scholarly journals Abdominal Aortic Screening Is a Priority for Health in Smoker Males: A Study on Central Italian Population

Author(s):  
Emma Altobelli ◽  
Filippo Gianfelice ◽  
Paolo Matteo Angeletti ◽  
Reimondo Petrocelli

Abdominal aortic aneurysm (AAA) is a major public health problem. In the last decade, in some European countries, abdominal aortic screening (AAS) is emerging as a potential prevention for the rupture of AAA. The goals of our study were to estimate AAA prevalence and risk factors in males and females in a central Italian population, also defining the cost-effectiveness of AAS programs. A pilot study screening was conducted between 1 January 2015 and 31 December 2019 in the municipality of Teramo (Abruzzo Region, Italy) in a group of men and women, ranging from the age of 65 to 79, who were not previously operated on for AAA. The ultrasound was performed by means of Acuson sequoia 512 Simens with a Convex probe. The anterior posterior of the infra-renal aorta was evaluated. The odds ratio values (ORs) were used to evaluate the risk of AAA, and the following determinants were taken into consideration: gender, smoke use, hypertension, and ischemic heart disease. We also estimated the direct costs coming from aneurysmectomy (surgical repair or endovascular aneurysms repair—EVAR). A total of 62 AAA (2.7%, mean age 73.8 ± 4.0) were diagnosed, of which 57 were in men (3.7%, mean age 73.6 ± 4.0) and 5 were in women (0.7%, mean age 74.3 ± 4.1). Male gender and smoke use are more important risk factors for AAA ≥ 3 cm, respectively: OR = 5.94 (2.37–14.99, p < 0.001) and OR = 5.21 (2.63–10.30, p < 0.000). A significant increase in OR was noted for AAA ≥ 3 cm and cardiac arrhythmia and ischemic heart disease, respectively: OR = 2.81 (1.53–5.15, p < 0.000) and OR = 2.76 (1.40–5.43, p = 0.006). Regarding the cost analysis, it appears that screening has contributed to the reduction in costs related to urgency. In fact, the synthetic indicator given by the ratio between the DRGs (disease related group) relating to the emergency and those of the elective activity went from 1.69 in the year prior to the activation of the screening to a median of 0.39 for the five-year period of activation of the screening. It is important to underline that the results of our work confirm that the screening activated in our territory has led to a reduction in the expenditure for AAA emergency interventions, having increased the planned interventions. This must be a warning for local stakeholders, especially in the post-pandemic period, in order to strengthen prevention.

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Yulian H. Kyyak ◽  
Olga Yu. Barnett ◽  
Marta P. Halkevych ◽  
Olha Ye. Labinska ◽  
Hryhoriy Yu. Kyyak ◽  
...  

2020 ◽  
Vol 14 (2) ◽  
pp. 72-77
Author(s):  
Muhammad Salman Tariq ◽  
Iram Manzoor ◽  
Qurat Ul Ain Zulfi ◽  
Naeem Hussain ◽  
Nimra Saleem ◽  
...  

Background: Ischemic heart disease (IHD) is one of the leading causes of mortality in Pakistan. With advancement in research, multiple causes have contributed in development of web of causation of this public health issue. The objective of this study was to assess gender differences in risk factors associated with ischemic heart disease in patients presenting at the biggest cardiology hospital of Lahore. Patients and methods: A comparative cross-sectional study was carried out in Punjab Institute of Cardiology, Lahore from January to August, 2018 on a sample of 296 diagnosed patients of IHD, through non-probability consecutive sampling technique. Data was collected on pretested questionnaire. The data was analyzed using SPSS version 22. Chi-Square test of significance was applied and a p-value ≤0.05 was considered statistically significant. Results: The mean age of participants was 45±12 years with predominance of male patients (71.3%). Frequency of risk factors for IHD included increase body mass index (83.8%), hypertension (61%), insufficient physical activity (43%), diabetes (38.5%) and smoking (23%). Increase serum cholesterol was reported in 95% and triglycerides in 99% of the participants. Gender difference was significant with females residing in urban population (p=0.054) and exercise routine (p=0.034). Males showed high tendency of IHD with smoking pattern (p<0.001) contrary to presence of diabetes in females (p=0.05), hypertension (p=0.054), BMI (p=0.0379) and stressful event in life (p=0.002). Males showed regular intake of medicines (p =0.045) after diagnosis as compared to female population. Conclusion: There is more frequency of ischemic heart disease in males as compared to females. Significant association was observed with residence in urban area, presence of diabetes, hypertension, high BMI and stressful event in life in occurrence of ischemic heart disease in female population.


2021 ◽  
Vol 10 (11) ◽  
pp. 2284
Author(s):  
Diana Gurzău ◽  
Alexandra Dădârlat-Pop ◽  
Bogdan Caloian ◽  
Gabriel Cismaru ◽  
Horaţiu Comşa ◽  
...  

Left bundle branch block is not a benign pathology, and its presence requires the identification of a pathological substrate, such as ischemic heart disease. Left bundle branch block appears to be more commonly associated with normal coronary arteries, especially in women. The objectives of our study were to describe the particularities of left bundle branch block in women compared to men with ischemic heart disease. Result: We included seventy patients with left bundle branch block and ischemic heart disease, with a mean age of 67.01 ± 8.89 years. There were no differences in the profile of risk factors, except for smoking and uric acid. The ventricular depolarization (QRS) duration was longer in men than women (136.86 ± 8.32 vs. 132.57 ± 9.19 msec; p = 0.018) and also men were observed to have larger left ventricular diameters. Left bundle branch block duration was directly associated with ventricular diameters and indirectly associated with left ventricular ejection fraction value, especially in women (R = −0.52, p = 0.0012 vs. R = −0.50, p = 0.002). In angiography, 80% of women had normal epicardial arteries compared with 65.7% of men; all these patients presented with microvascular dysfunction. Conclusion: The differences between the sexes were not so obvious in terms of the presence of risk factors; instead, there were differences in electrocardiographic, echocardiographic, and angiographic aspects. Left bundle branch block appears to be a marker of microvascular angina and systolic dysfunction, especially in women.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Imaoka ◽  
N Umemoto ◽  
S Oshima

Abstract Background In clinical setting, ischemic heart disease is a challenging problem in hemodialysis (HD) population. Coronary flow reserve (CFR) measured by 13 ammonia positron emitting tomography (13NH3PET) is an established and reliable modality for detecting coronary artery disease. Furthermore, some prior studies show CFR is an important and independent predictor for cardiovascular event and mortality. On the other hand, HD patients with malnutrition status have poor prognosis. We have reported about the relationship between cardiovascular events and geriatric nutrition risk index (GNRI). Now, we wonder the predictability of combination of CFR and GNRI. Methods and result We collected 438 consecutive HD patients who received 13NH3PET in our hospital suspected for ischemic heart disease. 29 patients were excluded due to undergoing coronary revascularization within 60 days, 103 patients were excluded due to incomplete database. In total, 306 HD patients were classified into 4 group according the median value of CFR (1.99) and GNRI (97.73); Low CFR Low GNRI group (n=77), High CFR and Low GNRI group (n=76), Low CFR High GNRI group (n=78) and High CFR High GNRI group (n=75). We collected their follow up data up to 1544 days (median 833 days) about all-cause mortality and cardiovascular (CV) mortality. Surprisingly, there is no mortality event in High CFR High GNRI group. We analyzed about all-cause mortality, CV mortality. Kaplan-Meyer analysis shows there are statistically intergroup differences in each (all-cause mortality; log rank p&lt;0.01, CV mortality; log rank p=0.02). Furthermore, we calculated area under the curve (AUC) analysis, net reclassification improvement (NRI) and integrated discrimination improvement (IDI)m adding GNRI and CFR on conventional risk factors. There are intergroup differences for all-cause mortality in AUC [conventional risk factors, +GNRI, +GNRI+CFR; 0.70, 0.72 (p=0.29), 0.79 (p&lt;0.01)], NRI [+GNRI; 0.32 (p=0.04), +GNRI+CFR 0.82 (p&lt;0.01)] and IDI [+GNRI; 0.01 (p=0.05), +GNRI+CFR 0.09 (p&lt;0.01)]. Conclusion HD patients with low CFR and malnutrition status has statistically significant poorer prognosis comparing HD patients with high CFR and without malnutrition status. Adding combination of GNRI and CFR on conventional risk factors improves the predictability of HD population's prognosis. Funding Acknowledgement Type of funding source: None


2015 ◽  
Vol 25 (2) ◽  
pp. 140-151 ◽  
Author(s):  
Puja K. Mehta ◽  
Janet Wei ◽  
Nanette K. Wenger

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