]. In addition to lipid accumulation in the arterial wall, inflammation plays an important role in the pathogenesis of plaque rupture and activating the thrombosis cascade [2]. The Mast cells contribution to plaque destabilization has been well established in multiple animal and human studies [3]. In a recent study, SM has been proven to be associated with a higher incidence of acute coronary syndrome even with lower plasma lipids level [4]. The study showed that 20% of patients with SM had cardiovascular events compared to only 6% in the control group with adjustment to all cardiac risk factors. Here, we present a case of acute myocardial infarction in a patient with SM with limited risk factors other than age.

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