scholarly journals CONTROL OF CARDIOVASCULAR RISK FACTORS IN PATIENTS AFTER MYOCARDIAL INFARCTION

2019 ◽  
Vol 72 (3) ◽  
pp. 472-483
Author(s):  
Jan W. Pęksa ◽  
Piotr Jankowski ◽  
Danuta Czarnecka
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Antiplatelet Therapy ◽  
Cardiovascular Prevention ◽  
Pharmacological Therapy ◽  
Unhealthy Lifestyle ◽  
Individual Level ◽  
Coronary Syndrome

Despite significant improvements in the diagnosis and treatment of cardiovascular diseases that have occurred in recent years, they remain the main cause of morbidity and mortality in the population. In many European countries, the incidence of coronary heart disease is currently 50% lower than it was in the early 1980s, which is the result of cardiovascular prevention. A special group of patients are people after myocardial infarction with very high cardiovascular risk. They should definitely implement activities at the individual level e. g. work on improving the unhealthy lifestyle and pharmacologically control other risk factors. A diet low in saturated fats should be recommended, i.e. mainly containing whole grains, vegetables, fruits and fish, recommend regular physical exercise: 150 min / week of moderate, aerobic physical activity, reducing the supply of calories in order to get rid of overweight or obesity. Help in quitting tobacco addiction should take place through the minimal nicotine intervention and, if necessary, pharmacological therapy. Another thing is the control of other risk factors, i. e. the appropriate treatment of dyslipidemia (the primary target is LDL cholesterol <1.8 mmol/l or reduction by ≥ 50%, if the initial concentration is between 1.8 and 3.5 mmol/l, treatment hypertension (target arterial pressure for most people aged 18–65 is in the range: 120–130/70–79 mmHg, if it is well tolerated, while for older people it is in the range: 130–139/70–79mmHg, if it is well tolerated), optimal diabetes therapy (target glycated hemoglobin <7%) and appropriate antiplatelet therapy (in most patients double antiplatelet therapy is recommended for 12 months after acute coronary syndrome). These activities lead to a significant improvement in quality of life and a decrease in mortality due to cardiovascular diseases.

P3400Definition of extremely high cardiovascular risk in patients after acute myocardial infarction - Data from the TERCET Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Dyrbus ◽  
M Gasior ◽  
P Desperak ◽  
T Osadnik ◽  
M Banach
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Multivariate Analysis ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Risk Category ◽  
High Cardiovascular Risk

Abstract Background The latest guidelines from the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) introduced a new “ultra-high risk” category of patients, for whom a low-density lipoprotein cholesterol (LDL-C) level <55 mg/dL (1.4 mmol/L) is advised. Purpose Therefore we aimed at identification of the risk factors in patients after acute myocardial infarction (MI), which increased the risk most, and might help to define the group of individuals at extremely high cardiovascular (CV) risk. Methods We analyzed consecutive patients included in the TERCET Registry admitted to the Polish tertiary cardiovascular centre due to MI between 2006 and 2018. According to the guidelines of the European Society of Cardiology (ESC), all patients included in the analysis are considered as of very high CV risk. All patients included in the registry underwent coronary angiography during the hospital stay. On the basis of multivariate analysis, we determined the subgroup of patients with the most unfavourable 12-month outcome (all-cause mortality). Results Finally, 4,562 patients admitted due to STEMI or NSTEMI and discharged from our centre were included in the analysis. According to the results of multivariate analysis performed with stepwise backward regression model, the following risk factors in patients after MI: LVEF<35% (odds ratio [OR]=3.83, 95% confidence interval [CI]: 3.14–4.67), age>75 years (OR=1.91, 95% CI: 1.55–2.35), lack of PCI of culprit vessel (OR=1.66, 95% CI: 1.26–2.20), multivessel CAD (OR=1.60, 95% CI: 1.30–1.99), atrial fibrillation (OR=1.53, 95% CI: 1.21–1.94), diabetes mellitus (OR=1.34, 95% CI: 1.11–1.64), increased LDL-C level (OR=1.09 per 1 mmol/L, 95% CI: 1.01–1.19) and increased creatinine level (OR=1.04 per 10 μmol/L, 95% CI: 1.04–1.05), might help to define the group of patients at extremely-high cardiovascular risk (all p<0.05). The aggregate summary of risk factors associated with extremely high risk is presented in the attached Figure. Next, the effect of the combination of the aforementioned risk factors will be investigated, and SCORE applied for patients in secondary prevention after MI will be prepared. Multivariate analysis results Conclusions To our knowledge, the presented study is the first such an analysis conducted on the population of patients after myocardial infarction gathered in the registry of secondary cardiovascular prevention. In patients after MI, potential risk factors were identified that might help to define the group of patients at ultra-high/extremely-high risk, what might contribute to significantly higher 12-month mortality. Acknowledgement/Funding None

scholarly journals Cannabis-induced recurrent myocardial infarction in a 21-year-old man: a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Dennis Lawin ◽  
Thorsten Lawrenz ◽  
Andi Tego ◽  
Christoph Stellbrink
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Young Patients ◽  
Potential Hazard ◽  
Thrombotic Occlusion ◽  
Diagonal Branch ◽  
Coronary Syndrome ◽  
Cannabis Consumption

Abstract Background Acute coronary syndrome (ACS) is rarely caused by coronary artery disease in young patients unless cardiovascular risk factors are present. Although non-atherosclerotic causes of ACS are rare, they need to be considered in young patients. Case summary We report on a 21-year-old patient referred to our institution with ACS. Electrocardiogram showed ST-segment elevation and coronary angiography revealed thrombotic occlusion of the left anterior descending artery. Reperfusion was achieved by thrombus aspiration, glycoprotein IIb/IIIa inhibitors (GPI), and drug-eluting stent (DES). The patient had no cardiovascular risk factors but reported cannabis consumption before symptom onset. Although he was put on dual antiplatelet therapy and strictly advised to avoid consumption, he continued to abuse cannabis and suffered three further ACS events within 18 months: the first 8 months later caused by thrombotic occlusion of a diagonal branch treated by GPI and DES, the second after 17 months due to thrombotic re-occlusion of the diagonal branch, and the third after 18 months by thrombotic occlusion of the circumflex artery, both events treated by GPI alone (all while still using cannabis). Since then, he stopped cannabis consumption and has been symptom-free for 8 months. Discussion This case highlights that cannabis-induced ACS must be considered as a cause of myocardial infarction in young adults. In contrast to ACS in the elderly population, this unusual ACS cause requires specific treatment. The risk of ACS relapse may substantial if cannabis abuse is continued. This potential hazard needs to be taken into consideration when legalization of cannabis is discussed.

scholarly journals The Innate Immune cGAS-STING-Pathway in Cardiovascular Diseases – A Mini Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Lavinia Rech ◽  
Peter P. Rainer
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cyclic Gmp ◽  
Innate Immune ◽  
Type I Interferons ◽  
Type I ◽  
Dna Sensor ◽  
Sting Pathway

Inflammation plays a central role in cardiovascular diseases (CVD). One pathway under investigation is the innate immune DNA sensor cyclic GMP-AMP synthase (cGAS) and its downstream receptor stimulator of interferon genes (STING). cGAS-STING upregulates type I interferons in response to pathogens. Recent studies show that also self-DNA may activate cGAS-STING, for instance, DNA released from nuclei or mitochondria during obesity or myocardial infarction. Here, we focus on emerging evidence describing the interaction of cGAS-STING with cardiovascular risk factors and disease. We also touch on translational therapeutic opportunities and potential further investigations.

scholarly journals Do You Know How Young Your Heart Is?

2018 ◽  
Vol 24 (2) ◽  
pp. 66-71
Author(s):  
Tase Cristina Ramona ◽  
Cojocaru Lucia ◽  
Rusali Andrei ◽  
Suta Cristina
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Young Patients ◽  
Good Clinical Outcome ◽  
Know How ◽  
Coronary Syndrome ◽  
First Time

Abstract We present the case of a 25 years old patient who was submitted to our unit with a first time acute coronary syndrome. Despite his young age he had multiple cardiovascular risk factors. Although the chest pain was atypical and the electrocardiogram on presentation had unspecific changes, repeated investigations established the diagnosis of anterolateral myocardial infarction. Per primam angioplasty with stent implantation in the proximal segment of left anterior descending artery was performed, with good clinical outcome. Awareness is the key in establishing the diagnosis of myocardial infarction in young patients.

Prevalence of cardiovascular risk factors and management practices of acute coronary syndrome in a tertiary care hospital

2015 ◽  
Vol 26 (6) ◽  
Author(s):  
Chandrasekhar Dilip ◽  
Shinu Cholamugath ◽  
Molniya Baby ◽  
Danisha Pattani
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Tertiary Care ◽  
Inclusion Criteria ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Β Blocker

AbstractA prospective study of patients with acute coronary syndrome (ACS), who met the inclusion criteria, was carried out. It was conducted in the cardiology department of tertiary care referral hospital in Kerala. An attempt was made to identify and determine the prevalence of cardiovascular risk factors in patients presenting with ACS and to evaluate the current treatment practice pattern of ACS and to compare it with standard treatment guidelines, thereby improving the quality of life of patients.Data of patients who met the inclusion criteria were collected in specially designed data collection form. The form included the patient data such as demographics, risk factors, procedures performed during the hospital stay, and in-hospital and discharge drug therapy. Patients with ACS included those with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). Descriptive statistics were performed. All statistical analysis was done using Statistical Package for Social Sciences (SPSS) software version 16.0.A total of 100 patients were studied having mean age of 62.57 years±12.18 years. Fifty-one percent were having NSTEMI, 33% were having STEMI, and 16% were having UA. Hypertension (63%) and diabetes (51%) were more prevalent in both men and women. Smoking among males was consistently high (48.6%), being highest among adults. Cardiac procedures performed include percutaneous transluminal coronary angioplasty (PTCA) in 45%, coronary angiogram (CAG) in 20%, and coronary artery bypass graft surgery (CABG) in 7%. In-hospital medications were antiplatelets (100%), thrombolytics (28%), statins (97%), anticoagulants (80%), nitrates (73%), β-blocker (32%), angiotensin-converting enzyme inhibitor (6%), angiotensin receptor blocker (9%), potassium opener (7%), vasodilator (1%), calcium channel blocker (9%), α-blocker (7%), and α+β blocker (7%).The contemporary profile of treatment patterns for patients with ACS indicates an improved adherence to the guidelines. The alarmingly high rate of modifiable risk factors remains a cause of concern and a challenge that needs to be tackled, as better control of cardiovascular risk factors is expected to have a favorable impact on the incidence of ACS.

Preventing cardiovascular complications in patients with dysglycaemia

ESC CardioMed ◽  
2018 ◽  
pp. 924-929
Author(s):  
Linda Mellbin ◽  
Lars Rydén
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Target Organ Damage ◽  
Cardiovascular Prevention ◽  
Organ Damage ◽  
Cardiovascular Complications ◽  
Unhealthy Lifestyle ◽  
Lipid Control ◽  
Multifactorial Approach

Dysglycaemic conditions, comprising diabetes mellitus and its pre-states, are important risk factors for cardiovascular disease, macro- as well as microvascular. People with diabetes and at least one other cardiovascular risk factor or target organ damage are at very high risk for future cardiovascular events, and all other people with diabetes are at high risk. This risk is multifactorial, that is, related not only to elevated blood glucose, but also to other factors including an unhealthy lifestyle, hypertension, and dyslipidaemia. An accumulation of several risk factors increases the cardiovascular risk exponentially. Thus, prevention of cardiovascular complications necessitates a multifactorial approach and the evidence-based treatment targets are stricter for people with than in those without dysglycaemia. This chapter summarizes important aspects of cardiovascular prevention in the setting of dysglycaemic conditions by presenting targets for lifestyle interventions and glycaemic, blood pressure, and lipid control together with appropriate measures to accomplish an effective cardiovascular prevention. The efficacy of such an approach has been verified by observational data as well as controlled clinical trials. Nevertheless, European surveys of cardiovascular prevention in clinical practice reveal that there is a considerable need for improved management in these aspects.

Trends and current questions of cardiovascular prevention in primary health care

2012 ◽  
Vol 153 (39) ◽  
pp. 1536-1546 ◽  
Author(s):  
István Ilyés ◽  
Zoltán Jancsó ◽  
Attila Simay
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Risk Group ◽  
Cardiovascular Prevention ◽  
Continuous Care ◽  
Primary Health

Although an impressive progress has been achieved in the treatment of cardiovascular diseases, they are at the top of the mortality statistics in Hungary. Prevention of these diseases is an essential task of the primary health care. Cardiovascular prevention is carried out at primary, secondary and tertiary levels using risk group and population preventive strategies. The two main tasks of primary cardiovascular prevention are health promotion and cardiovascular disease prevention, and its main programs are ensuring healthy nutrition, improving physical training and accomplishing an anti-smoking program. The essential form of secondary prevention is the screening activity of the primary health care. The majority of cardiovascular risk factors can be discovered during the doctor–patient consultation, but laboratory screening is needed for assessing metabolic risks. The official screening rules of the cardiovascular risk factors and diseases are based on diagnostic criteria of the metabolic syndrome; however, nowadays revealing of global cardiometabolic risks is also necessary. In patients without cardiovascular diseases but with risk factors, a cardiovascular risk estimation has to be performed. In primary care, there is a possibility for long term follow-up and continuous care of patients with chronic diseases, which is the main form of the tertiary prevention. In patients with cardiovascular diseases, ranking to cardiovascular risk groups is a very important task since target values of continuous care depend on which risk group they belong to. The methods used during continuous care are lifestyle therapy, specific pharmacotherapy and organ protection with drugs. Combined health education and counselling is the next element of the primary health care prevention; it is a tool that helps primary, secondary and tertiary prevention. Changes needed for improving cardiovascular prevention in primary care are the following: appropriate evaluation of primary prevention, health education and counselling, renewal of the cardiovascular screening system based on the notion of global cardiometabolic risk, creating a unified cardiovascular prevention guideline, and operating primary care cardiovascular prevention within the framework of an integrated prevention system. Orv. Hetil., 2012, 153, 1536–1546.

CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY LUNG DISEASES

2020 ◽  
pp. 21-25
Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Digestive System ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Internal Organs ◽  
History Of

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

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