scholarly journals Premature Coronary Artery Disease Is More Prevalent in People Who Go to Bed Late

2021 ◽  
Vol 24 (12) ◽  
pp. 876-880
Author(s):  
Farzad Masoudkabir ◽  
Zahra Mohammadi ◽  
Mohammad Alirezaei ◽  
Bahman Cheraghian ◽  
Zahra Rahimi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Obstructive Coronary Artery Disease ◽  
Health Study ◽  
Premature Coronary Artery Disease ◽  
Significant Difference ◽  
Artery Disease ◽  
The Impact

Background: Little is known regarding the impact of quantity and quality of sleep on the incidence of cardiovascular disease. The aim of this study was to investigate the possible independent association of late bedtime and premature coronary artery disease (PCAD). Methods: Between October 2016 and November 2019, we conducted a cross-sectional population-based study on 30101 participants aged 20–65 years in Khuzestan Comprehensive Health Study (KCHS). Data on major risk factors of cardiovascular disease, habit history, physical activity, and sleep behavior was gathered and participants underwent blood pressure, anthropometric, and serum lipid and glucose profile measurements. PCAD was defined as documented history of developing obstructive coronary artery disease before 45 years in men and before 55 years in women. Results: Of a total of 30101 participants (64.1% female, mean age: 41.7±11.7 years) included in this study, 1602 (5.3%, 95% confidence interval: 5.1%–5.6%) had PCAD. Late bedtime was reported in 7613 participants (25.3%, 95% confidence interval: 24.9%–25.8%). Age-sex standardized prevalence for PCAD and late bedtime were 3.62 (3.43-3.82) and 27.8 (27.2–28.4), respectively. There was no significant difference (P=0.558) regarding prevalence of PCAD between those with late bedtime (5.5%, 95% CI: 4.9%–6.0%) and those with early bedtime (5.3%, 95% CI: 5.0%–5.6%). However, after adjustment for potential confounders, late bedtime was independently associated with PCAD (OR=1.136, 95% CI=1.002–1.288, P=0.046). Conclusion: In this study, late bedtime was significantly associated with presence of PCAD. Future prospective studies should elucidate the exact role of late bedtime in developing coronary atherosclerosis prematurely.

scholarly journals Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

2021 ◽  
Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Long Term Outcomes ◽  
Vital Status ◽  
Increased Risk ◽  
Artery Disease ◽  
The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

scholarly journals Prevalence of metabolic syndrome in patients with premature coronary artery disease proven by coronary angiogram

2017 ◽  
Vol 5 (11) ◽  
pp. 5021 ◽  
Author(s):  
Varun Sundaramoorthy ◽  
Anith Kumar Mambatta ◽  
Yoganathan Chidambaram ◽  
Rajendiran Gopalan ◽  
Sujaya Menon
Keyword(s):  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Coronary Artery ◽  
Young Patients ◽  
International Diabetes Federation ◽  
Premature Coronary Artery Disease ◽  
Coronary Angiogram ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Artery Disease

Background: Metabolic syndrome (MS) is associated with premature coronary artery disease (CAD). The aim of this study was to evaluate the prevalence of MS and its association with severity of CAD proven by coronary angiogram (CAG) in young patients.Methods: We included patients, aged 45 years or less, admitted with acute coronary syndrome (ACS), who had CAD confirmed by coronary angiography. They were divided into two groups according to the presence or absence of MS based on International Diabetes Federation (IDF) criteria. CAD was classified into single, double and triple vessel disease (TVD). The prevalence of MS and its individual parameters was calculated.Results: Among 90 young patients who presented with ACS, MS was present in 67 patients (74.44%). Among those with MS, the prevalence of each individual criterion was statistically significant in MS group (P <0.05). Prevalence of pre-existing hypertension and diabetes was significantly higher in MS group (p <0.01). Smoking, alcohol consumption and family history of CAD were not statistically significant in patients with and without MS. Fifteen out of 90 patients (14 in MS group) who presented with ACS had TVD in CAG, but this was not statistically significant (p 0.06).Conclusions: This study confirms a very high prevalence of MS in young Indian patients with premature CAD. MS was more prevalent than the conventional risk factor smoking in young CAD patients. We could not find significant difference in severity of CAD based on CAG between MS and non-MS group.

scholarly journals Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Tiffany M. Powell-Wiley ◽  
Paul Poirier ◽  
Lora E. Burke ◽  
Jean-Pierre Després ◽  
Penny Gordon-Larsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Weight Loss ◽  
Coronary Artery ◽  
Disease Risk ◽  
Artery Disease ◽  
The Impact

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.

scholarly journals Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings

2021 ◽  
Vol 10 (9) ◽  
pp. 1863
Author(s):  
Jorge Rodríguez-Capitán ◽  
Andrés Sánchez-Pérez ◽  
Sara Ballesteros-Pradas ◽  
Mercedes Millán-Gómez ◽  
Rosa Cardenal-Piris ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Obstructive Coronary Artery Disease ◽  
Hazard Ratio ◽  
Coronary Syndrome ◽  
Cardiovascular Prognosis ◽  
Artery Disease

The clinical significance of non-obstructive coronary artery disease is the subject of debate. Our objective was to evaluate the long-term cardiovascular prognosis associated with non-obstructive coronary artery disease in patients undergoing coronary angiography, and to conduct a stratification by sex, diabetes, and clinical indication. We designed a multi-centre retrospective longitudinal observational study of 3265 patients that were classified into three groups: normal coronary arteries (lesion <20%, 1426 patients), non-obstructive coronary artery disease (20–50%, 643 patients), and obstructive coronary artery disease (>70%, 1196 patients). During a mean follow-up of 43 months, we evaluated a combined cardiovascular event: acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Multivariable-adjusted Cox proportional hazard models showed a worse prognosis in patients with non-obstructive coronary artery disease, in comparison with patients of normal coronary arteries group, in the total population (hazard ratio 1.72, 95% confidence interval 1.23–2.39; p for trend <0.001), in non-diabetics (hazard ratio 2.12, 95% confidence interval: 1.40–3.22), in women (hazard ratio 1.75, 95% confidence interval 1.10–2.77), and after acute coronary syndrome (hazard ratio 2.07, 95% confidence interval 1.25–3.44). In conclusion, non-obstructive coronary artery disease is associated with an impaired long-term cardiovascular prognosis. This association held for non-diabetics, women, and after acute coronary syndrome.

scholarly journals Association between anti-diabetes treatments and cardiovascular risk in diabetes patients with and without coronary artery disease

2019 ◽  
Vol 16 (4) ◽  
pp. 351-359 ◽  
Author(s):  
Christine Gyldenkerne ◽  
Kevin Kris Warnakula Olesen ◽  
Morten Madsen ◽  
Troels Thim ◽  
Lisette Okkels Jensen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Obstructive Coronary Artery Disease ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Artery Disease ◽  
Glucose Lowering Therapy ◽  
Diabetes Patients

Objective: We examined the risk of myocardial infarction associated with glucose-lowering therapy among diabetes patients with and without obstructive coronary artery disease. Methods: A cohort of patients with type 1 or type 2 diabetes (n = 12,030), who underwent coronary angiography from 2004 to 2012, were stratified by presence of obstructive (any stenosis ⩾50%) coronary artery disease and by type of diabetes treatment: diet, non-insulin treatment and insulin (±oral anti-diabetics). The primary endpoint was myocardial infarction. Adjusted hazard ratios were calculated using diet-treated patients without coronary artery disease as reference. Results: In patients without coronary artery disease, risk of myocardial infarction was similar in patients treated with non-insulin medication (adjusted hazard ratio 0.70, 95% confidence interval 0.27–1.81) and insulin (adjusted hazard ratio 0.76, 95% confidence interval 0.27–2.08) as compared to diet only. In patients with coronary artery disease, the risk of myocardial infarction was higher than in the reference group and an incremental risk was observed being lowest in patients treated with diet (adjusted hazard ratio 3.79, 95% confidence interval 1.61–8.88), followed by non-insulin medication (adjusted hazard ratio 5.42, 95% confidence interval 2.40–12.22), and highest in insulin-treated patients (adjusted hazard ratio 7.91, 95% confidence interval 3.51–17.82). Conclusion: The presence of obstructive coronary artery disease defines the risk of myocardial infarction in diabetes patients. Glucose-lowering therapy, in particular insulin, was associated with risk of myocardial infarction only in the presence of coronary artery disease.

P885Cardiovascular events in patients with suspected ST-elevation myocardial infarction and no obstructive coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Andersson ◽  
L S Laustsen ◽  
A Laustsen ◽  
F Pedersen ◽  
L E Bang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
St Elevation Myocardial Infarction ◽  
Receiver Operating Curve ◽  
Significant Difference ◽  
St Elevation ◽  
Coronary Procedures ◽  
Artery Disease

Abstract Background Patients with suspected ST-elevation myocardial infarction (STEMI) and no obstructive coronary artery disease (CAD) comprise a heterogeneous group with varying prognoses. Purpose To evaluate the prognostic value of cardiac troponin T (cTnT) in patients with suspected STEMI and no obstructive CAD. Methods Patients with suspected STEMI and no obstructive (<50% diameter stenosis) CAD were consecutively included from 2009–2014. Patients were classified as having normal cTnT, dynamic cTnT elevation, or stationary cTnT elevation. All patients were followed with respect to major adverse cardiovascular events (MACE), cardiovascular readmission, and repeat coronary procedures, until 1 year after discharge. Results The study included 502 patients with suspected STEMI and no obstructive CAD: 165 (33%) had normal cTnT, 293 (58%) had dynamic cTnT elevation and 44 (9%) had stationary cTnT elevation. Within one year after admission, 40 (8%) had MACE, 81 (16%) had cardiovascular readmission, and 8 (2%) underwent repeat coronary procedures. The risk of MACE was elevated in patients with stationary cTnT elevation compared with normal cTnT (OR 13.6, 95% CI 2.3–80.2, p=0.004). There was no statistically significant difference between those with dynamic cTnT elevation and normal cTnT (OR 2.9, 95% CI 0.6–14.0, p=0.189). Adding cTnT pattern to a conventional risk model, area under the receiver operating curve for predicting the 1-year risk of MACE improved significantly (80% vs. 85%, p=0.004, Figure 1). Figure 1 Conclusion In patients with suspected STEMI and no obstructive CAD, cTnT pattern during acute hospitalization is associated with the 1-year risk of MACE and improves risk prediction for the individual patient. Acknowledgement/Funding The Danish Heart Foundation, the A.P. Møller Foundation, the Foundation of Reinholdt W. Jorck and Wife, Rigshospitalet's Research Foundation

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