scholarly journals Association between gallstone disease and ischemic stroke in Korea

2021 ◽  
Vol 26 (4) ◽  
pp. 649-655
Author(s):  
Eun Sun Gill ◽  
Young Jin Jeong ◽  
Junyong Lee
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Obstructive Coronary Artery Disease ◽  
Gallstone Disease ◽  
Smoking History ◽  
Artery Disease

Background & Objectives: In Korea, stroke incidence is projected to rise due to the rapid aging of the Korean population. Additionally, gallstone disease incidence is increasing in Korea, due to dietary and westernized lifestyle. In this cross-sectional study, we investigated the association between gallstone disease and ischemic stroke in Korea. Methods: We included 566 patients aged 40‒89 years who underwent abdominal ultrasound or abdominal computed tomography at the VHS Medical Center between January 2008 and December 2010. Patient records were reviewed for the presence of hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, obstructive coronary artery disease, and smoking history. The associations between risk factors, including gallstone disease, and ischemic stroke were analyzed using Pearson’s chi-square tests. Multiple logistic regression analysis was performed with age, sex, smoking history, hypertension, obstructive coronary artery disease, and atrial fibrillation as covariates. Results: Age, sex, hypertension, obstructive coronary artery disease, atrial fibrillation, and smoking history were identified as significant risk factors for ischemic stroke (p-value < 0.05). Gallstone disease demonstrated an unadjusted odds ratio for ischemic stroke of 2.171 (95% confidence interval, 1.264‒3.729); after adjustment for risk factors, the odds ratio was 2.015 (95% confidence interval, 1.151‒3.528). Conclusion: In Korean patients, gallstone disease and ischemic stroke are correlated. Despite an unclear causality, the risk for ischemic stroke is significantly increased in patients with gallstone disease, even after adjusting for various confounders. Clinicians should be aware of the possibility of ischemic stroke in patients with gallstone disease, and should manage and educate patients accordingly.

A cross-sectional study for risk factor model predictive for developing ischemic stroke: a clinical pharmacist’s approach

2021 ◽  
Author(s):  
Adel Sadeq ◽  
Asim Ahmed Elnour ◽  
Nadia Al Mazrouei ◽  
Mohamed Baraka
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Outcome Measure ◽  
Cross Sectional ◽  
History Of ◽  
Artery Disease

Abstract BackgroundThere is a paucity of studies in ischemic stroke in our region.Aim The aim of the current study was to delineate the potentially risk factors for the development of ischemic stroke. MethodsWe have conducted a cross-sectional hospital-based study that has enrolled 210 subjects. The subjects have had presented to the emergency department in a tertiary hospital at the United Arab Emirates. Subjects were diagnosed with ischemic stroke within 24 hours of presentation. Outcome measureThe main outcome measure was the development of ischemic stroke during indexed hospital visit.ResultsThe mean age was 47.5 ±3.2 with higher preponderance of males over females (60.9%) and 48.1% were ≥65 years. The final logistic regression model for the development of ischemic stroke contains seven variables. In descending order the seven predictive risk factors for the development of ischemic stroke were: hypertension (OR 6.1, CI 2.4-9.5; P =0.029), coronary artery disease (OR 4.2, 3.7-9.1; P =0.038), low physical activity (OR 4.2, CI 2.1-9.1; P =0.035), history of previous stroke (OR 4.1, 1.4-3.4; P =0.033), atrial fibrillation (OR 3.2, CI 2.6-8.2; P =0.017), family history of stroke (OR 3.1, 1.3-6.9; P =0.042) and diabetes mellitus (OR 2.7, CI 1.25-6.1; P =0.035). The specificity of the model was 54.2%, the sensitivity was 89.7%, and the overall accuracy was 77.3%.ConclusionIt is prudent to control the modifiable risk factors for the development of stroke such as hypertension, diabetes, atrial fibrillation, coronary artery disease and low physical activity.

scholarly journals Prevalence, Epidemiological Characteristics, and Pharmacotherapy of Coronary Artery Disease among Patients with Atrial Fibrillation: Data from Jo-Fib Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 605
Author(s):  
Hanna K. Al-Makhamreh ◽  
Mohammed Q. Al-Sabbagh ◽  
Ala’ E. Shaban ◽  
Abdelrahman F. Obiedat ◽  
Ayman J. Hammoudeh
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Agents ◽  
Retrospective Case ◽  
Increased Risk ◽  
Artery Disease ◽  
Epidemiological Characteristics ◽  
Cad Risk

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.

scholarly journals Predictive potential assessment of preoperative risk factors for atrial fibrillation in patients with coronary artery disease after coronary artery bypass grafting

2020 ◽  
Vol 35 (4) ◽  
pp. 128-136
Author(s):  
K. I. Shakhgeldyan ◽  
V. Y. Rublev ◽  
B. I. Geltser ◽  
B. O. Shcheglov ◽  
V. G. Shirobokov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Artery Disease

Introduction. Postoperative atrial fibrillation (POAF) is one of the most common complications of coronary artery bypass grafting (CABG) and occurs in 25–65% of patients.Aim. The study aimed to assess the predictive potential of preoperative risk factors for POAF in patients with coronary artery disease (CAD) after CABG based on machine learning (ML) methods.Material and Methods. An observational retrospective study was carried out based on data from 866 electronic case histories of CAD patients with a median age of 63 years and a 95% confidence interval [63; 64], who underwent isolated CABG on cardiopulmonary bypass. Patients were assigned to two groups: group 1 comprised 147 (18%) patients with newly registered atrial fibrillation (AF) paroxysms; group 2 included 648 (81.3%) patients without cardiac arrhythmia. The preoperative clinical and functional status was assessed using 100 factors. We used statistical analysis methods (Chi-square, Fisher, Mann – Whitney, and univariate logistic regression (LR) tests) and ML tests (multivariate LR and stochastic gradient boosting (SGB)) for data processing and analysis. The models’ accuracy was assessed by three quality metrics: area under the ROC-curve (AUC), sensitivity, and specificity. The cross-validation procedure was performed at least 1000 times on randomly selected data.Results. The processing and analysis of preoperative patient status indicators using ML methods allowed to identify 10 predictors that were linearly and nonlinearly related to the development of POAF. The most significant predictors were the anteroposterior dimension of the left atrium, tricuspid valve insufficiency, ejection fraction <40%, duration of the P–R interval, and chronic heart failure of functional class III–IV. The accuracy of the best predictive multifactorial model of LR was 0.61 in AUC, 0.49 in specificity, and 0.72 in sensitivity. The values of similar quality metrics for the best model based on SGB were 0.64, 0.6, and 0.68, respectively.Conclusion. The use of SGB made it possible to verify the nonlinearly related predictors of POAF. The prospects for further research on this problem require the use of modern medical care methods that allow taking into account the individual characteristics of patients when developing predictive models.

scholarly journals Sudden Cardiac Death in the Young

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Francis J. Ha ◽  
Hui-Chen Han ◽  
Prashanthan Sanders ◽  
Kim Fendel ◽  
Andrew W. Teh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Body Mass Index ◽  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Odds Ratio ◽  
Cardiac Death ◽  
Arrhythmic Death ◽  
Sudden Arrhythmic Death Syndrome ◽  
Artery Disease

Background: Sudden cardiac death (SCD) in the young is devastating. Contemporary incidence remains unclear with few recent nationwide studies and limited data addressing risk factors for causes. We aimed to determine incidence, trends, causes, and risk factors for SCD in the young. Methods and Results: The National Coronial Information System registry was reviewed for SCD in people aged 1 to 35 years from 2000 to 2016 in Australia. Subjects were identified by the International Classification of Diseases , Tenth Revision code relating to circulatory system diseases (I00–I99) from coronial reports. Baseline demographics, circumstances, and cause of SCD were obtained from coronial and police reports, alongside autopsy and toxicology analyses where available. During the study period, 2006 cases were identified (median age, 28±7 years; men, 75%; mean body mass index, 29±8 kg/m 2 ). Annual incidence ranged from 0.91 to 1.48 per 100 000 age-specific person-years, which was the lowest in 2013 to 2015 compared with previous 3-year intervals on Poisson regression model ( P =0.001). SCD incidence was higher in nonmetropolitan versus metropolitan areas (0.99 versus 0.53 per 100 000 person-years; P <0.001). The most common cause of SCD was coronary artery disease (40%), followed by sudden arrhythmic death syndrome (14%). Incidence of coronary artery disease–related SCD decreased from 2001–2003 to 2013–2015 ( P <0.001). Proportion of SCD related to sudden arrhythmic death syndrome increased during the study period ( P =0.02) although overall incidence was stable ( P =0.22). Residential remoteness was associated with coronary artery disease–related SCD (odds ratio, 1.44 [95% CI, 1.24–1.67]; P <0.001). For every 1-unit increase, body mass index was associated with increased likelihood of SCD from cardiomegaly (odds ratio, 1.08 [95% CI, 1.05–1.11]; P <0.001) and dilated cardiomyopathy (odds ratio, 1.04 [95% CI, 1.01–1.06]; P =0.005). Conclusions: Incidence of SCD in the young and specifically coronary artery disease–related SCD has declined in recent years. Proportion of SCD related to sudden arrhythmic death syndrome increased over the study period. Geographic remoteness and obesity are risk factors for specific causes of SCD in the young.

scholarly journals Clinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry

2020 ◽  
Vol 21 (5) ◽  
pp. 479-488 ◽  
Author(s):  
Alexander R van Rosendael ◽  
A Maxim Bax ◽  
Jeff M Smit ◽  
Inge J van den Hoogen ◽  
Xiaoyue Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Prognostic Value ◽  
Coronary Computed Tomography Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Artery Disease

Abstract Aims In patients without obstructive coronary artery disease (CAD), we examined the prognostic value of risk factors and atherosclerotic extent. Methods and results Patients from the long-term CONFIRM registry without prior CAD and without obstructive (≥50%) stenosis were included. Within the groups of normal coronary computed tomography angiography (CCTA) (N = 1849) and non-obstructive CAD (N = 1698), the prognostic value of traditional clinical risk factors and atherosclerotic extent (segment involvement score, SIS) was assessed with Cox models. Major adverse cardiac events (MACE) were defined as all-cause mortality, non-fatal myocardial infarction, or late revascularization. In total, 3547 patients were included (age 57.9 ± 12.1 years, 57.8% male), experiencing 460 MACE during 5.4 years of follow-up. Age, body mass index, hypertension, and diabetes were the clinical variables associated with increased MACE risk, but the magnitude of risk was higher for CCTA defined atherosclerotic extent; adjusted hazard ratio (HR) for SIS &gt;5 was 3.4 (95% confidence interval [CI] 2.3–4.9) while HR for diabetes and hypertension were 1.7 (95% CI 1.3–2.2) and 1.4 (95% CI 1.1–1.7), respectively. Exclusion of revascularization as endpoint did not modify the results. In normal CCTA, presence of ≥1 traditional risk factors did not worsen prognosis (log-rank P = 0.248), while it did in non-obstructive CAD (log-rank P = 0.025). Adjusted for SIS, hypertension and diabetes predicted MACE risk in non-obstructive CAD, while diabetes did not increase risk in absence of CAD (P-interaction = 0.004). Conclusion Among patients without obstructive CAD, the extent of CAD provides more prognostic information for MACE than traditional cardiovascular risk factors. An interaction was observed between risk factors and CAD burden, suggesting synergistic effects of both.

scholarly journals Coronary Artery Perforation

2019 ◽  
Vol 04 (02) ◽  
pp. 110-120
Author(s):  
Tripti Deb ◽  
Jyotsna Maddury ◽  
Prasant Kr. Sahoo
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Standard Treatment ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Intervention ◽  
Coronary Artery Perforation ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Complex Lesions

AbstractPercutaneous coronary intervention (PCI) is considered as the standard treatment of obstructive coronary artery disease in indicated patients. Even though PCI gives symptomatic angina improvement, but associated with serious complications like coronary artery perforation (CAP), the incidence is quite low. With the more complex lesions for successful angioplasty, different devices are required, which in turn increase the incidence of CAP in these patients. Here we review the classification, incidence, pathogenesis, clinical sequela, risk factors, predictors, and management of CAP in the current era due to PCI.

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