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Sample records for artery risk development

  1. [The role of the team of family physician in prevention of changing risk factors important in development of arterial hypertension].

    Science.gov (United States)

    Beganlić, Azijada; Batić-Mujanović, Olivera; Tulumović, Ajsa; Zilzić, Muharem

    2005-01-01

    Arterial hypertension (AH) is one of the commonest noninfective chronic disease according to its important and the role in the morbidity and mortality, which is the reason for patients coming to the family phisician. Detection and treatment of high blood pressure are the major responsibility of physician in the primary care. If the family physician team (physician and nurse) make a good assessment of the risk factors which is important in development of arterial hypertension, the appearance of disease and its complications can be prevented or delayed. The most important for prevention of arterial hypertension is adoption a healthy lifestyle and it is nonseparate part of arterial hypertension treatment. PMID:16268072

  2. Arterial stiffness as a risk factor for coronary artery disease.

    Science.gov (United States)

    Liao, Josh; Farmer, John

    2014-02-01

    Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.

  3. The Association between Androgenic Hormone Levels and the Risk of Developing Coronary Artery Disease (CAD

    Directory of Open Access Journals (Sweden)

    Farzad ALLAMEH

    2016-02-01

    Full Text Available Background: The aim of the study was to evaluate the relationship between the serum levels of androgens and Coronary Artery Disease (CAD in an Iranian population.Methods: Male individuals admitted to Tehran Heart Center and Sina Hospital, Tehran, Iran from 2011-2012 were categorized into CAD and control groups based on selective coronary angiography. Baseline demographic data, including age, BMI, diabetes, and a history of hypertension were recorded. Patients were also assessed for their serum levels of total testosterone, free testosterone, estradiol, dehydroepi and rosterone sulfate (DHEA-S, and Sex Hormone Binding Globulin (SHBG. Data analysis was carried out chi-square and ANOVA tests as well as logistic regression analysis.Results: Two hundred patients were in the CAD group and 135 individuals in control group. In the CAD group, 69 had single-vessel disease, 49 had two-vessel diseases, and 82 had three-vessel diseases. Statistically significant differences were observed between the individuals in the two groups with respect to age (P<0.0001, diabetes (P<0.0001, and a history of hypertension (P=0.018. The serum levels of free testosterone (P=0.048 and DHEA-S (P<0.0001 were significantly higher in the control group than in the CAD group; however, the serum level of SHBG was higher in the CAD group than in the control group (P=0.007. Results of the logistic regression analysis indicated that only age (P=0.042 and diabetes (P=0.003 had significant relationships with CAD.Conclusion: Although the serum levels of some of the androgens were significantly different between the two groups, no association was found between androgenic hormone levels and the risk of CAD, due mainly to the effect of age and diabetes. Keywords: Coronary Artery Disease (CAD, Androgenic hormones, Testosterone, DHEA-S, Estradiol, SHBG 

  4. The Association between Androgenic Hormone Levels and the Risk of Developing Coronary Artery Disease (CAD)

    Science.gov (United States)

    ALLAMEH, Farzad; POURMAND, Gholamreza; BOZORGI, Ali; NEKUIE, Sepideh; NAMDARI, Farshad

    2016-01-01

    Background: The aim of the study was to evaluate the relationship between the serum levels of androgens and Coronary Artery Disease (CAD) in an Iranian population. Methods: Male individuals admitted to Tehran Heart Center and Sina Hospital, Tehran, Iran from 2011–2012 were categorized into CAD and control groups based on selective coronary angiography. Baseline demographic data, including age, BMI, diabetes, and a history of hypertension were recorded. Patients were also assessed for their serum levels of total testosterone, free testosterone, estradiol, dehydroepi and rosterone sulfate (DHEA-S), and Sex Hormone Binding Globulin (SHBG). Data analysis was carried out chi-square and ANOVA tests as well as logistic regression analysis. Results: Two hundred patients were in the CAD group and 135 individuals in control group. In the CAD group, 69 had single-vessel disease, 49 had two-vessel diseases, and 82 had three-vessel diseases. Statistically significant differences were observed between the individuals in the two groups with respect to age (P<0.0001), diabetes (P<0.0001), and a history of hypertension (P=0.018). The serum levels of free testosterone (P=0.048) and DHEA-S (P<0.0001) were significantly higher in the control group than in the CAD group; however, the serum level of SHBG was higher in the CAD group than in the control group (P=0.007). Results of the logistic regression analysis indicated that only age (P=0.042) and diabetes (P=0.003) had significant relationships with CAD. Conclusion: Although the serum levels of some of the androgens were significantly different between the two groups, no association was found between androgenic hormone levels and the risk of CAD, due mainly to the effect of age and diabetes. PMID:27057516

  5. PHACTR1 Gene Polymorphism Is Associated with Increased Risk of Developing Premature Coronary Artery Disease in Mexican Population

    Science.gov (United States)

    Pérez-Hernández, Nonanzit; Vargas-Alarcón, Gilberto; Posadas-Sánchez, Rosalinda; Martínez-Rodríguez, Nancy; Tovilla-Zárate, Carlos Alfonso; Rodríguez-Cortés, Adrián Asael; Pérez-Méndez, Oscar; Blachman-Braun, Ruben; Rodríguez-Pérez, José Manuel

    2016-01-01

    Single-nucleotide polymorphisms (SNPs) in the protein phosphatase and actin regulator 1 gene (PHACTR1) have been associated with susceptibility to develop several diseases, including cardiovascular disease. The purpose of this study was to evaluate the role of two polymorphisms (rs2026458 and rs9349379) of the PHACTR1 gene in the susceptibility to the risk of developing premature coronary artery disease (CAD) in the Mexican population. The genotype analysis was performed using 5’exonuclease TaqMan genotyping assays in a group of 994 patients with premature CAD and 703 controls. A similar genotype distribution of rs2026458 was observed in both groups; however, under an additive model adjusted by age, body mass index, type 2 diabetes mellitus, smoking, dyslipidemia, and hypertension, the rs9349379 G allele was associated with a higher risk for developing premature CAD (odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.03–1.46, p-value (p) = 0.024). The two PHACTR1 polymorphisms were not in linkage disequilibrium. In summary, our results suggest that the PHACTR1 rs9349379 polymorphism plays an important role in the risk of developing premature CAD in the Mexican population. PMID:27517945

  6. PHACTR1 Gene Polymorphism Is Associated with Increased Risk of Developing Premature Coronary Artery Disease in Mexican Population

    Directory of Open Access Journals (Sweden)

    Nonanzit Pérez-Hernández

    2016-08-01

    Full Text Available Single-nucleotide polymorphisms (SNPs in the protein phosphatase and actin regulator 1 gene (PHACTR1 have been associated with susceptibility to develop several diseases, including cardiovascular disease. The purpose of this study was to evaluate the role of two polymorphisms (rs2026458 and rs9349379 of the PHACTR1 gene in the susceptibility to the risk of developing premature coronary artery disease (CAD in the Mexican population. The genotype analysis was performed using 5’exonuclease TaqMan genotyping assays in a group of 994 patients with premature CAD and 703 controls. A similar genotype distribution of rs2026458 was observed in both groups; however, under an additive model adjusted by age, body mass index, type 2 diabetes mellitus, smoking, dyslipidemia, and hypertension, the rs9349379 G allele was associated with a higher risk for developing premature CAD (odds ratio (OR = 1.22, 95% confidence interval (CI = 1.03–1.46, p-value (p = 0.024. The two PHACTR1 polymorphisms were not in linkage disequilibrium. In summary, our results suggest that the PHACTR1 rs9349379 polymorphism plays an important role in the risk of developing premature CAD in the Mexican population.

  7. [Risk factors for arterial disease].

    Science.gov (United States)

    Madoery, Roberto; Rubin, Graciela; Luquez, Hugo; Luquez, Cecilia; Cravero, Cecilia

    2004-01-01

    The risk factors of arterial disease (FREA) predict a future damage over the vascular system of the human body. Its detection are considered a key for the diagnostic as well as for the preventive and even curative strategies. For a long time, scientist considered those factors originated as a consecuence of large studies during the middle of the last century, with current validity up to our days. A simple classification spoke of them as traditionals. Further investigations described the so called new or emergents.factors that where joint together accordingly to their actions: coagulation factors, psicosocial, inflamatories and infectious. A recent classification, taking into account the type of impact, divided them into; causatives, predisposals and conditionals. Also, it was described a mechanism, the oxidative power, with consecuences over the endothelium, in the last part of the process. Before, another mechanism was described: the insulin resistance and the hiperinsulinism, bases for the Metabolic Syndrome, that includes a number of traditional risk factors.

  8. Diabetes Mellitus, ArterialWall, and Cardiovascular Risk Assessment

    OpenAIRE

    Michaela Kozakova; Carlo Palombo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structura...

  9. AGE, ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK

    Institute of Scientific and Technical Information of China (English)

    蒋雄京; 刘国仗; 刘力生

    2001-01-01

    The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-

  10. Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early- and Late-Onset Preeclampsia and Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Elisa Llurba

    2009-01-01

    Full Text Available Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE and/or intrauterine growth restriction (IUGR. Methods. A prospective multicentre study that included all women with singleton pregnancies at 19–22 weeks of gestation (w. The mean pulsatility index (mPI of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w and late-onset PE and/or IUGR. Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91.6%. PE developed in 75 (1.2% and IUGR in 69 (1.1% cases. Uterine Doppler mPI was 0.99 and the 90th centile was 1.40. For 10% false-positive rate, uterine Doppler mPI identified 70.6% of pregnancies that subsequently developed early-onset PE and 73.3% of pregnancies that developed early-onset IUGR. The test had a lower detection rate for the late-onset forms of the disease (23.5% for PE and 30% for IUGR. Maternal history has a low sensitivity in the detection of early-onset cases, although it is better at detecting late-onset PE. Conclusion. Uterine artery Doppler and maternal risk factors seem to select two different populations - early and late-onset PE which might suggest a different pathogenesis.

  11. Homocysteine as risk factor for coronary artery disease in pakistan

    International Nuclear Information System (INIS)

    Pakistani people belong to an ethnic group which has the highest rate of coronary artery disease. There are a number of risk factors for developing the coronary artery disease (CAD). Homocysteine, a sulphur containing amino acid, has been reported to be an independent risk factor for CAD. The present study was done to find out the role of hyperhomocysteinemia in the development of coronary artery disease in Pakistan. Materials and Methods: A cross sectional study was carried out. There were 40 angiographically diagnosed male patients of coronary artery disease between 30 - 40 years of age taken as cases and 40 age, sex and socioeconomically matched healthy subjects with normal carotid doppler study taken as controls. Fasting venous blood from cases and controls was taken in E.D.T.A vacationers. Plasma was analyzed for homo-cysteine level by enzyme immunoassay method. Results: Mean plasma concentration of homocysteine in coronary artery disease patients i.e. cases was 13.5 +- 6.8 mu mol/L and was higher than the mean for controls (10.76 +- 2.27 mu mol/L) to a significant extent. Conclusion: Hyperhomocysteinemia through inter-play with the classical cardiovascular risk factors may be aggravating the risk of coronary artery disease in Pakistani people. (author)

  12. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment

    Science.gov (United States)

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  13. Peripheral and central arterial pressure and its relationship to vascular target organ damage in carotid artery, retina and arterial stiffness. Development and validation of a tool. The Vaso risk study

    Directory of Open Access Journals (Sweden)

    Patino-Alonso Maria C

    2011-04-01

    Full Text Available Abstract Background Ambulatory blood pressure monitoring (ABPM shows a better correlation to target organ damage and cardiovascular morbidity-mortality than office blood pressure. A loss of arterial elasticity and an increase in carotid artery intima-media thickness (IMT has been associated with increased cardiovascular morbidity-mortality. Tools have been developed that allow estimation of the retinal arteriovenous index but not all studies coincide and there are contradictory results in relation to the evolution of the arteriosclerotic lesions and the caliber of the retinal vessels. The purpose of this study is to analyze the relationship between peripheral and central arterial pressure (clinic and ambulatory and vascular structure and function as evaluated by the carotid artery intima-media thickness, retina arteriovenous index, pulse wave velocity (PWV and ankle-brachial index in patients with and without type 2 diabetes. In turn, software is developed and validated for measuring retinal vessel thickness and automatically estimating the arteriovenous index. Methods/Design A cross-sectional study involving a control group will be made, with a posterior 4-year follow-up period in primary care. The study patients will be type 2 diabetics, with a control group of non-diabetic individuals. Consecutive sampling will be used to include 300 patients between 34-75 years of age and no previous cardiovascular disease, one-half being assigned to each group. Main measurements: age, gender, height, weight and abdominal circumference. Lipids, creatinine, microalbuminuria, blood glucose, HbA1c, blood insulin, high sensitivity C-reactive protein and endothelial dysfunction markers. Clinic and ambulatory blood pressure monitoring. Carotid ultrasound to evaluate IMT, and retinography to evaluate the arteriovenous index. ECG to assess left ventricle hypertrophy, ankle-brachial index, and pulse wave analysis (PWA and pulse wave velocity (PWV with the Sphigmocor

  14. Vitamin D deficiency is associated with development of subclinical coronary artery disease in HIV-infected African American cocaine users with low Framingham-defined cardiovascular risk

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    Lai H

    2013-11-01

    Full Text Available Hong Lai,1 Elliot K Fishman,1 Gary Gerstenblith,2 Richard Moore,2 Jeffrey A Brinker,2 Jeanne C Keruly,2 Shaoguang Chen,3 Barbara Detrick,3 Shenghan Lai1–31Department of Radiology, 2Department of Medicine, 3Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USAAbstract: Chronic cocaine use may lead to premature atherosclerosis, but the prevalence of and risk factors for coronary artery disease (CAD in asymptomatic cocaine users have not been reported. The objective of this study was to examine whether vitamin D deficiency is associated with the development of CAD in human immunodeficiency virus (HIV-infected African American cocaine users with low CAD risk.Methods: In this prospective follow-up study, we investigated 169 HIV-infected African American cocaine users with low Framingham risk at baseline. The main outcome measures were incidence of subclinical CAD and development of subclinical CAD.Results: Fifty of the 169 African Americans had evidence of subclinical disease on the initial cardiac computed tomography. A second cardiac computed tomography was performed on the 119 African Americans without disease on the first scan. The total sum of person-years of follow-up was 289.6. Subclinical CAD was detected in 11 of these, yielding an overall incidence of 3.80/100 person-years (95% confidence interval 1.90–6.80. Among the factors investigated, only vitamin D deficiency was independently associated with development of subclinical CAD. The study did not find significant associations between CD4 count, HIV viral load, or antiretroviral treatment use and the incidence of subclinical CAD. This study appears to suggest that there is a threshold level of vitamin D (10 ng/mL above which the effect of vitamin D on subclinical CAD is diminished.Conclusion: The incidence of subclinical CAD in HIV-infected African American cocaine users with low CAD risk is high, especially in those with vitamin D deficiency. Well designed

  15. The study of risk in pulmonary arterial hypertension

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    Gerald Simonneau

    2012-09-01

    Full Text Available A growing body of published evidence exists on the risk factors for disease progression in pulmonary arterial hypertension (PAH. The Scientific Steering Committee for the Study of Risk in PAH was established to bring together leading clinical and statistical experts in PAH and risk modelling, for the purpose of advancing the understanding of the risk of development and progression of PAH. Herein, we discuss the impact of this information on three key areas: 1 clinical decision-making; 2 policy and reimbursement; and 3 future trials and research.

  16. Study on the screening program and risk factors of carotid artery stenosis with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李庆祥

    2013-01-01

    Objective The purpose of this research project was to evaluate the relationship and risk factors between coronary artery disease and carotid artery stenosis (CAS) ,screened by duplex ultra-sonography.Methods 1339 patients with coronary artery disease were enrolled into this

  17. Outcomes of follow-up CT for small (5-10-mm) arterially enhancing nodules in the liver and risk factors for developing hepatocellular carcinoma in a surveillance population

    Energy Technology Data Exchange (ETDEWEB)

    Park, Min Jung; Kim, Young-sun; Lee, Won Jae; Lim, Hyo K.; Rhim, Hyunchul [Sungkyunkwan University School of Medicine, Department of Radiology, Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Jongmee [Korea University Guro Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2010-10-15

    To evaluate the outcomes of small (5-10 mm), arterially enhancing nodules (SAENs) shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma (HCC) surveillance population and to determine risk factors for developing HCC. The study population included 112 patients (male:female = 100:12; aged 36-92 years) with 175 SAENs who were at risk of HCC. We evaluated serial changes during follow-up (1.4-41.8 months, mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development. Of 175 SAENs, 101(57.7%) disappeared and 34(19.4%) persisted. Forty SAENs (22.9%) became HCC in 33 patients (29.5%). Presence of HCC treatment history (p = 0.005, risk ratio = 7.429), a larger size of SAEN (p = 0.003, risk ratio = 1.630), presence of coexistent HCC (p = 0.021, risk ratio = 3.777) and absence of coexistent typical arterioportal shunts (p = 0.003, risk ratio = 4.459) turned out to be independently significant risk factors for future development of HCC. SAENs were frequently seen in an HCC surveillance population and have a 22.9% probability of becoming HCC on a per-lesion basis. Risk increased particularly when the lesion was associated with a previous or concurrent HCC, a large size or found without a coexistent typical arterioportal shunt. (orig.)

  18. The relation between body size perception and change in body mass index over 13 years: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

    Science.gov (United States)

    Lynch, Elizabeth; Liu, Kiang; Wei, Gina S; Spring, Bonnie; Kiefe, Catarina; Greenland, Philip

    2009-04-01

    The authors assessed associations of body size perception and weight change over 13 years in black men and women and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1992-2005). The perceptions of self and ideal body size were measured by using the Stunkard 9-figure scale at the year 7 examination (1992-1993). Figures were classified into underweight, normal weight, overweight, and obese. Self-ideal discrepancy yielded 4 body size satisfaction categories. Body mass index (BMI) (measured at years 7, 10, 15, and 20) was the dependent variable in gender-specific adjusted multiple regression models stratified by year 7 BMI. Obese women who perceived themselves as obese lost 0.09 BMI units annually, while those who perceived themselves as normal weight gained 0.31 units annually (P = 0.0005); obese women who considered their body size much too large had less annual weight gain than did those who considered their body size a bit too large (0.21 vs. 0.38 BMI units; P = 0.009). Obese women with overweight ideal body size gained less weight annually than did those with normal weight ideal body size (0.12 vs. 0.27 BMI units; P = 0.04). Results for men showed fewer and weaker associations. When obese women perceive themselves as obese and feel that their body size is too large, they gain less weight over time. PMID:19221119

  19. Arterial distensibility in adolescents: the influence of adiposity, the metabolic syndrome, and classic risk factors.

    OpenAIRE

    Whincup, P H; Gilg, J A; Donald, A E; Katterhorn, M.; Oliver, C.; Cook, D.G.; Deanfield, J E

    2005-01-01

    BACKGROUND: Atherosclerosis develops from childhood, but the determinants of this preclinical stage remain uncertain. We examined the relations of classic coronary risk factors, adiposity and its associated metabolic disturbances, to arterial distensibility (a marker of early arterial disease) in 13- to 15-year-olds, some of whom had previously been studied at ages 9 to 11 years. METHODS AND RESULTS: Brachial artery distensibility was measured by a noninvasive ultrasound technique in 471 Brit...

  20. Instrumental-Variables Simultaneous Equations Model of Physical Activity and Body Mass Index: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    Science.gov (United States)

    Meyer, Katie A; Guilkey, David K; Tien, Hsiao-Chuen; Kiefe, Catarina I; Popkin, Barry M; Gordon-Larsen, Penny

    2016-09-15

    We used full-system-estimation instrumental-variables simultaneous equations modeling (IV-SEM) to examine physical activity relative to body mass index (BMI; weight (kg)/height (m)(2)) using 25 years of data (1985/1986 to 2010/2011) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (n = 5,115; ages 18-30 years at enrollment). Neighborhood environment and sociodemographic instruments were used to characterize physical activity, fast-food consumption, smoking, alcohol consumption, marriage, and childbearing (women) and to predict BMI using semiparametric full-information maximum likelihood estimation to control for unobserved time-invariant and time-varying residual confounding and differential measurement error through model-derived discrete random effects. Comparing robust-variance ordinary least squares, random-effects regression, fixed-effects regression, single-equation-estimation IV-SEM, and full-system-estimation IV-SEM, estimates from random- and fixed-effects models and the full-system-estimation IV-SEM were unexpectedly similar, despite the lack of control for residual confounding with the random-effects estimator. Ordinary least squares tended to overstate the significance of health behaviors in BMI, while results from single-equation-estimation IV-SEM were notably different, revealing the impact of weak instruments in standard instrumental-variable methods. Our robust findings for fixed effects (which does not require instruments but has a high cost in lost degrees of freedom) and full-system-estimation IV-SEM (vs. standard IV-SEM) demonstrate potential for a full-system-estimation IV-SEM method even with weak instruments. PMID:27614300

  1. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  2. Prevalence and risk factors of atherosclerotic renal artery stenosis

    Institute of Scientific and Technical Information of China (English)

    严健华

    2013-01-01

    Objective To explore the prevalence and risk factors of atherosclerotic renal artery stenosis(ARAS) in patients undergoing coronary angiography.Methods A total of 2506 patients with suspected and known coronary

  3. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

    DEFF Research Database (Denmark)

    Nicolaides, Andrew N; Kakkos, Stavros K; Kyriacou, Efthyvoulos;

    2010-01-01

    The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis.......The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis....

  4. Cervical Artery Dissection: Emerging Risk Factors

    OpenAIRE

    Micheli, S.; Paciaroni, M; Corea, F; Agnelli, G.; M. Zampolini; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan’s syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of...

  5. Arterial hypertension and cardiovascular risk in HIV-infected patients.

    Science.gov (United States)

    Calò, Lorenzo A; Caielli, Paola; Maiolino, Giuseppe; Rossi, Gianpaolo

    2013-08-01

    The dramatic change of the natural history of HIV-infected patients by highly active antiretroviral therapy (HAART) has exposed these patients to cardiovascular risk, including cardiovascular disease and hypertension. In HIV-infected patients, the development of arterial hypertension, at least in the medium-long term is an established feature, although recognized predictors of its development have not been clearly identified. In addition, conflicting data regarding the influence of antiretroviral therapy (ART) are reported. The presence of a proinflammatory state and oxidative stress-mediated endothelial dysfunction seem, however, to play a pathophysiologic role. In this review, we examine and provide a comprehensive, literature based, consideration of the pathophysiologic aspects of hypertension in these patients. HIV-infected patients, independently of the presence of hypertension, remain at very high cardiovascular risk due to the presence of the same cardiovascular risk factors recognized for the general population with, in addition, the indirect influence of the ART, essentially via its effect on lipid metabolism. This review based on the evidence from the literature, concludes that the management of HIV-infected patients in terms of cardiovascular prevention emerges as a priority. The consideration of cardiovascular risk in these patients should receive the same emphasis given for the general population at high cardiovascular risk, including adequate blood pressure control according to international guidelines.

  6. Arterial hypertension, microalbuminuria, and risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Jensen, J S; Feldt-Rasmussen, B; Strandgaard, S;

    2000-01-01

    Albumin excretion in urine is positively correlated with the presence of ischemic heart disease and atherosclerotic risk factors. We studied prospectively whether a slight increase of urinary albumin excretion, ie, microalbuminuria, adds to the increased risk of ischemic heart disease among...... hypertensive subjects. In 1983 and 1984, blood pressure, urinary albumin/creatinine concentration ratio, plasma total and HDL cholesterol levels, body mass index, and smoking status were obtained in a population-based sample of 2085 subjects, aged 30 to 60 years, who were free from ischemic heart disease......, diabetes mellitus, and renal or urinary tract disease. Untreated arterial hypertension or borderline hypertension was present in 204 subjects, who were followed until 1993 by the National Hospital and Death Certificate Registers with respect to development of ischemic heart disease. During 1978 person...

  7. Risk stratification of patients suspected of coronary artery disease

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Voss, Mette; Hansen, Vibeke B;

    2012-01-01

    To compare the performance of five risk models (Diamond-Forrester, the updated Diamond-Forrester, Morise, Duke, and a new model designated COronary Risk SCORE (CORSCORE) in predicting significant coronary artery disease (CAD) in patients with chest pain suggestive of stable angina pectoris....

  8. Androgenetic alopecia and risk of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Lata Sharma

    2013-01-01

    Full Text Available Background: Androgenetic alopecia (AGA or male pattern baldness (MPB has been found to be associated with the risk of coronary artery disease (CAD. The well-known risk factors are family history of CAD, hypertension, increased body mass index (BMI, central obesity, hyperglycemia, and dyslipidemia. The newer risk factors are serum lipoprotein-a (SL-a, serum homocysteine (SH, and serum adiponectin (SA. Aim : Identifying individuals at risk of CAD at an early age might help in preventing CAD and save life. Hence, a comparative study of CAD risk factors was planned in 100 males of AGA between the age of 25 and 40 years with equal number of age- and sex-matched controls. Materials and Methods : Patients of AGA grade II or more of Hamilton and Norwood (HN Scale and controls were examined clinically and advised blood test. The reports were available for fasting blood sugar (FBS, serum total serum cholesterol (SC in 64 cases, 64 controls; lipoproteins (high, low, very low density, HDL, LDL, VLDL, serum triglycerides (ST in 63 cases, 63 controls; SL-a in 63 cases, 74 controls; SH in 56 cases, 74 controls; and SA in 62 cases, 74 controls. Results : In these cases family history (FH of AGA and CAD was significantly high. The blood pressure (BP was also found to be significantly high in the cases. The difference of mean serum HDL, LDL, VLDL, ST, SH, and SL-a in cases and controls were statistically significant and with increasing grade of AGA, the risk factors also increased. Conclusion : Patients with AGA appear to be at an increased risk of developing CAD, therefore, clinical evaluation of cases with AGA of grade II and above may be of help in preventing CAD in future.

  9. Presence of anomalous coronary seen on angiogram is not associated with increased risk of significant coronary artery disease.

    Science.gov (United States)

    Suryanarayana, Prakash; Kollampare, Shubha; Riaz, Irbaz Bin; Lee, Justin; Husnain, Muhammad; Luni, Faraz Khan; Movahed, Mohammad Reza

    2014-12-01

    It is unclear if anomalous coronary arteries are at higher risk for atherosclerosis. The link between anomalous coronary artery and early coronary artery disease has been suggested. The aim of this study is to determine whether the coronary artery anomaly predisposes to development of significant coronary disease. Using retrospective chart review, patients with documented anomalous coronary arteries recognized during coronary angiography between years 2000 to 2007 were analyzed. Prevalence of significant atherosclerotic coronary artery disease (defined as more than 50% luminal narrowing) was compared between normal and anomalous coronaries. A total of 147 patients with anomalous coronary arteries were found. Right coronary artery was the most common anomalous artery 128 of 148 (86.5%) in our dataset. There was no difference in the occurrence of atherosclerosis between anomalous and nonanomalous coronaries. Significant atherosclerosis was present in 59 of the 148 anomalous coronary arteries (37.8%), and 112 of the 293 nonanomalous coronary arteries (38.2%, p = 0.9). On the basis of our study, there is no evidence that anomalous coronary arteries predispose to significant coronary artery disease in comparison to normal coronary arteries.

  10. Hostility, Anger and Risk of Coronary Artery Atherosclerosis

    Directory of Open Access Journals (Sweden)

    E Masoudnia

    2011-02-01

    Full Text Available Introduction: The previous researches about the etiology of coronary artery atherosclerosis have accentuated on clinical and medical risk factors, such as cigarette smoking, hypertension, diabetes mellitus, hyperlipidemia, positive family background, myocardial ischemia history in family, atherogenic diet, increase of A lipoprotein, inflammatory factors such as increase of cross-reactive protein and so on. Although factors in behavioral medicine are recognized as an independent risk factor in coronary artery atherosclerosis, few researches have been done on hostility and anger. The aim of this study was to determine the difference between normal people(Control group and people with coronary artery atherosclerosis(Case group with regards to hostility and anger. Methods: This study was performed as a case-control design. Data was collected from seventy-seven patients with coronary artery atherosclerosis who had referred to Afshar Hospital Professional Heart Clinic in Yazd city and seventy-eight normal people were used as control. Two groups completed the Buss and Perry Aggression Questionnaire(BPAQ to measure their hostility and anger. Results: The results of the analysis showed that there was a statistically significant difference regarding hostility(p<.05 and anger(p<.001 between the two groups. Hierarchical multiple logistic regression analysis showed that the sociodemographic and clinical variables(step 1 explained 35.5 % to 47.4%, while hostility and anger(step 2 explained 6.7% to 9% of the variance in incidence of coronary artery atherosclerosis. Conclusion: Hostility and anger are strong risk factors for coronary artery atherosclerosis or CAD in Iran. Therefore, in order to decrease the incidence rate of coronary artery atherosclerosis in Iran, alongside medical interventions, attention should also be paid towards behavioral interventions in order to modify hostile and angrily behavior.

  11. Associations Between Conventional Cardiovascular Risk Factors and Risk of Peripheral Artery Disease in Men

    NARCIS (Netherlands)

    Joosten, Michel M.; Pai, Jennifer K.; Bertoia, Monica L.; Rimm, Eric B.; Spiegelman, Donna; Mittleman, Murray A.; Mukamal, Kenneth J.

    2012-01-01

    Context Previous studies have examined the associations of individual clinical risk factors with risk of peripheral artery disease (PAD), but the combined effects of these risk factors are largely unknown. Objective To estimate the degree to which the 4 conventional cardiovascular risk factors of sm

  12. Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia

    DEFF Research Database (Denmark)

    Mejer, N; Gotland, N; Uhre, M L;

    2015-01-01

    OBJECTIVES: An association between infection and arterial thromboembolic events (ATE) has been suggested. Here we examined the risk of myocardial infarction (MI), stroke and other ATE after Staphylococcus aureus bacteremia (SAB). METHODS: Danish register-based nation-wide observational cohort study...

  13. Hepatitis C virus infection and risk of coronary artery disease

    DEFF Research Database (Denmark)

    Roed, Torsten; Lebech, Anne-Mette; Kjaer, Andreas;

    2012-01-01

    Several chronic infections have been associated with cardiovascular diseases, including Chlamydia pneumoniae, human immunodeficiency virus and viral hepatitis. This review evaluates the literature on the association between chronic hepatitis C virus (HCV) infection and the risk of coronary artery...... disease (CAD)....

  14. Oxidation-Specific Biomarkers and Risk of Peripheral Artery Disease

    NARCIS (Netherlands)

    Bertoia, Monica L.; Pai, Jennifer K.; Lee, Jun-Hee; Taleb, Adam; Joosten, Michel M.; Mittleman, Murray A.; Yang, Xiaohong; Witztum, Joseph L.; Rimm, Eric B.; Tsimikas, Sotirios; Mukamal, Kenneth J.

    2013-01-01

    Objectives The goal of this study was to examine the prospective association between oxidation-specific biomarkers, primarily oxidized phospholipids (OxPL) on apolipoprotein B-100-containing lipoproteins (OxPL/apoB) and lipoprotein (a) [Lp(a)], and risk of peripheral artery disease (PAD). We examine

  15. Risk factors for hemoptysis in idiopathic and hereditary pulmonary arterial hypertension.

    Directory of Open Access Journals (Sweden)

    Darryl Tio

    Full Text Available INTRODUCTION: When hemoptysis complicates pulmonary arterial hypertension (PAH, it is assumed to result from bronchial artery hypertrophy. In heritable PAH, the most common mutation is in the BMPR2 gene, which regulates growth, differentiation and apoptosis of mesenchymal cells. The aim of this study is to determine the relationship in PAH between the occurrence of hemoptysis, and disease progression, bronchial artery hypertrophy, pulmonary artery dilation and BMPR2 mutations. METHODS: 129 IPAH patients underwent baseline pulmonary imaging (CT angio or MRI and repeated right-sided heart catheterization. Gene mutations were assessed in a subset of patients. RESULTS: Hemoptysis was associated with a greater presence of hypertrophic bronchial arteries and more rapid hemodynamic deterioration. The presence of a BMPR2 mutation did not predispose to the development of hemoptysis, but was associated with a greater number of hypertrophic bronchial arteries and a worse baseline hemodynamic profile. CONCLUSION: Hemoptysis in PAH is associated with bronchial artery hypertrophy and faster disease progression. Although the presence of a BMPR2 mutation did not correlate with a greater incidence of hemoptysis in our patient cohort, its association with worse hemodynamics and a trend of greater bronchial arterial hypertrophy may increase the risk of hemoptysis.

  16. Risk Factors for Hemoptysis in Idiopathic and Hereditary Pulmonary Arterial Hypertension

    Science.gov (United States)

    Tio, Darryl; Leter, Edward; Boerrigter, Bart; Boonstra, Anco; Vonk-Noordegraaf, Anton; Bogaard, Harm Jan

    2013-01-01

    Introduction When hemoptysis complicates pulmonary arterial hypertension (PAH), it is assumed to result from bronchial artery hypertrophy. In heritable PAH, the most common mutation is in the BMPR2 gene, which regulates growth, differentiation and apoptosis of mesenchymal cells. The aim of this study is to determine the relationship in PAH between the occurrence of hemoptysis, and disease progression, bronchial artery hypertrophy, pulmonary artery dilation and BMPR2 mutations. Methods 129 IPAH patients underwent baseline pulmonary imaging (CT angio or MRI) and repeated right-sided heart catheterization. Gene mutations were assessed in a subset of patients. Results Hemoptysis was associated with a greater presence of hypertrophic bronchial arteries and more rapid hemodynamic deterioration. The presence of a BMPR2 mutation did not predispose to the development of hemoptysis, but was associated with a greater number of hypertrophic bronchial arteries and a worse baseline hemodynamic profile. Conclusion Hemoptysis in PAH is associated with bronchial artery hypertrophy and faster disease progression. Although the presence of a BMPR2 mutation did not correlate with a greater incidence of hemoptysis in our patient cohort, its association with worse hemodynamics and a trend of greater bronchial arterial hypertrophy may increase the risk of hemoptysis. PMID:24194909

  17. Coronary artery disease risk assessment from unstructured electronic health records using text mining.

    Science.gov (United States)

    Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

    2015-12-01

    Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD. PMID:26319542

  18. Coronary artery disease risk assessment from unstructured electronic health records using text mining.

    Science.gov (United States)

    Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Chang, Nai-Wen; Dai, Hong-Jie

    2015-12-01

    Coronary artery disease (CAD) often leads to myocardial infarction, which may be fatal. Risk factors can be used to predict CAD, which may subsequently lead to prevention or early intervention. Patient data such as co-morbidities, medication history, social history and family history are required to determine the risk factors for a disease. However, risk factor data are usually embedded in unstructured clinical narratives if the data is not collected specifically for risk assessment purposes. Clinical text mining can be used to extract data related to risk factors from unstructured clinical notes. This study presents methods to extract Framingham risk factors from unstructured electronic health records using clinical text mining and to calculate 10-year coronary artery disease risk scores in a cohort of diabetic patients. We developed a rule-based system to extract risk factors: age, gender, total cholesterol, HDL-C, blood pressure, diabetes history and smoking history. The results showed that the output from the text mining system was reliable, but there was a significant amount of missing data to calculate the Framingham risk score. A systematic approach for understanding missing data was followed by implementation of imputation strategies. An analysis of the 10-year Framingham risk scores for coronary artery disease in this cohort has shown that the majority of the diabetic patients are at moderate risk of CAD.

  19. Low risk of coronary artery disease in patients with acromegaly.

    Science.gov (United States)

    Dos Santos Silva, Cintia Marques; Lima, G A B; Volschan, I C M; Gottlieb, I; Kasuki, L; Neto, L Vieira; Gadelha, M R

    2015-12-01

    The aims of this study are to determine the prevalence of coronary atherosclerosis in acromegalic patients and to investigate the relationship between the coronary artery calcium score (CS) and acromegaly status and clinical parameters [Framingham risk score (FRS)]. Fifty-six acromegalic patients and paired non-acromegalic volunteers were stratified according to the FRS into low-, intermediate-, and high-risk groups. CS was assessed using multidetector computed tomography. The patients were considered to have controlled or active acromegaly at the time they were submitted to evaluation. Sixty-six percent of acromegalic patients exhibited arterial hypertension, 36 % had diabetes mellitus, and 34 % had hypercholesterolemia. The median FRS and the median risk for cardiovascular event within the next 10 years were similar in the acromegalics and the controls. The median total CS and CS >75th percentile didn't differ significantly between these groups. In patients with controlled acromegaly, a low, intermediate, or high FRS risk was observed in 86, 14, and 0 %, respectively. In patients with active disease, a low, intermediate, or high FRS risk was verified in 94, 3, and 3 %, respectively, and differences between the controlled and active groups were not significant. Seventy-two percent of the patients had total CS = 0, and there were no differences between the controlled and active groups. The risk of coronary artery disease in acromegalic patients, determined according to FRS and CS, is low despite the high prevalence of metabolic abnormalities.

  20. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The ... Recommendation | 1 Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults Potential ...

  1. Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

    Directory of Open Access Journals (Sweden)

    Usama Elewa

    Full Text Available Arterial stiffness, as measured by pulse wave velocity (PWV, is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5% patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV - (upper limit of the age-adjusted PWV values for the general population. Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

  2. Common polymorphisms of ALOX5 and ALOX5AP and risk of coronary artery disease

    OpenAIRE

    Assimes, Themistocles L.; Knowles, Joshua W.; Priest, Jame s R.; Basu, Analabha; Volcik, Kelly A.; Southwick, Audrey; Tabor, Holly K.; Hartiala, Jaana; Allayee, Hooman; Grove, Megan L.; Tabibiazar, Raymond; Sidney, Stephen; Fortmann, Stephen P.; Go, Alan; Hlatky, Mark

    2008-01-01

    Recent human genetic studies suggest that allelic variants of leukotriene pathway genes influence the risk of clinical and subclinical atherosclerosis. We sequenced the promoter, exonic, and splice site regions of ALOX5 and ALOX5AP and then genotyped 7 SNPs in ALOX5 and 6 SNPs in ALOX5AP in 1,552 cases with clinically significant coronary artery disease (CAD) and 1,583 controls from Kaiser Permanente including a subset of participants of the coronary artery risk development in young adults st...

  3. ABO Blood Group and Risk of Thromboembolic and Arterial Disease

    DEFF Research Database (Denmark)

    Vasan, Senthil K; Rostgaard, Klaus; Majeed, Ammar;

    2016-01-01

    BACKGROUND: ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies. METHODS AND RESULTS: We used the SCANDAT2...... (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987......-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis...

  4. A Clinical model to identify patients with high-risk coronary artery disease

    NARCIS (Netherlands)

    Y. Yang (Yelin); L. Chen (Li); Y. Yam (Yeung); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D.S. Berman (Daniel); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); R.C. Cury (Ricardo); A. Delago (Augustin); A. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); R.P. Karlsberg (Ronald); P.A. Kaufmann (Philipp); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); T.M. LaBounty (Troy); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James K.); B.J.W. Chow (Benjamin)

    2015-01-01

    textabstractObjectives This study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD). Background Although current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify th

  5. Total Adiponectin and Risk of Symptomatic Lower Extremity Peripheral Artery Disease in Men

    NARCIS (Netherlands)

    Joosten, Michel M.; Joshipura, Kaumudi J.; Pai, Jennifer K.; Bertoia, Monica L.; Rimm, Eric B.; Mittleman, Murray A.; Mukamal, Kenneth J.

    2013-01-01

    Objective-Lower concentrations of adiponectin have been linked to subsequent risk of coronary heart disease in healthy individuals. Whether similar relationships exist for the development of systemic atherosclerosis, such as peripheral artery disease (PAD), is uncertain. We investigated the associat

  6. Risk Factors for Ventilator Dependency Following Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Qiang Ji, Qianglin Duan, Xisheng Wang, Jianzhi Cai, Yongxin Zhou, Jing Feng, Yunqing Mei

    2012-01-01

    Full Text Available Background: Ventilator dependency following coronary artery bypass grafting (CABG is often associated with significant morbidity and mortality. However, few reports have focused on the independent risk factors for ventilator dependency following CABG. This study aimed to evaluate the independent risk factors for ventilator dependency following coronary artery bypass grafting (CABG. Methods: The relevant pre-, intra- and post-operative data of patients without a history of chronic obstructive pulmonary disease undergoing isolated CABG from January 2003 to December 2008 in our center were retrospectively analyzed. Elapsed time between CABG and extubation of more than 48 hours was defined as postoperative ventilator dependency (PVD. Results: The incidence of PVD was 13.8% (81/588. The in-hospital mortality in the PVD group was significantly higher than that in the non-PVD group (8.6% versus 2.4%, p=0.0092. Besides the length of ICU and hospital stay, PVD correlated with negative respiratory outcomes. The independent risk factors for PVD were preoperative congestive heart failure (OR=2.456, 95%CI 1.426-6.879, preoperative hypoalbuminemia (OR=1.353, 95%CI 1.125-3.232, preoperative arterial oxygen partial pressure (PO2 (OR=0.462, 95%CI 0.235-0.783 and postoperative anaemia (OR=1.541, 95%CI 1.231-3.783. Conclusions: Preoperative congestive heart failure, preoperative hypoalbuminemia, low preoperative PO2 and postoperative anaemia were identified as four independent risk factors for ventilator dependency following CABG.

  7. Arterial hypertension as risk factor for spontaneous cervical artery dissection. A case–control study

    OpenAIRE

    Pezzini, A; Caso, V; Zanferrari, C; Del Zotto, E; Paciaroni, M; Bertolino, C; Grassi, M.(INFN Sezione di Roma, Roma, Italy); Agnelli, G.; Padovani, A

    2006-01-01

    Because of the presumed non‐atherosclerotic pathogenesis, the potential link between spontaneous cervical artery dissection (sCAD) and common risk factors for atherosclerosis has never been investigated systematically. Therefore, this prospective, multicentre, case–control study compared the frequency of tobacco use, hypertension, diabetes mellitus, and hypercholesterolaemia among a group of consecutive patients with sCAD (n  =  153), a group of patients with ischaemic stroke, not related to ...

  8. Cardiovascular Risk Factors and Specific Coronary Artery Calcification in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Mathias Prokop

    2009-09-01

    Full Text Available Background: Myocardial infarctions at different locations have been related to different sets of risk factors. This study was designed to examine the association between cardiovascular risk factors and specific coronary artery calcification (CAC.Methods: The study population comprised 573 postmenopausal women selected from a population-based cohort study. Established vascular risk factors were measured. The women underwent a multi detector-row computed tomography (16-MDCT (Philips Mx 8000 IDT 16 to assess coronary calcium. The Agatston score was used to quantify coronary calcium. Logistic regression models were utilized to assess the relations.Results: The prevalence of coronary artery calcification (Agatston score>0 was 61.5% (n=348. CAC was most common in the left anterior descending (LAD artery with a prevalence of 43.9%; and the rates of prevalence in the right coronary artery (RCA, the circumflex (LCX, the left main artery (LM, and the posterior descending artery (PDA were 23.1%, 19.4%, 15.8%, and 0.3%, respectively. In the multivariate regression models, age was predominantly related to the calcification in the LAD and LCX, low density lipoprotein to calcification in the LAD, and cholesterol to the calcification of the RCA. Hypertension and systolic & diastolic blood pressures were related to the calcification of the LCX, whereas smoking was predominantly related to the calcification of both LAD and RCA. Finally, age, body mass index, and systolic blood pressure were significantly related to the calcification in the LM.Conclusion: Our findings showed that the consequences of elevated risk factor levels on the development of atherosclerosis appeared to be different across the segments of the coronary arteries.

  9. Arterial stiffness, central hemodynamics, and cardiovascular risk in hypertension

    Directory of Open Access Journals (Sweden)

    Palatini P

    2011-12-01

    Full Text Available Paolo Palatini1, Edoardo Casiglia1, Jerzy Gąsowski2, Jerzy Głuszek3, Piotr Jankowski4, Krzysztof Narkiewicz5, Francesca Saladini1, Katarzyna Stolarz-Skrzypek4, Valérie Tikhonoff1, Luc Van Bortel6, Wiktoria Wojciechowska4, Kalina Kawecka-Jaszcz41Department of Clinical and Experimental Medicine, University of Padova, Padua, Italy; 2Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland; 3Department of Arterial Hypertension, University Hospital, Poznan, Poland; 4First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland; 5Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland; 6Heymans Institute of Pharmacology, Ghent University, Ghent, BelgiumAbstract: This review summarizes several scientific contributions at the recent Satellite Symposium of the European Society of Hypertension, held in Milan, Italy. Arterial stiffening and its hemodynamic consequences can be easily and reliably measured using a range of noninvasive techniques. However, like blood pressure (BP measurements, arterial stiffness should be measured carefully under standardized patient conditions. Carotid-femoral pulse wave velocity has been proposed as the gold standard for arterial stiffness measurement and is a well recognized predictor of adverse cardiovascular outcome. Systolic BP and pulse pressure in the ascending aorta may be lower than pressures measured in the upper limb, especially in young individuals. A number of studies suggest closer correlation of end-organ damage with central BP than with peripheral BP, and central BP may provide additional prognostic information regarding cardiovascular risk. Moreover, BP-lowering drugs can have differential effects on central aortic pressures and hemodynamics compared with brachial BP. This may explain the greater beneficial effect provided by newer antihypertensive drugs beyond peripheral BP

  10. Carotid artery revascularization : Surgical and endovascular developments

    OpenAIRE

    de Borst, G. J.

    2007-01-01

    Carotid artery revascularization. Surgical and endovascular developments. Stroke is among the most disabling chronic diseases and the third major cause of death in the Western world. In the Netherlands around 12 per 1000 inhabitants suffers a stroke, and in 2005 over 10.000 people died as a result of stroke representing 7.6% of all deaths. In 10-20% of patients stroke is heralded by transient cerebral deficit. These harbingers of stroke allow a certain amount of time to search for the cause o...

  11. Epidemiology, classification, and modifiable risk factors of peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Nicolas W Shammas

    2007-05-01

    Full Text Available Nicolas W ShammasMidwest Cardiovascular Research Foundation, Cardiovascular Medicine, PC, Davenport, IA, USAAbstract: Peripheral arterial disease (PAD is part of a global vascular problem of diffuse atherosclerosis. PAD patients die mostly of cardiac and cerebrovascular-related events and much less frequently due to obstructive disease of the lower extremities. Aggressive risk factors modification is needed to reduce cardiac mortality in PAD patients. These include smoking cessation, reduction of blood pressure to current guidelines, aggressive low density lipoprotein lowering, losing weight, controlling diabetes and the use of oral antiplatelet drugs such as aspirin or clopidogrel. In addition to quitting smoking and exercise, cilostazol and statins have been shown to reduce claudication in patients with PAD. Patients with critical rest limb ischemia or severe progressive claudication need to be treated with revascularization to minimize the chance of limb loss, reduce symptoms, and improve quality of life.Keywords: peripheral arterial disease, epidemiology, risk factors, classification

  12. Current Roles and Future Applications of Cardiac CT: Risk Stratification of Coronary Artery Disease

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeonyee Elizabeth [Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lim, Tae-Hwan [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736 (Korea, Republic of)

    2014-07-01

    Cardiac computed tomography (CT) has emerged as a noninvasive modality for the assessment of coronary artery disease (CAD), and has been rapidly integrated into clinical cares. CT has changed the traditional risk stratification based on clinical risk to image-based identification of patient risk. Cardiac CT, including coronary artery calcium score and coronary CT angiography, can provide prognostic information and is expected to improve risk stratification of CAD. Currently used conventional cardiac CT, provides accurate anatomic information but not functional significance of CAD, and it may not be sufficient to guide treatments such as revascularization. Recently, myocardial CT perfusion imaging, intracoronary luminal attenuation gradient, and CT-derived computed fractional flow reserve were developed to combine anatomical and functional data. Although at present, the diagnostic and prognostic value of these novel technologies needs to be evaluated further, it is expected that all-in-one cardiac CT can guide treatment and improve patient outcomes in the near future.

  13. Current Roles and Future Applications of Cardiac CT: Risk Stratification of Coronary Artery Disease

    International Nuclear Information System (INIS)

    Cardiac computed tomography (CT) has emerged as a noninvasive modality for the assessment of coronary artery disease (CAD), and has been rapidly integrated into clinical cares. CT has changed the traditional risk stratification based on clinical risk to image-based identification of patient risk. Cardiac CT, including coronary artery calcium score and coronary CT angiography, can provide prognostic information and is expected to improve risk stratification of CAD. Currently used conventional cardiac CT, provides accurate anatomic information but not functional significance of CAD, and it may not be sufficient to guide treatments such as revascularization. Recently, myocardial CT perfusion imaging, intracoronary luminal attenuation gradient, and CT-derived computed fractional flow reserve were developed to combine anatomical and functional data. Although at present, the diagnostic and prognostic value of these novel technologies needs to be evaluated further, it is expected that all-in-one cardiac CT can guide treatment and improve patient outcomes in the near future

  14. Association between arterial stiffness and risk of coronary artery disease in a community-based population

    Institute of Scientific and Technical Information of China (English)

    Zhang Yun; Ye Ping; Luo Leiming; Bai Yongyi; Xu Ruyi; Xiao Wenkai; Liu Dejun

    2014-01-01

    Background Arterial stiffness is well known as an important risk factor for coronary artery disease.In this study,we aimed to investigate the association between carotid-ankle pulse wave velocity (caPWV) and risk of coronary artery disease (CAD),and the interaction between pulse wave velocity (PWV) and other potential risk factors of CAD.Methods A community-based cross-sectional study was conducted for subjects living in Beijing,China.We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing.A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.Results We found CAD subjects were more likely to have a higher body massindex (BMI),fasting glucose,uric acid,low-density lipoprotein (LDL) cholesterol,high-sensitivity Creactive protein (hs-CRP),carotic-femoral pulse wave velocity (cfPWV) and caPWV (P <0.05),and CAD subjects had a significantly lower HDL cholesterol levels (P <0.05).Moreover,the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects.The multiple Logistic regression analysis showed that hypertension,higher uric acid,hs-CRP,cfPWV and caPWV levels significantly increased the risk of CAD,with ORs (Cl) of 1.47 (1.25-1.74),1.17 (1.01-1.26),1.35 (1.10-1.67),1.15 (1.09-1.19) and 1.07 (1.01-1.15),respectively.Higher HDL cholesterol was significantly associated with reduced risk of CAD,with ORs (CI) of 0.58 (0.40-0.83).In addition,cfPWV had significant association with age,hypertension,LDL cholesterol,with Pearson's coefficients of 0.166,0.074,and 0.030,respectively.Conclusions cfPWV and caPWV are independently associated with significant CAD,and cfPWV has significant correlation with age and hypertension.cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.

  15. Relation of anthropometric variables to coronary artery disease risk factors

    Directory of Open Access Journals (Sweden)

    Virendra C Patil

    2011-01-01

    Full Text Available Background and Objectives: Anthropometric variables and their relation to conventional coronary artery disease (CAD risk factors in railway employees have been inadequately studied in India. This cross-sectional survey was carried out in the Solapur division of the Central railway in the year 2004, to assess the anthropometric variables in railway employees and their relation to conventional CAD risk factors. Materials and Methods: A total of 995 railway employees, with 872 males and 123 females participated in this cross-sectional study. All subjects underwent anthropometric measurements, fasting lipid profile, and blood sugar level. Various anthropometric indices were calculated for body mass index (BMI, waist circumference (WC, waist-to-hip ratio (WHR, waist-to-height ratio (WHtR, and abdominal volume index (AVI. Statistical analysis was done by EPI Info 6 statistical software. Results: Compared to all other obesity indices, WHtR was most prevalent in both genders. High WHtR was present in 699 (80.16% males and 103 (83.73% females. Age ≥45 years, high systolic BP, high diastolic BP, low HDL, high triglyceride, and diabetes mellitus were positively correlated with high BMI, high WC, high WHR, high WHtR, and high AVI. High BMI, high WC, high WHR, high WHtR, and high AVI were negatively associated with physical inactivity. Conclusions: Over all, anthropometric variables in both genders were significantly deranged in subjects with coronary risk factors. Compared to all other anthropometric variables, WHtR was statistically significantly associated with a majority of coronary artery risk factors. Hence we recommend inclusion of WHtR as a parameter of obesity to predict coronary artery disease risk factor along with WC, WHR, and BMI in epidemiologic studies.

  16. INDUSTRIAL RISK Programme development

    International Nuclear Information System (INIS)

    INC-DTCI ICIS Rm. Valcea conducts basic and applied research among which there is the INDUSTRIAL RISK Programme that comprises studies of risk analysis and evaluation at objectives and activities in zones were risk factors are in operation, factors leading potentially to natural or technological disasters. The risk analysis and evaluation methodology proposed is a follow-up of the action plan for risk reduction in industry. The risk management refers to risk and its components assessment and identification of places where improvements are to be introduced. The risk analysis and evaluation model was developed for installations in chemical industry and are also applicable for the installations of heavy water production by H2O-H2S isotopic exchange. The risk studies supply information necessary in making decisions, aiming at preventing the operation incidence and reducing their consequences

  17. Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

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    Annie M Bérard

    Full Text Available BACKGROUND: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups. METHODS AND RESULTS: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old presenting either a peripheral arterial occlusive disease (N = 64 or a thromboangiitis obliterans (N = 49, and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin and zinc. Premature peripheral arterial occlusive disease was characterized by the presence of a family history of peripheral arterial and carotid artery diseases (OR 2.3 and 5.8 respectively, 95% CI, high lipoprotein (a levels above 300 mg/L (OR 2.3, 95% CI, the presence of the factor V Leiden (OR 5.1, 95% CI and the glycoprotein Ia(807T,837T,873A allele (OR 2.3, 95% CI. In thromboangiitis obliterans group, more patients were regular consumers of cannabis (OR 3.5, 95% CI and higher levels in plasma copper has been shown (OR 6.5, 95% CI. CONCLUSIONS: According to our results from a non exhaustive list of study parameters, we might hypothesize for 1 a genetic basis for premature peripheral arterial occlusive disease development and 2 the prevalence of environmental factors in the development of thromboangiitis obliterans (tobacco and cannabis. Moreover, for the first time, we demonstrated that the 807T/837T/873A allele of platelet glycoprotein Ia may confer an additional risk for development of peripheral

  18. Smoking and hyperlipidemia are important risk factors for coronary artery spasm

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To investigate the role of coronary artery spasm in the etiology of chest pain lacking significant coronary stenosis and to identify the clinical risk factors related to coronary artery spasm. Methods Two hundred and seventy five patients with chest pain, but without significant coronary artery stenosis underwent the intracoronary acetylcholine test. Coronary artery spasm was diagnosed while coronary artery stenosis increased to 90% and was accompanied by the usual chest pain with or without ischemic changes on electrocardiogram. Logistic regression was employed to investigate the relationships between coronary artery spasm and sex, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and results of electrocardiographic treadmill stress test. Left ventricular ejection fraction and end diastolic pressure were compared between spasm group and non-spasm group. Results Coronary artery spasm was detected in 103 out of 271 patients, a rate of 38%. Logistic regression analysis showed that smoking and hyperlipidemia increased the relative risk of coronary artery spasm 4.2 times and 2.3 times, respectively. There was a significantly negative relationship between diabetes mellitus and coronary artery spasm. Furthermore, there was no coronary artery spasm detected in left ventricular ejection fraction and end diastolic pressure. Conclusions Coronary artery spasm was one of the important etiological factors for patients with chest pain but no coronary artery stenosis. Smoking and hyperlipidemia were the main clinical risk factors for coronary artery spasm.

  19. Mitochondrial Haplogroups and Risk of Pulmonary Arterial Hypertension.

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    Samar Farha

    Full Text Available Pulmonary arterial hypertension (PAH is a serious and often fatal disease. It is a panvasculopathy of the pulmonary microcirculation characterized by vasoconstriction and arterial obstruction due to vascular proliferation and remodeling and ultimately right ventricular failure. Mitochondrial dysfunction is a universal finding in pulmonary vascular cells of patients with PAH, and is mechanistically linked to disease origins in animal models of pulmonary hypertension. Mitochondria have their own circular DNA (mtDNA, which can be subgrouped into polymorphic haplogroup variants, some of which have been identified as at-risk or protective from cardiovascular and/or neurodegenerative diseases. Here, we hypothesized that mitochondrial haplogroups may be associated with PAH. To test this, mitochondrial haplogroups were determined in a cohort of PAH patients and controls [N = 204 Caucasians (125 PAH and 79 controls and N = 46 African Americans (13 PAH and 33 controls]. Haplogroup L was associated with a lower rate of PAH as compared to macrohaplogroups N and M. When haplogroups were nested based on ancestral inheritance and controlled for age, gender and race, haplogroups M and HV, JT and UK of the N macro-haplogroup had significantly higher rates of PAH compared to the ancestral L (L0/1/2 and L3 (all p ≤ 0.05. Overall, the findings suggest that mitochondrial haplogroups influence risk of PAH and that a vulnerability to PAH may have emerged under the selective enrichment of specific haplogroups that occurred with the migration of populations out of Africa.

  20. Mitochondrial Haplogroups and Risk of Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Farha, Samar; Hu, Bo; Comhair, Suzy; Zein, Joe; Dweik, Raed; Erzurum, Serpil C; Aldred, Micheala A

    2016-01-01

    Pulmonary arterial hypertension (PAH) is a serious and often fatal disease. It is a panvasculopathy of the pulmonary microcirculation characterized by vasoconstriction and arterial obstruction due to vascular proliferation and remodeling and ultimately right ventricular failure. Mitochondrial dysfunction is a universal finding in pulmonary vascular cells of patients with PAH, and is mechanistically linked to disease origins in animal models of pulmonary hypertension. Mitochondria have their own circular DNA (mtDNA), which can be subgrouped into polymorphic haplogroup variants, some of which have been identified as at-risk or protective from cardiovascular and/or neurodegenerative diseases. Here, we hypothesized that mitochondrial haplogroups may be associated with PAH. To test this, mitochondrial haplogroups were determined in a cohort of PAH patients and controls [N = 204 Caucasians (125 PAH and 79 controls) and N = 46 African Americans (13 PAH and 33 controls)]. Haplogroup L was associated with a lower rate of PAH as compared to macrohaplogroups N and M. When haplogroups were nested based on ancestral inheritance and controlled for age, gender and race, haplogroups M and HV, JT and UK of the N macro-haplogroup had significantly higher rates of PAH compared to the ancestral L (L0/1/2 and L3) (all p ≤ 0.05). Overall, the findings suggest that mitochondrial haplogroups influence risk of PAH and that a vulnerability to PAH may have emerged under the selective enrichment of specific haplogroups that occurred with the migration of populations out of Africa. PMID:27224443

  1. Recapitulation of Developing Artery Muscularization in Pulmonary Hypertension

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    Abdul Q. Sheikh

    2014-03-01

    Full Text Available Excess smooth muscle accumulation is a key component of many vascular disorders, including atherosclerosis, restenosis, and pulmonary artery hypertension, but the underlying cell biological processes are not well defined. In pulmonary artery hypertension, reduced pulmonary artery compliance is a strong independent predictor of mortality, and pathological distal arteriole muscularization contributes to this reduced compliance. We recently demonstrated that embryonic pulmonary artery wall morphogenesis consists of discrete developmentally regulated steps. In contrast, poor understanding of distal arteriole muscularization in pulmonary artery hypertension severely limits existing therapies that aim to dilate the pulmonary vasculature but have modest clinical benefit and do not prevent hypermuscularization. Here, we show that most pathological distal arteriole smooth muscle cells, but not alveolar myofibroblasts, derive from pre-existing smooth muscle. Furthermore, the program of distal arteriole muscularization encompasses smooth muscle cell dedifferentiation, distal migration, proliferation, and then redifferentiation, thereby recapitulating many facets of arterial wall development.

  2. RISK ANALYSIS DEVELOPED MODEL

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    Georgiana Cristina NUKINA

    2012-07-01

    Full Text Available Through Risk analysis developed model deciding whether control measures suitable for implementation. However, the analysis determines whether the benefits of a data control options cost more than the implementation.

  3. Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

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    Pantaleo Maria

    2012-06-01

    Full Text Available Abstract Background Tyrosine kinase inhibitors (TKIs are currently approved for the treatment of metastatic renal cell carcinoma (mRCC. The cardiotoxic effects of sorafenib and sunitinib may cause hypertension, left ventricular ejection fraction (LVEF dysfunction and/or congestive heart failure (CHF, and arterial thrombo-embolic events (ATE. Only three cases of coronary artery disease related to sorafenib therapy have been described in the literature, and all were due to arterial vasospasm without evidence of coronary artery stenosis on angiography. Cardiotoxicity is commonly associated with the presence of cardiovascular risk factors, such as a history of hypertension or coronary artery disease. Case presentation We describe a patient who experienced an unusual cardiac event after 2 years of sorafenib treatment. A 58-year-old man with mRCC developed acute coronary syndrome (ischemia/infarction associated with critical sub-occlusion of the common trunk of the left coronary artery and some of its branches, which was documented on coronary angiography. The patient underwent triple coronary artery bypass surgery, and sorafenib treatment was discontinued. He did not have any cardiovascular risk factors, and his cardiac function and morphology were normal prior to sorafenib treatment. Conclusions Further investigation of a larger patient population is needed to better understand cardiac damage due to TKI treatment. Understanding the usefulness of careful cardiovascular monitoring might be important for the prevention of fatal cardiovascular events, and to avoid discontinuation of therapy for the underlying cancer.

  4. Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

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    Weiwei Wu

    Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

  5. Alcohol consumption and risk of peripheral arterial disease: the Rotterdam study

    NARCIS (Netherlands)

    R. Vliegenthart (Rozemarijn); J.M. Geleijnse (Marianne); W.T. Meijer (Wouter); F.J.A. van Rooij (Frank); D.E. Grobbee (Diederick); J.C.M. Witteman (Jacqueline); A. Hofman (Albert)

    2002-01-01

    textabstractModerate alcohol consumption is associated with a reduced risk of cardiovascular disease. Data on alcohol consumption and atherosclerosis are scarce. To determine the association between alcohol consumption and risk of peripheral arterial disease, the authors carried ou

  6. Risks and diagnosis of coronary artery disease in Hodgkin lymphoma survivors

    Institute of Scientific and Technical Information of China (English)

    Serhan; Kupeli

    2014-01-01

    Higher mortality rates are reported because of cardiovascular diseases in individuals living in industrialized areas of the World.In cancer patients,cardiotoxic chemotherapeutic agents and/or mediastinal radiotherapy are additional risk factors for the development of coronary artery disease.An improved survival rate for patients with Hodgkin lymphoma was reported in recent decades.Determining and handling the long-term effects of cancer treatment have become more important nowadays,parallel to the good results reached in survival rates.Mediastinal radiotherapy and cardiotoxic chemotherapeutic agents are routinely used to treat Hodgkin lymphoma but are commonly associated with a variety of cardiovascular complications.Drugs used in cancer treatment and radiotherapy may cause deleterious effects on contractile capacity and conduction system of the heart.Approximately ten years after the completion of all therapies,the cardiovascular disease risk peaks in patients who survived from Hodgkin lymphoma.The value of coronary computed tomography angiography as a diagnostic tool in determining coronary artery disease as early as possible is underlined in this review,in patients who are in remission and carry the risk of coronary artery disease probably because of chemo/radiotherapy used in their treatment.Survivors of Hodgkin lymphoma especially treated with combined chemoradiotherapy at younger ages are candidates for coronary computed tomography angiography.

  7. The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

    Science.gov (United States)

    Nagar, Teena; Sharma, Deepak; Choudhary, Mukesh; Khoiwal, Shusheela; Nagar, Rajendra Prasad; Pandita, Aakash

    2015-01-01

    AIM To study the role of Doppler imaging in prediction of high-risk pregnancies and their outcomes. METHODS AND MATERIAL This prospective study in a setup of tertiary-level care center includes 500 high-risk pregnant women from rural and urban sectors and evaluates the predictive values of various Doppler indices. RESULTS Out of 500 patients, 110 patients had abnormal Doppler among them, 70 patients had abnormal uterine artery Doppler, and 50 patients had abnormal umbilical artery Doppler flow indices. In all, 10 patients had both umbilical artery and uterine artery abnormal Doppler indices. When uterine artery was abnormal (70 patients), 20 patients had preeclampsia, 10 patients had pregnancy-induced hypertension (PIH), and 25 patients had intrauterine growth restriction (IUGR). Systolic/diastolic (S/D) ratio and notch had sensitivity of 60% and positive predictive value of 33.3% and 37.5%, respectively. When umbilical artery was abnormal (50 patients), 10 had preeclampsia, 15 had PIH, and 15 had IUGR. S/D ratio had the highest positive predictive value of 40%; sensitivity is same for all. In uterine artery, combination of parameters had the best sensitivity of 80%, followed by notch and S/D ratio. In umbilical artery, combination of parameters, S/D ratio, and RI (resistance index) had sensitivity of 40%; specificity of all the indices was 91–96%. In all, 20 patients had bilateral notch, and among them 15 developed preeclampsia and 15 developed IUGR. When both uterine and umbilical artery Doppler were abnormal (10 patients), all patients had preeclampsia and IUGR. CONCLUSION Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality. PMID:25922590

  8. An Update on the Utility of Coronary Artery Calcium Scoring for Coronary Heart Disease and Cardiovascular Disease Risk Prediction.

    Science.gov (United States)

    Kianoush, Sina; Al Rifai, Mahmoud; Cainzos-Achirica, Miguel; Umapathi, Priya; Graham, Garth; Blumenthal, Roger S; Nasir, Khurram; Blaha, Michael J

    2016-03-01

    Estimating cardiovascular disease (CVD) risk is necessary for determining the potential net benefit of primary prevention pharmacotherapy. Risk estimation relying exclusively on traditional CVD risk factors may misclassify risk, resulting in both undertreatment and overtreatment. Coronary artery calcium (CAC) scoring personalizes risk prediction through direct visualization of calcified coronary atherosclerotic plaques and provides improved accuracy for coronary heart disease (CHD) or CVD risk estimation. In this review, we discuss the most recent studies on CAC, which unlike historical studies, focus sharply on clinical application. We describe the MESA CHD risk calculator, a recently developed CAC-based 10-year CHD risk estimator, which can help guide preventive therapy allocation by better identifying both high- and low-risk individuals. In closing, we discuss calcium density, regional distribution of CAC, and extra-coronary calcification, which represent the future of CAC and CVD risk assessment research and may lead to further improvements in risk prediction.

  9. Effect of Cardio-Metabolic Risk Factors Clustering with or without Arterial Hypertension on Arterial Stiffness: A Narrative Review

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    Vasilios G. Athyros

    2013-11-01

    Full Text Available The clustering of cardio-metabolic risk factors, either when called metabolic syndrome (MetS or not, substantially increases the risk of cardiovascular disease (CVD and causes mortality. One of the possible mechanisms for this clustering's adverse effect is an increase in arterial stiffness (AS, and in high central aortic blood pressure (CABP, which are significant and independent CVD risk factors. Arterial hypertension was connected to AS long ago; however, other MetS components (obesity, dyslipidaemia, dysglycaemia or MetS associated abnormalities not included in MetS diagnostic criteria (renal dysfunction, hyperuricaemia, hypercoaglutability, menopause, non alcoholic fatty liver disease, and obstructive sleep apnea have been implicated too. We discuss the evidence connecting these cardio-metabolic risk factors, which negatively affect AS and finally increase CVD risk. Furthermore, we discuss the impact of possible lifestyle and pharmacological interventions on all these cardio-metabolic risk factors, in an effort to reduce CVD risk and identify features that should be taken into consideration when treating MetS patients with or without arterial hypertension.

  10. ACR appropriateness criteria asymptomatic patient at risk for coronary artery disease.

    Science.gov (United States)

    Earls, James P; Woodard, Pamela K; Abbara, Suhny; Akers, Scott R; Araoz, Philip A; Cummings, Kristopher; Cury, Ricardo C; Dorbala, Sharmila; Hoffmann, Udo; Hsu, Joe Y; Jacobs, Jill E; Min, James K

    2014-01-01

    Atherosclerotic cardiovascular disease is the leading cause of death for both men and women in the United States. Coronary artery disease has a long asymptomatic latent period and early targeted preventive measures can reduce mortality and morbidity. It is important to accurately classify individuals at elevated risk in order to identify those who might benefit from early intervention. Imaging advances have made it possible to detect subclinical coronary atherosclerosis. Coronary artery calcium score correlates closely with overall atherosclerotic burden and provides useful prognostic information for patient management. Our purpose is to discuss use of diagnostic imaging in asymptomatic patients at elevated risk for future cardiovascular events. The goal for these patients is to further refine targeted preventative efforts based on risk. The following imaging modalities are available for evaluating asymptomatic patients at elevated risk: radiography, fluoroscopy, multidetector CT, ultrasound, MRI, cardiac perfusion scintigraphy, echocardiography, and PET. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:24316232

  11. The Peripheral Arterial disease study (PERART/ARTPER: prevalence and risk factors in the general population

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    Vicheto Marisa

    2010-01-01

    Full Text Available Abstract Background The early diagnosis of atherosclerotic disease is essential for developing preventive strategies in populations at high risk and acting when the disease is still asymptomatic. A low ankle-arm index is a good marker of vascular events and may be diminished without presenting symptomatology (silent peripheral arterial disease. The aim of the study is to know the prevalence and associated risk factors of peripheral arterial disease in the general population. Methods We performed a cross-sectional, multicentre, population-based study in 3786 individuals >49 years, randomly selected in 28 primary care centres in Barcelona (Spain. Peripheral arterial disease was evaluated using the ankle-arm index. Values Results The prevalence (95% confidence interval of peripheral arterial disease was 7.6% (6.7-8.4, (males 10.2% (9.2-11.2, females 5.3% (4.6-6.0; p Multivariate analysis showed the following risk factors: male sex [odds ratio (OR 1.62; 95% confidence interval 1.01-2.59]; age OR 2.00 per 10 years (1.64-2.44; inability to perform physical activity [OR 1.77 (1.17-2.68 for mild limitation to OR 7.08 (2.61-19.16 for breathless performing any activity]; smoking [OR 2.19 (1.34-3.58 for former smokers and OR 3.83 (2.23-6.58 for current smokers]; hypertension OR 1.85 (1.29-2.65; diabetes OR 2.01 (1.42-2.83; previous cardiovascular disease OR 2.19 (1.52-3.15; hypercholesterolemia OR 1.55 (1.11-2.18; hypertriglyceridemia OR 1.55 (1.10-2.19. Body mass index ≥25 Kg/m2 OR 0.57 (0.38-0.87 and walking >7 hours/week OR 0.67 (0.49-0.94 were found as protector factors. Conclusions The prevalence of peripheral arterial disease is low, higher in males and increases with age in both sexes. In addition to previously described risk factors we found a protector effect in physical exercise and overweight.

  12. Frequency of coronary artery disease (cad) risk factors in armed forces

    International Nuclear Information System (INIS)

    To determine the frequency of risk factors of coronary artery disease (CAD) in apparently healthy soldiers of Pakistan Armed Forces. Study Design: Cross sectional descriptive study. Place and Duration of Study: Department of medicine, CMH Okara from July 2012 to Dec 2012. Patients and Methods: The study included 2215 male currently serving soldiers in age range of 18 to 52 years by consecutive sampling. Relevant history, body mass index (BMI), waist circumference (WC) and blood pressure (BP) of each subject were recorded. BMI > 25 kg/m/sup 2/ and WC > 90 cm was considered obesity and abdominal obesity respectively. BP > 140/90 mmHg was defined as hypertension. All the participants of study underwent blood glucose fasting, blood glucose random, ECG recording, personality assessment and lipid profile. Risk estimation was done using Eric Brittain scoring system. Results: In our study group 95.5% patients were having at least 1 risk factor of CAD, 54 % were having 2 to 4 risk factors while 3.93% had > 4 risk factors. Risk estimation of CAD using Eric Brittain scoring system showed that a large proportion of study group had high probability of developing ischemic heart disease in next 6 years. Conclusion: A large proportion of our soldiers are harboring risk of CAD due to increase in frequency of 8 conventional CAD risk factors especially obesity. (author)

  13. [Impact of lipid metabolism parameters on the development and progression of coronary artery disease : An update].

    Science.gov (United States)

    Sinning, D; Leistner, D M; Landmesser, U

    2016-06-01

    Disorders of lipid metabolism play a major role in the development and progression of coronary artery disease. Dyslipidemia therefore plays a central role in therapeutic approaches for prevention and treatment of cardiovascular events associated with coronary artery disease. Epidemiological studies have shown an association between various lipid metabolism parameters, the risk of developing coronary artery disease and progression of a pre-existing disease. In particular, increased levels of low-density lipoprotein cholesterol (LDL-C), reduced levels of HDL cholesterol (HDL-C), as well as high levels of triglycerides and increased lipoprotein(a) [Lp(a)] levels can be taken into account when assessing the risk stratification of patients for primary prevention of coronary artery disease. Lifestyle and dietary changes, intensified statin therapy and possibly the addition of ezetimibe remain the major interventions in both primary and secondary prevention of coronary artery disease, as they improve the prognosis particularly by lowering levels of LDL-C. Recently, genetic studies have contributed to extending our understanding of the relationship between lipid metabolism and coronary artery disease. A causal role for progression of coronary artery disease could be demonstrated for LDL-C, Lpa and triglyceride-rich lipoproteins (TRL), which could not be demonstrated for HDL-C in various studies. Furthermore, the effect of reduction of LDL-C by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition and by the cholesteryl ester transfer protein (CETP) inhibitor anacetrapib on cardiovascular events is currently being investigated in large clinical outcome study programs.

  14. [Analysis of changes in characteristics of arterial hypertension occupational risk in workers of nonferrous metallurgy].

    Science.gov (United States)

    Vlasova, E M; Shliapnikov, D M; Lebedeva, T M

    2015-01-01

    The article covers changes in occupational cardiovascular risk for workers of nonferrous,metallurgy. Findings are that exposure to noise up to 94 dB with length of service increases possible atherosclerosis and metabolic syndrome. With 5 years of service, risk of the predicted conditions increases by 40.5%. When occupational exposure lasts over 5 years, risk of arterial hypertension increases. A group of workers without exposure to occupational factors appeared to have no connection between length of service and metabolic syndrome and arterial hypertension. Risk evolution modelling proved that risk of functional disorders in nonferrous metallurgy workers becomes unacceptable after 5 years of service (cardiovascular disorders are critical).

  15. Serum uric acid is a risk factor for large-artery atherosclerosis cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Jianjun Guo; Qingyu Shen; Jie Li; Xiaoming Rong; Ying Peng; Yamei Tang

    2011-01-01

    Using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification for acute ischemic stroke, 371 patients with either acute large-artery atherosclerosis or small-artery occlusion cerebral infarction were recruited to investigate the potential impact of elevated serum uric acid on cerebrovascular disorders. The results showed that patients who have suffered from large-artery atherosclerosis, relative to small-artery occlusion patients, were characterized by elevated serum uric acid but reduced high-density lipoprotein cholesterol and triglyceride levels. Logistic regression showed that elevated uric acid and lower triglyceride levels were the main risk factors for patients with large-artery atherosclerosis. The findings of this study suggest that hyperuricemia may be a risk factor for stroke.

  16. High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; ten Kate, Min Ki; Waanders, Femke; Veeger, Nic J. G. M.; Brouwer, Jan-Leendert P.; Vogt, Liffert; Navis, Gerjan; van der Meer, Jan

    2008-01-01

    Background-No data are available on the absolute risk of either venous thromboembolism (VTE) or arterial thromboembolism (ATE) in patients with nephrotic syndrome. Reported risks are based on multiple case reports and small studies with mostly short-term follow-up. We assessed the absolute risk of V

  17. Correlation between the FINish diabetes risk score and the severity of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Đurić Predrag

    2014-01-01

    Full Text Available Background/Aim. The FINish Diabetes RIsk SCore (FINDRISC which includes age, body mass index (BMI, waist circumference, physical (in activity, diet, arterial hypertension, history of high glucose levels, and family history of diabetes, is of a great significance in identifying patients with impaired glucose tolerance and a 10-year risk assessment of developing type 2 diabetes in adults. Due to the fact that the FINDRISC score includes parameters which are risk factors for coronary artery disease (CAD, our aim was to determine a correlation between this score, and some of its parameters respectively, with the severity of angiographically verified CAD in patients with stable angina in two ways: according to the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX score and the number of diseased coronary arteries. Methods. The study included 70 patients with stable angina consecutively admitted to the Clinic of Cardiology, Military Medical Academy, Belgrade. The FINDRISC score was calculated in all the patients immediately prior to angiography. Venous blood samples were collected and inflammatory markers [erythrocyte sedimentation rate (ESR, leucocytes, C-reactive protein (CRP, total cholesterol, HDL cholesterol, triglycerides and fasting glucose] determined. Coronary angiography was performed in order to determine the severity of coronary artery disease according to the SYNTAX score and the number of affected coronary vessels: 1-vessel, 2-vessel or 3-vessel disease (hemodynamically significant stenoses: more than 70% of the blood vessel lumen. The patients were divided into three groups regarding the FINDRISC score: group I: 5-11 points; group II: 12-16 points; group III: 17-22 points. Results. Out of 70 patients (52 men and 18 women enrolled in this study, 14 had normal coronary angiogram. There was a statistically significant positive correlation between the FINDRISC score and its parameters respectively

  18. Pre-clinical atherosclerosis evaluated by carotid artery intima-media thickness and the risk factors in children

    Institute of Scientific and Technical Information of China (English)

    YANG Xiao-zheng; LIU Ying; MI Jie; TANG Chao-shu; DU Jun-bao

    2007-01-01

    Background Atherosclerosis as a cardiovascular disease was found to begin even in the fetal period. However,information about risk factors of pre-clinical atherosclerosis in childhood has been limited. Hence, this study was aimed to find out the risk factors of atherosclerosis by measuring the carotid artery intima-media thickness in children. High resolution B-mode ultrasound used to examine the carotid artery intima-media thickness was demonstrated to be useful in finding the early carotid structural changes.Methods The study included 79 children who were divided into two groups according to their ages: group Ⅰ consisted of 42 children with ages from 5 to 9 years and group Ⅱ consisted of 37 children with ages from 10 to 18 years, Among them,23 had a positive family history for risk, such as hypertension, obesity or dyslipidemia. Blood samples were collected and total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein were assayed. The carotid artery intima-media thickness was measured by ultrasound. Comparisons were done between the two groups using Student's t tests and Chi-square analysis. Body mass index, blood pressure, levels of lipids, family history and the carotid artery intima-media thickness were calculated by conditional logistic regression analysis.Results Compared with the children without a positive family history, the incidence of the increased carotid artery intima-media thickness was significantly high (x2=4.364, P<0.05). There were no statistically significant differences between left and right carotid arteries in carotid artery intima-media thickness (P>0.05). In this study, diastolic blood pressure and the atherosclerosis index were suggested to be the risk factors to the thickened carotid artery intima-media thickness. In group I the diastolic blood pressure's odds radio was 1.187 (P=0.035) and the atherosclerosis index odds radio was 37.165 (P=0.001); in group Ⅱ the diastolic blood pressure's odds

  19. Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors

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    Xi Yang

    2015-04-01

    Full Text Available OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiography. RESULTS: The incidence of coronary atherosclerosis was higher in the high-risk group than in the no-risk group. The involved branches of the coronary artery, the diffusivity of the lesion, the degree of stenosis, and the nature of the plaques were significantly more severe in the high-risk group compared with the no-risk group (all p < 0.05. CONCLUSION: Among stable individuals with high-risk factors, early coronary artery lesions are common and severe. Computed tomography has promising value for the early screening of coronary lesions.

  20. Prevalence Pattern of Risk Factors for Coronary Artery Disease among Patients Presenting for Coronary Artery Bypass Grafting in Oman

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    Rajeeva Rivikath Pieris

    2014-05-01

    Full Text Available Objectives: To identify the pattern of prevalence of risk factors in patients presenting for coronary artery bypass grafting at a single center in Oman. Methods: All patients who had coronary artery bypass grafting between March 2008 to March 2010 were included and data were obtained from history and laboratory investigations. The prevalence rates of eight conventional risk factors are presented as a retrospective single center observational study. Results: Out of 146 total patients, 107 (73.29% were male. The age ranged from 31 to 87 years old. The mean age was 58.18 ± 10.08 years (males = 56.81 ± 10.42, females = 61.95 ± 7.97. Hypertension was present in 119 patients (81.51%, 115 patients (78.77% had dyslipidemia, 107 patients (73.29% were male, 79 patients (54.11% had diabetes mellitus, 70 patients (47.95% were over the age of 60 years, 41 patients (28.08% gave a history of smoking, 31 patients (21.23% were obese, and 19 patients (13.01% gave a positive family history. Conclusions: The most common risk factor was hypertension, followed by dyslipidemia, male gender, diabetes mellitus, old age, smoking, obesity and positive family history; 87.7% had three or more risk factors. The females in this study were older than the males and had more risk factors at presentation. The most common combination of factors seen together was diabetes, hypertension, dyslipidemia and male gender.

  1. Coronary artery calcification and ECG pattern of left ventricular hypertrophy or strain identify different healthy individuals at risk

    DEFF Research Database (Denmark)

    Diederichsen, Søren Zöga; Gerke, Oke; Olsen, Michael Hecht;

    2013-01-01

    PURPOSE:: To improve risk stratification for development of ischaemic heart disease, several markers have been proposed. Both the presence of coronary artery calcification (CAC) and ECG pattern of left ventricular hypertrophy/strain have been shown to provide independent prognostic information....... In this study, we investigated the association between established risk factors, ECG measurements and the presence of coronary artery calcification. METHOD:: A random sample of healthy men and women aged 50 or 60 years were invited to the screening study. Established risk factors were measured. A noncontrast...... computed tomographic (CT) scan was performed to assess the CAC score. ECG analysis included left ventricular hypertrophy (LVH) using the Sokolow-Lyon criteria and the Cornell voltage × QRS duration product, and strain pattern based on ST segment depression and T-wave abnormalities. The association between...

  2. Weak Prediction Power of the Framingham Risk Score for Coronary Artery Disease in Nonagenarians

    OpenAIRE

    Josef Yayan

    2014-01-01

    Background Coronary artery disease (CAD) is caused by an acute myocardial infarction and is still feared as a life-threatening heart disease worldwide. In order to identify patients at high risk for CAD, previous studies have proposed various risk assessment scores for the prevention of CAD. The most commonly used risk assessment score for CAD worldwide is the Framingham Risk Score (FRS). The FRS is used for middle-aged people; hence, its appropriateness has not been demonstrated to predict t...

  3. Nonobstructive Coronary Artery Disease and Risk of Myocardial Infarction

    Science.gov (United States)

    Maddox, Thomas M.; Stanislawski, Maggie A.; Grunwald, Gary K.; Bradley, Steven M.; Ho, P. Michael; Tsai, Thomas T.; Patel, Manesh R.; Sandhu, Amneet; Valle, Javier; Magid, David J.; Leon, Benjamin; Bhatt, Deepak L.; Fihn, Stephan D.; Rumsfeld, John S.

    2016-01-01

    IMPORTANCE Little is known about cardiac adverse events among patients with nonobstructive coronary artery disease (CAD). OBJECTIVE To compare myocardial infarction (MI) and mortality rates between patients with nonobstructive CAD, obstructive CAD, and no apparent CAD in a national cohort. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of all US veterans undergoing elective coronary angiography for CAD between October 2007 and September 2012 in the Veterans Affairs health care system. Patients with prior CAD events were excluded. EXPOSURES Angiographic CAD extent, defined by degree (no apparent CAD: no stenosis >20%; nonobstructive CAD: ≥1 stenosis ≥20% but no stenosis ≥70%; obstructive CAD: any stenosis ≥70% or left main [LM] stenosis ≥50%) and distribution (1,2, or 3 vessel). MAIN OUTCOMES AND MEASURES The primary outcome was 1-year hospitalization for nonfatal MI after the index angiography. Secondary outcomes included 1-year all-cause mortality and combined 1-year MI and mortality. RESULTS Among37 674 patients, 8384 patients (22.3%) had nonobstructive CAD and 20 899 patients (55.4%) had obstructive CAD. Within 1 year, 845 patients died and 385 were rehospitalized for MI. Among patients with no apparent CAD, the 1-year MI rate was 0.11% (n = 8, 95% CI, 0.10%–0.20%) and increased progressively by 1-vessel nonobstructive CAD, 0.24% (n = 10, 95% CI, 0.10%–0.40%); 2-vessel nonobstructive CAD, 0.56% (n = 13, 95% CI, 0.30%–1.00%); 3-vessel nonobstructive CAD, 0.59% (n = 6, 95% CI, 0.30%–1.30%); 1-vessel obstructive CAD, 1.18% (n = 101, 95% CI, 1.00%–1.40%); 2-vessel obstructive CAD, 2.18% (n = 110, 95% CI, 1.80%–2.60%); and 3-vessel or LM obstructive CAD, 2.47% (n = 137, 95% CI, 2.10%–2.90%). After adjustment, 1-year MI rates increased with increasing CAD extent. Relative to patients with no apparent CAD, patients with 1-vessel nonobstructive CAD had a hazard ratio (HR) for 1-year MI of 2.0 (95% CI, 0.8–5.1); 2-vessel

  4. A Novel Risk Score to the Prediction of 10-year Risk for Coronary Artery Disease Among the Elderly in Beijing Based on Competing Risk Model.

    Science.gov (United States)

    Liu, Long; Tang, Zhe; Li, Xia; Luo, Yanxia; Guo, Jin; Li, Haibin; Liu, Xiangtong; Tao, Lixin; Yan, Aoshuang; Guo, Xiuhua

    2016-03-01

    The study aimed to construct a risk prediction model for coronary artery disease (CAD) based on competing risk model among the elderly in Beijing and develop a user-friendly CAD risk score tool. We used competing risk model to evaluate the risk of developing a first CAD event. On the basis of the risk factors that were included in the competing risk model, we constructed the CAD risk prediction model with Cox proportional hazard model. Time-dependent receiver operating characteristic (ROC) curve and time-dependent area under the ROC curve (AUC) were used to evaluate the discrimination ability of the both methods. Calibration plots were applied to assess the calibration ability and adjusted for the competing risk of non-CAD death. Net reclassification index (NRI) and integrated discrimination improvement (IDI) were applied to quantify the improvement contributed by the new risk factors. Internal validation of predictive accuracy was performed using 1000 times of bootstrap re-sampling. Of the 1775 participants without CAD at baseline, 473 incident cases of CAD were documented for a 20-year follow-up. Time-dependent AUCs for men and women at t = 10 years were 0.841 [95% confidence interval (95% CI): 0.806-0.877], 0.804 (95% CI: 0.768-0.839) in Fine and Gray model, 0.784 (95% CI: 0.738-0.830), 0.733 (95% CI: 0.692-0.775) in Cox proportional hazard model. The competing risk model was significantly superior to Cox proportional hazard model on discrimination and calibration. The cut-off values of the risk score that marked the difference between low-risk and high-risk patients were 34 points for men and 30 points for women, which have good sensitivity and specificity. A sex-specific multivariable risk factor algorithm-based competing risk model has been developed on the basis of an elderly Chinese cohort, which could be applied to predict an individual's risk and provide a useful guide to identify the groups at a high risk for CAD among the Chinese adults over 55

  5. Association of carotid artery intima-media thickness and cardiovascular risk factors in adult

    International Nuclear Information System (INIS)

    Increased intima-media thickness (IMT) of the common carotid artery is an early marker of atherosclerosis and a powerful predictor of coronary and cerebrovascular diseases. The purpose of this study was to evaluate the correlation between carotid artery IMT and cardiovascular risk factors. Total 134 adult were performed with Ultrasonography to measure IMT at common carotid artery, the physical measurements and blood tests, the following results were obtained. As a result, IMT showed higher value in male IMT than female IMT. And, the IMT increased according to the age increased. Also, TC and AI have positive significant correlation with IMT. In Conclusion, cardiovascular risk factors with adult are associated with increased IMT of common carotid artery

  6. Association of carotid artery intima-media thickness and cardiovascular risk factors in adult

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young [Dept. of Diagnostic Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Kim, Hwa Sun [Dept. of Radiological Technology, Ansan University, Ansan (Korea, Republic of); Kim, Shin Young [Dept. of Anatomy and Cell Biology, School of Medicine, Hanyang University, Seoul (Korea, Republic of)

    2013-03-15

    Increased intima-media thickness (IMT) of the common carotid artery is an early marker of atherosclerosis and a powerful predictor of coronary and cerebrovascular diseases. The purpose of this study was to evaluate the correlation between carotid artery IMT and cardiovascular risk factors. Total 134 adult were performed with Ultrasonography to measure IMT at common carotid artery, the physical measurements and blood tests, the following results were obtained. As a result, IMT showed higher value in male IMT than female IMT. And, the IMT increased according to the age increased. Also, TC and AI have positive significant correlation with IMT. In Conclusion, cardiovascular risk factors with adult are associated with increased IMT of common carotid artery.

  7. Common genetic loci influencing plasma homocysteine concentrations and their effect on risk of coronary artery disease

    Science.gov (United States)

    The strong observational association between total homocysteine (tHcy) concentrations and risk of coronary artery disease (CAD) and the null associations in the homocysteine-lowering trials have prompted the need to identify genetic variants associated with homocysteine concentrations and risk of CA...

  8. Risk of stroke after coronary artery bypass grafting: effect of age and comorbidities

    DEFF Research Database (Denmark)

    Mérie, Charlotte; Køber, Lars; Olsen, Peter Skov;

    2012-01-01

    The risk of stroke after coronary artery bypass grafting (CABG) is known to increase dramatically with age. During recent years, the age of patients operated on has increased and concomitant therapy has changed. Therefore, we have re-evaluated the risk of stroke after CABG....

  9. Alcohol consumption and risk of peripheral arterial disease : the Rotterdam Study

    NARCIS (Netherlands)

    Vliegenthart, R.; Geleijnse, J.M.; Hofman, A.; Meijer, W.T.; Rooij, van F.J.A.; Grobbee, D.E.; Witteman, J.C.M.

    2002-01-01

    Moderate alcohol consumption is associated with a reduced risk of cardiovascular disease. Data on alcohol consumption and atherosclerosis are scarce. To determine the association between alcohol consumption and risk of peripheral arterial disease, the authors carried out a cross-sectional study (199

  10. Alcohol consumption and risk of peripheral arterial disease - The Rotterdam Study

    NARCIS (Netherlands)

    Vliegenthart, R; Geleijnse, JM; Hofman, A; Meijer, WT; van Rooij, FJA; Grobbee, DE; Witteman, JCM

    2002-01-01

    Moderate alcohol consumption is associated with a reduced risk of cardiovascular disease. Data on alcohol consumption and atherosclerosis are scarce. To determine the association between alcohol consumption and risk of peripheral arterial disease, the authors carried out a cross-sectional study (199

  11. Prognostic Significance of Subclinical Atherosclerosis of Arteries for Cardiovascular Risk Identification in Patients with Autoimmune Thyroiditis

    Directory of Open Access Journals (Sweden)

    Kazakova Т.А.

    2012-09-01

    Full Text Available The aim of the investigation is to study the state of arteries of elastic and muscular type in patients with autoimmune thyroiditis and subclinical hypothyroidism to reveal potential factors of cardiovascular risk. Materials and Methods. There have been studied three groups of patients, each group consisting of 29 females: 1st — control group, with no abnormalities, 2nd — with autoimmune thyroiditis and euthyroid status, 3rd — with autoimmune thyroiditis and subclinical hypothyroidism. There have been estimated hormonal status (ТТГ, Т4, Т3, antibody level to thyroglobulin and thyroid peroxydase, endothelial function and arterial stiffness. Results. In subclinical hypothyroidism there is significant decrease of endothelial function of brachial artery, with normal indices of non-endothelium dependent vasodilation; arterial wall stiffness and endothelial dysfunction increase, that is determined by a number of factors including the levels of T3, T4, thyrotropic hormone, lipid profile, and arterial pressure. The level of systemic arterial pressure can be of great concern in the increase of arterial stiffness if there are no marked changes of lipid spectrum. The obtained data indicate the negative effect of even minimal thyroid function on vessel condition that can contribute to the increase of cardiovascular risk along with lipid spectrum disorders in this group of patients.

  12. Experience of cardiac rehabilitation after coronary artery surgery: effects on health and risk factors

    OpenAIRE

    Lindsay, G.; Hanlon, W.P; Smith, L.N.; Belcher, P.R.

    2003-01-01

    Objective:Cardiac rehabilitation (CR) programs are provided to support the recovery process following acute myocardial infarction and coronary artery bypass grafting (CABG). Attendance varies. We related attendance following CABG to severity of cardiac symptoms, general health status (Short Form-36) and prevalence of modifiable coronary artery disease (CAD) risk factors. METHODS: 209 patients due to undergo CABG were recruited and assessed preoperatively as well as at a mean of 16.4 months po...

  13. Rural Development as Risk Management

    OpenAIRE

    Philip Kostov; John Lingard

    2004-01-01

    This paper proposes a new concept of rural development in an uncertain world. The nature of risk and uncertainty is discussed and risk management is defined as a positive model of economic and social behaviour. Some relevant paradigms for rural development are briefly reviewed and evaluated within the general approach of risk management. It is demonstrated that the suggested view of risk management can effectively combine and reconcile different approaches outlining their advantages and short...

  14. Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data

    OpenAIRE

    Kivimäki, Mika; Nyberg, Solja; Fransson, Eleonor; Heikkilä, Katriina; Alfredsson, Lars; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Ferrie, Jane; Goldberg, Marcel; Hamer, Mark; Jokela, Markus; Karasek, Robert; Kittel, France

    2013-01-01

    International audience; It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease. We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985-2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk facto...

  15. Relative risk of hypertension and coronary artery disease in diabetes mellitus

    International Nuclear Information System (INIS)

    During the year 1996-1997, 3275 diabetic patients, registered in Diabetic Clinic of Jinnah Hospital, Lahore, were studied to note the effect of various variables of diabetes mellitus (DM) on hypertension (HTN) and coronary artery diseases (CAD). Out of these 1402 (42.8%) were hypertensive patients. HTN was observed more frequently in obese, older age, longer duration of DM, poor glycemic control and dyslipidemia with p<0.0001. The relative risk (RR) of HTN was significantly increased (p<0.001) in obese (M2.53, F7.77 times), older age (M 3.69,F 9.64 times), longer duration of Dm (2.3 times for both sexes), poor glycemic control (M 2.89, F 4.75 times) and dyslipedemia (M 1.62-5.27, F2.56-9.53 times). While the RR of CAD due to HTN was 4.6 times (M5.4, F4.2 times) (p<0.0001) as compared to normotensive diabetic patients. The risk of developing HTN is more in female diabetics and of CAD in male hypertensive diabetic patients. It is concluded that obesity, older age, poor glycemic control, longer duration of DM and dyslipidemia increases the risk of HTN 2-9.5 times and HTN increases the risk of CAD by 4-5 times, hence requiring aggressive and comprehensive treatment of the diabetes mellitus syndrome. (author)

  16. Inflammation and Arterial Hypertension: From Pathophysiological Links to Risk Prediction.

    Science.gov (United States)

    Pietri, Panagiota; Vlachopoulos, Charalambos; Tousoulis, Dimitris

    2015-01-01

    Over the last years, ample data have demonstrated the pivotal role of low-grade inflammation in the pathophysiology of atherosclerosis and cardiovascular disease. It is well established that inflammatory activation, serving either as a substrate, in the chronic phase of atherosclerotic disease, or as a trigger, in the acute phase, increases cardiovascular events. Considering hypertension, the inflammatory process is implicated in its pathophysiology through a bidirectional relationship since arterial hypertension may enhance inflammation and vice versa. Inflammatory biomarkers such as high-sensitivity C-reactive protein, have shown predictive value for both the incidence of hypertension and the clinical outcomes in hypertensive patients. In the present review, data on the association between arterial hypertension and low-grade inflammation will be reported and potential pathophysiological pathways and clinical implications underlying this association will be discussed.

  17. Cocoa intake and arterial stiffness in subjects with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Recio-Rodríguez José

    2012-02-01

    Full Text Available Abstract Background To analyze the relationship of cocoa intake to central and peripheral blood pressure, arterial stiffness, and carotid intima-media thickness in subjects with some cardiovascular risk factor. Findings Design: A cross-sectional study of 351 subjects (mean age 54.76 years, 62.4% males. Measurements: Intake of cocoa and other foods using a food frequency questionnaire, central and peripheral (ambulatory and office blood pressure, central and peripheral augmentation index, pulse wave velocity, ambulatory arterial stiffness index, carotid intima-media thickness, and ankle-brachial index. Results: Higher pulse wave velocity and greater cardiovascular risk were found in non-cocoa consumers as compared to high consumers (p Conclusions In subjects with some cardiovascular risk factors, cocoa consumption does not imply improvement in the arterial stiffness values. Trial Registration Clinical Trials.gov Identifier: NCT01325064.

  18. Developments in the percutaneous treatment of obstructive coronary artery disease

    OpenAIRE

    Agostoni, P.

    2009-01-01

    Percutaneous coronary interventions are recognized techniques to treat coronary artery disease. However, despite the progress in the development of materials and techniques, several limitations affect the acute and long-term performance of these procedures. In particular, there are three mayor drawbacks: restenosis, thrombosis and technical feasibility of the procedure. The recent introduction of drug-eluting stents has been a major step forward in reducing restenosis. The pivotal randomized ...

  19. Clinical Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Surgery in High Surgical Risk Patients With Left Main or Three-Vessel Coronary Artery Disease

    OpenAIRE

    Tonga Nfor; Kambiz Shetabi; Wael Hassan; Quinta Nfor; Jayant Khitha; Anjan Gupta; Tanvir Bajwa; Suhail Allaqaband

    2015-01-01

    Purpose: Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass graft surgery (CABG) in patients with unprotected left main or three-vessel coronary artery disease (LM-3VD) have excluded patients at high surgical risk. We compared clinical outcomes after PCI with drug-eluting stents to CABG in high surgical risk patients with LM-3VD. Methods: Patients with symptomatic LM-3VD who had Society of Thoracic Surgeons (STS)-predicted operative mortality >...

  20. Periodontitis as a Risk Factor in Non-Diabetic Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Vida Nesar Hoseini

    2010-11-01

    Full Text Available Coronary Artery Disease (CAD is responsible for much mortality across the w orld, especially in our country .The conventional risk factors for atherosclerosis are well understood, but they can account for only about 50 to 70% of atherosclerotic events in the general population. The aim of this study was to investigate relationships between prevalent Coronary Artery Disease (CAD and clinical periodontal disease in patients with angiographic ally proven coronary artery disease. 152 consecutive patients w ith angiographically proven coronary artery disease will be included in this study, who received a complete periodontal examination during visit. Patients with normal coronary, average plaque index (1.6±1.02 Index of bleeding (1.51±0.92, mean adhesion level (3.57±1.18. But patients with coronary artery disease, the mean plaque index (2.46±0.62 Index of bleeding (1.86±0.92, mean adhesion level (4.13±1.45. These differences are statistically significant. (p<0.05 In this study, average depth of probe entrance on the surface of teeth has had little relation w ith cardiovascular disease (p = 0.051. According to the results of this study, in peoples over 40 years, who had coronary artery disease proved by coronary angiography, gingival inflammation (periodentitis has a significant relation as a risk factor.

  1. Targeted deletion of the 9p21 noncoding coronary artery disease risk interval in mice

    Energy Technology Data Exchange (ETDEWEB)

    Visel, Axel; Zhu, Yiwen; May, Dalit; Afzal, Veena; Gong, Elaine; Attanasio, Catia; Blow, Matthew J.; Cohen, Jonathan C.; Rubin, Edward M.; Pennacchio, Len A.

    2010-01-01

    Sequence polymorphisms in a 58kb interval on chromosome 9p21 confer a markedly increased risk for coronary artery disease (CAD), the leading cause of death worldwide 1,2. The variants have a substantial impact on the epidemiology of CAD and other life?threatening vascular conditions since nearly a quarter of Caucasians are homozygous for risk alleles. However, the risk interval is devoid of protein?coding genes and the mechanism linking the region to CAD risk has remained enigmatic. Here we show that deletion of the orthologous 70kb noncoding interval on mouse chromosome 4 affects cardiac expression of neighboring genes, as well as proliferation properties of vascular cells. Chr4delta70kb/delta70kb mice are viable, but show increased mortality both during development and as adults. Cardiac expression of two genes near the noncoding interval, Cdkn2a and Cdkn2b, is severely reduced in chr4delta70kb/delta70kb mice, indicating that distant-acting gene regulatory functions are located in the noncoding CAD risk interval. Allelespecific expression of Cdkn2b transcripts in heterozygous mice revealed that the deletion affects expression through a cis-acting mechanism. Primary cultures of chr4delta70kb/delta70kb aortic smooth muscle cells exhibited excessive proliferation and diminished senescence, a cellular phenotype consistent with accelerated CAD pathogenesis. Taken together, our results provide direct evidence that the CAD risk interval plays a pivotal role in regulation of cardiac Cdkn2a/b expression and suggest that this region affects CAD progression by altering the dynamics of vascular cell proliferation.

  2. The risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect?

    LENUS (Irish Health Repository)

    Al-Sarraf, Nael

    2010-11-01

    Smoking is reported to increase the risk of arrhythmias. However, there are limited data on its effects on arrhythmias following coronary artery bypass graft (CABG). This is a retrospective review of a prospective database of all CABG patients over an eight-year period. Our cohort (n=2813) was subdivided into: current (n=1169), former (n=837), and non-smokers (n=807). Predictors of arrhythmias following CABG in relation to smoking status were analysed. Atrial arrhythmias occurred in 942 patients (33%). Ventricular arrhythmias occurred in 48 patients (2%) and high-grade atrioventricular block occurred in five patients (0.2%). Arrhythmias were lower in current smokers than former and non-smokers (29% vs. 40% vs. 39%, respectively P<0.001). Logistic regression analysis showed 30% arrhythmia risk reduction in smokers compared to non-smokers [odds ratio (OR) 0.7, 95% confidence intervals (CI) 0.5-0.8] and this effect persisted after accounting for potential confounders while former smokers had the same risk as non-smokers (OR 1.04, CI 0.9-1.3). There were no significant differences in mortality. Smokers are less prone to develop arrhythmias following CABG. This paradox effect is lost in former smokers. This effect is possibly due to a lower state of hyper adrenergic stimulation observed in smokers than non-smokers following the stress of surgery.

  3. Inhibition of the renin-angiotensin system for lowering coronary artery disease risk.

    Science.gov (United States)

    Sheppard, Richard J; Schiffrin, Ernesto L

    2013-04-01

    The renin-angiotensin system when activated exerts proliferative and pro-inflammatory actions and thereby contributes to progression of atherosclerosis, including that occurring in the coronary arteries. It thus contributes as well to coronary artery disease (CAD). Several clinical trials have examined effects of renin-angiotensin system inhibition for primary and secondary prevention of coronary heart disease. These include important trials such as HOPE, EUROPA and PEACE using angiotensin converting enzyme inhibitors, VALIANT, OPTIMAAL and TRANSCEND using angiotensin receptor blockers, and the ongoing TOPCAT study in patients with preserved ejection fraction heart failure, many of who also have coronary artery disease. Data are unavailable as yet of effects of either direct renin inhibitors or the new angiotensin receptor/neprilysin inhibitor agents. Today, inhibition of the renin-angiotensin system is standard-of-care therapy for lowering cardiovascular risk in secondary prevention in high cardiovascular risk subjects. PMID:23523606

  4. Common genetic loci influencing plasma homocysteine concentrations and their effect on risk of coronary artery disease

    NARCIS (Netherlands)

    J.B.J. van Meurs (Joyce); G. Paré (Guillaume); S.M. Schwartz (Stephen); A. Hazra (Aditi); T. Tanaka; S.H.H.M. Vermeulen (Sita); I. Cotlarciuc (Ioana); X. Yuan (Xin); A. Mälarstig (Anders); S. Bandinelli (Stefania); J.C. Bis (Joshua); H.J. Blom (Henk); M.J. Brown (Morris); C. Chen (Christopher); R. Clarke (Robert); A. Dehghan (Abbas); J. Erdmann (Jeanette); L. Ferrucci; A. Hamsten (Anders); A. Hofman (Albert); D. Hunter (David); A. Goel (Anuj); A.D. Johnson (Andrew); S. Kathiresan (Sekar); E. Kampman (Ellen); D.P. Kiel (Douglas); L.A.L.M. Kiemeney (Bart); J.C. Chambers (John); P. Kraft (Peter); J. Lindemans (Jan); B. McKnight (Barbara); C.P. Nelson (Christopher P.); C.J. O'Donnell (Christopher); B.M. Psaty (Bruce); P.M. Ridker (Paul); F. Rivadeneira Ramirez (Fernando); L.M. Rose (Lynda); U. Seedorf (Udo); D.S. Siscovick (David); H. Schunkert (Heribert); J. Selhub (Jacob); P.M. Ueland (Per); P. Vollenweider (Peter); G. Waeber (Gérard); D. Waterworth (Dawn); H. Watkins (Hugh); J.C.M. Witteman (Jacqueline); M. den Heijer (Martin); P.F. Jacques (Paul); A.G. Uitterlinden (André); J.S. Kooner (Jaspal); D.J. Rader (Daniel); M.P. Reilly (Muredach); V. Mooser (Vincent); D.I. Chasman (Daniel); N.J. Samani (Nilesh); K.R. Ahmadi (Kourosh)

    2013-01-01

    textabstractBackground: The strong observational association between total homocysteine (tHcy) concentrations and risk of coronary artery disease (CAD) and the null associations in the homocysteinelowering trials have prompted the need to identify genetic variants associated with homocysteine concen

  5. Increased risk of venous thromboembolism and arterial cardiovascular events in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Kristensen, Søren Lund; Ahlehoff, Ole; Lindhardsen, Jesper;

    2012-01-01

    This focused review describes the current knowledge of the association between inflammatory bowel disease (IBD) and cardiovascular disease. Atherosclerosis is a chronic inflammatory disease, and as well as venous thromboembolism this disease shares inflammatory mechanisms with IBD. Patients...... with IBD have a high risk of venous thromboembolism especially during IBD flare-ups. Their risk of arterial cardiovascular disease may also be increased. The risk of cardiovascular disease in patients with IBD warrants clinical attention, and it is possible that the risk can be modified by applying anti...

  6. Working at Night in Hospital Environment is a Risk Factor for Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Sinem Özbay

    2012-09-01

    Full Text Available Aim: Arterial stiffness is an independent risk factor for cardiovascular disease. In previous studies, emotional stress has been reported to be a risk factor for cardiovascular disease. In this study, we aimed to investigate the effects of anxiety, stress and fatigue associated with working at night in hospital environment on arterial stiffness in physicians. Methods: The study was carried out with 30 physicians employed in Medical Faculty of Uludağ University between October 2011 and March 2012. Measurements were made using Pulse Wave Sensor HDI system (Hypertension Diagnostics Inc, Eagan, MN(Set No: CR000344 by radial artery pulse wave at the onset and end of night shift. Results: The mean age of night doctors included in the study was 26 years (range: 22-38 and the female/male ratio was 2/1. It was determined that mean values of arterial stiffness were significantly higher after night shift (1330±360 dyne/sn/cm-5 compared to mean values before night shift (1093±250 dyn/s/cm-5 (p=0.01. In the evaluation of other parameters before and after night shift, no statistically significant difference was detected (p>0.05. Conclusion: The increasing arterial stiffness in hospital employees after night shift could be attributed to the effects of stress and fatigue experienced during night shift. (The Me di cal Bul le tin of Ha se ki 2012; 50: 93-5

  7. Pulmonary stenosis development and reduction of pulmonary arterial hypertension in atrioventricular septal defect: a case report

    Directory of Open Access Journals (Sweden)

    Ninet Gérard

    2009-09-01

    Full Text Available Abstract A 24-year-old patient was admitted for dyspnoea and syncope. He had a previous history of complete atrio-ventricular septal defect and trisomy 21. At the age of 6 months, in 1984, cardiac catheterization revealed a quasi-systemic pulmonary arterial hypertension with a bidirectional shunt corresponding to an Eisenmenger syndrome. Corrective cardiac surgery was not performed at this time because surgical risk was considered too high. Until the age of 20 years old, he showed few symptoms while under medical treatment. But since 2006, his functional status became worse with an increased dyspnoea, syncopes, and severe cyanosis. In these conditions, haemodynamic parameters have been re-evaluated in 2006 and 2008. They highlighted a late and progressive development of a valvular and infundibular pulmonary stenosis leading to a normalisation of pulmonary arterial pressures. At the age of 24 , the patient underwent corrective cardiac surgery which was successful. Late development of both infundibular and valvular pulmonary stenosis have not been described before in non operated congenital ventricular septal defects, but development of one or the other abnormality would be found in 8% of patients. The physiopathological mechanism of this obstruction is unclear. Nevertheless, in unoperated congenital cardiac shunt lesions, reversibility of severe pulmonary arterial hypertension should be reconidered and re-assessed during follow up.

  8. Risk factors for developing diabetic foot

    Directory of Open Access Journals (Sweden)

    Julia Estela Willrich Boell

    2014-06-01

    Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

  9. Contribution of arterial hypertension to vascular risk in diabetic patients

    OpenAIRE

    Marre, M.; Bouhanick, B.; Hadjadj, S.; Weekers, Laurent

    1999-01-01

    Hypertension is a major cardiovascular risk factor in diabetic subjects. Recent trials have suggested that blood pressure objectives should be < or = 140/80 mmHg. However, there is currently no evidence supporting any particular preferential drug strategy for this treatment objective. Peer reviewed

  10. Helicobacter pylori:Does it add to risk of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Vishal; Sharma; Amitesh; Aggarwal

    2015-01-01

    Helicobacter pylori(H. pylori) is a known pathogen implicated in genesis of gastritis, peptic ulcer disease, gastric carcinoma and gastric lymphoma. Beyond the stomach, the organism has also been implicated in the causation of immune thrombocytopenia and iron deficiency anemia. Although an area of active clinical research, the role of this gram negative organism in causation of atherosclerosis and coronary artery disease(CAD) remains enigmatic. CAD is a multifactorial disease which results from the atherosclerosis involving coronaryarteries. The major risk factors include age, diabetes mellitus, smoking, hypertension and dyslipidemia. The risk of coronary artery disease is believed to increase with chronic inflammation. Various organisms like Chlamydia and Helicobacter have been suspected to have a role in genesis of atherosclerosis via causation of chronic inflammation. This paper focuses on available evidence to ascertain if the role of H. pylori in CAD causation has been proven beyond doubt and if eradication may reduce the risk of CAD or improve outcomes in these patients.

  11. Postoperative internal carotid artery restenosis after local anesthesia: presence of risk factors versus intraoperative shunt.

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Hajnic, Hrvoje; Ahel, Zaky

    2010-08-01

    Published data suggest that the regional anesthetic technique used for carotid endarterectomy (CEA) increases the systolic arterial blood pressure and heart rate. At the same time local anesthesia reduced the shunt insertion rate. This study aimed to analyze risk factors and ischemic symptomatology in patients with postoperative internal carotid artery restenosis. The current retrospective study was undertaken to assess the results of CEA in 8000 patients who were operated during a five-year period in six regional cardiovascular centers. Carotid color coded flow imaging, medical history, clinical findings and atherosclerotic risk factors were analyzed. Among them, there were 33 patients (0.4%) with postoperative re-occlusion after CEA. The patients with restenosis were re-examined with carotid color coded flow imaging and data were compared with 33 consecutive patients with satisfactory postoperative findings to serve as a control group. In the restenosis group eight risk factors were analyzed (hypertension, smoking, hyperlipidemia, diabetes mellitus, history of stroke, transitory ischemic attack, heart attack and coronary disease), and compared with risk factors in control group. Study results suggested that early postoperative internal carotid artery restenosis was not caused by atherosclerosis risk factors but by intraoperative shunt usage. PMID:20439301

  12. Hyperhomocystenemia is a Risk Factor For Coronary Artery Disease in Patients of Diabetes Mellitus in India

    Directory of Open Access Journals (Sweden)

    Dr. Ashok Kumar Behera

    2014-12-01

    Full Text Available Background: Prevalence of coronary artery disease (CAD is very high amongst the people of Indian subcontinent. Among the Indians more than 60% of the CAD remains unexplained by conventionally risk factor. Recently a number of new cardiovascular risk factors have been identified & homocysteine is one of them. Various clinical studies have shown that higher homocysteine level is a risk factor for atherosclerotic vascular disease. Studies on the association of hyperhomocysteinemia as a cardiovascular risk factor in Indian patients have shown conflicting results. Hyperhomocysteinemia has been reported both in type-1 and type-2 Diabetes mellitus & has been correlated with macro vascular complication in western population. There is very limited number of studies of hyperhomocysteinemia as a cardiovascular risk factor in Indian Diabetic patients. So we undertook this study. Methods: We studied 80 patients of diabetes mellitus with 20 healthy control subjects. Out of 80 patients, 40 patients of diabetes mellitus with CAD (Group-Cand their homocysteine level compared with 40 patients of diabetes mellitus without CAD (Group-B and 20 controls (Group-A. Results: The mean homocysteine level in Group-A is found to be 10.2±1.4 μmol/L, in Group-B is 12.75±4.2 μmol/L where as in Group-C is 19.4±7.5 μmol/L. The mean homocysteine level was significantly high in patients of diabetes mellitus with coronary artery disease in comparison to patients of diabetes mellitus without coronary artery disease and healthy controls at p<0.01. Conclusion: Increased level of homocysteine is a risk factor for coronary artery disease in patients with of diabetes mellitus.

  13. High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

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    Zaher Fanari

    2014-01-01

    Full Text Available Patients with multivessel coronary artery disease are more likely to have extensive atherosclerosis that involves other major arteries. Critical subclavian artery (SCA stenosis can result in coronary subclavian steal syndrome that may present as recurrent ischemia and even myocardial infarction in patients with coronary artery bypass graft (CABG. In patients with concomitant severe native coronary disease, occluded saphenous venous grafts (SVG to other arteries, percutaneous intervention on critical subclavian artery (SCA stenosis that will compromise the blood flow to left internal mammary graft (LIMA and left anterior descending (LAD artery will be a high-risk procedure and may be associated with cardiogenic shock, especially in patients with preexisting ischemic cardiomyopathy. The use of percutaneous left ventricular (LV assist device like Impella will offer better hemodynamic support and coronary perfusion and therefore results in decreased myocardial damage, maximized residual cardiac function, and lower incidence of cardiogenic shock.

  14. Risk Factors and Clinical Evaluation of Superficial Femoral Artery Stent Fracture: Prote'ge'GPS Stent

    International Nuclear Information System (INIS)

    To evaluate the occurrence of superficial femoral artery stent fractures, the risk factors of stent fracture, and the relationship between fractures and clinical findings. Of the 38 patients who underwent treatment with Prote'ge'GPS stenting due to arterial occlusions on the superficial femoral artery, 17 also underwent a clinical analysis. Forty-three stents were inserted in the 17 superficial femoral arteries, ranging between 15 and 50 cm in length, with a mean treated length of 26.4 cm (15-50 cm). A fracture was evaluated by taking a PA and lateral simple radiography, as well as a follow-up evaluation accompanied with a CT angiography, DSA, and a color Doppler sonography. The examination involved the assessment of the difference between bone fractures due to length, placement, and frequency. Fractures occurred in 13 of 43 stents (30.2%). A total of 10 (71.4%) occurred in the upper third, compared to 4 (28.6%) in the lower third of the superficial femoral artery. In addition, 10 stents (71.4%) had a single strut fracture, whereas 4 (28.6%) had multiple strut fractures. A stent fracture occurred more frequently when the stents and lesions were longer (p=0.021, 0.012) and the stents were inserted near the joint. However, there was no significant relationship between stent numbers and the fractures (p=0.126). When the stents were inserted along the popliteal artery, a stent fracture occurred more frequently in the lower third of the artery. The stent fractures did not significantly influence the patency rate of the stented artery (p=0.44) Prote'ge'GPS stents in the superficial femoral artery revealed a considerable number of fractures and the fracture frequency showed a significant relationship with the length of stents and lesions. The closer stent insertion was to the joints, the more frequently fractures occurred. There were no evident significant relationships between the presence of stent fractures and the patency of the stented arteries

  15. Endovascular embolization of pseudoaneurysm of left colic artery developing after renal biopsy

    OpenAIRE

    Madhusudhan, K. S.; Gamanagatti, S.; Gupta, A K

    2015-01-01

    Vascular complications after percutaneous renal biopsy are uncommon and may require interventional management. In most of these cases, the pathology is a renal arterial pseudoaneurysm (PsA) or an arterio-venous fistula. Injury to other vessels like aorta, lumbar arteries or mesenteric arteries is rare with only one case of left colic artery PsA reported in literature. We report a case of a 60-year-old female, who developed left colic artery PsA after renal biopsy, which was successfully embol...

  16. MODIFIED CLASSIC RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE HAN POPULATION

    Institute of Scientific and Technical Information of China (English)

    Han-bin Cui; Joseph B Muhlestein; Sheng-huang Wang; Dong-qi Wang; Chang-cong Cui; Xin-yi Chen; Xiao-min Chen; Zheng Zhang; Hong-kao Zhang; Feng Bai

    2007-01-01

    To investigate the levels of cardiovascular disease risk factors and their relations to clinical phenotype associated with coronary artery disease (CAD).Methods The subjects were recruited from five independent cardiovascular centers. Coronary angiography was employed to define the CAD with stenosis in each major vessel ≥70% and control with stenosis < 10% in every lesion.The classic risk factors including family history, body mass index, smoking habits, hypertension, diabetes mellitus, and serum lipid levels were surveyed according to established criteria. Associations between risk levels and clinical phenotypes were assessed by case control and correlation analysis.Results A total of 762 individuals were collected, including 481 men and 281 women, aged from 17 to 81 (mean 60 ± 10) years. The patients with CAD accounted for 55.5% of all participants, and controls 44. 5%, respectively. Compared with the pattern in published data, our study showed that mean serum high density lipoprotein cholesterol (HDL-C)level was significantly lower (P <0. 001 ) and triglycerides was significantly higher (P <0. 001 ), while total cholesterol (TC) and low density lipoprotein cholesterol levels were comparative ( both P > 0. 05 ). The prevalence of low HDL-C ( <40 g/L) and hypertriglyceridemia ( > 150 g/L) were 27. 2% and 41.4%, respectively. Mean serum levels of HDL-C and apolipoprotein A1 were significantly higher in female subjects than in male ( P < 0. 001 ). Lower HDL-C functioned as an independent risk factor for CAD only in men (RR = 2. 8, 95% CI: 1.5-4. 2, P < 0. 001 ), yet increased non-HDL cholesterol combined with diabetes mellitus and obesity seemed to play a key role in the development of CAD in women. Similarity in risk association with CAD was found for hypertension and TC/HDL ratio in male and female subjects, while family history had no relationship with the presence of CAD.Conclusion It is remarkable that emphasis of intervention in future

  17. Risk factors associated with pulmonary arterial hypertension in patients with systemic sclerosis and implications for screening

    Directory of Open Access Journals (Sweden)

    C.P. Denton

    2011-12-01

    Full Text Available Pulmonary arterial hypertension (PAH is a relatively common complication of systemic sclerosis (SSc affecting 5–12% of patients, and its development is associated with significant morbidity and a particularly poor prognosis. Deaths associated with other complications of SSc, such as renal crisis, have fallen significantly in recent years in line with improvements in their treatment and management. However, mortality due to PAH in this population, although improved, has shown a less dramatic decline. The early diagnosis of PAH in SSc would allow for earlier treatment, before functional and haemodynamic impairment becomes severe; this may further improve outcome, and evidence suggests that screening of SSc patients for PAH is associated with improved survival. In addition, patients with PAH associated with SSc are not a homogeneous population and they differ in terms of disease haemodynamic severity, functional capacity and rate of disease progression. Likewise, management strategies may differ, and the ability to stratify patients may help optimise screening and treatment. A number of patient-, clinical- and disease-specific risk factors associated with the development and prognosis of PAH in SSc have been identified, but their optimal use, alone or in combination, in screening and stratification of patients remains to be established.

  18. Acute Myocardial Infarction Is a Risk Factor for New Onset Diabetes in Patients with Coronary Artery Disease

    OpenAIRE

    Chul Soo Park; Woo Baek Chung; Yun Seok Choi; Pum Joon Kim; Jong Min Lee; Ki-Hyun Baek; Hee Yeol Kim; Ki Dong Yoo; Ki-Ho Song; Wook Sung Chung; Ki Bae Seung; Man Young Lee; Hyuk-Sang Kwon

    2015-01-01

    Objective To test the hypothesis that acute myocardial infarction (AMI) might accelerate development of new onset diabetes in patients with coronary artery disease independent of known risk factors. Methods We conducted a retrospective cohort study within COACT (CathOlic medical center percutAneous Coronary inTervention) registry. From a total of 9,127 subjects, 2,036 subjects were diabetes naïve and followed up for at least one year with both index and follow-up laboratory data about diabete...

  19. Balloon-expandable stent implantation for the treatment of severe arterial stenosis located at the origin of vertebral artery: its perioperative risk and short-term prognosis

    International Nuclear Information System (INIS)

    Objective: To investigate the perioperative risk and short-term efficacy of balloon-expandable stent implantation in treating severe arterial stenosis located at the origin of vertebral artery. Methods: During the period from Jan. 2010 to Sep. 2011, a total of 27 patients with 29 symptomatic arterial stenosis (≥ 70%) which was located at the origin of vertebral artery were treated with balloon-expandable stent implantation after they had failed to respond the conventional medication for ischemia symptoms. The patients were followed up at 1, 3, 6, 9 and 12 months after the treatment. The blood cholesterol, blood sugar, blood pressure were estimated. Arterial ultrasonography was reexamined 6 months after the treatment, and DSA was performed at 12 months after the therapy. The results were analyzed. Results: Stent implantation was successfully accomplished in all 27 patients. The mean stenosis ratio decreased from preoperative (92.55±5.26)% to postoperative (3.27±4.6)%. No procedure-related complications occurred. Clinical followed-up was conducted for 12 months after the procedure, and no ischemia events of posterior circulation occurred. No in-stent restenosis or stent deformation was observed. Conclusion: For the treatment of severe arterial stenosis located at the origin of vertebral artery balloon-expandable stent implantation is safe and effective with fewer complications and satisfactory short-term efficacy. (authors)

  20. Coronary CT angiography in clinical triage of patients at high risk of coronary artery disease

    DEFF Research Database (Denmark)

    Kühl, J Tobias; Hove, Jens D; Kristensen, Thomas S;

    2016-01-01

    OBJECTIVES: To test if cardiac computed tomography angiography (CCTA) can be used in the triage of patients at high risk of coronary artery disease. DESIGN: The diagnostic value of 64-detector CCTA was evaluated in 400 patients presenting with non-ST segment elevation myocardial infarction using...... in patients with high likelihood of coronary artery disease and could, in theory, be used to triage high risk patients. As many obstacles remain, including logistical and safety issues, our study does not support the use of CCTA as an additional diagnostic test before ICA in an all-comer NSTEMI population....... invasive coronary angiography (ICA) as the reference method. The relation between the severity of disease by CCTA and a combined endpoint of death, re-hospitalization due to new myocardial infarction, or symptom-driven coronary revascularization was assessed. RESULTS: CCTA detects significant (>50...

  1. The persistent trigeminal artery: development, imaging anatomy, variants, and associated vascular pathologies.

    Science.gov (United States)

    Meckel, Stephan; Spittau, Bjoern; McAuliffe, William

    2013-01-01

    The persistent trigeminal artery (PTA) is the most common and most cephalad-located embryological anastomosis between the developing carotid artery and vertebrobasilar system to persist into adulthood. As such, it is frequently reported as an incidental finding in computed tomography angiography and magnetic resonance angiography studies. Here, we review the embryology, anatomy, and angiographic imaging findings, including important variants of this commonly encountered cerebrovascular anomaly (reported incidence of PTA/PTA variants ranges from 0.1% to 0.76%). Further, the aim is to present the range of associated arterial anomalies or syndromes, as well as pathologies that are associated with a PTA: aneurysms, trigeminal cavernous fistulas, and trigeminal nerve compression. Besides summarizing the risks and clinical presentation of such pathologies, their management is discussed with endovascular strategies mostly being the primary choice for aneurysms and trigeminal cavernous fistulas. Symptomatic trigeminal nerve compression can be treated with microvascular decompression surgery. As an illustrative example, a case of a trigeminal cavernous fistula on a PTA variant is included, mainly to emphasize the importance of understanding the variant anatomy for treatment planning in such pathologies. Finally, recommendations on how to manage patients with PTA-associated vascular pathologies are advanced. PMID:22170080

  2. Excess coronary artery disease risk in South Asian immigrants: Can dysfunctional high-density lipoprotein explain increased risk?

    Directory of Open Access Journals (Sweden)

    Sunita Dodani

    2008-08-01

    Full Text Available Sunita DodaniMedical College of Georgia, Augusta, GA, USABackground: Coronary artery disease (CAD is the leading cause of mortality and morbidity in the United States (US, and South Asian immigrants (SAIs have a higher risk of CAD compared to Caucasians. Traditional risk factors may not completely explain high risk, and some of the unknown risk factors need to be explored. This short review is mainly focused on the possible role of dysfunctional high-density lipoprotein (HDL in causing CAD and presents an overview of available literature on dysfunctional HDL.Discussion: The conventional risk factors, insulin resistance parameters, and metabolic syndrome, although important in predicting CAD risk, may not sufficiently predict risk in SAIs. HDL has antioxidant, antiinflammatory, and antithrombotic properties that contribute to its function as an antiatherogenic agent. Recent Caucasian studies have shown HDL is not only ineffective as an antioxidant but, paradoxically, appears to be prooxidant, and has been found to be associated with CAD. Several causes have been hypothesized for HDL to become dysfunctional, including Apo lipoprotein A-I (Apo A-I polymorphisms. New risk factors and markers like dysfunctional HDL and genetic polymorphisms may be associated with CAD.Conclusions: More research is required in SAIs to explore associations with CAD and to enhance early detection and prevention of CAD in this high risk group.Keywords: South Asian immigrants, coronary heart disease, cardiovascular risk, high-density lipoprotein

  3. Pathogenesis of coronary artery disease: focus on genetic risk factors and identification of genetic variants

    Directory of Open Access Journals (Sweden)

    Sayols-Baixeras S

    2014-01-01

    Full Text Available Sergi Sayols-Baixeras, Carla Lluís-Ganella, Gavin Lucas, Roberto ElosuaCardiovascular Epidemiology and Genetics Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, SpainAbstract: Coronary artery disease (CAD is the leading cause of death and disability worldwide, and its prevalence is expected to increase in the coming years. CAD events are caused by the interplay of genetic and environmental factors, the effects of which are mainly mediated through cardiovascular risk factors. The techniques used to study the genetic basis of these diseases have evolved from linkage studies to candidate gene studies and genome-wide association studies. Linkage studies have been able to identify genetic variants associated with monogenic diseases, whereas genome-wide association studies have been more successful in determining genetic variants associated with complex diseases. Currently, genome-wide association studies have identified approximately 40 loci that explain 6% of the heritability of CAD. The application of this knowledge to clinical practice is challenging, but can be achieved using various strategies, such as genetic variants to identify new therapeutic targets, personal genetic information to improve disease risk prediction, and pharmacogenomics. The main aim of this narrative review is to provide a general overview of our current understanding of the genetics of coronary artery disease and its potential clinical utility.Keywords: coronary artery disease, pathogenesis, genetic risk factors, genetic variants

  4. Risk factors for peripheral arterial disease in the tropics and its comparison with the western population

    Institute of Scientific and Technical Information of China (English)

    Myla Yacob; Edwin Stephen; Nupur Bit; Mazda Turel; David Sadhu; Sunil Agarwal

    2010-01-01

    Objective:To identify and compare the existence of similar and other risk factors in the perspective of an Indian population. Methods:It was designed as a case control study and was conducted in the Department of General and Vascular Surgery Unit 2 of Christian Medical College, Vellore, India between the periods July 2003 to June 2005. 100 patients with an ABPI<0.9 and 100 controls were studied. Results:Peripheral arterial disease (PAD) was found to be commoner among males (87%). While atherosclerosis was the commonest aetiology (54%), the incidence of Thromboangiitis Obliterans was also not uncommon (38%). Smoking was the main risk factor in the Indian context (83%) as compared to hypercholesterolemia (60%) in the West. The patients with atherosclerotic PAD were middle-aged and had concomitant diabetes (50%) and hypertension (30%). Conclusions:Peripheral arterial disease occurs in a relatively younger age group in India as compared to their Western counterparts. Thromboangiitis Obliterans was found to be a significant aetiology for arterial occlusive disease, with smoking as the primary risk factor followed by diabetes, hypertension and hypercholesterolemia.

  5. ARTERIAL STIFFNESS PARAMETERS IN PATIENTS WITH MODERATE/HIGH CARDIOVASCULAR RISK DURING LISINOPRIL AND SIMVASTATIN TREATMENT

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    V. N. Isakova

    2016-01-01

    Full Text Available Aim. To evaluate parameters of arterial stiffness by non-invasive arteriography in patients with moderate/high cardiovascular risk receiving lisinopril and simvastatin.Material and methods. 20 patients (aged 50-55 y.o. with arterial hypertension of the 1st degree and dislipidemia are included in the study. All patients had pulse wave velocity (PWV ≥ 10 m/s and/or the corrected index of pulse wave augmentation (AI × 80 ≥ -10% according to non-invasive arteriography data; and moderate-high cardiovascular risk (≥ 3%. Patients received therapy with lisinopril and simvastatin. Blood pressure (BP levels and lipid profiles were assessed before therapy and in 1, 2, 6 and 12 month of the observation. Non-invasive arteriography was performed before therapy and in 2, 6 and 12 months later.Results. BP target levels were reached within 1 month of treatment as well as improvement of lipid profile was reached within 2 months in majority of the patients. Reference PWV and AI were reached in 85,7% of patients within one year of treatment.Conclusion. Arterial stiffness parameters help to evaluate cardiovascular risk changes accurately as the results of treatment.

  6. Contributions of nuclear cardiology to prognosis and risk stratification in coronary artery disease

    International Nuclear Information System (INIS)

    Myocardial perfusion imaging in patients with suspected or known coronary artery disease and stable symptoms enables not only accurate diagnosis of disease but also entails prognostic value. Myocardial perfusion SPECT contributes to assessment of future cardiac events independently of other clinical parameters. A normal stress myocardial perfusion scan is associated with a favorable prognosis in all pre-test risk subsets similar to that of the general population independent of history, symptoms, and exercise electrocardiography test variables. Cardiac risk and benefit from invasive therapeutic strategies increase in relation to the severity of the abnormality of perfusion and function assessed by gated myocardial perfusion SPECT. Thus, stress myocardial perfusion imaging may serve as a gatekeeper for referral to coronary angiography enabling effective risk stratification in patients with suspected or documented coronary artery disease. In severe coronary artery disease accompanied by left ventricular dysfunction preoperative prediction of reversibility of functional impairment and improvement in survival after revascularization can be achieved by viability testing using nuclear cardiology. Absence of viability is associated with no significant difference in functional and survival outcomes, irrespective of treatment strategy. Therefore, unnecessary revascularization can be avoided in cases with absent evidence of viability. (orig.)

  7. Association of Aortic Valve Sclerosis with Previous Coronary Artery Disease and Risk Factors

    Directory of Open Access Journals (Sweden)

    Filipe Carvalho Marmelo

    2014-11-01

    Full Text Available Background: Aortic valve sclerosis (AVS is characterized by increased thickness, calcification and stiffness of the aortic leaflets without fusion of the commissures. Several studies show an association between AVS and presence of coronary artery disease. Objective: The aim of this study is to investigate the association between presence of AVS with occurrence of previous coronary artery disease and classical risk factors. Methods: The sample was composed of 2,493 individuals who underwent transthoracic echocardiography between August 2011 and December 2012. The mean age of the cohort was 67.5 ± 15.9 years, and 50.7% were female. Results: The most frequent clinical indication for Doppler echocardiography was the presence of stroke (28.8%, and the most common risk factor was hypertension (60.8%. The most prevalent pathological findings on Doppler echocardiography were mitral valve sclerosis (37.1% and AVS (36.7%. There was a statistically significant association between AVS with hypertension (p < 0.001, myocardial infarction (p = 0.007, diabetes (p = 0.006 and compromised left ventricular systolic function (p < 0.001. Conclusion: Patients with AVS have higher prevalences of hypertension, stroke, hypercholesterolemia, myocardial infarction, diabetes and compromised left ventricular systolic function when compared with patients without AVS. We conclude that there is an association between presence of AVS with previous coronary artery disease and classical risk factors.

  8. Correlation between body mass index and the risk factors and severity of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Jing LI

    2011-04-01

    Full Text Available Objective To assess the correlation between body mass index and the risk factors and severity of coronary artery disease.Methods Five thousand two hundred and ninety-four patients with suspected coronary artery disease,who underwent coronary angiography from Jan.2001 to Mar.2007 at 20 medical centers in China,were enrolled in the present study.The patients were divided into normal,overweight and obesity group,and body mass index(BMI,blood pressure(BP,blood glucose,serum total cholesterol(TC,triglyceride(TG,low-density lipoprotein cholesterol(LDL-C and high-density lipoprotein cholesterol(HDL-C were measured.The correlation between BMI and the risk factors and severity of coronary artery disease(CAD was analyzed.And the correlation between gender in different BMI group and CAD rick factors was also evaluated.Results The BMI was correlated with BP,TC,blood glucose,age and HDL-C(P 0.05 in male group.The BMI was correlated with BP,TC,TG,LDL-C and high blood glucose(P 0.05 in female group.Logistic regression analysis showed that hypertension was a prominent predictor of overweight and obesity(OR=2.102,95%CI 1.762~2.509.Conclusion BMI is significantly correlated with blood glucose,BP,TG,TC,LDL-C and HDL-C,but it is not an independent risk factor for CAD.

  9. NONINVASIVE EVALUATION OF VASCULAR WALL STIFFNESSIN HEALTHY ADOLESCENTS, THE RISK FACTORS FOR ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    G. P. Filippov

    2015-01-01

    Full Text Available Objective. To evaluate the main indicators characterizing the rigidity of the vascular wall in healthy ado-lescents with such risk factors (RF for arterial hypertension (AH as a family history on hypertension and smoking. Identify changes in the initial elastic-elastic properties of the arteries at the preclinical stage of development of hypertension.Material and methods. It was formed two groups of comparison. Age studied from 13 to 17 years (mean age (15.00 ± 0.31 years. The first group consisted of 30 healthy adolescents whose parents suffer from hypertension from a young age. The second group consisted of 30 healthy smokers teenager from healthy parents. The control group consisted of 30 healthy adolescents from healthy parents. Determines the basic stiffness of the vascular wall: PWV, CAVI, SAI.Results. A significant in crease in the indicators characterizing the rigidity of the vascular wall in the two comparison groups relative to the control. PWV: 6,89 ± 0,56 (first group, 7.13 ± 0.55 (second group and 5.5 ± 0.41 (control, p < 0.05.L-CAVI: 5,46 ± 0,39 (first group, 5.84 ± 0.61 (second group and 4.32 ± 0.41 (control, p < 0.05.R-CAVI: 5,63 ± 0,39 (first group, 5.89 ± 0.56 (second group and 4.49 ± 0.41(control, p < 0.05. R-AI: 0,89 ± 0,09 (first group, 0.95 ± 0.12 (second group and 0.62 ± 0.1 (control, p < 0.05.Smoking teenagers and adolescents with family history of hypertension, there are changes in the initial stiffness of the vessel wall, which requires the allocation of at-riskfor the development of hypertension and prevention activities at the preclinical stage of development ofthe disease.

  10. Coronary Artery Disease: A Descriptive Analysis of Risk Factors: Before and After Treatment

    Directory of Open Access Journals (Sweden)

    S Dinkar, Suresh Rao, M Vakamudi, R Saldanha, KR Balakrishnan

    2010-12-01

    Full Text Available With the increasing life span of man, the number of ageing people is also increasing, and along with that the number of diseases affecting them is also increasing. Atherosclerotic coronary artery disease is one of them. Coronary revascularization was started in 1960s through the pioneering efforts of David Sabiston and Kolessov. This is a retrospective descriptive study. A total number of 1050 Patients were operated on beating heart surgery from 1998 to Nov. 2002 out of which 852 patients were analysed to know the results and prognostic outcomes. Mean age was 57.8 years (range 31 - 80years with M:F ratio of 7:1. The pre-operative parameters studied were DM, HTN, hyperlipidemia, family history of CAD, smoking and past history of MI. other parameters included pulmonary disease, chronic renal failure, CVA, APD, PVD etc. 55.75% patients were diabetic, 53.99% were hypertensive and 24.4% had history of hyperlipidemia. Family history was positive in 12.9% of the patients, 25% were smokers and 44% had history of previous MI. average number of diseased vessels was 2.34 with triple vessel disease being most common. 6.6% had history of pulmonary diseases, 7.4% had pre-operative renal failure and 2% had past history of CV stroke. Overall in-hospital mortality was 1.4%. relative risk for mortality, morbidity, new onset of renal failure, CVA, arrhythmias, CCF were calculated. Mean hospital stay was 9.83days (range 6 - 41years, mean ICU stay was 74.3 hours (range 73 - 700years. Usage of blood and blood products was significantly less. Freedom from complications was 93%. LVEF<40%, age >70 years, high diastolic PA pressure> 15mm Hg were found to be significant risk factors for mortality. Females were found to be 2.6 times more at risk for mortality and development of complications as compared to males. Patients with previous history of MI were found to be more at risk of developing complications increasing their hospital and ICU stay.

  11. Association between Vitamin D Status and Risk of Peripheral Arterial Disease: The Dong-gu Study

    Science.gov (United States)

    Oh, Su-Hyun; Kweon, Sun-Seog; Choi, Jin-Su; Rhee, Jung-Ae; Lee, Young-Hoon; Nam, Hae-Sung; Jeong, Seul-Ki; Park, Kyeong-Soo; Ryu, So-Yeon; Choi, Seong-Woo

    2016-01-01

    Low levels of vitamin D have been associated with increased cardiovascular disease risk. However, few studies have evaluated the association between vitamin D status and peripheral arterial disease (PAD). We therefore aimed to investigate whether low 25-hydroxyvitamin D (25(OH)D) levels were associated with increased risk of PAD in the Korean population. This cross-sectional study was conducted among 8,960 subjects aged 50 years or older without known myocardial infarction or stroke. PAD was defined by an ankle brachial blood pressure index vitamin D levels may contribute to PAD in the Korean population.

  12. Traditional Cardiovascular Risk Factors and Coronary Artery Calcification in Adults With Polymyositis and Dermatomyositis

    DEFF Research Database (Denmark)

    Diederichsen, Louise P; Diederichsen, Axel C P; Simonsen, Jane A;

    2015-01-01

    OBJECTIVE: To determine the occurrence of traditional cardiovascular (CV) risk factors and coronary artery calcification (CAC) in adults with polymyositis (PM) or dermatomyositis (DM) compared to healthy controls and to assess the association between CV risk factors, PM/DM, and CAC score. METHODS....../DM, and CAC were studied by multivariate analyses. RESULTS: Thirty-three percent of the patients were obese compared to 11% of the controls (P = 0.005). Hypertension and diabetes mellitus were more frequent in patients (71% versus 42%; P = 0.002, and 13% versus 0%; P = 0.007), and patients had higher levels...

  13. Association between Vitamin D Status and Risk of Peripheral Arterial Disease: The Dong-gu Study.

    Science.gov (United States)

    Oh, Su-Hyun; Kweon, Sun-Seog; Choi, Jin-Su; Rhee, Jung-Ae; Lee, Young-Hoon; Nam, Hae-Sung; Jeong, Seul-Ki; Park, Kyeong-Soo; Ryu, So-Yeon; Choi, Seong-Woo; Shin, Min-Ho

    2016-09-01

    Low levels of vitamin D have been associated with increased cardiovascular disease risk. However, few studies have evaluated the association between vitamin D status and peripheral arterial disease (PAD). We therefore aimed to investigate whether low 25-hydroxyvitamin D (25(OH)D) levels were associated with increased risk of PAD in the Korean population. This cross-sectional study was conducted among 8,960 subjects aged 50 years or older without known myocardial infarction or stroke. PAD was defined by an ankle brachial blood pressure index vitamin D levels may contribute to PAD in the Korean population. PMID:27689032

  14. Anterior Hox Genes in Cardiac Development and Great Artery Patterning

    Directory of Open Access Journals (Sweden)

    Brigitte Laforest

    2014-03-01

    Full Text Available During early development, the heart tube grows by progressive addition of progenitor cells to the arterial and venous poles. These cardiac progenitor cells, originally identified in 2001, are located in the splanchnic mesoderm in a region termed the second heart field (SHF. Since its discovery, our view of heart development has been refined and it is well established that perturbation in the addition of SHF cells results in a spectrum of congenital heart defects. We have previously shown that anterior Hox genes, including Hoxb1, Hoxa1 and Hoxa3, are expressed in distinct subdomains of the SHF that contribute to atrial and subpulmonary myocardium. It is well known that Hox proteins exert their function through interaction with members of the TALE family, including Pbx and Meis factors. The expression profile of Pbx and Meis factors overlaps with that of anterior Hox factors in the embryonic heart, and recent data suggest that they may interact together during cardiac development. This review aims to bring together recent findings in vertebrates that strongly suggest an important function for Hox, Pbx and Meis factors in heart development and disease.

  15. Inflammation and infection do not promote arterial aging and cardiovascular disease risk factors among lean horticulturalists.

    Directory of Open Access Journals (Sweden)

    Michael Gurven

    Full Text Available Arterial aging is well characterized in industrial populations, but scantly described in populations with little access to modern medicine. Here we characterize health and aging among the Tsimane, Amazonian forager-horticulturalists with short life expectancy, high infectious loads and inflammation, but low adiposity and robust physical fitness. Inflammation has been implicated in all stages of arterial aging, atherogenesis and hypertension, and so we test whether greater inflammation associates with atherosclerosis and CVD risk. In contrast, moderate to vigorous daily activity, minimal obesity, and low fat intake predict minimal CVD risk among older Tsimane.Peripheral arterial disease (PAD, based on the Ankle-Brachial Index (ABI, and hypertension were measured in Tsimane adults, and compared with rates from industrialized populations. No cases of PAD were found among Tsimane and hypertension was comparatively low (prevalence: 3.5%, 40+; 23%, 70+. Markers of infection and inflammation were much higher among Tsimane than among U.S. adults, whereas HDL was substantially lower. Regression models examine associations of ABI and BP with biomarkers of energy balance and metabolism and of inflammation and infection. Among Tsimane, obesity, blood lipids, and disease history were not significantly associated with ABI. Unlike the Tsimane case, higher cholesterol, C-reactive protein, leukocytes, cigarette smoking and systolic pressure among North Americans are all significantly associated with lower ABI.Inflammation may not always be a risk factor for arterial degeneration and CVD, but instead may be offset by other factors: healthy metabolism, active lifestyle, favorable body mass, lean diet, low blood lipids and cardiorespiratory health. Other possibilities, including genetic susceptibility and the role of helminth infections, are discussed. The absence of PAD and CVD among Tsimane parallels anecdotal reports from other small-scale subsistence

  16. Derivation of flow related risk indices for stenosed left anterior descending coronary arteries with the use of computer simulations.

    Science.gov (United States)

    Papadopoulos, Konstantinos P; Gavaises, Manolis; Pantos, Ioannis; Katritsis, Demosthenes G; Mitroglou, Nicholas

    2016-09-01

    The geometry of the coronary vessel network is believed to play a decisive role in the initiation, progression and outcome of coronary artery disease (CAD) and the occurrence of acute coronary syndromes (ACS). It also determines the flow field in the coronary artery which can be linked to CAD evolution. In this work geometric 3D models of left anterior descending (LAD) coronary arteries associated with either myocardial infarction (MI) or stable (STA) CAD were constructed. Transient numerical simulations of the flow for each model showed that specific flow patterns develop in different extent in the different groups examined. Recirculation zones, present distal the stenosis in all models, had larger extent and duration in MI cases. For mild stenosis (up to 50%) areas with low time averaged wall shear stress TAWSS (3Pa) appeared only in MI models; in moderate and severe stenosis (>50%) these areas were present in all models but were significantly larger for MI than STA models. These differentiations were expressed via numerical indices based on TAWSS, oscillating shear index (OSI) and relative residence time (RRT). Additionally we introduced the coagulation activation index (CAI), based on the threshold behaviour of coagulation initiation, which exceeded the suggested threshold only for MI models with intermediate stenosis (up to 50%). These results show that numerical simulations of flow can produce arithmetic indices linked with the risk of CAD complications. PMID:27387905

  17. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Beck-Razi, Nira [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Rambam Medical Center, Department of Medical Imaging, Haifa (Israel); Bar-Joseph, Gad [Israel Institute of Technology, Pediatric Critical Care Unit, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Ofer, Amos; Gaitini, Diana [Israel Institute of Technology, Department of Medical Imaging, The Rappaport Faculty of Medicine, Technion, Haifa (Israel); Hoffman, Aharon [Israel Institute of Technology, Department of Vascular Surgery, Rambam Health Care Center, The Rappaport Faculty of Medicine, Technion, Haifa (Israel)

    2010-12-15

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  18. From arteritis to mycotic aneurysm: visualization of the progression of mycotic aneurysm development following femoral arterial line insertion in an infant

    International Nuclear Information System (INIS)

    Although uncommon, mycotic aneurysms in infants can be lethal because of the high risk of rapid expansion and rupture. Most catheter-associated mycotic aneurysms reported in the first year of life develop following umbilical artery catheterizations. We describe the sonographic detection of an early stage mycotic aneurysm in a 4-month-old following femoral artery catheterization complicated by methicillin-resistant Staphylococcus aureus (MRSA) septicemia. We also describe the sonographic and radiographic progression of this mycotic aneurysm before surgery. (orig.)

  19. Resistin might not be a risk factor for carotid artery atherosclerosis in elderly Chinese males

    Institute of Scientific and Technical Information of China (English)

    Hao WANG; Yu-Tang WANG; Li FAN; Yu-Tao GUO; Yang SHI; Tao TAO; Yue-Xiang ZHAO

    2014-01-01

    Objective To investigate the correlation between the serum resistin level and carotid artery atherosclerosis in elderly Chinese males. Methods The study enrolled 235 elderly Chinese males [median age 76 (range 60-97) years] scheduled for ultrasound examination of carotid artery plaque and determination of carotid artery intima-media thickness (CIMT). They were divided into carotid atherosclerotic plaque (CAP) and carotid atherosclerotic plaque-free (CAP-free) groups according to the ultrasound results. Their clinical profiles were col-lected, and the serum resistin and other blood biochemistry levels were determined.Results The CAP group was older and had a thicker mean CIMT than the CAP-free group. However, there was no difference in the serum resistin level between the groups. CIMT was positively correlated with age (r = 0.299,P< 0.001). The serum resistin level was not correlated with CIMT, even after controlling for age. Multiple linear regression analysis revealed that age (β = 0.001,P< 0.001) and body mass index (β = 0.002,P= 0.015) were significantly and posi-tively correlated with the mean CIMT. Only age [odds ratio (OR): 1.159; 95% confidence interval (CI): 1.078-1.183,P< 0.001] was associ-ated with the presence of carotid artery atherosclerotic plaque. The serum resistin level was not correlated with the mean CIMT or associated with the presence of carotid artery atherosclerotic plaque.Conclusion The results suggest that resistin might not be a risk factor for atherosclerosis in elderly Chinese males.

  20. Evaluation of Hs-CRP Levels and Interleukin 18 (-137G/C) Promoter Polymorphism in Risk Prediction of Coronary Artery Disease in First Degree Relatives

    OpenAIRE

    Rajesh Kumar G; Mrudula Spurthi K; Kishore Kumar G; Mohanalatha Kurapati; Saraswati M; Mohini Aiyengar T; Chiranjeevi P; Srilatha Reddy G; Nivas S; Kaushik P; Sanjib Sahu K; Surekha Rani H

    2015-01-01

    Background Coronary Artery Disease (CAD) is clearly a multifactorial disease that develops from childhood and ultimately leads to death. Several reports revealed having a First Degree Relatives (FDRS) with premature CAD is a significant autonomous risk factor for CAD development. C - reactive protein (CRP) is a member of the pentraxin family and is the most widely studied proinflammatory biomarker. IL-18 is a pleiotrophic and proinflammatory cytokine which is produced mainly by macrophages an...

  1. Association between depression and development of coronary artery disease: pathophysiologic and diagnostic implications

    Directory of Open Access Journals (Sweden)

    Sakamoto

    2011-03-01

    Full Text Available Carlos V Serrano Jr1, Karina Tiemi Setani2, Erica Sakamoto2, Anna Maria Andrei3, Renério Fraguas41Heart Institute (InCor, 2Medical School, University of São Paulo, Brazil; 3Albert Einstein Hospital, São Paulo, Brazil; 4Department and Institute of Psychiatry, Medical School, University of São Paulo, BrazilAbstract: Depression and coronary artery disease (CAD are both extremely prevalent diseases. In addition, compromised quality of life and life expectancy are characteristics of both situations. There are several conditions that aggravate depression and facilitate the development of CAD, as well as provoke a worse prognosis in patients with already established CAD: inferior adherence to medical orientations (medications and life style modifications, greater platelet activation and aggregation, endothelial dysfunction, and impaired autonomic dysfunction (lowered heart rate variability. Recent literature has shown that depression alone is becoming an independent risk factor for cardiac events both in primary and secondary prevention. As the diagnosis of depression in patients with heart disease is difficult, due to similarities of symptoms, the health professional should perform a careful evaluation to differentiate the clinical signs of depression from those related with general heart diseases. After a myocardial infarction, depression is an independent risk factor for mortality. Successful therapy of depression has been shown to improve patients’ quality of life and cardiovascular outcome. However, multicentric clinical trials are needed to support this inference. A practical liaison between qualified professionals is necessary for the better management of depressed patients with excess risk in developing CAD. Accordingly, pathophysiological and clinical implications between depression and CAD are discussed in this article.Keywords: depression, coronary artery disease, behavioral disorders, prognosis

  2. Common variants associated with plasma triglycerides and risk for coronary artery disease

    DEFF Research Database (Denmark)

    Do, R.; Willer, C. J.; Schmidt, E. M.;

    2013-01-01

    Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common...... variants recently mapped for plasma lipids (P triglycerides in risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and we show that the direction and magnitude of the associations...... with both traits are factors in determining CAD risk. Second, we consider loci with only a strong association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol (HDL-C) levels, the strength...

  3. Venous and arterial thrombotic risks with thalidomide: evidence and practical guidance.

    Science.gov (United States)

    Palumbo, Antonio; Palladino, Carmela

    2012-10-01

    Oral immunomodulatory drugs (IMiDs), namely thalidomide, lenalidomide and pomalidomide, interfere with several pathways important for disease progression. Today they play a crucial role in the treatment of multiple myeloma patients, and have considerably improved myeloma outcomes. These agents, and thalidomide in particular, are associated with higher rates of thromboembolic events, both venous and arterial. Individual risk factors for thromboembolic events include advanced age, previous history of thromboembolism, an indwelling central venous catheter, comorbid conditions (e.g. infections, diabetes, cardiac disease, obesity), current or recent immobilization, recent surgery and inherited thrombophilic abnormalities. Cancer therapy and cancer itself also increase the risk of thromboembolic events. The aim of this review is to help clinicians to define the risk of thrombotic events in patients treated with thalidomide and thus to provide practical recommendations to manage thromboprophylaxis in these patients.

  4. Importance of atherosclerotic stenotic lesion of the brachiocephalic arteries in the development of cognitive impairments

    Directory of Open Access Journals (Sweden)

    D. R. Khasanova

    2015-03-01

    Full Text Available The impact of the pattern of atherosclerotic stenotic lesion on the clinical presentation of cognitive impairments (CIs has been inadequately investigated. Objective: to estimate the impact of the degree and site of an atherosclerotic stenotic process on cerebral perfusion and cognitive functions. Patients and methods. A total of 123 patients (65 men and 58 women aged 50 to 75 years with brachiocephalic artery stenosis of at least 40%, without hypertension, diabetes mellitus, or other systemic vascular pathology were examined. The structural state of the brain substance and the state of cerebral blood flow were evaluated by magnetic resonance imaging and magnetic resonance angiography. The scale described by P. Scheltens et al. was used to determine changes in the white matter. The site and degree of a stenotic process were estimated by extracranial and transcranial duplex scanning. CIs were identified applying a set of neuropsychological assessment scales. The Hamilton hospital depression rating scale was also employed. Results and discussion. Varying degrees of CIs were detected in the majority of the examinees with brachiocephalic artery atherosclerosis. The most severe CIs were associated with the involvement of parietal and frontal lobes. There was significant deterioration in cognitive functions with a higher percentage of stenosis: more severe CIs were seen in the presence of stenosis in the carotid system than in those in the vertebrobasilar bed. In addition, the patients with concomitant stenoses and tandem stenoses were observed to have more pronounced CIs than those with single artery stenosis. Cerebral atherosclerosis is shown to be one of the major risk factors for CIs. Not only the degree of stenoses, but also to a greater extent their site was observed to impact the occurrence of CIs accompanied by the development of a perfusion deficit in the specific vascular beds. The determination of the pattern of a stenotic process will be

  5. Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

    Science.gov (United States)

    Shimazaki, N.; Tokunaga, H.; Katou, Y.; Hayashi, T.; Arai, T.

    2009-02-01

    We have studied to develop the new thermal angioplasty methodology, photo-thermo dynamic balloon angioplasty (PTDBA), which provides artery dilatation with short-term (<15s) and uniform heating through the balloon by the combination of the efficient laser driven heat generation and fluid perfusion. Thermal denaturation degree of the collagen in artery media may be the important factor to attain sufficient artery dilatation for the PTDBA. In order to predict the optimum heating condition i.e. the balloon temperature and heating duration, we investigated the thermal denaturation dynamics of artery collagen in ex vivo. The extracted fresh porcine carotid artery was used. The temperature-dependent light scattering property and mechanical property of the artery specimen were simultaneously measured during artery temperature rising by specially made setup to assess the denaturation of arterial collagen. The change rate of the backscattered light intensity from the artery specimen; I(T)/I0 with 633nm was measured to evaluate the artery scattering property change with the thermal denaturation. The artery specimen was heated from 25°C to 80°C with constant temperature rising rate of 3°C/min. The measured I(T)/I0 was suddenly increased over 48°C. This boundary temperature might be the initiation temperature of the arterial collagen denaturation. We defined the variation of the I(T)/I0 as the collagen denaturation ratio, and calculated the reactive enthalpy by the chemical equilibrium theory. Since the calculated enthalpy was similar to the enthalpy in literature report, the variety of I(T)/I0 during the temperature rising might be attributed to the collagen conformational change due to the denaturation. In terms of the artery internal force measurement, the artery force was decreased with increasing of the artery temperature up to 65°C (i.e. softening), and increased over 65°C (i.e. shrinkage). We confirmed that the changes of the backscattered light (at 633nm in

  6. The Prevalence and Awareness of Cardiometabolic Risk Factors in Southern Chinese Population with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Xinrui Li

    2013-01-01

    Full Text Available Background. Cardiometabolic risk factors significantly accelerate the progression of coronary artery disease (CAD; however, whether CAD patients in South China are aware of the prevalence of these risk factors is not clear yet. Methods. The study consisted of 2312 in-admission CAD patients from 2008 to 2011 in South China. Disease history including hypertension, dyslipidemia, and diabetes was relied on patients' self-reported records. Physical and clinical examinations were tested to assess the real prevalence of the cardiometabolic risk factors. Results. 57.9% of CAD patients had more than 3 cardiometabolic risk factors in terms of the metabolic syndrome. The self-known and real prevalence of hypertension, diabetes, and dyslipidemia were 56.6%, 28.3%, and 25.1% and 91.3%, 40.9%, and 92.0%, respectively. The awareness rates were 64.4%, 66.3%, and 28.5% for hypertension, diabetes, and dyslipidemia. The prevalence of cardiometabolic risk factors was significantly different among gender and among disease status. Conclusions. Most CAD patients in South China had more than three cardiometabolic risk factors. However, the awareness rate of cardiometabolic diseases was low, especially for dyslipidemia. Strategies of routine physical examination programs are needed for the early detection and treatment of cardiometabolic risk factors in order to prevent CAD progression and prognosis.

  7. Assessment of influence of traditional cardiovascular risk factors and inflammation on arterial wall structural characteristics in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    T V Korotaeva

    2009-01-01

    Full Text Available Assessment of influence of traditional cardiovascular risk factors and inflammation on arterial wall structural characteristics in psoriatic arthritis. Objective. To assess possibility of traditional cardiovascular risk (CVR factors application as markers of subclinical atherosclerosis in pts with psoriatic arthritis (PA. Material and methods. 130 pts with PA (51 male and 79 female without clinical signs of coronary heart disease (CHD and stroke. were included. Mean age was 43 years (39-48 years, mean PA duration – 7 years (2 months-42 years, mean psoriasis duration – 15 years (5,5 – 26 years. PA activity was assessed with DAS4. Age, total cholesterol (TC, high density lipoprotein (HDLP, low density lipoprotein (LDLP, C-reactive protein (CRP, fibrinogen, systolic blood pressure, body mass index (BMI, atherogenity coefficient (AC, relative risk of CHD development, presence of diabetes and smoking were evaluated. Mean and maximal intima-media complex thickness (IMCT of common carotid arteries was examined with duplex scanning. Results. TC, LDLP and AC elevation was revealed in all and BMI elevation – in one third of pts. In 55% of pts CVR was mean and higher, in 23,5% CVR was absent and in 21,5% CVR was below mean. CVR significantly correlated with mean and maximal carotid arteries IMCT (R=0,48, p<0,00001 and R=0,41, p<0,00001 and fibrinogen (R=0,22, p<0,011. In women CVR correlated with fibrinogen (R=0,27, p<0,16, BMI (R=0,35, p<0,16, mean and maximal carotid arteries IMCT (R=0,50, p<0,00001 and R=0,38, p<0,0005 respectively and psoriasis duration (R=0,30, p<0,006. In men CVR did not correlated with fibrinogen. CVR did not correlated with DAS4 and CRP. Conclusion. CVR in PA is not connected with traditional markers of inflammation andindex of clinical disease activity.

  8. Comparison of Novel Coronary Artery Disease Risk Factors between Obese and Normal Adolescent

    Science.gov (United States)

    Kouzehgaran, Samaneh; Vakili, Rahim; Nematy, Mohsen; Safarian, Mohamad; Ghayour-Mobarhan, Majid; Khajedaluee, Mohamad

    2015-01-01

    Background Coronary artery disease is considered as the most common cause of death in all societies including Iran. This study seeks to compare the new risk factors of coronary-artery diseases in obese adolescents and control group. Methods In this cross-sectional study, amongst the obese adolescents registered in the nutrition clinic of Ghaem Hospital, 80 individuals were selected. As the control group, additional 80 adolescent students having the same gender and age as the obese group, but with normal weight were selected. These two groups were selected randomly and their serum level of vitamin D, anti-heat shock protein27 (HSP27), balance of oxidants and antioxidants, and homocysteine were determined and compared. Results In this study, 42 (53.2%) and 37 (46.8%) of the obese and normal weight groups were male, respectively. The mean value of triglyceride, cholesterol, and LDL in the obese group was higher than the normal group, but the mean value for HDL, vitamin D, homocysteine, PAB (Preoxidant and Antioxidants Balance), and anti-HSP27 was not significantly different between the groups. In the base of homocysteine >15 µmol/l, 26.6% of the obese group had hyperhomocysteinemia, therefore homocysteine may be a new risk factor for coronary artery disease in obese adolescents (χ2=4.072; P value=0.091). Conclusion The findings of this study showed that despite the presence of obesity in adolescence and adolescents, new risk factors are not present among them more than the control group. This was in contrast to what was seen in adults. PMID:26170518

  9. The defense response and alcohol intake: A coronary artery disease risk? The SABPA Study.

    Science.gov (United States)

    Oosthuizen, Woudri; Malan, Leoné; Scheepers, Jacobus D; Cockeran, Marike; Malan, Nicolaas T

    2016-01-01

    The behavioral defense coping response (DefS) as a measure of coping with emotional stress may increase alcohol intake (gamma glutamyl transferase (γGT)), the risk for coronary artery disease (CAD) and insulin sensitivity (homeostasis model assessment, HOMA). We assessed associations between coping and cardiometabolic risk markers in a bi-ethnic cohort (N = 390) from South Africa. Ambulatory blood pressure (BP) and ECG, fasting blood and coping scores were obtained. Africans, and mostly when utilizing DefS, showed higher 24h BP, a low-grade inflammatory state, central obesity, increased HOMA [4.07 (3.66, 4.47)] and more ST events compared to their Caucasian counterparts. ROC γ-GT analyses predicting 24-h ambulatory hypertension showed a higher γ-GT cut-point in Africans (55.4 U/l) than in Caucasians (19.5 U/l). Odds ratios (ORs) of γ-GT cut-points predicting 24-h ambulatory hypertension was evident in DefS African men [OR: 7.37 (95% CI: 6.71-8.05), p = 0.003] and in DefS Caucasians, albeit at a lower γ-GT cut-point (19.5 U/l). Higher γ-GT cut-points in DefS Africans or Caucasians were not associated with HOMA > 3. DefS accompanied by alcohol abuse in taxing emotional situations, if no social support is forthcoming, underscores a profile of reduced coronary perfusion. It may enhance vasoconstriction of the coronary arteries, with compensatory increases in BP, and induce a risk for future coronary artery disease. PMID:27399032

  10. Comparison of Novel Coronary Artery Disease Risk Factors between Obese and Normal Adolescent

    Directory of Open Access Journals (Sweden)

    Samaneh Kouzehgaran

    2015-07-01

    Full Text Available Background: Coronary artery disease is considered as the most common cause of death in all societies including Iran. This study seeks to compare the new risk factors of coronary-artery diseases in obese adolescents and control group. Methods: In this cross-sectional study, amongst the obese adolescents registered in the nutrition clinic of Ghaem Hospital, 80 individuals were selected. As the control group, additional 80 adolescent students having the same gender and age as the obese group, but with normal weight were selected. These two groups were selected randomly and their serum level of vitamin D, anti-heat shock protein27 (HSP27, balance of oxidants and antioxidants, and homocysteine were determined and compared. Results: In this study, 42 (53.2% and 37 (46.8% of the obese and normal weight groups were male, respectively. The mean value of triglyceride, cholesterol, and LDL in the obese group was higher than the normal group, but the mean value for HDL, vitamin D, homocysteine, PAB (Preoxidant and Antioxidants Balance, and anti-HSP27 was not significantly different between the groups. In the base of homocysteine >15 µmol/l, 26.6% of the obese group had hyperhomocysteinemia, therefore homocysteine may be a new risk factor for coronary artery disease in obese adolescents (χ2=4.072; P value=0.091. Conclusion: The findings of this study showed that despite the presence of obesity in adolescence and adolescents, new risk factors are not present among them more than the control group. This was in contrast to what was seen in adults.

  11. [Hyperandrogenism as a risk factor of coronary artery disease in young women].

    Science.gov (United States)

    Sablik, Zbigniew; Samborska-Sablik, Anna; Bolińska-Sołtysiak, Halina; Goch, Jan Henryk; Kula, Krzysztof

    2006-02-01

    The aim of the study was an attempt to assess the relative roles of common risk factors of coronary artery disease (CAD) and sex hormones in the pathogenesis of CAD in young menstruating women. 38 women in the age of 35-47 years with past myocardial infarction and angiographically proven critical changes in coronary arteries, with one-vessel disease in 22 women (58%) or multi-vessel disease in 16 (42%) were examined. A referee group consisted of 15 healthy women in the age of 35-45 years. In all women multiple risk factors were searched, including value of body mass index (BMI) and waist-hip ratio (WHR). In 4-7 day of sexual cycle at 8.00 a.m. blood from cubital vein was taken to measure concentrations of biochemical parameters and hormones: estradiol, testosterone (T), dehydroepiandrosterone sulphate, folliclestimulating hormone, luteinizing hormone, prolactin, thyreotropin, progesterone, cortisol and sex-hormone binding globulin. In women with CAD, comparing to healthy ones, a higher frequency of arterial hypertension (55% vs 7%), cigarete smoking (95% vs. 46%), hirsutism (84% vs. 30%) and dyslipidaemia was found. Concentration of T was significantly higher in women with CAD than in healthy women (3.5 +/- 1.5 nmol/l--vs. 2.4 +/- 1.0, p fit with occurence of CAD. Significant relation with CAD was proven for visceral obesity, eleveted concentration of T and cigarette smoking, either. Conclusions. Apart from common known risk factors as visceral obesity, dyslipidaemia and cigarette smoking it is hiperandrogenism that may participate in pathogenesis of CAD in women in the reproductive age. PMID:17274467

  12. Peripheral arterial disease: A high risk – but neglected – disease population

    Directory of Open Access Journals (Sweden)

    Lip Gregory YH

    2005-06-01

    Full Text Available Abstract Peripheral arterial disease (PAD is a common, progressive manifestation of atherothrombotic vascular disease, which should be managed no different to cardiac disease. Indeed, there is growing evidence that PAD patients are a high risk group, although still relatively under-detected and under treated. This is despite the fact that PAD patients are an increased mortality rate comparable to those with pre-existing or established cardiovascular disease [myocardial infarction, stroke]. With a holistic approach to atherothrombotic vascular disease, our management of PAD can only get better.

  13. Study on the Relationship between the Third Trimester Umbilical Artery S/D Value and Fetal Growth & Development in High-Risk Pregnancy%高危妊娠孕晚期脐动脉S/D值与胎儿综合生长发育情况的关系研究

    Institute of Scientific and Technical Information of China (English)

    程娟娟; 冉文军

    2016-01-01

    Objective To study the relationship between third trimester umbilical artery S/D (Systolic/Diastolic Ratio) value and fetal growth&development in high-risk pregnancy. Methods The study was conducted in the hospital from July 2013 to July 2014, including 40 patients with GDM (Gestational Diabetes Mellitus), 63 patients with HDP (Hypertension Disorder Complicating Pregnancy) and 73 pregnant women without complications (Control Group). The age, gestational weeks, MAP (Mean Arterial Pressure), third trimester S/D ratio, genetic tendency, body index, height, weight and head circumference of neonatus and the Neonatal Apgar score were recorded, and ZLI (Zhang Lu Index) and RI (Raul Index) were calculated for comparison between three groups. Results S/D value was negatively correlated with ZLI and RI. The umbilical artery blood S/D value of GDM Group and HDP Group were higher than that of Control Group with the same gestational weeks, and the control of blood pressure level in HDP Group affected S/D value, ZLI and RI. The increased S/D value for pregnancy more than 39 weeks might have adverse effects on fetal and perinatal prognosis. GDM Group with a family history of diabetes and HDP Group with a family history of high blood pressure would further affect the perinatal growth. In reference with the standards of neonatal physical development, ZLI was more accurate than RI in evaluating the condition of the newborn. Whether S/D=2.5 was taken as the warning value for high-risk pregnancy in late pregnancy (over 35 weeks) remained to be validated through a large number of data. Conclusion The late pregnancy umbilical artery S/D value of high-risk pregnant women relfected the fetal intrauterine growth. The neonatal body mass index, ZLI and RI were correlated with the total value of S/D, which showed that the S/D value had a certain role in prognosis. The coefifcient of determination of SD and ZLI was two times of SD and RI, suggesting that ZLI and SD were more closely than RI

  14. Association between T174M polymorphism in the angiotensinogen gene and risk of coronary artery disease: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Wen-Zhu Wang

    2013-01-01

    Background Angiotensinogen (AGT) T174M gene polymorphism has been suggested to be linked to risk of coronary artery disease, however, results from studies of this association have been inconsistent. In this study, we assess the relationship between AGT T174M gene polymorphism and coronary artery disease. Methods We conducted a meta-analysis of 18 case-control studies with 8,147 coronary artery disease cases and 5,344 controls in Google scholar, PubMed, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases to identify eligible studies published by July, 2012. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated from these studies. Results Overall, a significant association was found between angiotensinogen T174M polymorphism and coronary artery association of T174M polymorphism with coronary stenosis risk in Caucasians.

  15. The Importance of Physical Fitness versus Physical Activity for Coronary Artery Disease Risk Factors: A Cross-Sectional Analysis.

    Science.gov (United States)

    Young, Deborah Rohm; Steinhardt, Mary A.

    1993-01-01

    This cross-sectional study examined relationships among physical fitness, physical activity, and risk factors for coronary artery disease (CAD) in male police officers. Data from screenings and physical fitness assessments indicated physical activity must be sufficient to influence fitness before obtaining statistically significant risk-reducing…

  16. Association of ABO Blood Types With Atherosclerosis Risk Factors and Number of Involved Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Golmohammadi Ali

    2016-01-01

    Full Text Available Objective: Cardiovascular disease (CVD is a common cause of morbidity and mortality. The relationship between ABO blood groups and main risk factors of CVD is unknown. So this study was designed to investigate whether there is an association between ABO blood groups and cardiovascular risk factors in otherwise healthy people. Materials and Methods: In this cross-sectional study, risk factors for CVD were screened in 300 patients with coronary artery disease (CAD who were hospitalized in Madani hospital (biggest heart center in Tabriz in 2013-2014 and evaluated by a questionnaire that aimed to extract information about age, sex, smoking, blood group type, weight, height, blood pressure, diabetes mellitus and family history of CVD. Data were analyzed with SPSS 17. Results: Of the total selected 300 patients, 69.3% were male, 35.3% were smoker, 61% were hypertensive, 30.3% were diabetic mellitus, 31% had hyperlipidemia, 70.97% were obese and 17.3% had family history of CVD. The mean age was 62.06 ± 11.40 years. Blood groups O (28%, A (43.3%, B (19% and AB (7.3% were the most frequent ones, respectively. According to our results, we found that the rate of CAD in individuals with the blood group A was higher than the other blood groups. Regarding the risk factors, however, no significant difference was observed between the blood groups. Conclusion: A correlation was found between blood group A and the incidence of CAD and there was no significant difference between the blood groups and cardiovascular risk factors and number of involved coronary arteries.

  17. Gender Differences in Coronary Artery Disease: Correlational Study on Dietary Pattern and Known Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    Mahdi Najafi

    2013-12-01

    Full Text Available Background: The relationship between diet and cardiovascular risk factors in men and women with Coronary Artery Disease (CAD has been the subject of recent studies. We studied a group of Iranian CAD patients to analyze any relationship between diet and CAD risk factors based on gender. Methods: In this study, 461 consecutive patients were assessed before their planned isolated coronary artery bypass graft surgery. They were interviewed to obtain the quantity and components of nutrients and micronutrients based on a validated food frequency questionnaire. Diet scores were calculated in each dietary group and the total score was reported as the Mediterranean Diet Quality Index (Med-DQI. Physical activity was assessed using International Physical Activity Questionnaire (IPAQ. Functional class, EuroSCORE and the frequency of the known risk factors in the men and women were recorded as well. Results: The women were more likely than the men to present with obesity, diabetes mellitus, hypercholesterolemia, and hypertension (all Ps < 0.001. Also, the women had higher functional class and mean of EuroSCORE (P < 0.001 and P = 0.03. Only six women (5.7% reported to have regular physical activity. In addition, Women’s energy intake was more likely to be supplied through fat. Cereals, fruit, and vegetable consumption in both genders was within the safe recommended range, while olive and fish consumption was low in both sexes. MedDQI score was different between men and women with hypertension (P = 0.018 and obesity (P = 0.048. Conclusions: Modifiable classical risk factors for CAD, except for smoking, were more prevalent in women and were associated with their diet. Therefore, women probably need to maintain low calorie intake while improving physical activity and dietary patterns to decrease the frequency and severity of modifiable cardiac risk factors.

  18. Peripheral artery disease is a coronary heart disease risk equivalent among both men and women

    DEFF Research Database (Denmark)

    Subherwal, Sumeet; Patel, Manesh R; Kober, Lars;

    2015-01-01

    AIMS: Lower extremity peripheral artery disease (PAD) has been proposed as a 'coronary heart disease (CHD) risk equivalent'. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender. METHODS: Using nationwide Danish...... the other groups. During follow up (median 1051 d, IQR 384-1938), we found that MI-alone patients had greater risk of adverse outcomes in the acute setting (first 90 d); however, the PAD-only and PAD + MI groups had higher long-term mortality at 7 years than those with MI alone (47.8 and 60.4 vs. 36.......62-1.80, respectively), and composite of death, MI, and ischaemic stroke, 95% CI HR, 1.38, 95% CI 1.36-1.42; and HR 1.68, 95% CI 1.61-1.75, respectively). The greater long-term risks of PAD were seen for both women and men. CONCLUSIONS: Both women and men with incident PAD have greater long-term risks of total...

  19. Lifetime risk factors and arterial pulse wave velocity in adulthood: the cardiovascular risk in young Finns study.

    Science.gov (United States)

    Aatola, Heikki; Hutri-Kähönen, Nina; Juonala, Markus; Viikari, Jorma S A; Hulkkonen, Janne; Laitinen, Tomi; Taittonen, Leena; Lehtimäki, Terho; Raitakari, Olli T; Kähönen, Mika

    2010-03-01

    Limited and partly controversial data are available regarding the relationship of arterial pulse wave velocity and childhood cardiovascular risk factors. We studied how risk factors identified in childhood and adulthood predict pulse wave velocity assessed in adulthood. The study cohort consisted of 1691 white adults aged 30 to 45 years who had risk factor data available since childhood. Pulse wave velocity was assessed noninvasively by whole-body impedance cardiography. The number of conventional childhood and adulthood risk factors (extreme quintiles for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, body mass index, and smoking) was directly associated with pulse wave velocity in adulthood (P=0.005 and P<0.0001, respectively). In multivariable regression analysis, independent predictors of pulse wave velocity were sex (P<0.0001), age (P<0.0001), childhood systolic blood pressure (P=0.002) and glucose (P=0.02), and adulthood systolic blood pressure (P<0.0001), insulin (P=0.0009), and triglycerides (P=0.003). Reduction in the number of risk factors (P<0.0001) and a favorable change in obesity status (P=0.0002) from childhood to adulthood were associated with lower pulse wave velocity in adulthood. Conventional risk factors in childhood and adulthood predict pulse wave velocity in adulthood. Favorable changes in risk factor and obesity status from childhood to adulthood are associated with lower pulse wave velocity in adulthood. These results support efforts for a reduction of conventional risk factors both in childhood and adulthood in the primary prevention of atherosclerosis. PMID:20083727

  20. Common Polymorphism A1298C in Methylenetetrahydrofolate Reductase Gene Is not a Risk Factor for Coronary Artery Disease in Selected Iranian Patients

    Directory of Open Access Journals (Sweden)

    Mojgan Mirakhori

    2007-08-01

    Full Text Available Background: Coronary artery disease (CAD is emerging as a major public health concern in most developing countries. During the past 10 years, the vast majority of over 100 case-control retrospective studies have shown that elevated plasma homocysteine level is a strong independent risk factor for coronary artery disease. Methylenetetrahydrofolate reductase (MTHFR is a key enzyme in folate and homocysteine metabolism. A second polymorphism, A1298C, in MTHFR gene, is reported to be associated with decreased enzyme activity and may give rise to elevated blood homocysteine level and increased risk of coronary artery disease. Methods: In the present study we used PCR-RFLP analysis to investigate the association between A1298C polymorphism and blood homocysteine level and the risk of CAD in 100 patients compared to 100 normal controls. Results: The frequency of mutated allele and genotype distribution showed no significant difference between patient and control groups. Although the elevated level in blood homocysteine were observed in Iranian CAD cases compared to the normal control, the A1298C polymorphism was not associated with increased CAD risk in studied population as supported by a P value>0.05 and chi-square equal to 0.697.Conclusion: An increased plasma homocysteine concentration confers an independent risk factor for CAD. Although A1298C polymorphism in MTHFR gene has effects on enzyme activity but our findings do not support a major role for this polymorphism in homocysteine metabolism and it can not be considered a major risk factor for coronary artery disease in a selected Iranian population.

  1. Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

    Science.gov (United States)

    Bauer, Stefan; Savundra, James

    2013-01-01

    We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained without the ulnar and radial artery. Arterial manipulation and tube insertion outside a specialist centre bears the risk of increased morbidity and potential microembolism and must therefore not be attempted.

  2. Coronary artery calcium scores and cardiovascular risk factors in 31,545 asymptomatic Korean adults.

    Science.gov (United States)

    Jang, Shin Yi; Kim, Sung Mok; Sung, Jidong; Cho, Soo Jin; Choe, Yeon Hyeon

    2016-06-01

    The aims of this study were to identify the distribution of coronary artery calcium score (CACS) by age group and cardiovascular (CV) risk factors and to evaluate the association between CV risk factors and CACS classification in asymptomatic adults. The study included 31,545 asymptomatic Koreans, over 20 years of age with no previous history of malignancy, proven coronary artery disease, or stroke, who underwent CACS computed tomography at the Health Promotion Center, Samsung Medical Center, between January 2005 and June 2013. Mean (±SD) age was 53.8 (±8.5) years overall, 56.1 (±8.3) in men, and 53.3 (±8.5) in women. They were classified into five groups based on their resting CACS: none (CAC = 0), minimal (0  CAC). Older age groups exhibited higher CACS values. The proportion of CACS classification in our study was 55.5 % with no CACS, 9.5 % with minimal CACS, 19.8 % with mild CACS, 10.8 % with moderate CACS, and 4.3 % with extensive CACS. Adjusted odds ratios (ORs) were calculated for CV risk factors to determine their association with CACS. When analyzed according to sex, in males, the adjusted OR for CACS increased with the presence of hypertension (HT), diabetes mellitus (DM), obesity, chronic kidney disease, and smoking status. While, in females, the adjusted OR for CACS increased with the presence of HT, DM, and obesity. CV risk factors appear to be significantly associated with CACS in the Korean population. PMID:27119164

  3. Common variants associated with plasma triglycerides and risk for coronary artery disease

    Science.gov (United States)

    Do, Ron; Willer, Cristen J.; Schmidt, Ellen M.; Sengupta, Sebanti; Gao, Chi; Peloso, Gina M.; Gustafsson, Stefan; Kanoni, Stavroula; Ganna, Andrea; Chen, Jin; Buchkovich, Martin L.; Mora, Samia; Beckmann, Jacques S.; Bragg-Gresham, Jennifer L.; Chang, Hsing-Yi; Demirkan, Ayşe; Den Hertog, Heleen M.; Donnelly, Louise A.; Ehret, Georg B.; Esko, Tõnu; Feitosa, Mary F.; Ferreira, Teresa; Fischer, Krista; Fontanillas, Pierre; Fraser, Ross M.; Freitag, Daniel F.; Gurdasani, Deepti; Heikkilä, Kauko; Hyppönen, Elina; Isaacs, Aaron; Jackson, Anne U.; Johansson, Åsa; Johnson, Toby; Kaakinen, Marika; Kettunen, Johannes; Kleber, Marcus E.; Li, Xiaohui; Luan, Jian'an; Lyytikäinen, Leo-Pekka; Magnusson, Patrik K.E.; Mangino, Massimo; Mihailov, Evelin; Montasser, May E.; Müller-Nurasyid, Martina; Nolte, Ilja M.; O'Connell, Jeffrey R.; Palmer, Cameron D.; Perola, Markus; Petersen, Ann-Kristin; Sanna, Serena; Saxena, Richa; Service, Susan K.; Shah, Sonia; Shungin, Dmitry; Sidore, Carlo; Song, Ci; Strawbridge, Rona J.; Surakka, Ida; Tanaka, Toshiko; Teslovich, Tanya M.; Thorleifsson, Gudmar; Van den Herik, Evita G.; Voight, Benjamin F.; Volcik, Kelly A.; Waite, Lindsay L.; Wong, Andrew; Wu, Ying; Zhang, Weihua; Absher, Devin; Asiki, Gershim; Barroso, Inês; Been, Latonya F.; Bolton, Jennifer L.; Bonnycastle, Lori L; Brambilla, Paolo; Burnett, Mary S.; Cesana, Giancarlo; Dimitriou, Maria; Doney, Alex S.F.; Döring, Angela; Elliott, Paul; Epstein, Stephen E.; Eyjolfsson, Gudmundur Ingi; Gigante, Bruna; Goodarzi, Mark O.; Grallert, Harald; Gravito, Martha L.; Groves, Christopher J.; Hallmans, Göran; Hartikainen, Anna-Liisa; Hayward, Caroline; Hernandez, Dena; Hicks, Andrew A.; Holm, Hilma; Hung, Yi-Jen; Illig, Thomas; Jones, Michelle R.; Kaleebu, Pontiano; Kastelein, John J.P.; Khaw, Kay-Tee; Kim, Eric; Klopp, Norman; Komulainen, Pirjo; Kumari, Meena; Langenberg, Claudia; Lehtimäki, Terho; Lin, Shih-Yi; Lindström, Jaana; Loos, Ruth J.F.; Mach, François; McArdle, Wendy L; Meisinger, Christa; Mitchell, Braxton D.; Müller, Gabrielle; Nagaraja, Ramaiah; Narisu, Narisu; Nieminen, Tuomo V.M.; Nsubuga, Rebecca N.; Olafsson, Isleifur; Ong, Ken K.; Palotie, Aarno; Papamarkou, Theodore; Pomilla, Cristina; Pouta, Anneli; Rader, Daniel J.; Reilly, Muredach P.; Ridker, Paul M.; Rivadeneira, Fernando; Rudan, Igor; Ruokonen, Aimo; Samani, Nilesh; Scharnagl, Hubert; Seeley, Janet; Silander, Kaisa; Stančáková, Alena; Stirrups, Kathleen; Swift, Amy J.; Tiret, Laurence; Uitterlinden, Andre G.; van Pelt, L. Joost; Vedantam, Sailaja; Wainwright, Nicholas; Wijmenga, Cisca; Wild, Sarah H.; Willemsen, Gonneke; Wilsgaard, Tom; Wilson, James F.; Young, Elizabeth H.; Zhao, Jing Hua; Adair, Linda S.; Arveiler, Dominique; Assimes, Themistocles L.; Bandinelli, Stefania; Bennett, Franklyn; Bochud, Murielle; Boehm, Bernhard O.; Boomsma, Dorret I.; Borecki, Ingrid B.; Bornstein, Stefan R.; Bovet, Pascal; Burnier, Michel; Campbell, Harry; Chakravarti, Aravinda; Chambers, John C.; Chen, Yii-Der Ida; Collins, Francis S.; Cooper, Richard S.; Danesh, John; Dedoussis, George; de Faire, Ulf; Feranil, Alan B.; Ferrières, Jean; Ferrucci, Luigi; Freimer, Nelson B.; Gieger, Christian; Groop, Leif C.; Gudnason, Vilmundur; Gyllensten, Ulf; Hamsten, Anders; Harris, Tamara B.; Hingorani, Aroon; Hirschhorn, Joel N.; Hofman, Albert; Hovingh, G. Kees; Hsiung, Chao Agnes; Humphries, Steve E.; Hunt, Steven C.; Hveem, Kristian; Iribarren, Carlos; Järvelin, Marjo-Riitta; Jula, Antti; Kähönen, Mika; Kaprio, Jaakko; Kesäniemi, Antero; Kivimaki, Mika; Kooner, Jaspal S.; Koudstaal, Peter J.; Krauss, Ronald M.; Kuh, Diana; Kuusisto, Johanna; Kyvik, Kirsten O.; Laakso, Markku; Lakka, Timo A.; Lind, Lars; Lindgren, Cecilia M.; Martin, Nicholas G.; März, Winfried; McCarthy, Mark I.; McKenzie, Colin A.; Meneton, Pierre; Metspalu, Andres; Moilanen, Leena; Morris, Andrew D.; Munroe, Patricia B.; Njølstad, Inger; Pedersen, Nancy L.; Power, Chris; Pramstaller, Peter P.; Price, Jackie F.; Psaty, Bruce M.; Quertermous, Thomas; Rauramaa, Rainer; Saleheen, Danish; Salomaa, Veikko; Sanghera, Dharambir K.; Saramies, Jouko; Schwarz, Peter E.H.; Sheu, Wayne H-H; Shuldiner, Alan R.; Siegbahn, Agneta; Spector, Tim D.; Stefansson, Kari; Strachan, David P.; Tayo, Bamidele O.; Tremoli, Elena; Tuomilehto, Jaakko; Uusitupa, Matti; van Duijn, Cornelia M.; Vollenweider, Peter; Wallentin, Lars; Wareham, Nicholas J.; Whitfield, John B.; Wolffenbuttel, Bruce H.R.; Altshuler, David; Ordovas, Jose M.; Boerwinkle, Eric; Palmer, Colin N.A.; Thorsteinsdottir, Unnur; Chasman, Daniel I.

    2013-01-01

    Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiologic studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P<5×10−8 for each) to examine the role of triglycerides on risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglycerides, and show that the direction and magnitude of both are factors in determining CAD risk. Second, we consider loci with only a strong magnitude of association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol, a polymorphism's strength of effect on triglycerides is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD. PMID:24097064

  4. CORRELATIONS OF DIFFERENT STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF ARTERIAL WALL WITH TRADITIONAL CARDIOVASCULAR RISK FACTORS IN HEALTHY PEOPLE OF DIFFERENT AGE. PART 1

    Directory of Open Access Journals (Sweden)

    I. D. Strazhesko

    2016-05-01

    Full Text Available Arterial wall status is determined by several characteristics, the main of them are as follows: pulse wave velocity (PWV, carotid arteries intima-media thickness (IMT, the presence of atherosclerotic plaques, endothelium-dependent vasodilation (EDVD. When these parameters change, the risk for cardiovascular disease (CVD grows. The nature of relationship between these indices in people without CVD clinical signs is understudied, especially in those of older age.Aim. To estimate correlations between different parameters of arterial wall in patients of different age without CVD.Material and methods. A total of 303 people aged 25-91 years without any manifestations of CVD or other chronic diseases and without regular medical treatment were examined. PWV estimation, carotid ultrasound with IMT measurement and atherosclerotic plaques amount calculation and EDVD estimation using reactive hyperemia test were performed. Results. Patients without CVD clinical signs rather often reveal arterial wall lesions already in the younger age group (mean age 40.9±8.7: reduced EDVD – in 26% of the cases, the presence of atherosclerotic plaques – in 22%, increased PWV – in 15%, increased IMT – in 8%. The prevalence of arterial wall alterations in the older age group (mean age 61.19±8.5 increase many-fold. All arterial wall parameters correlate with age. The stronger correlation was revealed between IMT and the amount of atherosclerotic plaques: r=0.46 (р<0.001 in the younger group and r=0.47 (р<0.001 in the older one. We didn’t find any relationship between PWV and EDVD in the younger group and between PWV and the amount of atherosclerotic plaques in the older one. Thickened carotid intima-media increases the risk of arterial stiffness by 2.3 times.Conclusion. Estimation of the state of arterial wall in people of young age without CVD allows detecting individuals who require active CVD prevention. Increased stiffness of arterial wall and the development

  5. RIESGO DE ARRITMIAS E HIPERTENSIÓN ARTERIAL / Risk of Arrhythmias and hypertension

    Directory of Open Access Journals (Sweden)

    Raimundo Carmona Puerta

    2012-03-01

    Full Text Available Resumen La mayor prevalencia de fibrilación auricular se duplica en pacientes con cardiopatía hipertensiva. En el estudio Framingham se encontraron como factores de riesgo: la hipertensión, la máxima duración y dispersión de la onda P del electrocardiograma, el tamaño de la aurícula y la masa ventricular izquierda. El sistema renina-angiotensina-aldosterona es responsable de la inflamación y los cambios estructurales que justifican la aparición de arritmias en el paciente hipertenso. La presencia de arritmias ventriculares, desde complejos ventriculares prematuros hasta la taquicardia ventricular, se ha demostrado entre un 10 - 27 % en los pacientes afectados, porcentaje que disminuye mientras más grave es la arritmia. Se han resumido los siguientes marcadores incruentos de riesgo para presentar arritmias ventriculares: dispersión y variabilidad del intervalo QT, presencia de potenciales tardíos, variabilidad de la frecuencia cardíaca, y morfología anormal y alternancia de la onda T. Todos ellos relacionados con cambios anátomo-estructurales de la pared ventricular, que afectan el potencial de acción. La importancia de conocer la epidemiología, fisiopatología, y los marcadores incruentos de riesgo de presentar arritmias en el paciente hipertenso, ofrece un camino para la aplicación de una correcta terapéutica en el control de las cifras de presión arterial y regresión de la hipertrofia, como lo han demostrado los fármacos inhibidores del sistema renina-angiotensina-aldosterona, que disminuyen el riesgo de arritmias. / Abstract The higher prevalence of atrial fibrillation is doubled in patients with hypertensive heart disease. In the Framingham study, the following risk factors were found: hypertension, maximum P wave duration and dispersion of the electrocardiogram, atrial size and left ventricular mass. The renin-angiotensin-aldosterone system is responsible for the inflammation and the structural changes that justify

  6. Renal artery stenosis in kidney transplants: assessment of the risk factors

    Directory of Open Access Journals (Sweden)

    Ghabili K

    2011-08-01

    Full Text Available Jalal Etemadi1, Khosro Rahbar2, Ali Nobakht Haghighi2, Nazila Bagheri2, Kianoosh Falaknazi2, Mohammad Reza Ardalan1, Kamyar Ghabili3, Mohammadali M Shoja31Department of Nephrology, Dialysis and Transplantation, Tabriz University of Medical Sciences, Tabriz, 2Department of Nephrology, Shaheed Beheshti University of Medical Sciences, Tehran, 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Transplant renal artery stenosis (TRAS is an important cause of hypertension and renal allograft dysfunction occurring in kidney transplant recipients. However, conflicting predisposing risk factors for TRAS have been reported in the literature.Objective: The aim of the present study was to assess the potential correlation between possible risk factors and TRAS in a group of living donor renal transplant recipients 1 year after the renal transplantation.Methods: We evaluated the presence of renal artery stenosis in 16 recipients who presented with refractory hypertension and/or allograft dysfunction 1 year after renal transplantation. Screening for TRAS was made by magnetic resonance angiography and diagnosis was confirmed by conventional renal angiography. Age, gender, history of acute rejection, plasma lipid profile, serum creatinine, blood urea nitrogen, serum uric acid, calcium phosphate (CaPO4 product, alkaline phosphatase, fasting blood sugar, hemoglobin, and albumin were compared between the TRAS and non-TRAS groups.Results: Of 16 kidney transplant recipients, TRAS was diagnosed in three patients (two men and one woman. High levels of calcium, phosphorous, CaPO4 product, and low-density lipoprotein (LDL cholesterol were significantly correlated with the risk of TRAS 1 year after renal transplantation (P < 0.05. Serum level of uric acid tended to have a significant correlation (P = 0.051.Conclusion: Correlation between high CaPO4 product, LDL cholesterol, and perhaps uric acid and TRAS in living

  7. Identification by ultrasound evaluation of the carotid and femoral arteries of high-risk subjects missed by three validated cardiovascular disease risk algorithms.

    Science.gov (United States)

    Postley, John E; Luo, Yanting; Wong, Nathan D; Gardin, Julius M

    2015-11-15

    Atherosclerotic cardiovascular disease (ASCVD) events are the leading cause of death in the United States and globally. Traditional global risk algorithms may miss 50% of patients who experience ASCVD events. Noninvasive ultrasound evaluation of the carotid and femoral arteries can identify subjects at high risk for ASCVD events. We examined the ability of different global risk algorithms to identify subjects with femoral and/or carotid plaques found by ultrasound. The study population consisted of 1,464 asymptomatic adults (39.8% women) aged 23 to 87 years without previous evidence of ASCVD who had ultrasound evaluation of the carotid and femoral arteries. Three ASCVD risk algorithms (10-year Framingham Risk Score [FRS], 30-year FRS, and lifetime risk) were compared for the 939 subjects who met the algorithm age criteria. The frequency of femoral plaque as the only plaque was 18.3% in the total group and 14.8% in the risk algorithm groups (n = 939) without a significant difference between genders in frequency of femoral plaque as the only plaque. Those identified as high risk by the lifetime risk algorithm included the most men and women who had plaques either femoral or carotid (59% and 55%) but had lower specificity because the proportion of subjects who actually had plaques in the high-risk group was lower (50% and 35%) than in those at high risk defined by the FRS algorithms. In conclusion, ultrasound evaluation of the carotid and femoral arteries can identify subjects at risk of ASCVD events missed by traditional risk-predicting algorithms. The large proportion of subjects with femoral plaque only supports the use of including both femoral and carotid arteries in ultrasound evaluation.

  8. Prevalence and related risk factors of peripheral arterial disease in elderly patients with type 2 diabetes in Wuhan, Central China

    Institute of Scientific and Technical Information of China (English)

    WANG Li; DU Fan; MAO Hong; WANG Hong-xiang; ZHAO Shi

    2011-01-01

    Bsckground The investigations of prevalence and risk factors of peripheral arterial disease (PAD) in type 2 diabetic patients have been carried out in many countries and regions,except for Central China.In this study,we determined the prevalence of PAD in type 2 diabetic patients and the related factors that gave rise to increasing of the risk of PAD development in Wuhan,China.Methods The study enrolled 2010 patients aged 60 years and older who were regularly visiting the Central Hospital of Wuhan that is a public hospital from 2005 to 2010,where all residents of the city were offered the medical services.PAD was defined as an ankle-brachial index <0.90 in either leg.To evaluate the role of various risk factors in PAD development,uniformed interviews,clinical examinations and laboratory investigation of all of participants were performed in this study.The correlation between potential risk factors and PAD was analyzed.Results In Wuhan,the prevalence rate of PAD was 24.1% in elderly diabetic patients.Totally,291 patients with PAD had at least one weak but not absent dorsalis pedis pulse in both feet,while 541 patients without PAD showed this way.At least one absent dorsalis pedis pulse was found in 192 patients with PAD as well as 10 patients without PAD.The results of multivariate regression analysis suggested that the age,smoking history,hypertension,diabetic neuropathy and macroangiopathy gave rise to significant increase of PAD development in type 2 diabetic diseases.Conclusions The prevalence of PAD in elderly patients with type 2 diabetes in Wuhan was close to the prevalence that was reported in other regions of China and other Asian countries.Control of the related risk factors and early diagnosis of PAD may play a role in PAD prevention and improving prognosis.

  9. Nuclear Thermal Propulsion Development Risks

    Science.gov (United States)

    Kim, Tony

    2015-01-01

    There are clear advantages of development of a Nuclear Thermal Propulsion (NTP) for a crewed mission to Mars. NTP for in-space propulsion enables more ambitious space missions by providing high thrust at high specific impulse ((is) approximately 900 sec) that is 2 times the best theoretical performance possible for chemical rockets. Missions can be optimized for maximum payload capability to take more payload with reduced total mass to orbit; saving cost on reduction of the number of launch vehicles needed. Or missions can be optimized to minimize trip time significantly to reduce the deep space radiation exposure to the crew. NTR propulsion technology is a game changer for space exploration to Mars and beyond. However, 'NUCLEAR' is a word that is feared and vilified by some groups and the hostility towards development of any nuclear systems can meet great opposition by the public as well as from national leaders and people in authority. The public often associates the 'nuclear' word with weapons of mass destruction. The development NTP is at risk due to unwarranted public fears and clear honest communication of nuclear safety will be critical to the success of the development of the NTP technology. Reducing cost to NTP development is critical to its acceptance and funding. In the past, highly inflated cost estimates of a full-scale development nuclear engine due to Category I nuclear security requirements and costly regulatory requirements have put the NTP technology as a low priority. Innovative approaches utilizing low enriched uranium (LEU). Even though NTP can be a small source of radiation to the crew, NTP can facilitate significant reduction of crew exposure to solar and cosmic radiation by reducing trip times by 3-4 months. Current Human Mars Mission (HMM) trajectories with conventional propulsion systems and fuel-efficient transfer orbits exceed astronaut radiation exposure limits. Utilizing extra propellant from one additional SLS launch and available

  10. Risk factors and consequences of unexpected trapping for ruptured anterior communicating artery aneurysms

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    Hitoshi Fukuda

    2014-01-01

    Full Text Available Background: While clipping cerebral aneurysms at the neck is optimal, in some cases this is not possible and other strategies are necessary. The purpose of this study was to describe the incidence, risk factors, and outcomes for inability to clip reconstruct ruptured anterior communicating artery (ACoA aneurysms. Methods: Of the 70 cases of ruptured ACoA aneurysms between January 2006 and December 2013, our institutional experience revealed four cases of small ACoA aneurysms that had been considered clippable prior to operation but required trapping. When a unilateral A2 segment of anterior cerebral artery (ACA was compromised by trapping, revascularization was performed by bypass surgery. Clinical presentation, angiographic characteristics, operative approach, intraoperative findings, and treatment outcomes were assessed. Results: Very small aneurysm under 3 mm was a risk factor for unexpected trapping. The reason for unexpected trapping was laceration of the aneurysmal neck in two cases, and lack of clippaple component due to disintegration of entire aneurysmal wall at the time of rupture in the others. Aneurysms with bilateral A1 were treated with sole trapping through pterional approach in two cases. The other two cases had hypoplastic unilateral A1 segment of ACA and were treated with combination of aneurysm trapping and revascularization of A2 segment of ACA through interhemispheric approach. No patients had new cerebral infarctions of cortical ACA territory from surgery. Cognitive dysfunction was observed in three cases, but all patients became independent at 12-month follow up. Conclusions: Unexpected trapping was performed when ruptured ACoA aneurysms were unclippable. Trapping with or without bypass can result in reasonable outcomes, with acceptable risk of cognitive dysfunction.

  11. Kale Juice Improves Coronary Artery Disease Risk Factors in Hypercjlolesterolemiic Men

    Institute of Scientific and Technical Information of China (English)

    SOO YEON KIM; SUN YOON; SOO MI KWON; KYE SOOK PARK; YANG CHA LEE-KIM

    2008-01-01

    Objective To evaluate the effect of 3-month kale(Brassica oleracea acephala)iuice supplementation on coronary artery disease risk factors among hypercholesterolemic men.Methods Thkty-two men with hypercholesterolemia (>200 mg/dL)were recruited after annual health examinations among the faculty and staff at university.The subijects consumed 150 mL of kale iuice per day for a 12-week intervention period.Dietary and anthropomeu-ic assessments were performed and blood samples were collected to evaluate biochemical profdes before and after supplementation.Results Serum concentrations of HDL-cholesterol,and HDL-to LDL-cholesterol ratio were significantly increased by 27%(P<0.0001)and 52%(P<0.0001),respectively.The LDL-cholesterol concentration and the atherogenic index were significantly reduced by 1O%(P=0.O007)and 24.2%(P<0.0001),respectively without affecting body mass index,waist and hip circumferences,or nutrient intakes after three months of supplementation.While there was no difference in the concentration of malondialdehvde,significant increase in glutathione peroxidase activity(P=0.0005)were accompanied by a significant increase in the serom selenium level(P=0.0132).It was also foand that the responses of these risk factors to kale inice administration were dependent on smoking status.Conelusion Regular meals supplementation with kale juice can favorably influence serum lipid profiles and antioxidant systems.and hence contribute to reduce the risks of coronary artery disease in male subjects with hyperlipidemia.

  12. Development of an improved high performance artery heat pipe

    Science.gov (United States)

    Kraehling, H.

    1981-05-01

    An existing space-qualified arterial high performance heat pipe was improved. Attempts to cut grooves with a self made single point threading tool were not successful. The grooves were not deep enough, so that a sufficient liquid supply over the entire circumference in the heating zone could not be obtained. Employment of commercially available thread taps showed an improvement in the groove depth but the groove profile itself was still poor. A further improvement of the profile shape was attained with a special set of threading tools consisting of an entering tap and a plug tap. Performance measurements with respective artery heat pipes confirmed that the heat pipe performance became better with the improvement of the circumferential groove profile. However, all investigated circumferential groove designs revealed a definitely poorer performance than the standard design with a screenwick as a secondary capillary structure.

  13. Prevalence of coronary artery disease risk factors in Iran: a population based survey

    Directory of Open Access Journals (Sweden)

    Gafarzadeh Motlag A

    2007-10-01

    Full Text Available Abstract Background Coronary artery disease (CAD is a leading cause of mortality, morbidity, and disability with high health care cost in Iran. It accounts for nearly 50 percent of all deaths per year. Yet little is known about CAD and CAD risk factors in the Iranian population. We aimed to assess the prevalence of different CAD risk factors in an Iranian population. Methods A descriptive cross sectional survey was conducted involving 3000 healthy adults at 18 years of age or above who were recruited with cluster random sampling. Demographic data and risk factors were determined by taking history, physical examination and laboratory tests. Results The average age was 36.23 ± 15.26. There was 1381 female (46% and 1619 male (54% out of which 6.3% were diabetic, 21.6% were smoker, and 15% had positive familial heart disease history. 61% had total cholesterol level > 200 mg/dL, 32% triglyceride > 200 mg/dl, 47.5% LDL-c > 130 mg/dl, 5.4% HDL-c 140 mmHg, 9.1% diastolic blood pressure > 90 mmHg and 87% of them were physically inactive. Conclusion Clinical and Para-clinical data indicated that Iranian adult population are of a high level of CAD risk factors, which may require urgent decision making to address national control measures regarding CAD.

  14. On-Pump Beating Coronary Artery Bypass in High Risk Coronary Patients

    Directory of Open Access Journals (Sweden)

    Abbas Afrasiabirad

    2015-01-01

    Full Text Available Background: There are some conflicting results with Conventional Coronary Artery Bypass Grafts (CCABG with arrested heart in coronary high-risk patients. Moreover, performing off-pump CABG in these cases may be associated with serious complications. The objective of this study is to evaluate the efficacy of the on-pump beating CABG (OPBCABG in coronary high-risk patients in comparison with the conventional methods. Methods: In a prospective research study, 3000 off-pump CABG patients were considered during June 2003 to December 2011. Among these, 157 patients with one or more of the following risk factors were included for OPBCABG; severe left main stenosis, early post-acute myocardial infarction with ongoing chest pain, unstable angina, intractable ventricular arrhythmia, post complicated coronary intervention and severe left ventricular dysfunction. These patients were compared with 157 similar patients undergone CCABG with aortic cross clamp before 2003. Results: Preoperative patient characteristics revealed no significant differences between the two groups. The patients’ mean age and number of grafts were 57 years and 3 per patient respectively. Hospital mortality was 3.2% and 9% in OPBCABG and CCABG groups, respectively (P<0.001. Preoperative myocardial infarction, requirement of inotropic agents and intraaortic balloon pump, renal dysfunction and prolonged ventilation time were significantly higher in CCABG group. Conclusion: Our results suggest that OPBCABG is effective in coronary high-risk patients and significantly reduces mortality and the incidence of perioperative MI and other major complications.

  15. Traumatic Popliteal Artery Pseudoaneurysm Developed during a Soccer Game

    OpenAIRE

    Lee, Seock Yeol; Lee, Seung-Jin; Lee, Chol-Sae

    2011-01-01

    A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those ...

  16. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    International Nuclear Information System (INIS)

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m2, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m2, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension

  17. Detection of Altered Risk Factors in Hospitalized Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Avany Fernandes Pereira

    2002-09-01

    Full Text Available OBJECTIVE: To assess biochemical, anthropometric, and dietary variables considered risk factors for coronary artery disease. METHODS: Using anthropometrics, dietary allowance, and blood biochemistry, we assessed 84 patients [54 males (mean age of 55± 8 years and 30 females (mean age of 57±7 years], who had severe ( > or = 70% coronary artery obstruction and nonsevere forms of coronary artery disease determined by cardiac catheterization. The severe form of the disease prevailed in 70% of the males and 64% of the females, and a high frequency of familial antecedents (92% ' 88% and history of acute myocardial infarction (80% ' 70% were observed. Smoking predominated among males (65% and diabetes mellitus among females (43%. RESULTS: Males and females had body mass index and body fat above the normal values. Females with nonsevere lesions had HDL > 35 mg/dL, and this constituted a discriminating intergroup indicator. Regardless of the severity of the disease, hyperglycemia and hypertriglyceridemia were found among females, and cholesterolemia > 200 mg/dL in both sexes, but only males had LDL fraction > 160 mg/dL and homocysteine > 11.7 mmol/L. The male dietary allowance was inadequate in nutrients for homocysteine metabolism and in nutrients with an antioxidant action, such as the vitamins B6, C, and folate. Individuals of both sexes had a higher lipid and cholesterol intake and an inadequate consumption of fiber. The diet was classified as high-protein, high-fat, and low-carbohydrate. CONCLUSION: The alterations found had no association with the severity of lesions, indicating the need for more effective nutritional intervention.

  18. Pulmonary Arterial Hypertension: Use of Delayed Contrast-Enhanced Cardiovascular Magnetic Resonance in Risk Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Bessa, Luiz Gustavo Pignataro, E-mail: lgpignataro@ig.com.br; Junqueira, Flávia Pegado; Bandeira, Marcelo Luiz da Silva; Garcia, Marcelo Iorio; Xavier, Sérgio Salles; Lavall, Guilherme; Torres, Diego; Waetge, Daniel [Hospital Universitário Clementino Fraga Filho, Ilha do Fundão, RJ (Brazil)

    2013-10-15

    Pulmonary arterial hypertension is a severe and progressive disease. Its early diagnosis is the greatest clinical challenge. To evaluate the presence and extension of the delayed myocardial contrast-enhanced cardiovascular magnetic resonance, as well as to verify if the percentage of the myocardial fibrosis mass is a severity predictor. Cross-sectional study with 30 patients with pulmonary arterial hypertension of groups I and IV, subjected to clinical, functional and hemodynamic evaluation, and to cardiac magnetic resonance. The mean age of patients was 52 years old, with female predominance (77%). Among the patients, 53% had right ventricular failure at diagnosis, and 90% were in functional class II/III. The mean of the 6-minute walk test was 395m. In hemodynamic study with right catheterism, the mean average pulmonary arterial pressure was 53.3mmHg, of the cardiac index of 2.1L/ min.m{sup 2}, and median right atrial pressure was 13.5 mmHg. Delayed myocardial contrast enhanced cardiovascular magnetic resonance was found in 28 patients. The mean fibrosis mass was 9.9 g and the median percentage of fibrosis mass was 6.17%. The presence of functional class IV, right ventricular failure at diagnosis, 6-minute walk test < 300 meters and right atrial pressure ≥ 15 mmHg, with cardiac index < 2.0 L/ min.m{sup 2}, there was a relevant association with the increased percentage of myocardial fibrosis. The percentage of the myocardial fibrosis mass indicates a non-invasive marker with promising perspectives in identifying patients with high risk factors for pulmonary hypertension.

  19. Hybrid coronary artery revascularization: logistics and program development.

    Science.gov (United States)

    Friedrich, Guy J; Jonetzko, Patricja; Bonaros, Nikos; Schachner, Thomas; Danzmayr, Michael; Kofler, Ruth; Laufer, G; Pachinger, O; Bonatti, Johannes

    2005-01-01

    Planning hybrid coronary artery revascularization--a combination of cardiac surgery with percutaneous procedures--requires, at first sight, a very complex logistical setup. Technical and equipment related details should be defined as early as possible in order to have time for training of all OR personnel involved. The most challenging aspect in OR-located hybrid coronary revascularization remains a very close cooperation of cardiac surgeons and interventional cardiologists. This teamwork does include indication findings and subsequent referral of multivessel coronary artery disease patients to hybrid procedures, as well as high individual flexibility of interventionalists and surgeons. The major prerequisite for this cooperation is a mutual acceptance of different revascularization approaches and the intent to combine their most striking advantages. Intraoperative graft angiography during coronary artery bypass grafting (CABG) procedures is one important step toward simultaneous hybrid coronary revascularization procedures. We describe our experience with on table angiography using a mobile C-arm for intraoperative imaging. This fluoroscopy system can in selected cases be used for simultaneous hybrid procedures. PMID:16112939

  20. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG: incidence, risk factors and mortality

    Directory of Open Access Journals (Sweden)

    Abbasi Kyomars

    2007-09-01

    Full Text Available Abstract Background Sternal wound infection (SWI is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG at Tehran Heart Center. Methods This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis was categorized according to the Oakley classification. Results In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases and deep SWI of 0.22 percent (21 cases. Perioperative (in-hospital mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h, and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05 in univariate analysis. In multivariate analysis, hypertension (OR = 10.7, re-exploration (OR = 13.4, and female gender (OR = 2.7 were identified as significant predictors of SWI (p Conclusion Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

  1. HEMODYNAMIC INSIGNIFICANT CAROTID ARTERIES STENOSIS AND RISK OF EMBOLIC STROKE IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    V. V. Semenova

    2009-01-01

    Full Text Available Aim. To assess a risk of vascular embolism in patients with ischemic heart disease (IHD and hemodynamic insignificant asymptomatic carotid stenosis.Material and methods. 100 patients with IHD were examined. Ultrasound scanning of the main cranial arteries and transcranial Dopplerography was performed in all patients as well as lipid spectrum, fibrinogen level and blood D-diameter concentration were evaluated.Results. 165 carotid atherosclerotic plaques (AP were detected in patients with IHD independently on angina severity. In IHD patients with nonhomogeneous hypoechogenic AP microembolic signals (MES were revealed in 44,78%, with nonhomogeneous hyperechogenic AP - in 25%, with homogeneous hypoechogenic AP - in 4,16% of patients. MES were not recorded in patients with homogeneous hyperechogenic AP. There were not relations between MES and parameters of lipid spectrum as well as fibrinogen and Ddiameter plasma levels.Conclusion. Thus, during transcranial dopplerographic monitoring MES were recorded in the third part (27,9% of IHD patients with hemodynamically insignificant carotid arteries stenosis. MES were predominantly observed in patients with nonhomogeneous AP especially with hypoechogenic components.

  2. Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Elayne Kelen de Oliveira

    2013-09-01

    Full Text Available INTRODUCTION: Characteristics of the patient and the coronary artery bypass grafting may predispose individuals to prolonged hospitalization, increasing costs and morbidity and mortality. OBJECTIVE: The objective of this study was to evaluate individual and perioperative risk factors of prolonged hospitalization in intensive care units and wards. METHODS: We conducted a case-control study of 104 patients undergoing isolated coronary artery bypass grafting with cardiopulmonary bypass. Patients hospitalized >3 days in the intensive care unit or >7 days in the ward were considered for the study. The association between variables was estimated by the chi-square test, odds ratio and logistic regression; P 3 days in the intensive care unit occurred for 22.1% of patients and >7 days in the ward for 27.9%. Among preoperative factors, diabetes (OR=3.17 and smoking (OR=4.07 were predictors of prolonged intensive care unit stay. Combining the pre-, intra-and postoperative variables, only mechanical ventilation for more than 24 hours (OR=6.10 was predictive of intensive care unit outcome. For the ward outcome, the preoperative predictor was left ventricular ejection fraction 24 hours for the intensive care unit and presence of infection for the ward.

  3. Contradictions Between Risk Management and Sustainable Development

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Odd Einar; Langhelle, Oluf; Engen, Ole A. [Univ. of Stavanger (Norway). Dept. of Media, Culture and Social Science

    2006-09-15

    The aim of this paper is to discuss how risk management as a methodology and mindset influence on priorities and decisions concerning sustainable development. Management of risks and hazards often rely on partial analysis with a limited time frame. This may lead to a paradoxical situation where risk management and extended use of risk analysis could hamper long term sustainable development. The question is: Does the use of risk and vulnerability analysis (RaV-analysis) hamper or contribute to sustainable development? Because risk management and assessment has a more narrow scope and a limited time perspective based on well established methodologies, the tangible impacts of risk reducing measures in a project is easier to calculate than long-term and intangible impacts on global development. Empirical evidence is still scarce, but our preliminary conclusion is that mainstream risk management and assessments is counterproductive to sustainable development.

  4. Contradictions Between Risk Management and Sustainable Development

    International Nuclear Information System (INIS)

    The aim of this paper is to discuss how risk management as a methodology and mindset influence on priorities and decisions concerning sustainable development. Management of risks and hazards often rely on partial analysis with a limited time frame. This may lead to a paradoxical situation where risk management and extended use of risk analysis could hamper long term sustainable development. The question is: Does the use of risk and vulnerability analysis (RaV-analysis) hamper or contribute to sustainable development? Because risk management and assessment has a more narrow scope and a limited time perspective based on well established methodologies, the tangible impacts of risk reducing measures in a project is easier to calculate than long-term and intangible impacts on global development. Empirical evidence is still scarce, but our preliminary conclusion is that mainstream risk management and assessments is counterproductive to sustainable development

  5. A genetic risk score of 45 coronary artery disease risk variants associates with increased risk of myocardial infarction in 6041 Danish individuals

    DEFF Research Database (Denmark)

    Krarup, N T; Borglykke, A; Allin, K H;

    2015-01-01

    CAD. METHODS: Genotype was available from 6041 Danes. An unweighted GRS was constructed by making a summated score of the 45 known genetic CAD risk variants. Registries provided information (mean follow-up = 11.6 years) on CAD (n = 374) and MI (n = 124) events. Cox proportional hazard estimates with......BACKGROUND: In Europeans, 45 genetic risk variants for coronary artery disease (CAD) have been identified in genome-wide association studies. We constructed a genetic risk score (GRS) of these variants to estimate the effect on incidence and clinical predictability of myocardial infarction (MI) and...... age as time scale was adjusted for sex, BMI, type 2 diabetes mellitus and smoking status. Analyses were also stratified either by sex or median age (below or above 45 years of age). We estimated GRS contribution to MI prediction by assessing net reclassification index (NRI) and integrated...

  6. Regression of pulmonary artery hypertension due to development of a pulmonary arteriovenous malformation

    Science.gov (United States)

    Hasan, Ashfaq; Sastry, B.K.S.; Aleem, M.A.; Reddy, Gokul; Mahmood, Syed

    2014-01-01

    Idiopathic Pulmonary Hypertension (IPAH) is characterized by elevated pulmonary arterial pressure in the absence of an identifiable underlying cause. The condition is usually relentlessly progressive with a short survival in the absence of treatment.1 We describe a patient of IPAH in whom the pulmonary artery pressures significantly abated with complete disappearance of symptoms, following spontaneous development of a pulmonary arterio-venous malformation (PAVM). PMID:25443608

  7. Tissue at risk in the deep middle cerebral artery territory is critical to stroke outcome

    Energy Technology Data Exchange (ETDEWEB)

    Rosso, Charlotte; Samson, Yves [Pitie-Salpetriere Hospital, AP-HP, Urgences Cerebro-Vasculaires, Paris (France); UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Colliot, Olivier [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Valabregue, Romain [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Centre for NeuroImaging Research (CENIR), Paris (France); Crozier, Sophie [Pitie-Salpetriere Hospital, AP-HP, Urgences Cerebro-Vasculaires, Paris (France); Dormont, Didier [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Pitie-Salpetriere Hospital, AP-HP, Department of Neuroradiology, Paris (France); Lehericy, Stephane [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Centre for NeuroImaging Research (CENIR), Paris (France); Pitie-Salpetriere Hospital, AP-HP, Department of Neuroradiology, Paris (France)

    2011-10-15

    The clinical efficacy of thrombolysis in stroke patients is explained by the increased rate of recanalization, which limits infarct growth. However, the efficacy could also be explained by the protection of specific sites of the brain. Here, we investigate where is this outcome-related tissue at risk using voxel-based analysis. We included 68 acute stroke patients with middle cerebral artery (MCA) occlusion on the admission MRI performed within 6 h of symptoms onset (H6) and 16 controls. MCA recanalization was assessed using the magnetic resonance angiography performed at day 1 (D1). Apparent diffusion coefficient (ADC) changes were analyzed using a voxel-based method between patients vs. controls group at admission (H6) in non-recanalized vs. recanalized and in 3-month poor vs. good outcome patients at D1. Complete or partial MCA recanalization was observed in 52 of 68 patients. Good outcome at 3 months occurred in 40 patients (59%). In non-recanalized patients, ADC was decreased in the deep MCA and watershed arterial territory (the lenticular nucleus, internal capsule, and the overlying periventricular white matter). This decrease was not observed in recanalized patients at D1 or patients at H6. Fiber tracking suggested that the area is crossed by the cortico-spinal, cerebellar, and intra-hemispheric association tracts. Finally, this area almost co-localized with the area associated with poor outcome. A clinically relevant area of tissue at risk may occur in patients with MCA infarcts at the level of deep white matter fiber tracts. These findings suggest that neuroprotection research should be refocused on white matter. (orig.)

  8. Superior mesenteric artery syndrome following scoliosis surgery: Its risk indicators and treatment strategy

    Institute of Scientific and Technical Information of China (English)

    Ze-Zhang Zhu; Yong Qiu

    2005-01-01

    AIM: To investigate the risk indicators, pattern of clinical presentation and treatment strategy of superior mesenteric artery syndrome (SMAS) after scoliosis surgery.METHODS: From July 1997 to October 2003, 640 patients with adolescent scoliosis who had undergone surgical treatment were evaluated prospectively, and among them seven patients suffered from SMAS after operation. Each patient was assigned a percentile for weight and a percentile for height. Values of the 5th、 10th、 25th、 50th、 75th、 and 95thpercentiles were selected to divide the observations. The sagittal Cobb angle was used to quantify thoracic or thoracolumbar kyphosis. All the seven patients presented with nausea and intermittent vomiting about 5 d after operation.An upper gastrointestinal barium contrast study showed a straight-line cutoff at the third portion of the duodenum representing extrinsic compression by the superior mesenteric artery (SMA).RESULTS: The value of height in the seven patients with SMAS was above the mean of sex- and age-matchednormal population, and the height percentile ranged from 5% to 50%. On the contrary, the value of weight was below the mean of normal population with the weight percentile ranging from 5% to 25%. Among the seven patients, four had a thoracic hyperkyphosis ranging from 55° to 88°(average 72°), two had a thoracolumbar kyphosis of 25° and 32° respectively. The seven patients were treated with fasting, antiemetic medication, and intravenous fluids infusion. Reduction or suspense of traction was adopted in three patients with SMAS during halo-femoral traction after anterior release of scoliosis. All the patients recovered completely with no sequelae. No one required operative intervention with a laparotomy.CONCLUSION: Height percentile<50% , weight percentile <25%, sagittal kyphosis, heavy and quick halo-femoral traction after spinal anterior release are the potential risk indicators for SMAS in patients undergoing correction surgery

  9. Relationship between framingham risk score and coronary artery calcium score in asymptomatic Korean individuals

    Energy Technology Data Exchange (ETDEWEB)

    Heo, So Young; Park, Noh Hyuck; Park, Chan Sub; Seong, Su Ok [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of)

    2016-02-15

    We explored the association between Framingham risk score (FRS) and coronary artery calcium score (CACS) in asymptomatic Korean individuals. We retrospectively analyzed 2216 participants who underwent routine health screening and CACS using the 64-slice multidetector computed tomography between January 2010 and June 2014. Relationship between CACS and FRS, and factors associated with discrepancy between CACS and FRS were analyzed. CACS and FRS were positively correlated (p < 0.0001). However, in 3.7% of participants with low coronary event risk and high CACS, age, male gender, smoker, hypertension, total cholesterol, diabetes mellitus, and body mass index (BMI; ≥ 35) were associated with the discrepancy. In the diagnostic prediction model for discrepancy, the receiver operating characteristic curve including factors associated with FRS, diastolic blood pressure (≥ 75 mm Hg), diabetes mellitus, and BMI (≥ 35) showed that the area under the curve was 0.854 (95% confidence interval, 0.819–0.890), indicating good sensitivity. Diabetes mellitus or obesity (BMI ≥ 35) compensate for the weakness of FRS and may be potential indicators for application of CACS in asymptomatic Koreans with low coronary event risk.

  10. Transluminal Attenuation Gradient for Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2014-11-01

    Kawasaki Disease (KD) can result in coronary aneurysms in up to 25% of patients if not treated early putting patients at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines for administering anti-coagulation therapy currently rely on anatomy alone. Previous studies including patient specific modeling and computer simulations in KD patients have suggested that hemodynamic data can predict regions susceptible to thrombus formation. In particular, high Particle Residence Time gradient (PRTg) regions have shown to correlate with regions of thrombus formation. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length. TAG has been used for characterizing coronary artery stenoses, however this approach has not yet been used in aneurysmal vessels. The aim of this study is to analyze the correlation between TAG and PRTg in KD patients with aneurysms and evaluate the use of TAG as an index to quantify thrombotic risk. Patient specific anatomic models for fluids simulations were constructed from CT angiographic image data from 3 KD aneurysm patients and one normal control. TAG values for the aneurysm patients were markedly lower than for the non-aneurysmal patient (mean -18.38 vs. -2). In addition, TAG values were compared to PRTg obtained for each patient. Thrombotic risk stratification for KD aneurysms may be improved by incorporating TAG and should be evaluated in future prospective studies.

  11. Preoperative statin is associated with decreased operative mortality in high risk coronary artery bypass patients

    Directory of Open Access Journals (Sweden)

    Maher Thomas D

    2010-02-01

    Full Text Available Abstract Background Statins are widely prescribed to patients with atherosclerosis. A retrospective database analysis was used to examine the role of preoperative statin use in hospital mortality, for patients undergoing isolated coronary artery bypass grafting (CABG. Methods The study population comprised 2377 patients who had isolated CABG at Allegheny General Hospital between 2000 and 2004. Mean age of the patients was 65 ± 11 years (range 27 to 92 years. 1594 (67% were male, 5% had previous open heart procedures, and 4% had emergency surgery. 1004 patients (42% were being treated with a statin at the time of admission. Univariate, bivariate (Chi2, Fisher's Exact and Student's t-tests and multivariate (stepwise linear regression analyses were used to evaluate the association of statin use with mortality following CABG. Results Annual prevalence of preoperative statin use was similar over the study period and averaged 40%. Preoperative clinical risk assessment demonstrated a 2% risk of mortality in both the statin and non-statin groups. Operative mortality was 2.4% for all patients, 1.7% for statin users and 2.8% for non-statin users (p Conclusions Between 2000 and 2004 less than 50% of patients at this institution were receiving statins before admission for isolated CABG. A retrospective analysis of this cohort provides evidence that preoperative statin use is associated with lower operative mortality in high-risk patients.

  12. Traumatic Popliteal Artery Pseudoaneurysm Developed during a Soccer Game.

    Science.gov (United States)

    Lee, Seock Yeol; Lee, Seung-Jin; Lee, Chol-Sae

    2011-08-01

    A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm. PMID:22263174

  13. Weak prediction power of the Framingham Risk Score for coronary artery disease in nonagenarians.

    Directory of Open Access Journals (Sweden)

    Josef Yayan

    Full Text Available Coronary artery disease (CAD is caused by an acute myocardial infarction and is still feared as a life-threatening heart disease worldwide. In order to identify patients at high risk for CAD, previous studies have proposed various risk assessment scores for the prevention of CAD. The most commonly used risk assessment score for CAD worldwide is the Framingham Risk Score (FRS. The FRS is used for middle-aged people; hence, its appropriateness has not been demonstrated to predict the likelihood of CAD occurrence in very elderly people. This article examines the possible predictive value of FRS for CAD in very elderly people over 90 years of age.Data on all patients over 90 years of age who received a cardiac catheter were collected from hospital charts from the Department of Internal Medicine, Saarland University Medical Center, and HELIOS Hospital Wuppertal, Witten/Herdecke University Medical Center, Germany, within a study period from 2004 to 2013. The FRSs and cardiovascular risk profiles of patients over 90 years of age with and without CAD after cardiac catheterization were compared.One hundred and seventy-five (91.15%, mean age 91.51±1.80 years, 74 females [42.29%]; 95% confidence interval [CI], 0.87-0.95 of a total 192 of the very elderly patients were found to have CAD. Based on the results of our study, the FRS seems to provide weak predictive ability for CAD in very elderly people (P = 0.3792.We found weak prediction power of FRS for CAD in nonagenarians.

  14. Environmental Risk Management for Developing Countries

    OpenAIRE

    Paul K Freeman; Howard Kunreuther

    2002-01-01

    Disaster losses in the developing world have increased substantially over the past decade and are likely to accelerate in future years. This paper proposes an environmental risk management program for developing countries that consists of six modules. The pre-disaster phase includes risk identification, risk mitigation, risk transfer, and preparedness; the post-disaster phase is devoted to emergency response and rehabilitation and reconstruction. We illustrate the elements of each of these ph...

  15. A drug development from risk management perspective

    OpenAIRE

    Hulín, Michal

    2011-01-01

    The purpose of this diploma thesis is to understand financing of drug development from an enterprise risk management perspective as well as to critically assess the efficiency of the ISO framework and risk management techniques used for determining whether to fund drug development or not. The diploma thesis is divided into theoretical and practical part. The first part starts with perception and assessment of uncertainty and risk in the past. It describes how risk-averse individuals attempted...

  16. Apolipoprotein A-V, triglycerides and risk of coronary artery disease : the prospective Epic-Norfolk Population Study

    NARCIS (Netherlands)

    Vaessen, Stefan F C; Schaap, Frank G; Kuivenhoven, Jan-Albert; Groen, Albert K; Hutten, Barbara A; Boekholdt, S Matthijs; Hattori, Hiroaki; Sandhu, Manjinder S; Bingham, Sheila A; Luben, Robert; Palmen, Jutta A; Wareham, Nicholas J; Humphries, Steve E; Kastelein, John J P; Talmud, Philippa J; Khaw, Kay-Tee

    2006-01-01

    In mouse models, apolipoprotein A-V (apoA-V) exhibits triglyceride (TG)-lowering effects. We investigated the apoA-V/TG relationship and the association of apoA-V with coronary artery disease (CAD) risk by determining serum apoA-V levels and genotypes in a nested case-control (n = 1,034/2,031) study

  17. The relation between coronary artery calcification in asymptomatic subjects and both traditional risk factors and living in the city centre

    DEFF Research Database (Denmark)

    Lambrechtsen, J; Gerke, Oke; Egstrup, Kenneth;

    2012-01-01

    Objective:  To evaluate the association between the risk factor of living in the city centre as a surrogate for air pollution and the presence of coronary artery calcification (CAC) in a population of asymptomatic Danish subjects. Design and subjects:  A random sample of 1825 men and women...

  18. Can Stress Echocardiography Compete with Perfusion Scintigraphy in the Detection of Coronary Artery Disease and Cardiac Risk Assessment?

    NARCIS (Netherlands)

    M.L. Geleijnse (Marcel); A. Elhendy (Abdou)

    2000-01-01

    textabstractAims: The aim of this review was to define the place of stress echocardiography in the context of perfusion scintigraphy for the detection of coronary artery disease (CAD) and the assessment of cardiac risk. Stress echocardiography has the benefits of widespread availability, relatively

  19. Risk factors for perinatal arterial ischaemic stroke in full-term infants : a case-control study

    NARCIS (Netherlands)

    Harteman, Johanna C.; Groenendaal, Floris; Kwee, Anneke; Welsing, Paco M. J.; Benders, Manon J. N. L.; de Vries, Linda S.

    2012-01-01

    Objective The incidence of perinatal arterial ischaemic stroke (PAIS) is about 1 in 2300 live births. Evidence about the aetiology is still lacking. The aim of this study was to identify maternal, perinatal and neonatal risk factors for symptomatic PAIS in full-term infants. Methods Each full-term i

  20. Deterministic quantitative risk assessment development

    Energy Technology Data Exchange (ETDEWEB)

    Dawson, Jane; Colquhoun, Iain [PII Pipeline Solutions Business of GE Oil and Gas, Cramlington Northumberland (United Kingdom)

    2009-07-01

    Current risk assessment practice in pipeline integrity management is to use a semi-quantitative index-based or model based methodology. This approach has been found to be very flexible and provide useful results for identifying high risk areas and for prioritizing physical integrity assessments. However, as pipeline operators progressively adopt an operating strategy of continual risk reduction with a view to minimizing total expenditures within safety, environmental, and reliability constraints, the need for quantitative assessments of risk levels is becoming evident. Whereas reliability based quantitative risk assessments can be and are routinely carried out on a site-specific basis, they require significant amounts of quantitative data for the results to be meaningful. This need for detailed and reliable data tends to make these methods unwieldy for system-wide risk k assessment applications. This paper describes methods for estimating risk quantitatively through the calibration of semi-quantitative estimates to failure rates for peer pipeline systems. The methods involve the analysis of the failure rate distribution, and techniques for mapping the rate to the distribution of likelihoods available from currently available semi-quantitative programs. By applying point value probabilities to the failure rates, deterministic quantitative risk assessment (QRA) provides greater rigor and objectivity than can usually be achieved through the implementation of semi-quantitative risk assessment results. The method permits a fully quantitative approach or a mixture of QRA and semi-QRA to suit the operator's data availability and quality, and analysis needs. For example, consequence analysis can be quantitative or can address qualitative ranges for consequence categories. Likewise, failure likelihoods can be output as classical probabilities or as expected failure frequencies as required. (author)

  1. Discordance between Risk Factors and Coronary Artery Calcium: Implications for Guiding Treatment Strategies in Primary Prevention Settings.

    Science.gov (United States)

    Joshi, Parag H; Nasir, Khurram

    2015-01-01

    Preventive efforts including smoking cessation campaigns, increased awareness of healthy lifestyle habits, risk factor modification, and the appropriate use of statins have been successful in reducing cardiovascular mortality over the last decade. The coronary artery calcium (CAC) scan has reliably been an additive predictor to traditional risk estimation methods, partly because of the heterogeneity between risk factor burden and atherosclerotic burden. The focus of this review is to highlight this heterogeneity by focusing on groups in which risk factor burden and subclinical atherosclerosis burden, as measured by CAC, are discordant. In high-risk groups with 0 CAC, the event rates are consistently low; in low-risk groups with elevated CAC (CAC>100), the event rates are consistently high. We conclude with our clinical perspective of the considerable heterogeneity between risk factors and atherosclerotic burden in the context of the 2013 ACC/AHA cholesterol treatment and risk assessment guidelines. PMID:25982215

  2. METABOLIC AND AUTOIMMUNE RISK FACTORS FOR CORONARY ARTERY DISEASE (CAD IN HEART TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    T. A. Khalilulin

    2010-01-01

    Full Text Available One of the most essential autoimmunity risk factors for development of CAD are increasing level of anticardiolipin antibodies and homocystein. This report presents retrospective analyses of 39 heart transplant recipients with maximal follow up over 16 years. Our results showed that hyperhomocystenemia and high levels of anticardiolipin antibodies play great value in development of CAD. Thus relative risks for development of CAD in presence both high levels of anticardiolipin antibodies and homocysteine are higher, than in traditional nonimmune risk factors. 

  3. The dynamic of aterosclerosis affection on brachio-cefalic arterys of the high risk patients under the hypolipidemic treatment

    Directory of Open Access Journals (Sweden)

    V.V. Simerzin

    2010-06-01

    Full Text Available Purpose. To study the statin influence on lipid exchange and the degree of the brachiocefalic arterys alteration. Methods. The research included 33 high risk patients. The patients inverstigation included lipid spectrum, blood coagulation indexes, by the means of triplex scanning of the brachiochefalic arterys the thickness of the intima - media complex and the expression of stenosis of carotid, vertebral and subclavian arterys were measured. Results. All the patients were divided into the groups according to the total cholesterol and low density lipoprotein cholesterol levels. Patients were divided into subgroups according to the expression of stenosis. The 1 group of patients received rosuvastating 10 mg, the 2 group - atorvastain 20 mg, 3the 3 group - simvastatin 40 mg. This inverstigation shows that the high risk patients with high levels of total cholesterol and low density lipoproteins have the highest expressiveness of brachiocefalic arterys atherosclerosis affection. Conclusion. The assignment of the statins to these patients is accompanied by the lowering of the levels of total cholesterol and low density lipoproteins and the quantity of arteries affected by the atherosclerosis and also by decreasing of the stenosis expression

  4. β2-microglobulin, cystatin C, and creatinine and risk of symptomatic peripheral artery disease

    NARCIS (Netherlands)

    Joosten, Michel M.; Pai, Jennifer K.; Bertoia, Monica L.; Gansevoort, Ron T.; Bakker, Stephan J. L.; Cooke, John P.; Rimm, Eric B.; Mukamal, Kenneth J.

    2014-01-01

    BACKGROUND: β2-Microglobulin and cystatin C may have advantages over creatinine in assessing risk associated with kidney function. We therefore investigated whether emerging filtration markers, β2-microglobulin and cystatin C, are prospectively associated with risk of the development of peripheral a

  5. Development of risk monitor RiskAngel for risk-informed applications in nuclear power plants

    International Nuclear Information System (INIS)

    This paper presents the development of risk monitor software RiskAngel at FDS Team and its applications as a plant specific risk monitor, which supports risk-informed configuration risk management for the two CANDU 6 units at the Third Qinshan Nuclear Power Plant in China. It also describes the regulatory prospective on risk-informed PSA applications and the use of risk monitor at operating nuclear power plants, high level technical and functional requirements for the development of CANDU specific risk monitor software, and future development trends. (author)

  6. Association between Traditional Risk Factors and CoronaryArtery Ectasia:AStudy on 10057Angiographic Procedures among Iranian Population

    Directory of Open Access Journals (Sweden)

    AliReza Amirzadegan

    2015-10-01

    Full Text Available Background: Whether coronary artery ectasia (CAE is a unique clinical finding or results from other clinical entities is still unknown. We aimed to determine the CAE prevalence, investigate the relationship between CAE and patients’ demographic and clinical characteristics, and assess the prognosis at follow-up in a sample of Iranian population.Methods: Totally, 10057 patients who underwent coronary angiography were divided into three categories: normal coronary arteries without co-existing coronary artery disease; CAE without co-existing coronary artery narrowing < 50%; and coronary artery stenosis with > 50% luminal narrowing (CAS.Results: The prevalence of CAE was 1.5%. Compared to the normal individuals, the CAE patients were older, were more frequently male, and had higher rates of myocardial infarction (MI. The CAE patients had a lower frequency of diabetes and MI than the CAS group. The CAE patients were largely focused between 40 to 60 years of age. The right coronary and left anterior descending arteries were the most involved arteries, and ectasia was located more frequently in the proximal part of these arteries. Patients with ectasia in the three main vessels had higher rates of MI. After a mean follow-up of 54.23 ±18.41 months, chest pain and dyspnea on exertion remained the main complaint in more than 97% of the patients, leading to hospital admission in more than 14%.Conclusion: There was no relationship between the presence of ectasia and conventional risk factors. According to our study, pure CAE may be deemed a benign feature of atherosclerosis; however, it can lead to frequent hospital admissions because of the persistence of cardiovascular symptoms.

  7. Clinicians' contributions to the development of coronary artery stents: a qualitative study of transformative device innovation.

    Directory of Open Access Journals (Sweden)

    Aaron S Kesselheim

    Full Text Available BACKGROUND: Medical device innovation remains poorly understood, and policymakers disagree over how to incentivize early development. We sought to elucidate the components of transformative health care innovation by conducting an in-depth case study of development of a key medical device: coronary artery stents. METHODS AND FINDINGS: We conducted semi-structured interviews with the innovators whose work contributed to the development of coronary artery stents who we identified based on a review of the regulatory, patent, and medical literature. Semi-structured interviews with each participant covered the interviewee's personal involvement in coronary artery stent development, the roles of institutions and other individuals in the development process, the interplay of funding and intellectual property in the interviewee's contribution, and finally reflections on lessons arising from the experience. Transcripts were analyzed using standard coding techniques and the constant comparative method of qualitative data analysis. CONCLUSIONS: We found that the first coronary artery stents emerged from three teams: Julio Palmaz and Richard Schatz, Cesare Gianturco and Gary Roubin, and Ulrich Sigwart. First, these individual physician-inventors saw the need for coronary artery stents in their clinical practice. In response, they developed prototypes with the support of academic medical centers leading to early validation studies. Larger companies entered afterwards with engineering support. Patents became paramount once the technology diffused. The case of coronary stents suggests that innovation policy should focus on supporting early physician-inventors at academic centers.

  8. [Prevalence and associated risk factors of arterial hypertension in Sobremonte and Ojo de Agua Departments in Cordoba State].

    Science.gov (United States)

    Pedraza, Antonio; Camino Willhuber, Gastón; Chaile, Iván

    2008-01-01

    Arterial Hypertension (AH) is a disease with multiple risk factors (RF), and it is one of the most important risk factor for cardiovascular diseases. The objective of this study was to determine the prevalence of AH in Sobremonte area and its correlation to other risk factors. The study was done in an special programme called "Solidarity in Health" (SIH) supported by the College of Medicine at the National University of Córdoba, which provided primary care to residents of Cachi Yaco (Sobremonte Department). It is an small village near Santiago del Estero province located in 226 km from Córdoba city. They went to the city and they examined the patients at the the "French and Berutti" school for nine consecutive years (2000-2008). Sobremonte area is the poorest deparment in the province of Córdoba and it has the highest rate of lowest socio-economic development, and a very deficient health care system.. The only hospital providing primary care is in San Francisco del Chañar, and the access is not free. The study involved the determination of the arterial pressure (AP) according to the seventh "JNC"criteria, body mass index (BMI), levels of alcohol consumption, exercise, salt consumption, diabetes and smoking in all the patients. Additionally, three water samples from different representative zones were collected and tested for sodium concentration. 471 patients were included. The incidence of AH was 43.5% of the patients. (51% men and 36% women). Higher incidence of AH was found in patients between 50 and 59 years old. There was a stadistical difference in the BMI, diabetes, and alcohol consumption between healthy patients and patients with AH. There was not any correlation between AH and exercise. We found higher levels of sodium in the water of this area and it was between 13-35 higher than in C6rdoba city and it was correlated with AH. We conclude that the increased sodium consumption is one of the most important risk factor of AH in this population.

  9. Risk Factors related to hemorrhage necessitating renal artery embolization after percutaneous nephrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Byon, Jung Hee; Han, Young Min; Jin, Gong Yong; Song, Ji Soo [Chonbuk National University Hospital and Medical School, Jeonju (Korea, Republic of)

    2015-12-15

    To investigate risk factors related to severe bleeding necessitating renal artery embolization (RAE) after percutaneous nephrostomy (PCN). 36 patients who underwent RAE from January 2005 to June 2014 were retrospectively reviewed. Among them, 10 patients underwent embolization because of severe bleeding after PCN (bleeding group). From 1762 patients who underwent PCN in the same period, we selected 21 patients who underwent PCN without bleeding after the procedure (non-bleeding group). We investigated possible related risk factors, such as the presence of underlying diseases, activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, puncture site, procedure time, size of the kidney, distance from skin to renal cortex, maximum caliber of the indwelling catheter, parenchymal thickness, and grade of hydronephrosis. We used Fisher's exact test and independent t test for data analyses. We classified hydronephrosis as either 'mild hydronephrosis,' or 'moderate or severe hydronephrosis.' The frequency of mild hydronephrosis was 80.0% (8/10) in the bleeding group and 33.3% (7/21) in the non-bleeding group (p = 0.023). There were no significant differences between the two groups in the incidence of underlying diseases. Similarly, other risk factors (PT, aPTT, platelet count, procedure time, distance from skin to renal cortex, maximum caliber of the indwelling catheter, kidney size, and parenhcymal thickness) also did not differ significantly between the two groups. Mild hydronephrosis is a risk factor for severe bleeding necessitating RAE after PCN. Therefore, when performing PCN, careful attention should be paid to patients with mild hydronephrosis.

  10. Prevalence and risk factors of asymptomatic peripheral arterial disease in patients with COPD in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ming-Shian Lin

    Full Text Available AIM: Chronic obstructive pulmonary disease (COPD is an independent risk factor for cardiovascular morbidity and mortality. The aim of this study was to determine the prevalence of asymptomatic peripheral arterial disease (PAD and the associated risk factors for patients with COPD. METHODS: This prospective cross-sectional study enrolled 427 COPD patients (mean age: 70.0 years without PAD symptoms consecutively. Demographic data, lung function and cardiovascular risk factors were recorded. The ankle-brachial index (ABI was used to detect PAD (ABI<0.90. RESULTS: The overall prevalence of asymptomatic PAD in the COPD patients was 8% (2.5% in the younger participants (<65 years of age, n = 118 and 10% in the elderly participants (≥65 years of age, n = 309. The COPD patients with asymptomatic PAD had a significantly higher rate of hyperlipidemia (47.1% vs. 10.4% and hypertension (79.4% vs. 45.8% than those without asymptomatic PAD (p<0.05. There was no significant difference in lung function (forced vital capacity and forced expiratory volume in one second between the two groups. In multivariate logistic regression, hyperlipidemia was the strongest independent factor for PAD (odds ratio (OR: 6.89, p<0.005, followed by old age (OR: 4.80, hypertension (OR: 3.39 and smoking burden (pack-years, OR: 1.02. CONCLUSIONS: The prevalence of asymptomatic PAD among COPD patients in Taiwan is lower than in Western countries. Hyperlipidemia, old age, hypertension, and smoking burden were the associated cardiovascular risk factors. However, there was no association between lung function and PAD in the COPD patients.

  11. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall

    Energy Technology Data Exchange (ETDEWEB)

    Sedighi, Nahid, E-mail: nsedighi@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmard, Amir Reza, E-mail: radmard@ams.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Radmehr, Ali, E-mail: radmehr@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hashemi, Pari, E-mail: phtums@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Hajizadeh, Abdolmahmoud, E-mail: mroomezi@yahoo.com [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of); Taheri, Amir Pejman Hashemi, E-mail: hashemip@sina.tums.ac.ir [Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences. North Kargar Ave., Tehran 14114 (Iran, Islamic Republic of)

    2011-08-15

    Objective: To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall. Materials and methods: A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT < 0.6 mm without plaque, medium-risk: 0.6 mm {<=} IMT {<=} 0.8 mm without plaque and high-risk: IMT > 0.8 mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects. Results: BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT < 0.6 mm, those with 0.6 mm {<=} IMT{<=} 0.8 mm and IMT > 0.8 mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P = 0.02) and hypertension (P = 0.004). Conclusion: The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.

  12. Association of vitamin D status with arterial blood pressure and hypertension risk

    DEFF Research Database (Denmark)

    Vimaleswaran, Karani S; Cavadino, Alana; Berry, Diane J;

    2014-01-01

    BACKGROUND: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated...... with blood pressure and hypertension risk. METHODS: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta......, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D...

  13. Prevalence of and risk factors for aspirin resistance in elderly patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Xian-Feng Liu; Jian Cao; Li Fan; Lin Liu; Jian Li; Guo-Liang Hu; Yi-Xin Hu; Xiao-Li Li

    2013-01-01

    Objective To assess the prevalence of and related risk factors for aspirin resistance in elderly patients with coronary artery disease (CAD). Methods Two hundred and forty-six elderly patients (75.9 ± 7.4 years) with CAD who received daily aspirin therapy (≥ 75 mg) over one month were recruited. The effect of aspirin was assessed using light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). Aspirin resistance was defined as ≥ 20% arachidonic acid (AA)-induced aggregation and ≥ 70% adenosine diphosphate (ADP)-induced aggregation in the LTA assay. An aspirin semi-responder was defined as meeting one (but not both) of the criteria described above. Based on the results of TEG, aspirin resistance was defined as ≥ 50% aggregation induced by AA. Results As determined by LTA, 23 (9.3%) of the elderly CAD patients were resistant to aspirin therapy; 91 (37.0%) were semi-responders. As determined by TEG, 61 patients (24.8%) were aspirin resistant. Of the 61 patients who were aspirin resistant by TEG, 19 were aspirin resistant according to LTA results. Twenty-four of 91 semi-responders by LTA were aspirin resistant by TEG. Multivariate logistic risk factor for aspirin resistance as determined by TEG. Conclusions A significant number of elderly patients with CAD are resistant to aspirin therapy. Fasting blood glucose level is closely associated with aspirin resistance in elderly CAD patients.

  14. [Risk factors for arterial hypertension in the adult population of an urban region of Ecuador].

    Science.gov (United States)

    Ortiz-Benavides, Rina Elizabeth; Torres-Valdez, Maritza; Sigüencia-Cruz, Wilson; Añez-Ramos, Roberto; Salazar-Vílchez, Juan; Rojas-Quintero, Joselyn; Bermúdez-Pirela, Valmore

    2016-06-01

    Objectives . To determine the risk factors for arterial hypertension (HTN) in the adult resident population of the city of Cuenca, Ecuador Materials and methods A cross-sectional analytical study of adults selected via multistage random sampling who underwent clinical, anthropometric, and laboratory evaluations. The diagnosis of HTN was defined according to the JNC-7 criteria. A multiple logistic regression model was performed Results A total of 318 persons were included. The prevalence of HTN was 25.8% (males: 27.2% vs. females: 24.7%; p = 0.617). In the multiple logistic regression model, the risk factors for HTN were age > 60 years (OR, 8.68; 95% CI, 3.56-21.14; p body mass index (OR, 2.36; 95% CI, 1.04-5.70; p = 0.042), high caloric intake (OR, 2.06; 95% CI, 1.01- 4.53; p = 0.044), and family history of HTN (OR, 1.58; 95% CI, 1.02-2.90; p = 0.040) Conclusions The presence of HTN in this population is associated with both intrinsic and environmental factors, which should be considered in routine evaluations to ensure its early identification and control. PMID:27656923

  15. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index

    Science.gov (United States)

    Beckmann, Marianne; Husmann, Marc

    2015-01-01

    Background Central augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures. Aim To assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA). Methods cAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease. Results In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006). Conclusion Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease. PMID:26452151

  16. Meta-Analysis on the Correlation Between APOM rs805296 Polymorphism and Risk of Coronary Artery Disease

    Science.gov (United States)

    Sun, HongYan; Shen, Dong; Zhang, ChunHong; Huang, DangSheng; Wang, YuMei; Zhang, LiWei

    2016-01-01

    Background The present meta-analysis aimed to summarize the inconsistent findings on the association of apolipoprotein M gene (ApoM) rs805296 polymorphism with the risk of coronary artery disease (CAD), and to obtain a more authentic result about this topic. Material/Methods A total of 7 available articles were identified through electronic databases – PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) – and their useful data were carefully extracted. The relationship between ApoM rs805296 polymorphism and CAD risk was assessed by odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs), which were calculated using the fixed- or random-effects model, according to the degree of heterogeneity. Hardy-Weinberg equilibrium test, sensitivity test, and publication bias examination were also performed in this meta-analysis. Results According to the pooled results, ApoM rs805296 polymorphism conferred an increased risk of CAD under all the genetic contrasts: CC versus TT, CC + TC versus TT, CC versus TT+TC, C versus T, and TC versus TT (OR=2.13, 95% CI=1.16–3.91; OR=1.80, 95% CI=1.50–2.17; OR=1.91, 95% CI=1.04–3.51; OR=1.72, 95% CI=1.45–2.04; OR=1.78, 95% CI=1.47–2.15). Conclusions ApoM rs805296 polymorphism may be a risk factor for developing CAD. PMID:26723879

  17. Risk assessment in incremental software development

    OpenAIRE

    Matsuo, Eric K.

    1999-01-01

    Cost overruns, schedule slips, and projects with fewer features or functions than originally specified are some of the difficulties that the software community faces in almost all software projects. The application of proper risk management throughout the lifecycle of the software development can drastically improve the chances of success. Risk management is an essential skill that many good mangers possess. Utilizing proper risk management provides early risk detection, which in turn gives t...

  18. Obese sedentary patients with dyspnoea on exertion who are at low risk for coronary artery disease by clinical criteria have a very low prevalence of coronary artery disease.

    Science.gov (United States)

    Bruckel, J T; Larsen, G; Benson, M R

    2014-06-01

    Dyspnoea, a much less specific symptom of ischaemia than chest discomfort, is common among obese patients. Patients with dyspnoea often undergo stress testing as part of their evaluation. We sought to examine the yield of stress testing in non-elderly, obese, sedentary patients with dyspnoea on exertion (DOE) as a chief complaint.We reviewed stress echocardiograms carried out on 203 patients in a stress testing laboratory at a major tertiary care centre. Of these, 81 (40%) fell into a group that was at low risk for coronary artery disease (CAD) by clinical criteria. Ischaemia was detected in two patients in the low-risk group (2.5%), and these results were likely false positives. In the higher risk group, 9.0% of functional tests showed ischaemia; after further testing, 2.5% of the higher risk patients were found to have obstructive coronary lesions. Clinical follow-up was performed for a mean of 815 days. New obstructive coronary disease was detected in 1.6% of all patients, and these patients were from the higher risk group. In obese sedentary patients with DOE but otherwise at low risk of coronary disease stress testing is of very low yield. DOE is generally not an anginal equivalent in this patient population.

  19. Integration of Different Risk Assessment Tools to Improve Stratification of Patients with Coronary Artery Disease.

    Science.gov (United States)

    Paredes, S; Rocha, T; de Carvalho, P; Henriques, J; Morais, J; Ferreira, J

    2015-10-01

    Cardiovascular disease (CVD) causes unaffordable social and health costs that tend to increase as the European population ages. In this context, clinical guidelines recommend the use of risk scores to predict the risk of a cardiovascular disease event. Some useful tools have been developed to predict the risk of occurrence of a cardiovascular disease event (e.g. hospitalization or death). However, these tools present some drawbacks. These problems are addressed through two methodologies: (i) combination of risk assessment tools: fusion of naïve Bayes classifiers complemented with a genetic optimization algorithm and (ii) personalization of risk assessment: subtractive clustering applied to a reduced-dimensional space to create groups of patients. Validation was performed based on two ACS-NSTEMI patient data sets. This work improved the performance in relation to current risk assessment tools, achieving maximum values of sensitivity, specificity, and geometric mean of, respectively, 79.8, 83.8, and 80.9 %. Additionally, it assured clinical interpretability, ability to incorporate of new risk factors, higher capability to deal with missing risk factors and avoiding the selection of a standard CVD risk assessment tool to be applied in the clinical practice. PMID:26215518

  20. Asthma Is Associated With a Subsequent Risk of Peripheral Artery Disease: A Longitudinal Population-Based Study.

    Science.gov (United States)

    Yao, Chih-Wei; Shen, Te-Chun; Lu, Chiung-Ray; Wang, Yu-Chiao; Lin, Cheng-Li; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang

    2016-01-01

    Asthma has been associated with the atherosclerosis risk, but not clear of peripheral artery disease (PAD). We attempted to examine the risk of PAD in patients with asthma.From the insurance claims data of Taiwan, we identified 28,158 newly diagnosed asthma patients in 2000 to 2005 and 56,316 persons without asthma randomly selected into the comparison cohort, frequency matched by sex, age, and the date of diagnosis. Both cohorts were followed up until the end of 2011 to estimate the incident PAD. Adjusted hazard ratios (aHRs) of PAD were estimated using the Cox proportional hazards model after controlling for sex, age, and comorbidities.The incidence of PAD was 1.46 times higher in the asthma cohort than in the comparison cohort, with an aHR of 1.34 [95% confidence interval (CI) = 1.24-1.45]. Incidence of PAD was higher in men, the aged, and those with comorbidities in both cohorts. The aHRs of PAD remained significant for the asthma cohort in all subgroups of sex, age, and the presence of comorbidity. The aHRs of PAD were 14.1 (95% CI = 8.18-24.5) in asthma patients with multiple emergency visits and 22.3 (95% CI = 15.6-31.9) for those with multiple hospitalizations.Although smoking is a potential confounding factor, this study suggests patients with asthma have a significantly higher risk of developing PAD than the general population. The results also support the notion that poor control of asthma status is a key factor in subsequent PAD development. PMID:26817901

  1. Risk Factors and Clinical Evaluation of Superficial Femoral Artery Stent Fracture: Prote'ge'GPS Stent

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Da Un; Kim, Jae Kyu; Jung, Hye Doo; Huh, Tae Wook; Yim, Nam Yeol; Oh, Hyun jun; Choi, Soo Jin Na [Chonnam National University Hospital, Chonnam National University, Medical School, Gwangju (Korea, Republic of); Chang, Nam Kyu [Chonnam National University Hwasun Hospital, Chonnam National University, Medical School, Hwasun (Korea, Republic of)

    2010-12-15

    To evaluate the occurrence of superficial femoral artery stent fractures, the risk factors of stent fracture, and the relationship between fractures and clinical findings. Of the 38 patients who underwent treatment with Prote'ge'GPS stenting due to arterial occlusions on the superficial femoral artery, 17 also underwent a clinical analysis. Forty-three stents were inserted in the 17 superficial femoral arteries, ranging between 15 and 50 cm in length, with a mean treated length of 26.4 cm (15-50 cm). A fracture was evaluated by taking a PA and lateral simple radiography, as well as a follow-up evaluation accompanied with a CT angiography, DSA, and a color Doppler sonography. The examination involved the assessment of the difference between bone fractures due to length, placement, and frequency. Fractures occurred in 13 of 43 stents (30.2%). A total of 10 (71.4%) occurred in the upper third, compared to 4 (28.6%) in the lower third of the superficial femoral artery. In addition, 10 stents (71.4%) had a single strut fracture, whereas 4 (28.6%) had multiple strut fractures. A stent fracture occurred more frequently when the stents and lesions were longer (p=0.021, 0.012) and the stents were inserted near the joint. However, there was no significant relationship between stent numbers and the fractures (p=0.126). When the stents were inserted along the popliteal artery, a stent fracture occurred more frequently in the lower third of the artery. The stent fractures did not significantly influence the patency rate of the stented artery (p=0.44) Prote'ge'GPS stents in the superficial femoral artery revealed a considerable number of fractures and the fracture frequency showed a significant relationship with the length of stents and lesions. The closer stent insertion was to the joints, the more frequently fractures occurred. There were no evident significant relationships between the presence of stent fractures and the patency of the stented arteries

  2. Managing Risk Areas in Software Development Offshoring

    DEFF Research Database (Denmark)

    Persson, John Stouby; Schlichter, Bjarne Rerup

    2015-01-01

    Software companies are increasingly offshoring development to countries with high expertise at lower cost. Offshoring involves particular risk areas that if ignored increase the likelihood of failure. However, the offshoring client’s maturity level may influence the management of these risk areas....... Against this backdrop, we present an interpretive case study of how managers perceive and mitigate the risk areas in software development offshoring with a mature CMMI level 5 (Capability Maturity Model, Integrated) software company as the client. We find that managers perceive and mitigate most...... of the offshoring risk areas in accordance with the findings of previous research. However, the risk area of task distribution is a notable exception. In this case, managers perceive high task uncertainty, equivocality, and coupling across sites as risk mitigation rather than risk taking. The paper discusses how...

  3. Development and pilot feasibility study of a health information technology tool to calculate mortality risk for patients with asymptomatic carotid stenosis: the Carotid Risk Assessment Tool (CARAT)

    OpenAIRE

    Faerber, Adrienne E.; Horvath, Rebecca; Stillman, Carey; O’Connell, Melissa L; Hamilton, Amy L; Newhall, Karina A; Likosky, Donald S.; Goodney, Philip P.

    2015-01-01

    Background Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians’ ability to recommend optimal treatments based on an individual’s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assess...

  4. Development of a model of the coronary arterial tree for the 4D XCAT phantom

    Science.gov (United States)

    Fung, George S. K.; Segars, W. Paul; Gullberg, Grant T.; Tsui, Benjamin M. W.

    2011-09-01

    A detailed three-dimensional (3D) model of the coronary artery tree with cardiac motion has great potential for applications in a wide variety of medical imaging research areas. In this work, we first developed a computer-generated 3D model of the coronary arterial tree for the heart in the extended cardiac-torso (XCAT) phantom, thereby creating a realistic computer model of the human anatomy. The coronary arterial tree model was based on two datasets: (1) a gated cardiac dual-source computed tomography (CT) angiographic dataset obtained from a normal human subject and (2) statistical morphometric data of porcine hearts. The initial proximal segments of the vasculature and the anatomical details of the boundaries of the ventricles were defined by segmenting the CT data. An iterative rule-based generation method was developed and applied to extend the coronary arterial tree beyond the initial proximal segments. The algorithm was governed by three factors: (1) statistical morphometric measurements of the connectivity, lengths and diameters of the arterial segments; (2) avoidance forces from other vessel segments and the boundaries of the myocardium, and (3) optimality principles which minimize the drag force at the bifurcations of the generated tree. Using this algorithm, the 3D computational model of the largest six orders of the coronary arterial tree was generated, which spread across the myocardium of the left and right ventricles. The 3D coronary arterial tree model was then extended to 4D to simulate different cardiac phases by deforming the original 3D model according to the motion vector map of the 4D cardiac model of the XCAT phantom at the corresponding phases. As a result, a detailed and realistic 4D model of the coronary arterial tree was developed for the XCAT phantom by imposing constraints of anatomical and physiological characteristics of the coronary vasculature. This new 4D coronary artery tree model provides a unique simulation tool that can be

  5. Evaluation of arterial diseases by intravenous digital angiography (IVSDA) and risk factors in patients with cerebrovascular disease

    International Nuclear Information System (INIS)

    Intravenous digital angiography (IVSDA) has been performed in 1,031 consecutive patients during the previous 4 years. Complications of IVSDA, such as coughing, dermal reaction, nausea and vomiting, occurred in 77 patients (7.5%). Among them, 234 patients with a definite diagnosis of cerebrovascular disease were entered onto this study. On the basis of findings of IVSDA, the patients were largely classified into six groups: internal carotid artery (ICA) occlusion, ICA stenosis, middle cerebral artery (MCA) occlusion, MCA stenosis, marked arterial elongation, and normal findings. A group of the patients with ICA occlusion was characterized by having sudden onset with less complicated hypertension. In this group, etiological factors seemed to be embolism, intra-atheromatic hemorrhage, and dissecting aneurysm, as well as atherosclerosis. Major risk factors were hypertension, smoking, diabetes mellitus, and ischemic heart disease for lesions of the main trunk; and severe hypertension, high hematocrit levels and elevated platelet aggregability for lesions of perforating and small cortical arteries and arterioles. In the case of arterial elongation, platelet aggregability elicited by ADP was not suppressed by antiplatelet agents. These patients need to receive intensive treatment to prevent relapse of the disease. (Namekawa, K)

  6. Evaluation of arterial diseases by intravenous digital angiography (IVSDA) and risk factors in patients with cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Fukui, Toshiya (Kakeyu Hospital, Nagano (Japan))

    1989-04-01

    Intravenous digital angiography (IVSDA) has been performed in 1,031 consecutive patients during the previous 4 years. Complications of IVSDA, such as coughing, dermal reaction, nausea and vomiting, occurred in 77 patients (7.5%). Among them, 234 patients with a definite diagnosis of cerebrovascular disease were entered onto this study. On the basis of findings of IVSDA, the patients were largely classified into six groups: internal carotid artery (ICA) occlusion, ICA stenosis, middle cerebral artery (MCA) occlusion, MCA stenosis, marked arterial elongation, and normal findings. A group of the patients with ICA occlusion was characterized by having sudden onset with less complicated hypertension. In this group, etiological factors seemed to be embolism, intra-atheromatic hemorrhage, and dissecting aneurysm, as well as atherosclerosis. Major risk factors were hypertension, smoking, diabetes mellitus, and ischemic heart disease for lesions of the main trunk; and severe hypertension, high hematocrit levels and elevated platelet aggregability for lesions of perforating and small cortical arteries and arterioles. In the case of arterial elongation, platelet aggregability elicited by ADP was not suppressed by antiplatelet agents. These patients need to receive intensive treatment to prevent relapse of the disease. (Namekawa, K).

  7. Análise de indicadores de risco para hipertensão arterial em crianças e adolescentes Análisis de indicadores de riesgo para la hipertensión arterial en niños y adolescentes Analysis of risk indicators for the arterial hypertension in children and teenagers

    Directory of Open Access Journals (Sweden)

    Thelma Leite de Araújo

    2008-03-01

    jóvenes. La presión arterial sistólica estuvo especialmente influenciada por indicadores antropométricos.The aim of this study was to evaluate the risk indicators for high blood pressure in children and teenagers. A cross-sectional study developed with 342 individuals of 6-18 years of age in a school of Fortaleza city. The most individuals were male (51,5%. The age mean was 11,7 years ( 3,19. It was frequent the scholars with overweight / obesity (16,8% and blood pressure above of the 90th percentile (44,7%. Sedentarism, smoking and drinking were present in 51,5%, 38% and 15,5% of the sample. The systolic blood pressure was correlated with the variable age, weight, height, waist and hip circumferences, subscapular skin-fold thickness and body mass index. There was correlation of the diastolic blood pressure with age, weight, height, and waist and hip circumferences. It was confirm the influence of risk factors on the blood pressure values of children and teenagers. The systolic blood pressure was especially influenced by anthropometric indicators.

  8. Prevalence of Coronary Artery Disease Risk factors in Teachers Residing in Shiraz-Iran 2009

    Directory of Open Access Journals (Sweden)

    J Tahmasebi

    2010-06-01

    Full Text Available Background: coronary artery diseases (CAD are the leading cause of mortality, morbidity and disability with high health care cost in any countries including Iran. The prevalence of all CAD risk factors including hypertension, diabetes, lipid profile abnormalities and obesity is rising in the population of Iran. Knowing the population at risk would lead to proper education to decrease these risk factors and ultimately would reduce CAD.Methods: This descriptive cross- sectional study was conducted in February to December 2009 and comprised a total of 3115 Shiraz educational staff, aged 21- 73 years.Questionnaires were applied to collect information including; demographic data, physical activity, history of CAD, hypertension, dyslipidemia, and smoking. In addition, waist circumference, height, weight, body mass index (BMI, and hip circumference (HC were measured and serum biochemistry profiles were determined on venous blood samples. Such data helped identify the prevalence of diabetes, hypercholesterolemia, hypertriglyceridemia, hypertension, overweight and obesity, central obesity, and smoking. Results: The mean age of 3115 participant was 42.7 and 41.5 years for men and women respectively. The prevalence of pre-diabetes, diabetes hypertension, hypercholesterolemia and hypertriglyceridemia were %10.2, %4, %18.2, %38.30 and %33.2 respectively. Diabetes, hypertension and dyslipidemia were more prevalent among males and older subjects. The prevalence of central obesity was %75.05 (IDF criteria and %40.64 (ATP- III criteria. The frequency of obesity, current smoking, ex-smoking and passive smoking were %12.1, %5.85 , %1.52 ,%7.9 respectively which were below the reported prevalence in Iran in previous studies, but physical inactivity was %73.3 which is very high in this study group.Conclusion: Although CAD risk factors seem to be very common in the study population, clinical and paraclinical data indicated that teachers residing in Shiraz have a

  9. Prevalence of Risk Factors for Coronary Artery Disease in the Brazilian State of Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Iseu Gus

    2002-05-01

    Full Text Available OBJECTIVE - To determine the risk factors prevalence for coronary artery disease in the State of Rio Grande do Sul, Brazil and to identify their relation with the age bracket. METHODS - We carried out an observational, cross-sectional study of 1,066 adults older than 20 years in the Brazilian State of Rio Grande do Sul. We investigated the risk factors: familial antecedents, systemic arterial hypertension, high levels of cholesterol and glycemia, overweight/obesity, smoking and sedentary lifestyle. A standardized questionnaire completed at the patients' dwellings by health agents were used; the data were stored in an EPI-INFO software database. The results were expressed with a 95% confidence interval. RESULTS - The sample composition was of 51.8% females. The risk factors prevalences were: 1 sedentary lifestyle 71.3%; 2 familial antecedents: 57.3%; 3 overweight/obesity (body mass index >25: 54.7%; 4 smokers: 33.9%; 5 hypertension: 31.6% (considering >140/90mmHg and 14.4% (considering >160/95mmHg; 6 high glycemia (>126 mg/dL: 7%; 7 high cholesterol >240 mg/dL: 5.6%. CONCLUSION - The prevalence of the major risk factors for coronary artery disease in the Brazilian state of Rio Grande do Sul could be determined in a study that integrated public and private institutions.

  10. Prevalence of arterial stiffness in North China, and associations with risk factors of cardiovascular disease: a community-based study

    Directory of Open Access Journals (Sweden)

    Wang Jin-Wen

    2012-12-01

    Full Text Available Abstract Background Brachial-ankle pulse wave velocity (baPWV, which reflects the stiffness of both central and peripheral muscular arteries, has been frequently used as a simple index for assessing arterial stiffness. The aim of the present study was to investigate the prevalence of arterial stiffness in North China based on baPWV measurements, and explore the associations between increased arterial stiffness and risk factors of cardiovascular diseases (CVD. Methods Twenty-three community populations were established in North China. For each participant, parameters for calculating baPWV, including blood pressures and pressure waveforms, were measured using a non-invasive automatic device. All participants were required to respond to an interviewer-led questionnaire including medical histories and demographic data, and to receive blood tests on biochemical indictors. Results A total of 2,852 participants were finally investigated. Among them, 1,201 people with low burden of CVD risk factors were chosen to be the healthy reference sample. The cut-off point of high baPWV was defined as age-specific 90th percentile of the reference sample. Thus, the prevalence of high baPWV was found to be 22.3% and 26.4% in men and women respectively. After adjusted for age, heart rate (HR, systolic blood pressure (SBP, fasting glucose level, and smoking were significantly associated with high baPWV in men; while level of serum total cholesterol (TC, HR, SBP, and diabetes were significantly associated with high baPWV in women. Conclusions Based on the age-specific cut-off points, the middle-aged population has a higher prevalence of high baPWV in North China. There exists a difference between men and women in terms of the potential risk factors associated with arterial stiffness.

  11. Analysis of relationship between severity of coronary artery disease and coronary artery disease risk factors%冠状动脉病变程度与冠心病危险因素的相关分析

    Institute of Scientific and Technical Information of China (English)

    刘恒宾

    2014-01-01

    目的:探讨冠心病患者冠状动脉病变的严重程度与冠心病危险因素的关系。方法选择冠心病患者116例为冠心病组,选择冠状动脉样硬化狭窄程度<50%的患者66例为对照组。分析冠状动脉狭窄程度与冠心病危险因素的关系。结果多因素分析结果显示,LVEF、Ccr与冠状动脉粥样硬化程度呈负相关,而hs-CRP与冠状动脉粥样硬化程度呈正相关(P<0.05或P<0.01)。结论冠状动脉狭窄程度与LVEF、Ccr呈负相关,与hs-CRP呈正相关。%Objective To analyze relationship between severity of coronary artery disease and coronary artery disease risk factors. Methods 116 cases with coronary artery disease were selected as group of coronary artery disease, and 66 cases with coronary artery sclerosis stenosis degree < 50% were selected as control group. Relationship between severity of coronary artery disease and coronary artery disease risk factors was analyzed. Results Multifactor analysis results showed LVEF and Ccr were negative correlation with severity of coronary artery disease,and hs-CRP was positive correlation with severity of coronary artery disease(P < 0.05 orP < 0.01). Conclusion LVEF and Ccr are negative correlation with severity of coronary artery disease,and hs-CRP is positive correlation with severity of coronary artery disease.

  12. Disproportionate Contributions of Select Genomic Compartments and Cell Types to Genetic Risk for Coronary Artery Disease.

    Directory of Open Access Journals (Sweden)

    Hong-Hee Won

    2015-10-01

    Full Text Available Large genome-wide association studies (GWAS have identified many genetic loci associated with risk for myocardial infarction (MI and coronary artery disease (CAD. Concurrently, efforts such as the National Institutes of Health (NIH Roadmap Epigenomics Project and the Encyclopedia of DNA Elements (ENCODE Consortium have provided unprecedented data on functional elements of the human genome. In the present study, we systematically investigate the biological link between genetic variants associated with this complex disease and their impacts on gene function. First, we examined the heritability of MI/CAD according to genomic compartments. We observed that single nucleotide polymorphisms (SNPs residing within nearby regulatory regions show significant polygenicity and contribute between 59-71% of the heritability for MI/CAD. Second, we showed that the polygenicity and heritability explained by these SNPs are enriched in histone modification marks in specific cell types. Third, we found that a statistically higher number of 45 MI/CAD-associated SNPs that have been identified from large-scale GWAS studies reside within certain functional elements of the genome, particularly in active enhancer and promoter regions. Finally, we observed significant heterogeneity of this signal across cell types, with strong signals observed within adipose nuclei, as well as brain and spleen cell types. These results suggest that the genetic etiology of MI/CAD is largely explained by tissue-specific regulatory perturbation within the human genome.

  13. Development of Smartphone Educational Application for Patients with Coronary Artery Disease

    OpenAIRE

    Cho, Min Jung; Sim, Jae Lan; Hwang, Seon Young

    2014-01-01

    Objectives This study was conducted to develop a smartphone application (app) as an educational learning instrument for coronary artery disease (CAD) patients and to assess the users' level of satisfaction. Methods This methodological research involves elicited learning content for CAD patients to develop a learning instrument using the smartphone app. The app was developed according to the steps of Assessment, Design, Development, Implementation, and Evaluation, which is a systematic instruc...

  14. A study of the role of GATA2 gene polymorphism in coronary artery disease risk traits.

    Science.gov (United States)

    Muiya, Nzioka P; Wakil, Salma; Al-Najai, Mohammed; Tahir, Asma I; Baz, Batoul; Andres, Editha; Al-Boudari, Olyan; Al-Tassan, Nada; Al-Shahid, Maie; Meyer, Brian F; Dzimiri, Nduna

    2014-07-10

    The GATA2 is a multi-catalytic transcription factor believed to play an important role in regulating inflammatory processes, largely contributory to cardiovascular-related events. However, its role in coronary artery disease (CAD) risk traits remains poorly understood. In a preliminary study using Affymetrix 250K, we established a link on chromosome (chr) 3, which harbors the GATA2 gene, to early onset of CAD in two families with heterozygous familial hyperlipidemia (HFH), suggesting a role for the gene in metabolic-related CAD in the general population. We then sequenced the gene in the families and an additional 200 individuals in the general population, followed by an association study for 8 SNPs on CAD metabolic risk traits in a total of 4557 individuals (2386 CAD cases versus 2171 angiographed controls) by the Applied Biosystems real-time PCR system. The rs1573949_C [1.15(1.00-1.32); p=0.049] was associated with MI, rs7431368_AA [5.2(1.05-26.60); p=0.43] conferred risk for harboring low high density lipoprotein, and obesity was linked to rs10934857_AA [5.69(1.04-30.98); p=0.045] following Bonferroni corrections and multivariate adjustments for confounders. Furthermore, a haplotype CCCGGGTC (χ(2)=4.23; p=0.04) constructed from the eight studied SNPs and its 6-mer derivative CGGGTC (χ(2)=5.05; p=0.025) were associated with CAD. Obesity was associated with the 6-mer CATAAA (χ(2)=3.66; p=0.049), and hypercholesterolemia was linked to the 8-mer CCTGGACC (χ(2)=6.02; p=0.014), but most significantly so with its 5-mer derivative, CTGGA (χ(2)=6.75; p=0.009). On the other hand, high low density lipoprotein was linked to TGG (χ(2)=4.48; p=0.034). Our study points to an association of GATA2 at both SNP and haplotype levels with important metabolic risk traits for atherosclerosis.

  15. Impact of insulin like growth factor-1 in development of coronary artery ectasia

    Directory of Open Access Journals (Sweden)

    Ibrahim Faruk Akturk

    2014-09-01

    Full Text Available Coronary artery ectasia (CAE is characterized by inappropriate dilatation of the coronary vasculature. The mechanisms of CAE are not well known. Insulin-like growth factor-1 (IGF-1 may make endothelial cells and smooth muscle cells more sensitive to the effects of growth hormone. In the present study, we hypothesized that IGF-1 may have an impact on the formation of ectasia and aneurysm in arterial system, and aimed to investigate the associations between the presence of CAE and serum IGF-1 levels in patients undergoing coronary angiography. The study included 2.980 subjects undergoing elective diagnostic coronary angiography. We selected 40 patients diagnosed with CAE as CAE group and 44 subjects with absolutely normal coronary arteries were assigned as normal control group. IGF-1 levels were measured in both groups of patients. Groups were similar in terms of age, sex and coronary artery disease risk factors. The serum IGF-1 levels were significantly higher in CAE patients with 109.64±54.64 ng/mL than in controls with 84.76±34.01 ng/mL (p=0.016. HDL levels were lower in ectasia group with 41.5±10.7 mg/dL than controls with 47.7±10.4 mg/dL (p=0.018. By means of logistic regression analysis, high IGF-1 and low HDL levels were found to be independent risk factors for the presence of CAE (p<0.02, p<0.016, respectively. The study revealed that there was a positive correlation between serum IGF-1 levels and presence of CAE, and high IGF-1 levels and low HDL levels were independent risk factors for the presence of CAE. Future studies are needed to confirm these results.

  16. Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry

    DEFF Research Database (Denmark)

    Cacoub, Patrice P; Abola, Maria Teresa B; Baumgartner, Iris;

    2009-01-01

    OBJECTIVES: To examine differences in risk factor (RF) management between peripheral artery disease (PAD) and coronary artery (CAD) or cerebrovascular disease (CVD), as well as the impact of RF control on major 1-year cardiovascular (CV) event rates. METHODS: The REACH Registry recruited >68000...

  17. Risk factors and ankle brachial indexes in cerebral infarction combined with peripheral arterial disease

    Institute of Scientific and Technical Information of China (English)

    Huihua Liu; Jun Wang

    2006-01-01

    BACKGROUND: Ankle brachial index(ABI)is widely involved in researches and clinical application of peripheral vascular injury of patients with diabetes (DM);however ,the application in cerebral infarction(CI)is rare.OBJECTIVE: To investigate the possible risk factor of cerebral infarction plus peripheral arterial disease(PAD),compare metabolic characteristics of patients who having CI plus PAD or only having CI,and understand the significance of ABI on screening and diagnosing CI plus PAD of lower limb.DESIGN: Contrast observation based on CI patients.SETTING: Deparment of Neurology,Nanxishan Hospital of Guangxi Zhang Autonomous Region.PARTICIPANTS:A total of 124 CI patients were selected from Department of Neurology.Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2005 to April 2006,including 72 males and 52 females aged from 45 to 88 years.All patients met the diagnostic criteria of cerebrovascular disease established by National Academic Conference of Cerebrovascular Diseases in 1995 and determined as cerebral infarction with MRI or CT examination.All patients provided informed consent.There were 46 cases(37.2%)with CI plus PAD and 78 cases(62.8%)only with CI.METHODS: Blood pressure of bilateral ankles and upper extremities was measured at plain clinostatism with DINAMAP blood pressure monitor(GE Company).The ratio between average systolic pressure of lateral ankle and average systolic pressure of both upper extremities was regarded as ABI.The normal ABI was equal to or more than 0.9.If ABI<0.9 occurred at one side,patients were diagnosed as PAD.On the second morning after hospitalization,blood was collected to measure fasting blood glucose(FBG),2-hour postprandial blood glucose(PBG2h),glycosylated hemoglobin(HbAlc),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).Among them,blood glucose.lipid and other biochemical markers were measured with enzyme chemistry assay

  18. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z;

    2012-01-01

    (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P<0.001). In Cox's models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or...... stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.......AimsPatients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no...

  19. Development of bilateral coronary artery aneurysms in a child with Noonan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Mauro, David M.; Flors, Lucia; Norton, Patrick T.; Hagspiel, Klaus D. [University of Virginia Health System, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Hoyer, Andrew W. [University of Virginia Health System, Department of Pediatrics, Division of Pediatric Cardiology, Charlottesville, VA (United States); Pediatric Cardiology Center of Oregon, Portland, OR (United States)

    2016-03-15

    Noonan syndrome is a constellation of congenital malformations including heart defects, facial anomalies and short stature. The cardiovascular defects are variable and extensive, with the most common being pulmonary stenosis and hypertrophic cardiomyopathy. Coronary artery anomalies have only been reported in a few cases. We report a child with Noonan syndrome status post pulmonary stenosis and atrial septal defect repair, who developed bilateral coronary artery aneurysms. The aneurysms were diagnosed with both cardiac magnetic resonance imaging and coronary computed tomography angiography. There had been no evidence of them on a cardiac MR exam 5 years previously. (orig.)

  20. Development of bilateral coronary artery aneurysms in a child with Noonan syndrome.

    Science.gov (United States)

    Mauro, David M; Flors, Lucia; Hoyer, Andrew W; Norton, Patrick T; Hagspiel, Klaus D

    2016-03-01

    Noonan syndrome is a constellation of congenital malformations including heart defects, facial anomalies and short stature. The cardiovascular defects are variable and extensive, with the most common being pulmonary stenosis and hypertrophic cardiomyopathy. Coronary artery anomalies have only been reported in a few cases. We report a child with Noonan syndrome status post pulmonary stenosis and atrial septal defect repair, who developed bilateral coronary artery aneurysms. The aneurysms were diagnosed with both cardiac magnetic resonance imaging and coronary computed tomography angiography. There had been no evidence of them on a cardiac MR exam 5 years previously. PMID:26515448

  1. Risk management in software development projects

    OpenAIRE

    McManus, John

    2004-01-01

    Very few software projects are completed on time, on budget, and to their original specification causing the global IT software industry to lose billions each year in project overruns and reworking software. Research supports that projects usually fail because of management mistakes rather than technical mistakes. Risk Management in Software Development Projects focuses on what the practitioner needs to know about risk in the pursuit of delivering software projects. Risk Management in Softwar...

  2. Effect of heterozygous β-thalassaemia trait on coronary atherosclerosis via coronary artery disease risk factors: a preliminary study

    OpenAIRE

    Hashemi, M.; Shirzadi, E; Talaei, Z; L. Moghadas; Shaygannia, I; Yavari, M; AMIRI, N.; H. Taheri; H. Montazeri; Shamsolkottabi, H

    2007-01-01

    Summary Background Thalassaemia is considered the most common genetic disorder worldwide. An association between the heterozygous β-thalassaemia trait and myocardial infarction has previously been observed. However, the relationship between heterozygous β-thalassaemia and atherosclerosis, considering other coronary artery disease (CAD) risk factors, has remained unclear. Methods A case-control study was conducted to evaluate the hypothesis that thalassaemia minor affects the likelihood of ath...

  3. Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patients without regional wall motion abnormality

    OpenAIRE

    Rostamzadeh, Alireza; Shojaeifard, Maryam; Rezaei, Yousef; Dehghan, Kasra

    2015-01-01

    Background: The prediction of coronary artery disease (CAD) by conventional echocardiographic measurements is principally based on the estimation of ejection fraction and regional wall motion abnormality (RWMA). This study aimed to determine whether strain echocardiography of left ventricle measured by velocity vector imaging (VVI) method could detect patients with a high-risk CAD. Methods: In a prospective study, a total of 119 consecutive patients who were assessed for eligibility were cate...

  4. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

    OpenAIRE

    Okon Ekwere Essien; Joseph Andy; Victor Ansa; Akaninyene Asuquo Otu; Alphonsus Udoh

    2014-01-01

    Introduction. Death from coronary artery disease (CAD) has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD) risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6%) of 747 autopsies. They were predominantly males, urban residents, and...

  5. A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients

    OpenAIRE

    Grewal, Keerat; Gravely-Witte, Shannon; Stewart, Donna E.; Grace, Sherry L.

    2011-01-01

    Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis, and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores, and recurrent events in CAD patients. One thousand two hundred and sixty eight CAD outpatients of 97 cardiologists were surveyed at two points. Recurrent events or hospitalization in the intervening 9 months were ...

  6. Can Stress Echocardiography Compete with Perfusion Scintigraphy in the Detection of Coronary Artery Disease and Cardiac Risk Assessment?

    OpenAIRE

    Geleijnse, Marcel; Elhendy, Abdou

    2000-01-01

    textabstractAims: The aim of this review was to define the place of stress echocardiography in the context of perfusion scintigraphy for the detection of coronary artery disease (CAD) and the assessment of cardiac risk. Stress echocardiography has the benefits of widespread availability, relatively low cost, portability, absence of radiation, and the determination of the ischaemic threshold. However, the echocardiographic windows are variable, sometimes with poor echogenicity, and interpretat...

  7. Disaster Risk Transfer for Developing Countries

    Science.gov (United States)

    Linneroothbayer, J.; Mechler, R.; Pflug, G.; Hochrainer, S.

    2005-12-01

    Financing disaster recovery often diverts resources from development, which can have long-term effects on economic growth and the poor in developing countries. Moreover, post-disaster assistance, while important for humanitarian reasons, has failed to meet the needs of developing countries in reducing their exposure to disaster risks and assuring sufficient funds to governments and individuals for financing the recovery process. The authors argue that part of disaster aid should be refocused from post-disaster to pre-disaster assistance including financial disaster risk management. Such assistance is now possible with new modeling techniques for estimating and pricing risks of natural disasters coupled with the advent of novel insurance instruments for transferring catastrophe risk to the global financial markets. The authors illustrate the potential for risk transfer in developing countries using the IIASA CATSIM model, which shows the potential impacts of disasters on economic growth in selected developing countries and the pros and cons of financial risk management to reduce those adverse impacts. The authors conclude by summarizing the advantages of investing in risk-transfer instruments (coupled with preventive measures) as an alternative to traditional post-disaster donor assistance. Donor-supported risk-transfer programs would not only leverage limited disaster aid budgets, but would also free recipient countries from depending on the vagaries of post-disaster assistance. Both the donors and the recipients stand to gain, especially since the instruments can be designed to encourage preventive measures. Precedents already exist for imaginative risk-transfer programs in highly exposed developing countries, including national insurance systems, micro-insurance schemes like weather derivatives and novel instruments (e.g., catastrophe bonds) to provide insurance cover for public sector risks.

  8. SLC2A10 genetic polymorphism predicts development of peripheral arterial disease in patients with type 2 diabetes. SLC2A10 and PAD in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Jiang Yi-Der

    2010-08-01

    Full Text Available Abstract Background Recent data indicate that loss-of-function mutation in the gene encoding the facilitative glucose transporter GLUT10 (SLC2A10 causes arterial tortuosity syndrome via upregulation of the TGF-β pathway in the arterial wall, a mechanism possibly causing vascular changes in diabetes. Methods We genotyped 10 single nucleotide polymorphisms and one microsatellite spanning 34 kb across the SLC2A10 gene in a prospective cohort of 372 diabetic patients. Their association with the development of peripheral arterial disease (PAD in type 2 diabetic patients was analyzed. Results At baseline, several common SNPs of SLC2A10 gene were associated with PAD in type 2 diabetic patients. A common haplotype was associated with higher risk of PAD in type 2 diabetic patients (haplotype frequency: 6.3%, P = 0.03; odds ratio [OR]: 14.5; 95% confidence interval [CI]: 1.3- 160.7 at baseline. Over an average follow-up period of 5.7 years, carriers with the risk-conferring haplotype were more likely to develop PAD (P = 0.007; hazard ratio: 6.78; 95% CI: 1.66- 27.6 than were non-carriers. These associations remained significant after adjustment for other risk factors of PAD. Conclusion Our data demonstrate that genetic polymorphism of the SLC2A10 gene is an independent risk factor for PAD in type 2 diabetes.

  9. Technology development risk assessment and mixed interests

    International Nuclear Information System (INIS)

    The main purpose of this work is to demonstrate by means of a critical analysis of the state-of-the-art in technological and environmental risk analysis and decision making, that risk and environmental management decisions involve heterogeneous groups of social actors, each representing conflicting interests. It is argued that risk analyses should therefore be based on social interaction and communication paradigma, as well as, on a new rational way of thinking concerning the optimum choice of suitable technological development strategies leading towards a publicly acceptable balance between national energy-economic strategic necessities and social and individual perception of risk

  10. Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis.

    Directory of Open Access Journals (Sweden)

    Franz Hafner

    Full Text Available OBJECTIVE: Endothelial dysfunction plays a key role in the development, progression, and clinical manifestation of atherosclerosis, and in symptomatic peripheral arterial disease, endothelial dysfunction and enlarged intima-media thickness might be associated with increased cardiovascular risk. Flow-mediated dilatation and serologic parameters are used to evaluate individual endothelial function. Brachial intima-media thickness, a less recognized parameter of cardiovascular risk, is independently associated with coronary artery disease. The aim of this study was to evaluate the prognostic value of ultrasound and serologic parameters of endothelial function in relation to cardiovascular mortality in peripheral arterial disease. DESIGN: monocentric, prospective cohort study. METHODS: Flow mediated dilatation and brachial intima-media thickness were assessed in 184 (124 male patients with peripheral arterial disease (Rutherford stages 2-3. Serologic parameters of endothelial function included asymmetric dimethylarginine (ADMA, symmetric dimethylarginine (SDMA, and L-homoarginine. Cardiovascular events were recorded during a follow-up of 99.1±11.1 months. Subjects who died of noncardiovascular causes were excluded from further analysis. RESULTS: Eighty-two patients (44.6% died during follow-up after a mean duration of 49.7±28.3 months. There were 49 cardiovascular deaths (59.8% and 33 other deaths (40.2%. Flow mediated dilatation was associated with cardiovascular death [1.17% (0.0, 4.3 vs. 4.1% (1.2, 6.4, p<0.001]. Intima-media thickness was greater in patients who succumbed to cardiovascular disease [0.37 mm (0.30, 0.41] than in survivors [0.21 mm (0.15, 0.38, p<0.001]. Brachial intima-media thickness above 0.345 mm was most predictive of cardiovascular death, with sensitivity and specificity values of 0.714 and 0.657, respectively (p<0.001. Furthermore, ADMA levels above 0.745 µmol/l and SDMA levels above 0.825 µmol/l were significantly

  11. Assessment of Alzheimer’s Disease Risk with Functional Magnetic Resonance Imaging: An Arterial Spin Labeling Study

    OpenAIRE

    Bangen, Katherine J.; Restom, Khaled; Liu, Thomas T.; Wierenga, Christina E.; Jak, Amy J.; Salmon, David P.; Bondi, Mark W.

    2012-01-01

    Functional magnetic resonance imaging (fMRI) of older adults at risk for Alzheimer’s disease (AD) by virtue of their cognitive (i.e., mild cognitive impairment [MCI]) and/or genetic (i.e., apolipoprotein E [APOE] ε4 allele) status demonstrate divergent brain response patterns during memory encoding across studies. Using arterial spin labeling MRI, we examined the influence of AD risk on resting cerebral blood flow (CBF) as well as the CBF and blood oxygenation level dependent (BOLD) signal re...

  12. 下肢动脉疾病危险因素研究现状%Study status on risk factors of lower extremity arterial disease

    Institute of Scientific and Technical Information of China (English)

    尹彦亮; 沈彦明

    2012-01-01

    Lower extremity arterial disease in the elderly has become a common disease, and slow progress of lower extremity arterial disease, longer duration, its risk factors contribute to the early high-risk groups to take preventive measures to avoid the serious consequences from occurring. And what are the factors promoting the development of LEAD play the more important role were not yet clear. The article from the smoking, hypertension, diabetes, blood lipids and other aspects-review the risk factors LEAD.%下肢动脉疾病已成为中老年人常见的疾病,而下肢动脉疾病进展慢,病程长,对其相关危险因素的研究有助于使高危人群早期采取预防措施,避免其严重后果的发生.而哪些因素在促进LEAD的发展中起到更加重要的作用,尚未明确.本文主要从吸烟、高血压、糖尿病、血脂等方面对LEAD的危险因素研究现状作一综述.

  13. Risk management of hydropower development in China

    International Nuclear Information System (INIS)

    There is a rapidly increasing demand for hydropower in China. However, little research has been conducted to systematically investigate the overall aspects of hydropower development risks. With support of the data collected from a fieldwork survey, this study reports the multiple facets of hydropower development risks in China as perceived by main project participants. All groups have a common view on the criticality of safety, and the groups also have their own priorities, i.e., resettlement of migrants, incompetence of subcontractors, project delay, inadequate or incorrect design, premature failure of facilities and ecological and environmental impacts are the key risks to clients, whereas quality of work, financial related risks, reputation, and claims and disputes are the main concerns to contractors. A case study of Three Gorges Project further demonstrates that, hydropower development risks can be effectively managed by encouraging joint efforts of all participants to achieve the goals on producing renewable energy, reducing emissions of CO2, and providing important social/economical benefits. Future hydropower development should emphasize the interactions between project delivery, environmental, and economical processes to reach appropriate trade-offs among involving stakeholders, by adequately considering the inter-relations between project participants' risks as well as hydropower project's externalities on a broad view. - Highlights: • Largely attributed to unforeseen geology conditions, safety is critical in hydropower development. • Resettlement of migrants is the principal risk to clients, whereas quality of works is the first concern to contractors. • One group's risks are typically related to others', needing collaborative risk management by participants. • Three Gorges Project plays a key role on producing renewable energy, and providing social/economical benefits. • Hydropower development should emphasize the interactions between project

  14. Ultrasound evaluation of intima media thickness of carotid arteries in dialysis patients and correlation with proposed risk factors

    Directory of Open Access Journals (Sweden)

    Damjanović Tatjana

    2003-01-01

    Full Text Available Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis, in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I,30 on hemodialysis, group II and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0,720 mm and group B (intima media thickness higher then 0,720mm. Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.

  15. High absolute risks and predictors of venous and arterial thromboembolic events in patients with nephrotic syndrome: results from a large retrospective cohort study.

    NARCIS (Netherlands)

    Mahmoodi, B.K.; Kate, M.K. ten; Waanders, F.; Veeger, N.J.; Brouwer, J.L.; Vogt, L.; Navis, G.; Meer, J.W.M. van der

    2008-01-01

    BACKGROUND: No data are available on the absolute risk of either venous thromboembolism (VTE) or arterial thromboembolism (ATE) in patients with nephrotic syndrome. Reported risks are based on multiple case reports and small studies with mostly short-term follow-up. We assessed the absolute risk of

  16. Cardiovascular Risk Factors in Young Patients of Coronary ArteryDisease: Differences over a Decade

    Directory of Open Access Journals (Sweden)

    Amitesh Aggarwal

    2014-10-01

    Full Text Available Introduction: Studies evaluating temporal trends of Coronary artery disease (CAD in youngpatients, from the India, are still lacking. The aim of this study was to evaluate temporal differencesin risk factors of young patients of CAD over a decade.Methods: This is a single centre retrospective study performed in a tertiary care teaching institutionin North India. Case records of young patients (≤40 years with acute coronary syndrome betweenJanuary 2000 to December 2001 and January 2009 to December 2010 were obtained. Recordswere sought for active smoking, family history, waist size, blood pressure, hypertension, fastingand postprandial blood sugar and lipid profile for both groups and analyzed using SPSS v.17. Forthe purpose of the study, p value <0.05 was considered statistically significant.Results: Medical records of a total of 79 and 83 patients with young CAD (≤ 40 years wereobtained for 2000-01 and 2009-10 period respectively. An increase in proportion of femalepatients, hypertension (p=0.004, dysglycemia (p<0.001, family history (p=0.01, metabolicsyndrome (p<0.001, low high density lipoprotein (HDL (p=0.07 and mean waist size (0.03was noted over the years. Among males, increase in number of dysglycemics (p=0.0002, positivefamily history (p<0.0001 and mean waist size (0.032 was statistically significant.Conclusion: Over a decade the patients with young CAD in our study, there was an increase inproportion of patients with metabolic syndrome, dysglycemia and low HDL.

  17. What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk

    Directory of Open Access Journals (Sweden)

    Pletcher Mark J

    2004-08-01

    Full Text Available Abstract Background The coronary artery calcium (CAC score is an independent predictor of coronary heart disease. We sought to combine information from the CAC score with information from conventional cardiac risk factors to produce post-test risk estimates, and to determine whether the score may add clinically useful information. Methods We measured the independent cross-sectional associations between conventional cardiac risk factors and the CAC score among asymptomatic persons referred for non-contrast electron beam computed tomography. Using the resulting multivariable models and published CAC score-specific relative risk estimates, we estimated post-test coronary heart disease risk in a number of different scenarios. Results Among 9341 asymptomatic study participants (age 35–88 years, 40% female, we found that conventional coronary heart disease risk factors including age, male sex, self-reported hypertension, diabetes and high cholesterol were independent predictors of the CAC score, and we used the resulting multivariable models for predicting post-test risk in a variety of scenarios. Our models predicted, for example, that a 60-year-old non-smoking non-diabetic women with hypertension and high cholesterol would have a 47% chance of having a CAC score of zero, reducing her 10-year risk estimate from 15% (per Framingham to 6–9%; if her score were over 100, however (a 17% chance, her risk estimate would be markedly higher (25–51% in 10 years. In low risk scenarios, the CAC score is very likely to be zero or low, and unlikely to change management. Conclusion Combining information from the CAC score with information from conventional risk factors can change assessment of coronary heart disease risk to an extent that may be clinically important, especially when the pre-test 10-year risk estimate is intermediate. The attached spreadsheet makes these calculations easy.

  18. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  19. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    International Nuclear Information System (INIS)

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  20. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    OpenAIRE

    Chevli, Parag; Kelash, Fnu; Gadhvi, Pragnesh; Grandhi, Sreeram; Syed, Amer

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50) and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset o...

  1. Prevalence of peripheral arterial disease in patients at non-high cardiovascular risk. Rationale and design of the PANDORA study

    Directory of Open Access Journals (Sweden)

    Cimminiello Claudio

    2010-08-01

    Full Text Available Abstract Background Lower extremity peripheral arterial disease (PAD is a marker of widespread atherosclerosis. Individuals with PAD, most of whom do not show typical PAD symptoms ('asymptomatic' patients, are at increased risk of cardiovascular ischaemic events. American College of Cardiology/American Heart Association guidelines recommend that individuals with asymptomatic lower extremity PAD should be identified by measurement of ankle-brachial index (ABI. However, despite its associated risk, PAD remains under-recognised by clinicians and the general population and office-based ABI detection is still poorly-known and under-used in clinical practice. The Prevalence of peripheral Arterial disease in patients with a non-high cardiovascular disease risk, with No overt vascular Diseases nOR diAbetes mellitus (PANDORA study has a primary aim of assessing the prevalence of lower extremity PAD through ABI measurement, in patients at non-high cardiovascular risk, with no overt cardiovascular diseases (including symptomatic PAD, or diabetes mellitus. Secondary objectives include documenting the prevalence and treatment of cardiovascular risk factors and the characteristics of both patients and physicians as possible determinants for PAD under-diagnosis. Methods/Design PANDORA is a non-interventional, cross-sectional, pan-European study. It includes approximately 1,000 primary care participating sites, across six European countries (Belgium, France, Greece, Italy, The Netherlands, Switzerland. Investigator and patient questionnaires will be used to collect both right and left ABI values at rest, presence of cardiovascular disease risk factors, current pharmacological treatment, and determinants for PAD under-diagnosis. Discussion The PANDORA study will provide important data to estimate the prevalence of asymptomatic PAD in a population otherwise classified at low or intermediate risk on the basis of current risk scores in a primary care setting. Trial

  2. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians - a population with the highest risk of premature coronary artery disease & diabetes.

    Science.gov (United States)

    Enas, Enas A; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C S; Mohan, Viswanathan

    2013-10-01

    Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians.

  3. Risk Factors for Developing Atopic Dermatitis

    DEFF Research Database (Denmark)

    G. Carson, Charlotte

    2013-01-01

    The aim of this thesis was to investigate possible risk factors affecting the development of AD. AD is a frequent disease among children and has a substantial impact on the lives of both the child and its family. A better understanding of the disease would enable better treatment, prevention...... and information to the families involved. Previous risk factor studies have been hampered by an unsuitable study design and/or difficulties in standardization when diagnosing AD, which limit their conclusions. In paper I, we conducted a traditional cross-sectional analysis testing 40 possible risk factors....... This traditional risk factor analysis led to two borderline significant results: duration of exclusive breastfeeding and mother's alcohol intake during the 3rd trimester. Since these possible two risk factors could neither be rejected nor accepted, we decided to do two in-depth studies, further investigating these...

  4. Development of a Tonometric Sensor with a Decoupled Circular Array for Precisely Measuring Radial Artery Pulse.

    Science.gov (United States)

    Jun, Min-Ho; Kim, Young-Min; Bae, Jang-Han; Jung, Chang Jin; Cho, Jung-Hee; Jeon, Young Ju

    2016-05-26

    The radial artery pulse is one of the major diagnostic indices used clinically in both Eastern and Western medicine. One of the prominent methods for measuring the radial artery pulse is the piezoresistive sensor array. Independence among channels and an appropriate sensor arrangement are important for effectively assessing the spatial-temporal information of the pulse. This study developed a circular-type seven-channel piezoresistive sensor array using face-down bonding (FDB) as one of the sensor combination methods. The three-layered housing structure that included independent pressure sensor units using the FDB method not only enabled elimination of the crosstalk among channels, but also allowed various array patterns to be created for effective pulse measurement. The sensors were arranged in a circular-type arrangement such that they could estimate the direction of the radial artery and precisely measure the pulse wave. The performance of the fabricated sensor array was validated by evaluating the sensor sensitivity per channel, and the possibility of estimating the blood vessel direction was demonstrated through a radial artery pulse simulator. We expect the proposed sensor to allow accurate extraction of the pulse indices for pulse diagnosis.

  5. Development of a Tonometric Sensor with a Decoupled Circular Array for Precisely Measuring Radial Artery Pulse

    Science.gov (United States)

    Jun, Min-Ho; Kim, Young-Min; Bae, Jang-Han; Jung, Chang Jin; Cho, Jung-Hee; Jeon, Young Ju

    2016-01-01

    The radial artery pulse is one of the major diagnostic indices used clinically in both Eastern and Western medicine. One of the prominent methods for measuring the radial artery pulse is the piezoresistive sensor array. Independence among channels and an appropriate sensor arrangement are important for effectively assessing the spatial-temporal information of the pulse. This study developed a circular-type seven-channel piezoresistive sensor array using face-down bonding (FDB) as one of the sensor combination methods. The three-layered housing structure that included independent pressure sensor units using the FDB method not only enabled elimination of the crosstalk among channels, but also allowed various array patterns to be created for effective pulse measurement. The sensors were arranged in a circular-type arrangement such that they could estimate the direction of the radial artery and precisely measure the pulse wave. The performance of the fabricated sensor array was validated by evaluating the sensor sensitivity per channel, and the possibility of estimating the blood vessel direction was demonstrated through a radial artery pulse simulator. We expect the proposed sensor to allow accurate extraction of the pulse indices for pulse diagnosis. PMID:27240363

  6. Changes in medical treatment six months after risk stratification with HeartScore and coronary artery calcification scanning of healthy middle-aged subjects

    DEFF Research Database (Denmark)

    Sørensen, Mette Hjortdal; Gerke, Oke; Lambrechtsen, Jess;

    2012-01-01

    Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT-scan as ......Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT......-scan as a part of a screening programme. Using the European HeartScore, the total 10-year cardiovascular mortality risk was estimated (≥5% risk was considered as high). Risk factors and CAC scores were reported to both the patients and their general practitioner. Six months after the screening, follow...

  7. Perioperative risk factors for prolonged mechanical ventilation and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Zahra S Faritous

    2011-01-01

    Full Text Available Background: Prolonged mechanical ventilation is an important recognized complication occurring during cardiovascular surgery procedures. This study was done to assess the perioperative risk factors related to postoperative pulmonary complications and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass. Methods: It was a retrospective study on 5,497 patients, including 31 patients with prolonged ventilatory support and 5,466 patients without it; from the latter group, 350 patients with normal condition (extubated in 6-8 hours without any complication were selected randomly. Possible perioperative risk factors were compared between the two groups using a binary logistic regression model. Results: Among the 5,497 women undergoing coronary artery bypass graft (CABG, 31 women needed prolonged mechanical ventilation (PMV, and 15 underwent tracheostomy. After logistic regression, 7 factors were determined as being independent perioperative risk factors for PMV. Discussion: Age ≥70 years old, left ventricular ejection fraction (LVEF ≤30%, preexisting respiratory or renal disease, emergency or re-do operation and use of preoperative inotropic agents are the main risk factors determined in this study on women undergoing CABG.

  8. An abdominal aortic calcification as a RISK FACTOR FOR cardio -cerebral events in patients with peripheral arterial

    Directory of Open Access Journals (Sweden)

    V. A. Zelinskiy

    2012-01-01

    Full Text Available Background. The patients with abdominal aortic calcification have a high risk of cardiocerebral events, but the pathways of them have not been reported so far. The goal of our study was to assess the structure and function of myocardium and to determine the morphological features of carotid artery atherosclerosis in patients with abdominal aortic calcification.Materials and methods. A total of 167 executive patients with peripheral arterial disease were enrolled in study. The study group included 85 patients with abdominal aortic calcification (men – 95.3 %; age median was – 66.6 ± 12. Control group included 82 patients without objective signs of abdominal aortic calcification. Abdominal aortic calcification was detected by CT imaging. All patients have undergone echocardiography and duplex scanning of carotid arteries.Results. Prevalence and severity of ischemic heart disease and cerebrovascular disease were statistically significant higher in patients with abdominal aortic calcification (91.7, 65.8 % vs. 67, 37.3 % (р < 0.01. We have found statistically significant differences between groupsin heart structure and function. A high left ventricular wall thickness (р < 0.01, left atrium dilation (р < 0.01 and enhanced of left ventricular mass (р < 0.05, ejection fraction reduction (р < 0.05 and more common diastolic dysfunction (р < 0.05 were determined inpatients with abdominal aortic calcification. An intima-media thickness of the common carotid artery was significantly higher in study group patients (1.38 ± 0.07 mm vs. 1.14 ± 0.06 mm (р < 0.001.Conclusion. Our findings suggested that abdominal aortic calcification is main reason of hypertrophy and dilation in the left heart due to enhanced peripheral resistance. Hypertrophy and dilation in the left heart is provided a high risk of cardiovascular events in patients withabdominal aortic calcification.

  9. Computed tomography coronary angiography accuracy in women and men at low to intermediate risk of coronary artery disease

    International Nuclear Information System (INIS)

    To investigate the diagnostic accuracy of CT coronary angiography (CTCA) in women at low to intermediate pre-test probability of coronary artery disease (CAD) compared with men. In this retrospective study we included symptomatic patients with low to intermediate risk who underwent both invasive coronary angiography and CTCA. Exclusion criteria were previous revascularisation or myocardial infarction. The pre-test probability of CAD was estimated using the Duke risk score. Thresholds of less than 30 % and 30-90 % were used for determining low and intermediate risk, respectively. The diagnostic accuracy of CTCA in detecting obstructive CAD (≥50 % lumen diameter narrowing) was calculated on patient level. P < 0.05 was considered significant. A total of 570 patients (46 % women [262/570]) were included and stratified as low (women 73 % [80/109]) and intermediate risk (women 39 % [182/461]). Sensitivity, specificity, PPV and NPV were not significantly different in and between women and men at low and intermediate risk. For women vs. men at low risk they were 97 % vs. 100 %, 79 % vs. 90 %, 80 % vs. 80 % and 97 % vs. 100 %, respectively. For intermediate risk they were 99 % vs. 99 %, 72 % vs. 83 %, 88 % vs. 93 % and 98 % vs. 99 %, respectively. CTCA has similar diagnostic accuracy in women and men at low and intermediate risk. (orig.)

  10. Age, gender and hypertension as major risk factors in development of subclinical atherosclerosis

    Directory of Open Access Journals (Sweden)

    Ajla Rahimić Ćatić

    2013-04-01

    Full Text Available Introduction: Intima-media thickness (IMT measurement of the common carotid artery (CCA is considered as useful indicator of carotid atherosclerosis. Early detection of atherosclerosis and its associated risk factors is important to prevent stroke and heart diseases. The aim of the present study was to investigate which risk factors are better determinants of subclinical atherosclerosis, measured by common carotidartery intima media thickness (CCA-IMT.Methods: A total of 74 subjects were randomly selected in this cross – sectional study. Information on the patient’s medical history and laboratory fi ndings were obtained from their clinical records. Risk factors relevant to this study were age, gender, cigarette smoking status, diabetes, hypertension and dyslipidemia. Ultrasound scanning of carotid arteries was performed with a 7,5 MHz linear array transducer (GE Voluson730 pro. The highest value of six common carotid artery measurements was taken as the fi nal IMT. Increased CCA-IMT was defi ned when it was > 1 mm.Results: Our data demonstrated higher CCA-IMT values in male patients compared with female patients. Increased CCA-IMT was the most closely related to age (PConclusion: Age, gender and hypertension are the most important risk factors in development of carotid atherosclerosis. Early detection of atherosclerosis among high-risk populations is important in order to prevent stroke and heart diseases, which are leading causes of death worldwide.

  11. TOWARDS SUSTAINABLE DEVELOPMENT THROUGH SOCIAL RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Anghel Irina

    2010-12-01

    Full Text Available Current incontestable realities such as climate change, deepening and widening globalization, demographic ageing, socio-cultural transformations, limited progress in tightening inequalities of income and welfare at the local as well as global scale, become springs of some of the most severe threats and challenges to the goal and process of sustainable development. They prove to be sources of new and old risks (environmental, economic, socio-political or life-cycle for developing and developed societies alike. Natural or manmade, the risks, and harsh realities, that many people have to face may narrow down the present, as well as future generations’ capacity and opportunity for sound development. The literature of the last two decades has increasingly acknowledged the tight interrelationships and inter-dependence between environmental sustainability, economic growth and societal wellbeing and development, which asks for an integrated and systemic approach to the policies governing sustainable development and its dimensions. The present paper advocates that, given the multiplication and higher imminence of social risks, the need for systemic intersectoral political approach and the imperative for moving beyond the curative role for social policy towards designing preventive, ex-ante social strategies, social risk management as concept, principle and means becomes instrumental to the progress towards sustainable development.

  12. WRITINGS RELATED WITH CORONARY ARTERY DISEASE AND RISK FACTORS WHICH WERE PRINTED IN TEN NATIONAL DAILY NEWSPAPER

    Directory of Open Access Journals (Sweden)

    Hakan ALTINTAS

    2005-10-01

    Full Text Available This study is a descriptive epidemiological study which was conducted in order to determine various properties of writings related to coronary artery disease (CAD and its risk factors in 10 top selling national newspapers based on newspaper listing. Most of the writings related to CAD and its risk factors composed less than 0.20%of total surface area of a newspaper. In 21.9%(16 of such writings, there were no pictures, and presentation techniques were not effective. When evaluated for scientific truth, 21.9%(16 of the writings were composed of false or partialy true writings. It was realized that newspapers under investigation did not spare enough space for writings related to CAD and its risk factors. [TAF Prev Med Bull 2005; 4(5.000: 253-264

  13. Fatores de risco em indivíduos com hipertensão arterial Factores de riesgo en individuos con hipertensión arterial Risk factors to patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Janete Pessuto

    1998-01-01

    Full Text Available Este trabalho teve o objetivo de verificar os hábitos relacionados aos fatores de risco em uma população de portadores de hipertensão arterial. A amostra foi composta por 70 indivíduos, constatando-se que a maioria não faz exercício, não tem atividade de lazer, havendo necessidade de programas educativos para aquisição destes hábitos .Há lacunas de informação, pois os clientes têm como ponto de referência, em sua maioria, a própria experiência, ao invés das orientações que recebem de vários profissionais.Este trabajo tuvo como objetivo verificar los hábitos relacionados con los factores de riesgo en una población de portadores de hipertensión arterial . Fueron entrevistados setenta individuos, y se constató que la gran mayoría no práctican ejercicios físicos y no tienen actividades de recreación, existiendo la necesidad de programas educativos para la aquisición de estes hábitos. Hay lagunas de información, pues la mayoría del clientes tienen como punto de referencia sus propias experiencias y no las orientaciones recibidas de varios profesionales.The aim of this research was to verify the habits related to the risk factors of one population with arterial hypertension. Seventy individuals were interviewed. Authors found that the majority do not practice any kind of physical exercise, they do not have leisure activities and need education programs to aquire these habits. There are gaps in information, because they have their own experience as a reference, in spite of the orientations they received from several professionals.

  14. Combination of high-sensitivity C-reactive protein and homocysteine may predict an increased risk of coronary artery disease in Korean population

    Institute of Scientific and Technical Information of China (English)

    CHO Doo-Yeoun; KIM Kyu-Nam; KIM Kwang-Min; LEE Duck-Joo; KIM Bom-Taeck

    2012-01-01

    Background The association of emerging biomarkers such as high-sensitivity C-reactive protein (hs-CRP),homocysteine and fibrinogen with the risk of coronary artery disease (CAD) is still uncertain in Asian population including Koreans and little is known about the combined effect of biomarkers on the risk of CAD.Methods A total of 10 650 subjects (6538 men and 4112 women) were enrolled in this study.A 10-year CAD risk was calculated using Framingham risk score modified by the National Cholesterol Education Program (NCEP) Adult Treatment Panel Ⅲ (ATP Ⅲ ) and levels of circulating hs-CRP,homocysteine and fibrinogen were measured using validated assays.Results The 10-year CAD risk gradually augmented with increase in the circulating levels of hs-CRP,homocysteine and fibrinogen.For the highest quartile of hs-CRP,odds ratio (OR) of high-risk for CAD (10-year risk ≥20%) compared with the lowest quartile was 3.97 (95% C/:2.51-6.29).For homocysteine and fibrinogen,ORs in the highest quartile compared to the lowest quartile were 5.10 (95% Cl:3.05-8.53,P <0.001) and 1.46 (95% Cl:0.69-3.11,P=0.325),respectively.OR of high-risk for CAD in both the highest quartile of hs-CRP and homocysteine was 9.05 (95% CI:5.30-15.45) compared with the below median of hs-CRP and homocysteine.Conclusions The present study demonstrated that hs-CRP and homocysteine are well associated with the 10-year CAD risk estimated using NCEP ATP Ⅲ in Koreans and combination of hs-CRP and homocysteine can have strong synergyin predicting the development of CAD.

  15. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    Directory of Open Access Journals (Sweden)

    Parag Chevli

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50 and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

  16. Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

    Directory of Open Access Journals (Sweden)

    Wei YUE

    2015-04-01

    Full Text Available Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke.  Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA, internal carotid artery (ICA, external carotid artery (ECA, vertebral artery (VA, subclavian artery (SCA and innominate artery of the population. The intima-media thickness (IMT, atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups.  Results 1 The detection rate of carotid atherosclerosis was 71.55% (684/956, and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ2 = 20.067, P = 0.000. 2 Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684, secondly intima-media thickening (13.01%, 89/684, followed by moderate to severe stenosis or occlusion (5.41%, 37/684. The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ2 = 19.269, P = 0.000. The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ2 = 9.824, P = 0.002. The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26 vs 1.52 (0.20, 2.84; Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%, secondly SCA (22.18%. Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA

  17. Development of risk-informed application technology

    International Nuclear Information System (INIS)

    This project aims at developing a risk-informed application technology to enhance the safety and economy of nuclear power plant altogether. For this, the PSA standard model is developed which meets the ASME PSA Standard Capability Category I +. In addition, to reduce the uncertainty of PSA, several new PSA technologies are developed. A methodology is developed to quantify the fault trees of initiating events and mitigation systems simultaneously, and a new measure is developed to judge the convergency of PSA results. A new frame is proposed to combine the Level 1 and 2 PSA models into a unified PSA model. The fire risk is re-assessed using a fire analysis computer code. To develop a risk-informed decision making framework, a new method to derive the importance of systems with common cause events is proposed. And it is proposed that a framework for eliciting and combining the experts' opinions consistently. The research results can be used in the regulatory body and the industry projects for risk-informed applications

  18. Development of 3D ultrasound techniques for carotid artery disease assessment and monitoring

    International Nuclear Information System (INIS)

    Quantitative measurements of carotid plaque burden are used to monitor patients and evaluate established interventions as well as new treatment options. Three-dimensional ultrasound (3D US) techniques were developed to noninvasively monitor the progression of carotid artery disease in both symptomatic and asymptomatic patients. Three-dimensional carotid US images were acquired and reconstructed, and methods for quantitative assessment were developed. The measurement of intima-media thickness (IMT) based on two-dimensional ultrasound (2D US) images was extended to a 3D vessel-wall-plus- plaque thickness (VWT), obtained by computing the distance between the carotid wall and lumen surfaces on a point-by-point basis. VWT measurements were superimposed on the arterial wall to produce 3D VWT maps. VWT changes were determined by comparing the 3D VWT maps obtained at two different time points. To facilitate the visualization and interpretation of the VWT and VWT-Change maps, a technique to flatten these maps was developed. Carotid remodeling involving changes in both arterial wall and plaque thickness was assessed with VWT maps obtained from in vivo 3D ultrasound images. 3D carotid ultrasound image evaluation with VWT mapping provides a feasible means for the analysis of plaque burden volumes and changes. (orig.)

  19. Uso crônico de decanoato de nandrolona como fator de risco para hipertensão arterial pulmonar em ratos Wistar Chronic use of nandrolone decanoate as risk factor for pulmonary arterial hypertension in Wistar rats

    Directory of Open Access Journals (Sweden)

    Jones Bernardes Graceli

    2010-02-01

    Full Text Available INTRODUÇÃO: O uso indiscriminado de esteróides anabolizantes sintéticos, análogos à testosterona, implica aumento do risco cardiovascular e hipertrofia cardíaca. Assim, o aumento da massa ventricular direita corrigido pelo peso corporal (i.é., hipertrofia ventricular direita - HVD, poderia elevar o risco para o desenvolvimento de hipertensão arterial pulmonar (HAP. OBJETIVOS: Examinar os efeitos do tratamento em longo prazo com decanoato de nadrolona na HVD e sua relação com a HAP em ratos. MÉTODOS: 16 ratos Wistar com três meses de idade foram aleatoriamente divididos em dois grupos: 1 controle-sham (CONT, n = 8; 2 tratados com decanoato de nandrolona (DECA, n = 8. O tratamento consistiu na aplicação intramuscular de Deca-durabolin® 6.0mg.kg-1 de peso corporal durante quatro semanas. Após tratamento, os animais foram anestesiados com hidrato de cloral (4.0mL.kg-1, i.p., submetidos à cateterização da artéria femoral para registro da pressão arterial media (PAM e frequência cardíaca (FC. O coração, os rins e o fígado foram retirados, pesados e avaliados os índices de hipertrofia, os quais foram calculados pela razão da massa do órgão pelo peso corporal (mg.g-1. RESULTADOS: Os animais tratados com DECA apresentaram aumento (p INTRODUCTION: The unsystematic use of anabolic steroids, synthetic analogs of testosterone, implies enhanced cardiovascular risk and cardiac hypertrophy. Thus, increased right ventricular mass corrected by the body weight (e.g.right ventricular hypertrophy -RVH could raise the risk for development of pulmonary arterial hypertension (PAH. OBJECTIVES: to examine the effects of long-term chronic treatment with nandrolone decanoate on the RVH and its relationship with PAH in rats. METHODS: 16 three-month Wistar male rats were treated with nandrolone decanoate (6.0 mg/kg-1 body weight; DECA, n=8 or control vehicle (CONT, n=8. The drug and vehicle were administered by a single injection in the femoral

  20. Clinical significance of erectile dysfunction developing after acute coronary event:exception to the rule or confirmation of the artery size hypothesis?

    Institute of Scientific and Technical Information of China (English)

    Piero Montorsi; Paolo M Ravagnani; Charalambos Vlachopoulos

    2015-01-01

    Erectile dysfunction (ED) has been found to frequently precedes the onset of coronary artery disease (CAD), representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a “window opportunity” to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis (ASH) has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels (i.e. the penile artery) being able to less well tolerate the same amount of plaque when compared with larger ones (i.e. the coronary artery). If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH.

  1. Epigenetics and Peripheral Artery Disease.

    Science.gov (United States)

    Golledge, Jonathan; Biros, Erik; Bingley, John; Iyer, Vikram; Krishna, Smriti M

    2016-04-01

    The term epigenetics is usually used to describe inheritable changes in gene function which do not involve changes in the DNA sequence. These typically include non-coding RNAs, DNA methylation and histone modifications. Smoking and older age are recognised risk factors for peripheral artery diseases, such as occlusive lower limb artery disease and abdominal aortic aneurysm, and have been implicated in promoting epigenetic changes. This brief review describes studies that have associated epigenetic factors with peripheral artery diseases and investigations which have examined the effect of epigenetic modifications on the outcome of peripheral artery diseases in mouse models. Investigations have largely focused on microRNAs and have identified a number of circulating microRNAs associated with human peripheral artery diseases. Upregulating or antagonising a number of microRNAs has also been reported to limit aortic aneurysm development and hind limb ischemia in mouse models. The importance of DNA methylation and histone modifications in peripheral artery disease has been relatively little studied. Whether circulating microRNAs can be used to assist identification of patients with peripheral artery diseases and be modified in order to improve the outcome of peripheral artery disease will require further investigation.

  2. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Pena, Adam;

    2016-01-01

    microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. METHODS AND RESULTS: After screening 3568 women, 963 women with angina-like chest pain and a diagnostic coronary angiogram without significant coronary......BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary.......01), hypertension (P=0.02), current smoking (Pstress testing...

  3. Contemporary medical management of peripheral arterial disease: a focus on risk reduction and symptom relief for intermittent claudication.

    Science.gov (United States)

    Agrawal, Kush; Eberhardt, Robert T

    2015-02-01

    Peripheral arterial disease (PAD) is primarily caused by progressive systemic atherosclerosis manifesting in the lower extremities. This review addresses the epidemiology, clinical presentation and evaluation, and medical management of PAD, with a focus on intermittent claudication. Key advances in the recognition of cardiovascular risk in asymptomatic individuals with mildly abnormal ankle-brachial index, newer reflections on exercise therapy, and a review of established and investigational agents for the treatment of symptomatic PAD, such as cilostazol, statins, and angiotensin-converting enzyme inhibitors, are highlighted.

  4. Disaster risk reduction and sustainable development

    International Nuclear Information System (INIS)

    During the past four decades, natural hazards such as earthquakes, volcanic activity, and slides, tsunami tropical cyclones and other severe storms, tornadoes and high winds, river floods and coastal flooding, wildfire and associated haze drought, sand/dust storms, and insect infestations have caused major loss of human lives and livelihoods, the destruction of economic and social infrastructure, as well as environmental damages. Economic losses have increased almost ten times during this period. As it happen in recent Asia Tsunami, in which over 2, 00,000 people reportedly killed, estimated five million homeless, and resulted in massive displacement of population and extensive damage to infrastructure. The escalation of severe disaster events triggered by natural hazards and related technological and environment disasters is increasingly threatening both sustainable development and poverty-reduction initiatives. The loss of human lives and the rise in the cost of reconstruction efforts and loss of development assets has forced the issue of disaster reduction and risk management higher on the policy agenda of affected governments as well a multilateral and bilateral agencies and NGOs. For this Disaster risk reduction-.strategies are aimed at enabling societies at risk to become engaged in the conscious management of risk and the reduction of vulnerability. The adoption of appropriate development policies can reduce disaster risk. These policies should be gender sensitive and need the necessary political commitment. They involve the adoption of suitable regulatory and other legal measures, institutional reform, improved analytical and methodological capabilities, financial planning, education and awareness. (author)

  5. GOUT OUTCOMES. LITERATURE REVIEW. PART II. COMORBID DISEASES, RISK OF DEVELOPING CARDIOVASCULAR CATASTROPHES AND DEATH IN GOUT PATIENTS

    Directory of Open Access Journals (Sweden)

    Igor Sergeevich Denisov

    2013-01-01

    Full Text Available The data showing an association between gout and hyperuricemia with renal failure, arterial hypertension, metabolic syndrome, type 2 diabetes mellitus, and ischemic heart disease are reported. The data on the role of gout and comorbid conditions as independent risk factors of developing atherosclerosis and cardiovascular catastrophes are presented. Furthermore, the effect of drug therapy for gout on the risk of developing comorbid conditions and cardiovascularcatastrophes is discussed.

  6. Arterial hypertension and cancer.

    Science.gov (United States)

    Milan, Alberto; Puglisi, Elisabetta; Ferrari, Laura; Bruno, Giulia; Losano, Isabel; Veglio, Franco

    2014-05-15

    Arterial hypertension and cancer are two of the most important causes of mortality in the world; correlations between these two clinical entities are complex and various. Cancer therapy using old (e.g., mitotic spindle poisons) as well as new (e.g., monoclonal antibody) drugs may cause arterial hypertension through different mechanisms; sometimes the increase of blood pressure levels may be responsible for chemotherapy withdrawal. Among newer cancer therapies, drugs interacting with the VEGF (vascular endothelial growth factors) pathways are the most frequently involved in hypertension development. However, many retrospective studies have suggested a relationship between antihypertensive treatment and risk of cancer, raising vast public concern. The purposes of this brief review have then been to analyse the role of chemotherapy in the pathogenesis of hypertension, to summarize the general rules of arterial hypertension management in this field and finally to evaluate the effects of antihypertensive therapy on cancer disease.

  7. Renal sympathetic denervation prevents the development of pulmonary arterial hypertension and cardiac dysfunction in dogs.

    Science.gov (United States)

    Hu, Wei; Yu, Sheng-Bo; Chen, Liao; Guo, Rui-Qiang; Zhao, Qing-Yan

    2015-08-01

    The renin-angiotensin-aldosterone system is activated in pulmonary arterial hypertension (PAH) patients, and this activation may have long-term negative effects on the progression of PAH. The purpose of this study was to evaluate the effects of transcatheter renal sympathetic denervation (RSD) on the development of pulmonary arterial hypertension and cardiac dysfunction in dogs using two-dimensional speckle tracking imaging. Twenty-two dogs were randomly divided into three groups: control group (n = 7), PAH group (n = 8), and PAH + RSD group (n = 7). All dogs were assessed using two-dimensional speckle tracking imaging. The ventricular strain, ventricular synchrony, left ventricular (LV) twist, and torsion rate were analyzed to evaluate cardiac function. After 8 weeks, the right ventricular lateral longitudinal strain and the septum longitudinal strain were reduced in the PAH group compared with the control group (p dogs.

  8. Mathematical modelling of atheroma plaque formation and development in coronary arteries

    Science.gov (United States)

    Cilla, Myriam; Peña, Estefanía; Martínez, Miguel A.

    2014-01-01

    Atherosclerosis is a vascular disease caused by inflammation of the arterial wall, which results in the accumulation of low-density lipoprotein (LDL) cholesterol, monocytes, macrophages and fat-laden foam cells at the place of the inflammation. This process is commonly referred to as plaque formation. The evolution of the atherosclerosis disease, and in particular the influence of wall shear stress on the growth of atherosclerotic plaques, is still a poorly understood phenomenon. This work presents a mathematical model to reproduce atheroma plaque growth in coronary arteries. This model uses the Navier–Stokes equations and Darcy's law for fluid dynamics, convection–diffusion–reaction equations for modelling the mass balance in the lumen and intima, and the Kedem–Katchalsky equations for the interfacial coupling at membranes, i.e. endothelium. The volume flux and the solute flux across the interface between the fluid and the porous domains are governed by a three-pore model. The main species and substances which play a role in early atherosclerosis development have been considered in the model, i.e. LDL, oxidized LDL, monocytes, macrophages, foam cells, smooth muscle cells, cytokines and collagen. Furthermore, experimental data taken from the literature have been used in order to physiologically determine model parameters. The mathematical model has been implemented in a representative axisymmetric geometrical coronary artery model. The results show that the mathematical model is able to qualitatively capture the atheroma plaque development observed in the intima layer. PMID:24196695

  9. BAF200 is required for heart morphogenesis and coronary artery development.

    Directory of Open Access Journals (Sweden)

    Lingjuan He

    Full Text Available ATP-dependent SWI/SNF chromatin remodeling complexes utilize ATP hydrolysis to non-covalently change nucleosome-DNA interactions and are essential in stem cell development, organogenesis, and tumorigenesis. Biochemical studies show that SWI/SNF in mammalian cells can be divided into two subcomplexes BAF and PBAF based on the subunit composition. ARID2 or BAF200 has been defined as an intrinsic subunit of PBAF complex. However, the function of BAF200 in vivo is not clear. To dissect the possible role of BAF200 in regulating embryogenesis and organ development, we generated BAF200 mutant mice and found they were embryonic lethal. BAF200 mutant embryos exhibited multiple cardiac defects including thin myocardium, ventricular septum defect, common atrioventricular valve, and double outlet right ventricle around E14.5. Moreover, we also detected reduced intramyocardial coronary arteries in BAF200 mutants, suggesting that BAF200 is required for proper migration and differentiation of subepicardial venous cells into arterial endothelial cells. Our work revealed that PBAF complex plays a critical role in heart morphogenesis and coronary artery angiogenesis.

  10. Pregnancy risks in women with pre-existing coronary artery disease, or following acute coronary syndrome

    NARCIS (Netherlands)

    Burchill, Luke J.; Lameijer, Heleen; Roos-Hesselink, Jolien W.; Grewal, Jasmine; Ruys, Titia P. E.; Kulikowski, Julia D.; Burchill, Laura A.; Oudijk, M. A.; Wald, Rachel M.; Colman, Jack M.; Siu, Samuel C.; Pieper, Petronella G.; Silversides, Candice K.

    2015-01-01

    Objective The objective of this study was to determine outcomes in pregnant women with pre-existing coronary artery disease (CAD) or following an acute coronary syndrome (ACS) including myocardial infarction (MI). Background The physiological changes of pregnancy can contribute to myocardial ischaem

  11. Risk in vaccine research and development quantified.

    Directory of Open Access Journals (Sweden)

    Esther S Pronker

    Full Text Available To date, vaccination is the most cost-effective strategy to combat infectious diseases. Recently, a productivity gap affects the pharmaceutical industry. The productivity gap describes the situation whereby the invested resources within an industry do not match the expected product turn-over. While risk profiles (combining research and development timelines and transition rates have been published for new chemical entities (NCE, little is documented on vaccine development. The objective is to calculate risk profiles for vaccines targeting human infectious diseases. A database was actively compiled to include all vaccine projects in development from 1998 to 2009 in the pre-clinical development phase, clinical trials phase I, II and III up to Market Registration. The average vaccine, taken from the preclinical phase, requires a development timeline of 10.71 years and has a market entry probability of 6%. Stratification by disease area reveals pandemic influenza vaccine targets as lucrative. Furthermore, vaccines targeting acute infectious diseases and prophylactic vaccines have shown to have a lower risk profile when compared to vaccines targeting chronic infections and therapeutic applications. In conclusion; these statistics apply to vaccines targeting human infectious diseases. Vaccines targeting cancer, allergy and autoimmune diseases require further analysis. Additionally, this paper does not address orphan vaccines targeting unmet medical needs, whether projects are in-licensed or self-originated and firm size and experience. Therefore, it remains to be investigated how these - and other - variables influence the vaccine risk profile. Although we find huge differences between the risk profiles for vaccine and NCE; vaccines outperform NCE when it comes to development timelines.

  12. The impact of umbilical and uterine artery Doppler indices on antenatal course, labor and delivery in a low-risk primigravid population.

    LENUS (Irish Health Repository)

    Cooley, Sharon M

    2012-02-01

    AIMS: To evaluate the impact of umbilical and uterine artery Doppler in the second and third trimester on antenatal course, labor and delivery in a low-risk primigravid population. METHODS: Prospective recruitment of 1011 low-risk primigravidas with uterine and umbilical artery Doppler assessment at 22-24 weeks and 36 weeks. All mothers and infants were reviewed postnatally with a retrospective analysis of ultrasound and clinical outcome data. RESULTS: Elevated uterine artery indices were associated with increased rates of threatened miscarriage, higher rates of pre-eclampsia (PET) and a higher incidence of fetal birth weight <2nd and 9th centile for gestation. Uterine artery pulsatility index (PI) >95th centile for gestation was associated with statistically higher rates of small-for-gestational age (SGA) infants. Elevated umbilical artery indices were associated with higher rates of induction of labor and a higher incidence of fetal birth weight infants <2nd and 9th centile for gestation. Umbilical artery PI >95th centile for gestation was associated with statistically higher rates of SGA infants. CONCLUSION: Elevated uterine and umbilical artery indices are associated with higher rates of maternal and fetal disease.

  13. Privatization, political risk and stock market development

    NARCIS (Netherlands)

    E.C. Perotti; P.H. van Oijen

    1999-01-01

    This paper investigates whether privatization in emerging economies has a significant indirect effect on local stock market development through the resolution of political risk. We argue that a sustained privatization program represents a major political test which gradually resolves uncertainty ove

  14. Benefit-Risk Assessment in Drug Development

    DEFF Research Database (Denmark)

    Sarac, Sinan

    This thesis covers the development, testing and use of an eight-step structured method for data-driven benefit-risk assessment. The aim of this thesis was to create a tailored method for the assessment of clinical data. The focus has been on three major aspects: (i) A simple preliminary method wa...

  15. Assessment of bleeding risk in patients with coronary artery disease on dual antiplatelet therapy. A systematic review.

    Science.gov (United States)

    Vries, Minka J A; van der Meijden, Paola E J; Henskens, Yvonne M C; ten Cate-Hoek, Arina J; ten Cate, Hugo

    2016-01-01

    Patients with coronary artery disease are usually treated with dual antiplatelet therapy (DAPT) after percutaneous coronary intervention. Patients on DAPT are at risk of both ischaemic and bleeding events. Although side-lined for a long time, real-life studies have shown that both the incidence and the associated morbidity and mortality of out-of-hospital bleeding are high. This indicates that prevention of (post-interventional) bleeding is as important as prevention of ischaemia. For this purpose it is crucial to reliably identify patients with a high bleeding risk. In order to postulate an algorithm, which could help identifying these patients, we performed a systematic review to determine the value of previously proposed prognostic modalities for bleeding. We searched and appraised the following tools: platelet function tests, genetic tests, bleeding scores and questionnaires and haemostatic tests. Most studies indicated that low on-treatment platelet reactivity (LTPR), as measured by several platelet function tests, and the carriage of CYP2C19*17 allele were independent risk factors for bleeding. A bleeding score also proved to be helpful in identifying patients at risk. No studies on haemostatic tests were retrieved. Several patient characteristics were also identified as independent predictors of bleeding, such as older age, female sex and renal failure. Combining these risk factors we propose an algorithm that would hypothetically facilitate identification of those patients at highest risk, warranting prevention measures for bleeding. This could be a starting point for further research concerning the topic.

  16. The role of disturbed blood flow in the development of pulmonary arterial hypertension : lessons from preclinical animal models

    NARCIS (Netherlands)

    Dickinson, Michael G.; Bartelds, Beatrijs; Borgdorff, Marinus A. J.; Berger, Rolf M. F.

    2013-01-01

    Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasoproliferative disorder characterized by the development of unique neointimal lesions, including concentric laminar intima fibrosis and plexiform lesions. Although the histomorphology of neointimal lesions is well described, the pat

  17. Mycotoxin food safety risk in developing countries

    OpenAIRE

    Bhat Ramesh V.; Vasanthi, Siruguri

    2003-01-01

    "Mycotoxins are produced by fungi, commonly known as mold. These toxins can develop during production, harvesting, or storage of grains, nuts, and other crops. Mycotoxins are among the most potent mutagenic and carcinogenic substances known. They pose chronic health risks: prolonged exposure through diet has been linked to cancer and kidney, liver, and immune-system disease. Because mycotoxins occur more frequently under tropical conditions and diets in many developing countries are more heav...

  18. Noninvasive Detection of Endothelial Function in Normal Subjects,Asymptomatic Patients at Risk of Atherosclerosis and Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    F. Rajabzadeh

    2005-06-01

    Full Text Available Background/Objective: The endothelial dysfunction is associated with atherosclerosis. The dilatory reaction of atherosclerotic vessels in response to occlusion is reduced. This reduction could be of value in atherosclerosis determination. This study aimed at comparing brachial artery response to occlusion and administration of nitroglycerine in three groups: coronary artery disease patients, individuals with corona ry disease risk factors but no coronary disease,and normal subjects. Patients and Methods: The participants included 23 healthy individuals, 22 subjects with cardiovascular risk factors (diabetes mellitus, smoking, hyperte nsion or hypercholesterolemia ,and 57 angiographically proven coronary pati ents. The brachial artery diameter was measured by color Doppler ultrasound at rest, 5 min utes after inflation of the cuff, and 5 minutes after sublingual administration of nitroglycerine pearl. Results: The vessel’s diameter increased the least in the coronary artery disease and coronary risk factor groups in comparison to nor mal subjects (p=0.003 and 0.048, respectively. Vessel dilatation in response to nitroglycerine did not differ in healthy individuals from the coronary patients or the risk factor group (p=0.96 and 0.77, respectively. Conclusion: Doppler ultrasound may be used as a noninvasive method to identify subjects with endothelial dysfunction at high risk of coronary artery disease who need intervention or more invasive procedures.

  19. Risk and Control Developments in Corporate Governance

    DEFF Research Database (Denmark)

    Holm, Claus; Laursen, Peter Birkholm

    2007-01-01

    Are the risk and control developments in corporate governance changing the role of the external auditor? This paper examines how the concepts of risk and control are incorporated in current corporate governance promulgations and analyses the implications for the role of the external auditor....... It is suggested that up till now the corporate governance debate has strengthened the position or role of the internal auditor in the advantage of the role of the external auditor. The promulgations have influenced the internal control mechanisms, and the control responsibilities have become more explicit...

  20. Clean development mechanism projects and portfolio risks

    International Nuclear Information System (INIS)

    Clean development mechanism (CDM) is expected to facilitate technology transfer from developed to developing countries as well as to economically reduce greenhouse gas emissions. In this article, we explore effective institutions to activate CDM projects. For this purpose, we have estimated internal rate of return (IRR) and other indicators on profitability for 42 CDM or JI projects, taking account of volatilities in the price of certified emission reductions (CER). As a result of Monte Carlo simulations, expected values and standard deviations in the IRR of the projects were quantitatively shown. Then we evaluated various risks in CDM, concluding that diversification of investment is an effective way to suppress these risks. Therefore securitization of CDM finance is proposed as a means of facilitating the diversification of investment. Namely, we present the concept of a CDM bond, which is a project bond with CER. We also investigated the role of governments to suppress risks in CDM. Referring to CERUPT, initiated by the Netherlands' government, the institution of 'insured CERUPT' is proposed to suppress downside risks in the IRR of the projects. We concluded that it is possible to make CDM projects viable by the 'insured CERUPT' and CDM bond

  1. Clean development mechanism projects and portfolio risks

    Energy Technology Data Exchange (ETDEWEB)

    Matsuhashi, Ryuji; Fujisawa, Sei [University of Tokyo (Japan). Graduate School of Frontier Science; Mitamura, Wataru; Momobayashi, Yutaka; Yoshida, Yoshikuni [University of Tokyo (Japan). Graduate School of Engineering

    2004-08-01

    Clean development mechanism (CDM) is expected to facilitate technology transfer from developed to developing countries as well as to economically reduce greenhouse gas emissions. In this article, we explore effective institutions to activate CDM projects. For this purpose, we have estimated internal rate of return (IRR) and other indicators on profitability for 42 CDM or JI projects, taking account of volatilities in the price of certified emission reductions (CER). As a result of Monte Carlo simulations, expected values and standard deviations in the IRR of the projects were quantitatively shown. Then we evaluated various risks in CDM, concluding that diversification of investment is an effective way to suppress these risks. Therefore securitization of CDM finance is proposed as a means of facilitating the diversification of investment. Namely, we present the concept of a CDM bond, which is a project bond with CER. We also investigated the role of governments to suppress risks in CDM. Referring to CERUPT, initiated by the Netherlands' government, the institution of ''insured CERUPT'' is proposed to suppress downside risks in the IRR of the projects. We concluded that it is possible to make CDM projects viable by the ''insured CERUPT'' and CDM bond. (author)

  2. Development of biodegradable radiopaque microsphere for arterial embolization-a pig study

    Institute of Scientific and Technical Information of China (English)

    Yi-Sheng; Liu; Xi-Zhang; Lin; Hong-Ming; Tsai; Hung-Wen; Tsai; Guan-Cheng; Chen; Syuan-Fong; Chen; Jui-Wen; Kang; Chen-Miao; Chou; Chiung-Yu; Chen

    2015-01-01

    AIM: To develop a new type of calibrated, biodegradable, and imaging detectable microsphere and evaluated its embolization safety and efficacy on pig’s liver and spleen. METHODS: Six kinds of pharmaceutical excipient were combined and atomized to form our microsphere. Twenty-four male Lanyu pigs weighing 25-30 kg were used. The arteries of spleen and liver were embolized with Gelfoam, Embosphere, or our microsphere. The serum biochemical tests, computed tomography(CT), liver perfusion scan, and tissue microscopy examination were done to evaluate the safety and efficacy of embolization. RESULTS: Radiopaque microspheres with a size ranging from 300 to 400 μm were produced. Embolization of hepatic and splenic artery of pigs with our microsphere significantly reduced the blood flow of liver and resulted in splenic infarction. The follow-up CT imaging and the microscopic examination showed intraarterial degradation of Gelfoam and microsphere. The blood testsdemonstrated insignificant changes with regards to liver and renal functions. CONCLUSION: Our microspheres, with the unique characteristics, can be used for transcatheter arterial embolization with effects equivalent to or better than Gelfoam and Embosphere in pigs.

  3. 64Cu-DOTATATE for Noninvasive Assessment of Atherosclerosis in Large Arteries and Its Correlation with Risk Factors

    DEFF Research Database (Denmark)

    Malmberg, Catarina; Ripa, Rasmus Sejersten; Johnbeck, Camilla Bardram;

    2015-01-01

    consecutive patients with neuroendocrine tumors underwent both (68)Ga-DOTATOC and (64)Cu-DOTATATE PET/CT scans, in random order. For each scan, the maximum and mean standardized uptake values (SUVs) were calculated in 5 arterial segments. In addition, the blood-pool-corrected target-to-background ratio...... calculated as maximum and mean uptake. There was a significant association between Framingham risk score and the overall maximum uptake of (64)Cu-DOTATATE using SUV (r = 0.4; P = 0.004) as well as target-to-background ratio (r = 0.3; P = 0.04), whereas no association was found with (68)Ga......-DOTATOC. The association of risk factors and maximum SUV of (64)Cu-DOTATATE was found driven by body mass index, smoking, diabetes, and coronary calcium score (P

  4. Fragility fracture: recent developments in risk assessment.

    Science.gov (United States)

    Aspray, Terry J

    2015-02-01

    More than half of older women who sustain a fragility fracture do not have osteoporosis by World Health Organization (WHO) bone mineral density (BMD) criteria; and, while BMD has been used to assess fracture risk for over 30 years, a range of other skeletal and nonskeletal clinical risk factors (CRFs) for fracture have been recognized. More than 30 assessment tools using CRFs have been developed, some predicting fracture risk and others low BMD alone. Recent systematic reviews have reported that many tools have not been validated against fracture incidence, and that the complexity of tools and the number of CRFs included do not ensure best performance with poor assessment of (internal or comparative) validity. Internationally, FRAX® is the most commonly recommended tool, in addition to QFracture in the UK, The Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool in Canada and Garvan in Australia. All tools estimate standard 10-year risk of major osteoporotic and 10-year risk of hip fracture: FRAX® is able to estimate fracture risk either with or without BMD, but CAROC and Garvan both require BMD and QFracture does not. The best evidence for the utility of these tools is in case finding but there may be future prospects for the use of 10-year fracture risk as a common currency with reference to the benefits of treatment, whether pharmacological or lifestyle. The use of this metric is important in supporting health economic analyses. However, further calibration studies will be needed to prove that the tools are robust and that their estimates can be used in supporting treatment decisions, independent of BMD.

  5. Does high altitude increase risks of the elderly patients with coronary artery disease?

    Institute of Scientific and Technical Information of China (English)

    Tian-Yi Wu; Zhong-Yan Zhan; Qin-Li Wu; Suo-Lung Baomu; Yu-Ling Jie; Min Sun

    2009-01-01

    Objective To assess the effect of altitude hypoxia on the elderly patients with coronary artery disease (CAD). Methods Three subject groups were surveyed during their train trip on the highest railroad--the Qinghai-Tibet Railway: 22 elderly individuals with documented CAD, 20 healthy elderly controls, and 20 healthy young controls, all of whom from Beijing near the sea level (76 m). Survey questions addressed clinical features of their healthy conditions and aspects of their coronary disease. The baseline study was performed at Xining at an altitude of 2261 m, and then during acute exposure to altitudes of 2808 m, 4768m, 5072 m and 4257 m by train for 24 hours. Resting pulse rate, blood pressure, oxygen saturation, electrocardiograph (ECG), and cardiac work estimated by the heart rate-blood pressure double product were obtained five times in each subject at different altitudes. Results On arrival to altitudes between 4768 m and 5072 m, the older passengers, especially those with preexisting coronary disease, had higher HR, higher BP, and lower SaO2, as well as more frequent abnormalities on ECG, as compared to the younger healthy subjects. As compared with the healthy elderly controls, incomplete right bundle branch block, left ventricular hypertrophy, and ST segment depression were more frequently seen in the elderly coronary patients (P<0.01). Cardiac work in group 1 was increased by 13% 12 hours after arrival to altitudes between 2808 m and 5072 m. Oxygen saturation decreased significantly with the altitude increasing by train ascent but improved after inhalation of oxygen. Most of the older subjects tolerated their sojourn at high altitude well except one who developed angina repeatedly with a significant ST segment depression. Conclusions Coronary events and ECG signs of myocardial ischemia are rare in elderly individuals with CAD who travel from sea level to moderate altitudes of 1500m to 2800 m. Patients with CAD who are well compensated at sea level

  6. Increased prevalence of coronary artery disease risk markers in patients with chronic hepatitis C – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Roed T

    2014-01-01

    Full Text Available Torsten Roed,1 Ulrik Sloth Kristoffersen,2 Andreas Knudsen,1,2 Niels Wiinberg,3 Anne-Mette Lebech,1 Thomas Almdal,4 Reimar W Thomsen,5 Andreas Kjær,2 Nina Weis1,61Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; 2Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 3Department of Clinical Physiology, Frederiksberg Hospital, Copenhagen, Denmark; 4Steno Diabetes Center, Copenhagen, Denmark; 5Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 6Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkObjective: Chronic hepatitis C is a global health problem and has been associated with coronary artery disease. Our aim was to examine the prevalence of coronary artery disease risk markers including endothelial biomarkers in patients with chronic hepatitis C and matched comparisons without manifest cardiovascular disease or diabetes in a cross-sectional design.Methods: Sixty patients with chronic hepatitis C (mean age 51 years were recruited from the Department of Infectious Diseases at Copenhagen University Hospital, and compared with 60 age-matched non-hepatitis C virus-infected individuals from a general population survey. We examined traditional coronary artery disease risk factors, metabolic syndrome, carotid intima media thickness, and a range of endothelial biomarkers.Results: Patients with chronic hepatitis C had more hypertension (40% versus 25%, prevalence ratio [PR] 1.6; 95% confidence interval [CI] 0.9–2.7 and smoked more (53% versus 38%, PR 1.4; 95% CI 0.9–2.1. The two groups had similar body mass index (mean 25.0 versus 25.7 kg/m2, whereas those with chronic hepatitis C had less dyslipidemia (including significantly lower low-density lipoprotein and cholesterol/high-density lipoprotein ratio, higher glycosylated hemoglobin level (mean 6.2 versus 5

  7. Relationship between Conventional Cardiovascular Disease Risk Assessment and Coronary Artery Calcification in Group Exposed to Inorganic Dusts

    International Nuclear Information System (INIS)

    The purpose of this study is to determine the relationship between the coronary artery calcification (CAC) and the conventional cardiovascular disease risk assessment (CCDRA). This study included 101 subjects who were exposed to inorganic dusts and underwent CAC scoring by multidetector CT (MDCT), laboratory tests, and a standardized questionnaire for CCDRA, after being approved from the Institutional Review Board and providing informed consent. All subjects were divided as either non-calcified group (< 1, 55.4%) or calcified group (≥ 1, 44.6%) from total CAC, and evaluated by CCDRA, such as Framingham risk score (FRS) and National Cholesterol Education Program (NCEP). Receiver operating characteristic (ROC) area of FRS was generated for predicting CAC risk using SPSS program (ver. 19.0, Chicago, IL, USA). Total CAC was significantly correlated with FRS (r = 0.283, p = 0.004). Crude odds ratio for CAC risk was 3.64 [95% confidence interval (CI) 1.39-9.52] in FRS ≥ 20%, and 2.87 (95% CI 1.24-6.65) in the high risk group of NCEP. Subjects with pneumoconiosis showed higher values of CAC (p 0.541) and FRS (p = 0.035) scores compared with subjects without pneumoconiosis. ROC area of FRS was 0.69 (95% CI 0.59-0.79) with a cutoff point of 13.5%. CAC measured MDCT is significantly correlated with FRS than other CCDRA

  8. Relationship between Conventional Cardiovascular Disease Risk Assessment and Coronary Artery Calcification in Group Exposed to Inorganic Dusts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jeong; Park, So Young [Occupational Lung Diseases Institute, KCOMWEL, Ansan (Korea, Republic of)

    2013-03-15

    The purpose of this study is to determine the relationship between the coronary artery calcification (CAC) and the conventional cardiovascular disease risk assessment (CCDRA). This study included 101 subjects who were exposed to inorganic dusts and underwent CAC scoring by multidetector CT (MDCT), laboratory tests, and a standardized questionnaire for CCDRA, after being approved from the Institutional Review Board and providing informed consent. All subjects were divided as either non-calcified group (< 1, 55.4%) or calcified group ({>=} 1, 44.6%) from total CAC, and evaluated by CCDRA, such as Framingham risk score (FRS) and National Cholesterol Education Program (NCEP). Receiver operating characteristic (ROC) area of FRS was generated for predicting CAC risk using SPSS program (ver. 19.0, Chicago, IL, USA). Total CAC was significantly correlated with FRS (r = 0.283, p = 0.004). Crude odds ratio for CAC risk was 3.64 [95% confidence interval (CI) 1.39-9.52] in FRS {>=} 20%, and 2.87 (95% CI 1.24-6.65) in the high risk group of NCEP. Subjects with pneumoconiosis showed higher values of CAC (p 0.541) and FRS (p = 0.035) scores compared with subjects without pneumoconiosis. ROC area of FRS was 0.69 (95% CI 0.59-0.79) with a cutoff point of 13.5%. CAC measured MDCT is significantly correlated with FRS than other CCDRA.

  9. Early Invasive Strategy in Unstable Coronary Artery Disease : Outcome in Relation to Risk Stratification

    OpenAIRE

    Diderholm, Erik

    2002-01-01

    In unstable coronary artery disease (CAD) it still is a matter of debate which patients should undergo early revascularisation. In the FRISC II study (n=2457) an early invasive strategy was, compared to a primarily non-invasive strategy, associated with reduced mortality and myocardial infarction (MI) rates. However, in this heterogeneous group of patients, tools for an appropriate selection to revascularisation are needed. From the FRISC II study we evaluated the prognosis, the angiographic ...

  10. Circulating Thrombotic Risk Factors in Young Patients with Coronary Artery Disease Who Are on Statins and Anti-platelet Drugs.

    Science.gov (United States)

    George, Reema; Sivadasanpillai, Harikrishnan; Jayakumari, Narayani; Bhatt, Anugya; Thulaseedharan, Jissa V; Tharakan, Jaganmohan A

    2016-07-01

    Thrombotic risk factors may contribute to premature coronary artery disease (CAD), in addition to the conventional risk factors. There is paucity of data on studies evaluating the role of thrombotic factors in premature CAD in Indian patients. Thus a case-control study was performed to evaluate the role of thrombotic and atherogenic factors in young patients with angiographically proven CAD who are on treatment with statins and anti-platelet drugs. 152 patients (≤55 years) with angiographically proven CAD and 102 asymptomatic controls were recruited. Clinical and biochemical data were obtained in both groups. Blood levels of thrombotic factors-fibrinogen, antithrombin-III, tissue-plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), von-Willebrand factor (v-WF), lipoprotein(a) [Lp(a)] and homocysteine were analyzed. Patients had high levels of conventional CAD risk factors (diabetes mellitus, smoking, hypertension, dyslipidemia and positive family history) compared to controls. Logistic regression analysis revealed that low antithrombin-III (odds ratio/OR 11.2; 95 % confidence interval/CI 2.29-54.01), high fibrinogen (OR 6.04; 95 % CI 1.09-33.21) and high Lp(a) (OR 4.54; 95 % CI 0.92-22.56), as important, independent risk factors in patients. PAI-1(OR 0.15; 95 % CI 0.03-0.69) levels were significantly lower in patients. But other thrombotic risk factors studied (t-PA, v-WF and homocysteine) were comparable among patients and controls. The treatment using statins and anti-platelet drugs might be contributing to the control of some of the thrombotic risk factors. The strategies aiming at lowering the levels of thrombotic risk factors along with conventional risk factors may be useful in primary and secondary prevention of CAD. PMID:27382201

  11. [Development of transmural myocardial infarction in young persons with intact coronary arteries during methadone use for the treatment of heroine addiction].

    Science.gov (United States)

    Ioseliani, D G; Semitko, S P; Gromov, D G; Kostianiov, I Iu; Klochko, M A; Koledinskiĭ, A G; Topchian, I S

    2004-01-01

    Linkage between acute coronary syndrome and narcotic drug (cocaine) intake was first described by D. Colleman in 1982. However risk of development of acute myocardial infarction during replacement therapy after opioid withdrawal has not been elucidated. The paper contains description of two cases of development of myocardial infarction in young persons with intact coronary arteries who received synthetic opioid methadone for facilitation of heroine discontinuation. These clinical cases should draw attention of physicians to side effects of the use of methadone for the treatment of heroine addiction.

  12. Peripheral arterial stenosis and coronary artery disease coincidence

    Directory of Open Access Journals (Sweden)

    Reza Ghasemi

    2014-12-01

    Full Text Available Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD is the cause of nearly half (48% of the deaths and, loss of productivity life. Peripheral arterial disease (PAD is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI, duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.      

  13. Incidence and Risk Factors for Atrial Fibrillation after First Coronary Artery Bypass Grafting in Urumiyeh Imam Khomeini Hospital from 2006 to 2008

    Directory of Open Access Journals (Sweden)

    M Golmohammadi

    2010-06-01

    Full Text Available Background: Atrial fibrillation (AF is the most common arrhythmic complication following coronary artery bypass surgery (CABG. The incidence of postoperative AF ranges from %10 to %0 and it usually tends to occur within 2 to 4 days after operation. The etiology of AF after cardiac surgery is incompletely understood. Aggressive prophylactic intervention should be directed and limited to high risk patients who are most likely to benefit from such procedure. The aim of this study was to identify the frequency of AF and to determine risk factors by using available clinical predictors of postoperative AF after CABG.Methods: The present study was a prospective observational investigation of 300 patients undergoing elective isolated CABG from 2006 to 2008 in Urumiyeh Imam Khomeini Hospital. Peri-operative risk factors were used to develop logistic regression equation in order to predict the development of post-operative AF. Results: A total of 300 patients aged 58± 10 (221 male were included in the study. The incidence of AF was %12/3(n=37. By univariate analysis, congestive heart failure (P=0.02, and low left ventricular ejection fraction (P=0.04 were associated with the development of post-CABG AF. However, in the logistic regression model CHF (OR: 4.87, 95%CI: 1.09-21.6, P=0.038 remained an independent predictor for the development of postoperative AF. On the other hand, patients with and without AF were similar regarding body mass index, preoperative heart rate , time of ventilation in ICU, pump time, grafting or absence of grafting on right coronary artery (RCA and the prevalence of chronic lung diseases, previous myocardial infarction, and diabetes mellitus. Patients who developed AF had longer ICU stay (OR=4.92, P=0/000.Conclusion: The results of the present study demonstrated that the combination of congestive heart failure, and low left ventricular ejection fraction can identify patients at high risk for occurrence of AF after CABG.

  14. Endovascular covered stent repair of an iatrogenic subclavian artery-to-pulmonary artery fistula and pseudoaneurysm.

    Science.gov (United States)

    Wheeler, Shane C; Zinn, Kenneth M; Hughes, Terence W

    2007-06-01

    An iatrogenic fistula and consequent pseudoaneurysm developed between the right subclavian artery and right pulmonary artery as a result of misplacement of a hemodialysis access catheter. The patient, who was considered to be at high risk for surgical repair, successfully underwent endovascular treatment that involved insertion of two nitinol stents covered with expanded polytetrafluoroethylene (stent-grafts), one into the right subclavian artery and the other into a right upper lobe pulmonary artery. Multi-detector row computed tomographic angiography played an integral role in the evaluation of the patient's vascular injury and treatment planning. PMID:17538141

  15. High Residual Collagen-Induced Platelet Reactivity Predicts Development of Restenosis in the Superficial Femoral Artery After Percutaneous Transluminal Angioplasty in Claudicant Patients

    Energy Technology Data Exchange (ETDEWEB)

    Gary, Thomas, E-mail: thomas.gary@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Prüller, Florian, E-mail: florian.prueller@klinikum-graz.at; Raggam, Reinhard, E-mail: reinhard.raggam@klinikum-graz.at [Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics (Austria); Mahla, Elisabeth, E-mail: elisabeth.mahla@medunigraz.at [Medical University of Graz, Department of Anesthesiology and Intensive Care Medicine (Austria); Eller, Philipp, E-mail: philipp.eller@medunigraz.at; Hafner, Franz, E-mail: franz.hafner@klinikum-graz.at; Brodmann, Marianne, E-mail: marianne.brodmann@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria)

    2016-02-15

    PurposeAlthough platelet reactivity is routinely inhibited with aspirin after percutaneous angioplasty (PTA) in peripheral arteries, the restenosis rate in the superficial femoral artery (SFA) is high. Interaction of activated platelets and the endothelium in the region of intervention could be one reason for this as collagen in the subendothelium activates platelets.Materials and MethodsA prospective study evaluating on-site platelet reactivity during PTA and its influence on the development of restenosis with a total of 30 patients scheduled for PTA of the SFA. Arterial blood was taken from the PTA site after SFA; platelet function was evaluated with light transmission aggregometry. After 3, 6, 12, and 24 months, duplex sonography was performed and the restenosis rate evaluated.ResultsEight out of 30 patients developed a hemodynamically relevant restenosis (>50 % lumen narrowing) in the PTA region during the 24-month follow-up period. High residual collagen-induced platelet reactivity defined as AUC >30 was a significant predictor for the development of restenosis [adjusted odds ratio 11.8 (9.4, 14.2); P = .04].ConclusionsHigh residual collagen-induced platelet reactivity at the interventional site predicts development of restenosis after PTA of the SFA. Platelet function testing may be useful for identifying patients at risk.

  16. Development and trial application of risk information

    International Nuclear Information System (INIS)

    JNES has been doing various activities to stimulate the introduction of Risk Informed Regulation (RIR) to the safety regulation of nuclear power plants (NPPs) in Japan. Some applications are already incorporated, such as the regulatory review of Maintenance Programs and Safety Significance Evaluation for Inspection Findings. In consideration with the experience of the accident in Fukushima Daiichi Nuclear Power Station, JNES addressed development of regulatory guidelines, evaluation of the current condition of Fukushima Daiichi Nuclear Power Station, evaluation of effectiveness of severe accident management measures with the backgrounds of insights and experiences on probabilistic risk assessment (PRA) and RIR. Especially, the experiences were applied to the development of the methodologies for evaluation of effectiveness of severe accident managements. As for inspection and operation of NPPs, JNES enhanced the PRA scope applied to the importance analysis for Maintenance Program, SDP and RI-ISI in consideration with the insights of RIR in Japan and other countries. (author)

  17. Dialysis modalities as risk factors in the development of atherosclerosis

    Directory of Open Access Journals (Sweden)

    Damjanović Tatjana

    2003-01-01

    Full Text Available Introduction Atherosclerosis is a major risk factor for increased cardiovascular morbidity and mortality in dialysis patients. First clinical symptoms are usually associated with initial atherosclerotic changes of blood vessels. The aim of this study was ultrasound evaluation of intimae media thickness (IMT of carotid arteries in dialysis patients and its correlation with certain risk factors. Patients and methods IMT was measured in 45 dialysis patients with no signs of cardiovascular diseases:15 continuous ambulatory peritoneal dialysis (CAPD patients, 30 haemodialysis (HD patients and in 20 healthy controls. IMT was correlated with certain risk factors for atherosclerosis (general parameters - age, gender, duration of dialysis cause of renal diseases, parameters of nutrition, parameters of calcium and phosphorus metabolism, lipid parameters, blood pressure and smoking. Results The mean carotid artery IMT was significantly higher in dialysis patients than in the control group (p<0.05. In addition, the mean IMT was statistically significantly higher in PD than in HD patients (p<0.05. In CAPD patients there was a significant correlation between IMT and total and LDL cholesterol. In the second group (HD patients IMT was significantly correlated with diastolic blood pressure, BMI and smoking. Conclusion Although atherosclerotic cardiovascular disease may not manifest in dialysis patients, IMT of carotid arteries significantly increases. Major risk factors affecting IMT are lipid disturbances in patients on peritoneal dialysis and hypertension, obesity and smoking in HD patients.

  18. C242T Polymorphism in CYBA Gene (p22phox) and Risk of Coronary Artery Disease in a Population of Caucasian Italians

    Science.gov (United States)

    Nasti, Sabina; Spallarossa, Paolo; Altieri, Paola; Garibaldi, Silvano; Fabbi, Patrizia; Polito, Luisa; Bacino, Luca; Brunelli, Michele; Brunelli, Claudio; Barsotti, Antonio; Ghigliotti, Giorgio

    2006-01-01

    Background: specific polymorphisms of genes regulating intracellular redox balance and oxidative stress are related to atherogenesis. Some studies have identified a relationship between progression of atherosclerosis and C242T mutation in CYBA gene coding for p22phox, a subunit of the NADH/NADPH oxidase system. Design: we investigated whether the C242T nucleotide transition is associated with the presence of coronary artery disease (CAD) in a population of 494 Caucasian Italians undergoing coronary angiography to diagnose the cause of chest pain. Results: the frequency of the T mutant allele that we found in 276 patients with angiographically documented CAD was significantly higher compared to what we observed in 218 subjects with normal coronary arteries (Controls) (respectively: 0.400 and 0.332, p < 0.01). The prevalence of the T allele was even stronger when we compared: 1) early onset (age ≤55) vs late onset (age ≥65) single-vessel CAD patients (respectively: 0.75 and 0.48, p < 0.05), and 2) the subgroup of CAD patients with at least one ≥98% stenosis in a coronary vessel vs those with no ≥98% stenosis in a coronary vessel (respectively: 0.425 and 0.365, p < 0.05). Conclusions: these results support the increased risk of developing early CAD and of having rapid progression of coronary stenosis in subjects carrying the C242T nucleotide transition among the Italian population. PMID:16788250

  19. Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Pencak Przemysław

    2013-01-01

    Full Text Available Abstract Background Process of accelerated atherosclerosis specific for uremia increases cardiovascular risk in patients with chronic kidney disease (CKD and may be influenced by the different structure of arteries. The study assesses the influence of traditional and novel risk factors on calcification of coronary arteries (CAC and abdominal aorta (AAC in hemodialysis patients (HD. Methods CAC and AAC were assessed by CT in 104 prevalent adult HD and 14 apparently healthy subjects with normal kidney function (control group. Mineral metabolism parameters, plasma levels of FGF-23, MGP, osteoprotegerin, osteopontin, fetuin-A, CRP, IL-6 and TNF-α were measured. Results CAC and AAC (calcification score ≥ 1 were found in 76 (73.1% and 83 (79.8% HD respectively, more frequent than in the control group. In 7 HD with AAC no CAC were detected. The frequency and severity of calcifications increased with age. Both CAC and AAC were more frequently detected in diabetics (OR = 17.37 and 13.00, respectively. CAC score was significantly greater in males. CAC and AAC scores were correlated significantly with pack-years of smoking and plasma osteoprotegrin levels. However the independent contribution of plasma osteoprotegerin levels was not confirmed in multiple regression analysis. Age (OR = 1.13 and hemodialysis vintage (OR = 1.14 were the independent risk factor favoring the occurrence of CAC; while age (OR = 1.20 was the only predictor of AAC occurrence in HD. Conclusions 1. AAC precedes the occurrence of CAC in HD patients. 2. The exposition to uremic milieu and systemic chronic microinflammation has more deteriorative effect on the CAC than the AAC.

  20. Delayed Presentation of a Carotid Artery Dissection Following Blunt Trauma in a Young Adult with Minimal Risk Factors.

    Science.gov (United States)

    Talburt, Jason; Cayton, Steward T; Alwood, Shannon; Musso, Mandi

    2016-01-01

    A 22-year-old woman presented to the emergency department (ED) after suffering injuries as a restrained driver in a head-on motor vehicle accident. Upon presentation to the ED, her Glasgow Coma Score (GCS) was 15. A computed tomography (CT) of the head and neck was negative. She was taken to surgery for orthopedic injuries. Recovery from general anesthesia was somewhat prolonged due to somnolence. Roughly two hours after transfer, her family noticed that she was not moving her left arm. Trauma staff noted she had a new left hemiparesis. She was promptly taken for a repeat head CT which showed a dense area of ischemia in her right cerebral hemisphere, in the distribution of the right middle cerebral artery (MCA). A CT angiogram of the head and neck revealed a large dissection of the right carotid artery below the level of C2-C3, complete occlusion of the right internal carotid artery beginning 2 cm superior to the bifurcation, and developing cerebral edema with subsequent leftward shift. PMID:27159489

  1. 48. Can early 24 hours Holter monitoring predict obstructive coronary artery lesions in patients with low risk acute coronary syndrome?

    Directory of Open Access Journals (Sweden)

    T. Taha

    2016-07-01

    Full Text Available Identification of patients at increased risk of death due to acute coronary syndrome (ACS can add to risk stratification and guide the next step in the management of those patients. Altered HRV has been associated with adverse outcomes in heart disease, but this has not been established in patients with acute chest pain.This study aimed to create a non-invasive, economical and risk-free method in the clinical evaluation and diagnosis of significant CAD among patients with unstable angina.Twenty-four-hour Holter recordings of 100 patients with ACS were initiated within 24 hours of admission at the emergency department; stress ECG was done for all patients while coronary angiography was done only for patients with abnormal stress test. Time domain, frequency domain, and nonlinear HRV were examined.The mean SDNN was statistically significantly lower in patients with abnormal stress test, many time and frequency domain HRV parameters was statistically lower in patients with significant coronary arteries obstruction. HRV measured close to the ACS onset may assist in risk stratification. HRV parameters may provide additional, incremental prognostic information to established assessment guidelines and possible early intervention in those patients.

  2. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

    Directory of Open Access Journals (Sweden)

    Okon Ekwere Essien

    2014-01-01

    Full Text Available Introduction. Death from coronary artery disease (CAD has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6% of 747 autopsies. They were predominantly males, urban residents, and of high social class with combination of CVD risk factors of hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activities, and obesity. The mean serum cholesterol of the clinical subjects was 4.7±1.57 mmol/L and 5.07±1.94 mmol/L for angina and myocardial infarction, respectively, which was higher than the mean total cholesterol for locality of 3.1 mmol/L. Conclusion. CAD and its risk factors are contributing to mortality and morbidity in South South Nigeria. These risk factors include hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activity, and obesity. Nigerians in this locality with CAD have raised serum lipids.

  3. A Study of Prevalence of Risk Factors for Coronary Artery Diseases in Asymptomatic Middle Aged and Elderly Subjects

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    Arvind Kumar, Sandeep Garg, Hem Lata Gupta

    2005-04-01

    Full Text Available This study was conducted to determine the prevalence of risk factors for coronary artery disease(CAD in apparently healthy middle aged and elderly population and to find the different betweenurban and rural group.Atotal of 160 individuals (80 urban and 80 rural were included in the study.All the subjects underwent detailed history and physical examination with special emphasis oncardiovascular system. The biochemical investigations were done in all the subjects which includedblood sugar, serum LDL and serum triglyceride levels. The prevalence of 2 or more than 2 riskfactors were observed in 95% subjects. The prevalence of smoking was 63%, which was moreprevalent in the rural population. The sedentary lifestyle was seen in 80% subjects more in femalesand urban group. The prevalence of asymptomatic hypertensives and isolated systolic hypertensionwere seen in 34% and 10% individuals respectively. Other risk factors were-diabetes mellitus (4%,Increase LDL (38%, hypertriglyceridemia (23% and central obesity (27.50%. The two mostcommon risk factors for CADwere sedentary lifestyle and smoking. These risk factors are modifiableand their reduction during adulthood can lead to marked reduction in the burden of CAD in middleaged and elderly Indian population.

  4. Cardiovascular risk factor profiles for peripheral artery disease and carotid atherosclerosis among Chinese older people: a population-based study.

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    Yajun Liang

    Full Text Available OBJECTIVES: Epidemiological data concerning atherosclerotic disease among older people in rural China are sparse. We seek to determine prevalence and cardiovascular risk factor profiles for peripheral artery disease (PAD and carotid atherosclerosis (CAS among Chinese older people living in a rural community. METHODS: This cross-sectional study included 1499 participants (age ≥60 years, 59.0% women of the Confucius Hometown Aging Project in Shandong, China. From June 2010-July 2011, data were collected through interviews, clinical examinations, and laboratory tests. PAD was defined as an ankle-brachial index ≤0.9. Carotid intima-media thickness (cIMT and carotid artery stenosis were assessed by ultrasonography. We defined moderate stenosis as carotid stenosis ≥50%, and severe stenosis as carotid stenosis ≥70%. cIMT≥1.81 mm was considered as an increased cIMT (a measure of CAS. Data were analyzed with multiple logistic models. RESULTS: The prevalence was 5.7% for PAD, 8.9% for moderate stenosis, 1.8% for severe stenosis, and 11.2% for increased cIMT. After controlling for multiple potential confounders, diabetes, an increased low-density lipoprotein cholesterol (LDL-C/high-density lipoprotein cholesterol (HDL-C ratio, and hypertension were significantly or marginally associated with PAD. Ever smoking, hypertension, and an increased LDL-C/HDL-C ratio were significantly associated with an increased likelihood of increased cIMT. An increasing number of those cardiovascular risk factors were significantly associated with an increasing odds ratio of PAD and increased cIMT, respectively (p for linear trend <0.001. CONCLUSION: Among Chinese older people living in a rural community, PAD, carotid artery stenosis, and an increased cIMT are relatively uncommon. Cardiovascular risk factor profiles for PAD and CAS are slightly different, with hypertension and an increased LDL-C/HDL-C ratio being associated with an increased likelihood of both PAD and

  5. Is carotid artery evaluation necessary for primary prevention in asymptomatic high-risk patients without atherosclerotic cardiovascular disease?

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    Kim GH

    2015-07-01

    Full Text Available GeeHee Kim,1 Ho-Joong Youn,2 Yun-Seok Choi,2 Hae Ok Jung,2 Wook Sung Chung,2 Chul-Min Kim1 1Department of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Objective: Routine measurement of the carotid intima–media thickness is not recommended in recent clinical practice guidelines for risk assessment of the first atherosclerotic cardiovascular disease (ASCVD event (the definition of which includes acute coronary syndromes, a history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease presumed to be of atherosclerotic origin. The aim of the present study was to elucidate the role of carotid artery evaluation for primary prevention of ASCVD in asymptomatic high-risk patients visiting a teaching hospital.Methods: Eight hundred seventy-three patients (487 male [55.8%], mean age 59.4±11.5 years who were statin-naive and without ASCVD, which was proven by coronary angiography or coronary CT angiography, were enrolled in this study. The patients underwent carotid scanning in the Medical Department of St Mary’s Hospital from September 2003 to March 2009. ASCVD outcomes were evaluated for median follow-up of 1,402 days.Results: A total of 119 participants experienced ASCVD events. In multivariate Cox regression analysis, age (hazard ratio [HR] =1.026, 95% confidence interval [CI] =1.002–1.050, P=0.033, history of smoking (HR =1.751, 95% CI =1.089–2.815, P=0.021, statin therapy (HR =0.388, 95% CI =0.205–0.734, P=0.004, and carotid plaques (HR =1.556, 95% CI =1.009–2.400, P=0.045 were associated with ASCVD events. In middle-aged group (45≤ age <65, n=473, history of smoking (HR =1.995, 95% CI =1.142–3.485, P=0.015, statin therapy (HR =0.320, 95% CI =0.131

  6. Correlation study of uterine spiral artery blood flow characteristics with placental development and hypoxia in patients with preeclampsia

    Institute of Scientific and Technical Information of China (English)

    Rong Ma

    2016-01-01

    Objective:To study the correlation of uterine spiral artery blood flow characteristics with placental development and hypoxia in patients with preeclampsia.Methods:A total of 66 patients diagnosed with preeclampsia in our hospital between June 2013 and May 2016 were selected as the preeclampsia group (PE group) of the study and healthy women who gave birth in our hospital during the same period were selected as control group. At 32-37 weeks of gestation, uterine spiral artery ultrasonography was conducted to determine blood flow parameters PI, RI and S/D, and peripheral blood was collected to separate mononuclear cells and then determine CTLA-4 and CD28 mRNA level; after childbirth, placenta tissue was collect to determine the levels of placental development-related cytokines and apoptotic molecules.Results: Uterine spiral artery RI, PI and S/D of PE group were significantly higher than those of control group; PLGF, NGF, EGF, IGF-I, VEGF, Xiap, Survivin, bcl-2 and CD28 content in placenta tissue of PE group were significantly lower than those of control group and negatively correlated with uterine spiral artery PI, RI and S/D while GDF-15, caspase-3, caspase-9 and CTLA-4 content were significantly higher than those of control group and positively correlated with uterine spiral artery PI, RI and S/D; CTLA-4 mRNA level in peripheral blood mononuclear cells of PE group was significantly higher than that of control group and positively correlated with uterine spiral artery were PI, RI and S/D while CD28 mRNA level was significantly lower than that of control group and negatively correlated with uterine spiral artery PI, RI and S/D.Conclusion:Uterine spiral artery blood flow resistance increases and blood flow volume decreases in patients with preeclampsia, and the above blood flow characteristics will hinder the placental development, induce cell apoptosis and aggravate the placental hypoxia.

  7. Association of Plasma Myeloperoxidase Level with Risk of Coronary Artery Disease in Patients with Type 2 Diabetes

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    Ping Song

    2015-01-01

    Full Text Available Aims. This study aimed to investigate whether the change of plasma myeloperoxidase (MPO level would be associated with the incidence of coronary artery disease (CAD among diabetic patients. Methods. 339 patients with type 2 diabetes mellitus (DM underwent coronary angiography. Of them, 204 cases had CAD and were assigned to CAD group and 135 cases without CAD were assigned to non-CAD group. Results. Compared to non-CAD group, CAD group had higher level of plasma MPO (p<0.01. Multiple linear regression analysis showed that plasma MPO level was correlated with Gensini score. Multiple logistic analysis showed that the odds ratios for CAD across increasing tertiles of MPO level were 1.191 (0.971–1.547 and 1.488 (1.115–2.228 (p=0.048, p=0.009 versus 1st tertile of MPO level, resp. by adjusting for age, sex, and other conventional risk factors for CAD. The subjects were stratified into nine groups according to tertiles of MPO and HbA1c. The odds ratio for CAD was significantly higher in group with highest levels of MPO and HbA1c (OR = 4.08, p<0.01. Conclusion. Plasma MPO level was positively correlated with the degree of coronary artery stenosis in type 2 diabetic patients, and increasing blood glucose might amplify the association between MPO and CAD.

  8. [Waist-hip ratio as a predictor of arterial hypertension risk in children and adolescents].

    Science.gov (United States)

    González-Jiménez, Emilio; Montero-Alonso, Miguel Ángel; Schmidt-RioValle, Jacqueline

    2013-11-01

    Resumen: Objetivos: Los objetivos de este estudio fueron verificar la existencia de una asociación significativa entre el estado nutricional de los alumnos y los valores del índice de cintura-cadera. En segundo lugar, comprobar una posible correlación entre los valores del índice de cintura-cadera y los niveles de presión arterial sistólica y diastólica. Muestra y metodología: Una población de 1001 adolescentes de entre 9 y 17 años de edad, pertenecientes a 18 centros educativos de las provincias de Granada y Almería. Se realizó una valoración completa del estado nutricional de los alumnos mediante antropometría así como la determinación de la presión arterial a todos los alumnos. Resultados: Los resultados obtenidos confirman una prevalencia de normopeso del 85,01%, frente a una tasa de sobrepeso del 9,99% y de obesidad del 4,99% para ambos sexos y con independencia de la edad. Se encontró una asociación significativa entre el estado nutricional y su relación los valores del índice cintura–cadera (F=118,060; p.

  9. A functional SNP in FLT1 increases risk of coronary artery disease in a Japanese population.

    Science.gov (United States)

    Konta, Atsuko; Ozaki, Kouichi; Sakata, Yasuhiko; Takahashi, Atsushi; Morizono, Takashi; Suna, Shinichiro; Onouchi, Yoshihiro; Tsunoda, Tatsuhiko; Kubo, Michiaki; Komuro, Issei; Eishi, Yoshinobu; Tanaka, Toshihiro

    2016-05-01

    Coronary artery disease (CAD) including myocardial infarction is one of the leading causes of death in many countries. Similar to other common diseases, its pathogenesis is thought to result from complex interactions among multiple genetic and environmental factors. Recent large-scale genetic association analysis for CAD identified 15 new loci. We examined the reproducibility of these previous association findings with 7990 cases and 6582 controls in a Japanese population. We found a convincing association of rs9319428 in FLT1, encoding fms-related tyrosine kinase 1 (P=5.98 × 10(-8)). Fine mapping using tag single-nucleotide polymorphisms (SNPs) at FLT1 locus revealed that another SNP (rs74412485) showed more profound genetic effect for CAD (P=2.85 × 10(-12)). The SNP, located in intron 1 in FLT1, enhanced the transcriptional level of FLT1. RNA interference experiment against FLT1 showed that the suppression of FLT1 resulted in decreased expression of inflammatory adhesion molecules. Expression of FLT1 was observed in endothelial cells of human coronary artery. Our results indicate that the genetically coded increased expression of FLT1 by a functional SNP implicates activation in an inflammatory cascade that might eventually lead to CAD. PMID:26791355

  10. Risk factors for mortality after coronary artery bypass grafting in patients with low left ventricular ejection fraction

    Institute of Scientific and Technical Information of China (English)

    WANG Jin; XIAO Feng; REN Jian; LI Yan; ZHANG Ming-li

    2007-01-01

    Background We managed to assess and confirm the risk factors for mortality after coronary artery bypass grafting (CABG) operations so as to map out the proper guidance of surgical strategy especially in patients with low left ventricular ejection fraction (LVEF) in domestic polyclinic like ours.Methods Five hundred and forty-eight consecutive patients underwent CABG from December 1999 through August 2005 were analyzed retrospectively. Eighty-nine cases had an LVEF of 40% or less. All together twenty-two candidate factors were evaluated for their association with perioperative death using univariate and multivariate stepwise Logistic analysis.Results When data from all the patients who had undergone CABG were taken into account, LVEF, left ventricular end diastolic diameter (LVEDD), mitral regurgitation, aneurysm of the heart wall, mitral repair/replacement, resection of aneurysm, concomitant aortic valve replacement, and perioperative intra-aortic balloon counter-pulsation (IABP), left ventricular assist device (LVAD) and cardiopulmonary bypass (CPB) all showed an association with perioperative death in univariate analysis, while an LVEF of >40%, on the other hand, appeared to be a protective factor. In multivariate analysis, moderate to severe mitral regurgitation, aneurysm of the heart wall, repair of septal perforation and aortic regurgitation were proved to be risk factors. When the analysis was restricted to patients with an LVEF of 40% or less,such variables as age, LVEDD, mitral regurgitation, mitral repair/replacement, IABP, and CPB were qualified as risk factors in a univariate analysis. Age, moderate mitral regurgitation, aneurysm of the heart wall, CPB, left main coronary artery disease and female were associated with perioperative death in a multivariate logistic regression analysis.Conclusions Concerning the prognosis, patients who undergo CABG would have different risk factors when data from all the enrolled patients or data from patients with LVEF

  11. Development of probabilistic risk analysis library

    International Nuclear Information System (INIS)

    We developed a library that is designed to perform level 1 Probabilistic Risk Analysis using Binary Decision Diagram (BDD). In particular, our goal is to develop a library that will allow Japanese electric utilities to take the advantages of BDD that can solve Event Tree (ET) and Fault Tree (FT) models analytically. Using BDD, the library supports negation in FT which allows more flexible modeling of ET/FT. The library is written by C++ within an object-oriented framework using open source software. The library itself is a header-only library so that Japanese electric utilities can take advantages of its transparency to speed up development and to build their own software for their specific needs. In this report, the basic capabilities of the library is briefly described. In addition, several applications of the library are demonstrated including validation of MCS evaluation of PRA model and evaluation of corrective and preventive maintenance considering common cause failure. (author)

  12. Heart transplantation and arterial elasticity

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    Colvin-Adams M

    2013-12-01

    healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy

  13. Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patients without regional wall motion abnormality

    Science.gov (United States)

    Rostamzadeh, Alireza; Shojaeifard, Maryam; Rezaei, Yousef; Dehghan, Kasra

    2015-01-01

    Background: The prediction of coronary artery disease (CAD) by conventional echocardiographic measurements is principally based on the estimation of ejection fraction and regional wall motion abnormality (RWMA). This study aimed to determine whether strain echocardiography of left ventricle measured by velocity vector imaging (VVI) method could detect patients with a high-risk CAD. Methods: In a prospective study, a total of 119 consecutive patients who were assessed for eligibility were categorized into three groups: (1) without CAD as normal (n=59), (2) 1- or 2-vessel disease as low-risk (n=29), and (3) left main and/or 3-vessel disease as high-risk (n=31). The peaks of systolic strain and strain rate from 18 curves of apical views were averaged as global longitudinal strain and strain rate (GLS and GLSR), respectively; the 6 systolic peaks of strain and strain rate at base- and mid-ventricular of short axis views were averaged as mean radial strain rate (MRSR). Results: GLS, GLSR, and basal MRSR of left ventricle were significantly lower in the high-risk group (P=0.047, P=0.004 and P=0.030, respectively). Receiver operating characteristics curve showed that the optimal values of GLS, GLSR, and basal MRSR for detecting the severe CAD were -17%, -1 s-1, and 1.45 s-1 with the sensitivities of 77%, 71%, and 71% and the specificities of 63%, 67%, and 62%, respectively. Conclusion: Decrements in the GLS, GLSR, and basal MRSR of the left ventricle can detect the high-risk CAD cases among patients without RWMA at rest. PMID:26309603

  14. Study of pattern of dyslipidemia and its correlation with cardiovascular risk factors in patients with proven coronary artery disease

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    Namita Mahalle

    2014-01-01

    Full Text Available Introduction: Dyslipidemia is a primary, widely established as an independent major risk factor for coronary artery disease (CAD. Asians differs in prevalence of various lipid abnormalities than non-Asians. Hence, this study was conducted with objective to evaluate the lipid abnormalities and there correlation with traditional and non-traditional risk factors in known subjects with CAD. Materials and Methods: We studied the pattern and association of dyslipidemia with cardiovascular risk factors in 300 (Male: 216; Female: 84, age: 60.9 ± 12.4 years, range: 25-92 years angiographically proved CAD patients. All patients were evaluated for anthropometry and cardiovascular risk factors and blood samples were collected for biochemical and inflammatory markers. Results: Hypercholesterolemia, hypertriglyceridemia and low high density lipoprotein (HDL was present in 23.3%, 63.0% and 54.6% in the total study population respectively. A total of 41.3% had atherogenic dyslipidemia (raised triglycerides [TG] and low HDL. Percentage of patients with type-2 diabetes mellitus and hypertension were higher in subjects with atherogenic dyslipidemia. Insulin sensitivity was low; insulin and insulin resistance (IR along with inflammatory markers were high in subjects with atherogenic dyslipidemia. Patients with atherogenic dyslipidemia had significantly lower serum vitamin B12 levels and higher homocysteine (Hcy levels. Hypertriglyceridemia was positively correlated with insulin, homeostasis model assessment of IR, Hcy, interleukin-6, Tumor necrosis factor-alpha, highly sensitive C-reactive protein and negatively with vitamin B12 and quantitative insulin check index and an opposite correlation of all quoted parameters was observed with low HDL. The correlation of traditional and non-traditional risk factors was stronger with low HDL and high TG compared with hypercholesterolemia. Conclusions: Hypertriglyceridemia and low HDL cholesterol is common in patients with

  15. Interactions between rs5498 polymorphism in the ICAM1 gene and traditional risk factors influence susceptibility to coronary artery disease.

    Science.gov (United States)

    Sarecka-Hujar, Beata; Zak, Iwona; Krauze, Jolanta

    2009-06-01

    Coronary artery disease (CAD) depends on multiple genetic and environmental factors. Adhesion molecules are markers of endothelium dysfunction. Intercellular adhesion molecule-1 (ICAM-1) interacts with leukocyte integrins and promotes atherosclerotic process at the surface of endothelial cells. The aim of the study was to assess the association between ICAM1 rs5498 polymorphism and CAD and to establish whether there are any interactions between this polymorphism and traditional risk factors in determining the risk of CAD. We studied 191 cases with angiographically documented CAD and 203 controls with no signs of cardiovascular diseases. The ICAM1 polymorphism was genotyped using PCR-RFLP method. Data were analyzed with the STATISTICA 7.1 and EpiInfo 6 softwares. We did not observe significant differences in the distribution of genotypes and alleles of rs5498 between cases and controls. We only found a tendency to a higher prevalence of G allele carriers (AG + GG) in patients compared to controls (68 vs. 64%, P = 0.399). A synergistic effect of G allele carrier-state and smoking that had influenced the risk of CAD [synergy index multiplicative (SIM = 2.09)] was observed. Smoking carriers of G allele compared to non-smoking AA were more prevalent in CAD group (39.8%) than among controls (13.3%, P < 0.0001, OR 4.81). Moreover, there was also a synergistic effect between G allele carrier-state and an elevated level of triacylglycerols (TG) (SIM = 1.28) increasing the risk of CAD. There is a synergistic interaction between rs5498 genotype and smoking that increases the risk of CAD. PMID:19048183

  16. REDUCTION OF CUMULATIVE CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION: THE ROLE OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS ACCORDING TO THE NEW EUROPEAN RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2007-01-01

    Full Text Available Conception of total cardio-vascular risk plays important role in defining tactics of arterial hypertension therapy according to the new European recommendations. Choice of antihypertensive therapy is based on meta-analysis of large clinical studies with hard end points. It is recommended to use five classes of antihypertensive drugs in mono- and combined therapy. Angiotensin converting enzyme (ACE inhibitors keep important place in the therapy of arterial hypertension accompanying with risk factors and associated diseases. Enalapril is one of the widely used ACE inhibitors, its efficiency was proved in prospective clinical studies. In high risk patients monotherapy with Enam (enalapril, Dr. Reddy’s decreases blood pressure and leads to positive metabolic changes. This results in significant risk reduction of cardio-vascular complications.

  17. Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons

    DEFF Research Database (Denmark)

    Rotger, Margalida; Glass, Tracy R; Junier, Thomas;

    2013-01-01

    BACKGROUND: Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the set...

  18. Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons

    NARCIS (Netherlands)

    Rotger, Margalida; Glass, Tracy R; Junier, Thomas; Lundgren, Jens; Neaton, James D; Poloni, Estella S; van 't Wout, Angélique B; Lubomirov, Rubin; Colombo, Sara; Martinez, Raquel; Rauch, Andri; Günthard, Huldrych F; Neuhaus, Jacqueline; Wentworth, Deborah; van Manen, Danielle; Gras, Luuk A; Schuitemaker, Hanneke; Albini, Laura; Torti, Carlo; Jacobson, Lisa P; Li, Xiuhong; Kingsley, Lawrence A; Carli, Federica; Guaraldi, Giovanni; Ford, Emily S; Sereti, Irini; Hadigan, Colleen; Martinez, Esteban; Arnedo, Mireia; Egaña-Gorroño, Lander; Gatell, Jose M; Law, Matthew; Bendall, Courtney; Petoumenos, Kathy; Rockstroh, Jürgen; Wasmuth, Jan-Christian; Kabamba, Kabeya; Delforge, Marc; De Wit, Stephane; Berger, Florian; Mauss, Stefan; de Paz Sierra, Mariana; Losso, Marcelo; Belloso, Waldo H; Leyes, Maria; Campins, Antoni; Mondi, Annalisa; De Luca, Andrea; Bernardino, Ignacio; Barriuso-Iglesias, Mónica; Torrecilla-Rodriguez, Ana; Gonzalez-Garcia, Juan; Arribas, José R; Fanti, Iuri; Gel, Silvia; Puig, Jordi; Negredo, Eugenia; Gutierrez, Mar; Domingo, Pere; Fischer, Julia; Fätkenheuer, Gerd; Alonso-Villaverde, Carlos; Macken, Alan; Woo, James; McGinty, Tara; Mallon, Patrick; Mangili, Alexandra; Skinner, Sally; Wanke, Christine A; Reiss, Peter; Weber, Rainer; Bucher, Heiner C; Fellay, Jacques; Telenti, Amalio; Tarr, Philip E; Schölvinck, Elisabeth H.

    2013-01-01

    BACKGROUND: Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the settin

  19. Prevalence and Risk Factors of Carotid Vessel Wall Inflammation in Coronary Artery Disease Patients FDG-PET and CT Imaging Study

    NARCIS (Netherlands)

    J. Bucerius; R. Duivenvoorden; V. Mani; C. Moncrieff; J.H.F. Rudd; C. Calcagno; J. Machac; V. Fuster; M.E. Farkouh; Z.A. Fayad

    2011-01-01

    OBJECTIVES We investigated the prevalence and clinical risk factors of carotid vessel wall inflammation by means of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in a population consisting of coronary artery disease (CAD) patients. BACKGROUND The atherosclerotic disease process is

  20. Physical activity, C-reactive protein levels and the risk of future coronary artery disease in apparently healthy men and women: the EPIC-Norfolk prospective population study

    NARCIS (Netherlands)

    S.M. Boekholdt; M.S. Sandhu; N.E. Day; R. Luben; S.A. Bingham; R.J.G. Peters; N.J. Wareham; K.T. Khaw

    2006-01-01

    Background Physical activity is inversely associated with the risk of future coronary artery disease. Whether this relationship is in part mediated by lower levels of systemic inflammation, as indicated by C-reactive protein concentrations, is unknown. Methods We performed a nested case-control stud

  1. The role of tissue renin angiotensin aldosterone system in the development of endothelial dysfunction and arterial stiffness

    Directory of Open Access Journals (Sweden)

    Annayya R Aroor

    2013-10-01

    Full Text Available Epidemiological studies support the notion that arterial stiffness is an independent predictor of adverse cardiovascular events contributing significantly to systolic hypertension, impaired ventricular-arterial coupling and diastolic dysfunction, impairment in myocardial oxygen supply and demand, and progression of kidney disease. Although arterial stiffness is associated with aging, it is accelerated in the presence of obesity and diabetes. The prevalence of arterial stiffness parallels the increase of obesity that is occurring in epidemic proportions and is partly driven by a sedentary life style and consumption of a high fructose, high salt and high fat western diet. Although the underlying mechanisms and mediators of arterial stiffness are not well understood, accumulating evidence supports the role of insulin resistance and endothelial dysfunction. The local tissue renin angiotensin aldosterone system (RAAS in the vascular tissue and immune cells and perivascular adipose tissue is recognized as an important element involved in endothelial dysfunction which contributes significantly to arterial stiffness. Activation of vascular RAAS is seen in humans and animal models of obesity and diabetes, and associated with enhanced oxidative stress and inflammation in the vascular tissue. The cross talk between angiotensin and aldosterone underscores the importance of mineralocorticoid receptors in modulation of insulin resistance, decreased bioavailability of nitric oxide, endothelial dysfunction and arterial stiffness. In addition, both innate and adaptive immunity are involved in this local tissue activation of RAAS. In this review we will attempt to present a unifying mechanism of how environmental and immunological factors are involved in this local tissue RAAS activation, and the role of this process in the development of endothelial dysfunction and arterial stiffness and targeting tissue RAAS activation.

  2. The Development of Coronary Artery Stents: From Bare-Metal to Bio-Resorbable Types

    Directory of Open Access Journals (Sweden)

    Ming-Yun Ho

    2016-07-01

    Full Text Available Coronary artery disease is the leading cause of death worldwide. Conventional balloon angioplasty is associated with high rates of complications such as coronary dissection and vessel recoil. The deployment of bare-metal stents (BMSs can overcome these problems and achieve a better patency rate than simple balloon angioplasty. It has been shown that the stent design including structure platform, size, length, and strut thickness has a major influence on the clinical results. Even though angioplasty with BMS implantation is widely used in coronary interventions, the restenosis rate due to neointimal hyperplasia remains high. Therefore, drug-eluting stents (DESs coated with anti-proliferative agents and polymers have been developed to reduce the restenosis rate and improve the clinical outcomes. Although the repeat revascularization rate of DESs is lower than that of BMSs, the long-term stent thrombosis rate is higher than for BMSs. Therefore, new and emerging generations of stents, in which, for example, thinner struts and bioresorbable polymers are used, are available for clinical use. However, there are only a limited number of clinical trials, in which these newer stents have been compared with BMSs and first- and second-generation DESs. The purpose of this review was to provide up-to-date information on the evolution of coronary artery stents from BMSs to DESs to bioresorbable stents (BRSs.

  3. Increased shear stress inhibits angiogenesis in veins and not arteries during vascular development.

    Science.gov (United States)

    Chouinard-Pelletier, Guillaume; Jahnsen, Espen D; Jones, Elizabeth A V

    2013-01-01

    Vascular development is believed to occur first by vasculogenesis followed by angiogenesis. Though angiogenesis is the formation of new vessels, we found that vascular density actually decreases during this second stage. The onset of the decrease coincided with the entry of erythroblasts into circulation. We therefore measured the level of shear stress at various developmental stages and found that it was inversely proportional to vascular density. To investigate whether shear stress was inhibitory to angiogenesis, we altered shear stress levels either by preventing erythroblasts from entering circulation ("low" shear stress) or by injection of a starch solution to increase the blood plasma viscosity ("high" shear stress). By time-lapse microscopy, we show that reverse intussusception (merging of two vessels) is inversely proportional to the level of shear stress. We also found that angiogenesis (both sprouting and splitting) was inversely proportional to shear stress levels. These effects were specific to the arterial or venous plexus however, such that the effect on reverse intussusception was present only in the arterial plexus and the effect on sprouting only in the venous plexus. We cultured embryos under altered shear stress in the presence of either DAPT, a Notch inhibitor, or DMH1, an inhibitor of the bone morphogenetic protein (BMP) pathway. DAPT treatment phenocopied the inhibition of erythroblast circulation ("low" shear stress) and the effect of DAPT treatment could be partially rescued by injection of starch. Inhibition of the BMP signaling prevented the reduction in vascular density that was observed when starch was injected to increase shear stress levels.

  4. Evaluation of Hs-CRP levels and interleukin 18 (-137G/C promoter polymorphism in risk prediction of coronary artery disease in first degree relatives.

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar G

    Full Text Available Coronary Artery Disease (CAD is clearly a multifactorial disease that develops from childhood and ultimately leads to death. Several reports revealed having a First Degree Relatives (FDRS with premature CAD is a significant autonomous risk factor for CAD development. C - reactive protein (CRP is a member of the pentraxin family and is the most widely studied proinflammatory biomarker. IL-18 is a pleiotrophic and proinflammatory cytokine which is produced mainly by macrophages and plays an important role in the inflammatory cascade.Hs-CRP levels were estimated by ELISA and Genotyping of IL-18 gene variant located on promoter -137 (G/C by Allele specific PCR in blood samples of 300 CAD patients and 300 controls and 100 FDRS. Promoter Binding sites and Protein interacting partners were identified by Alibaba 2.1 and Genemania online tools respectively. Hs-CRP levels were significantly high in CAD patients followed by FDRS when compared to controls. In IL-18 -137 (G/C polymorphism homozygous GG is significantly associated with occurrence of CAD and Hs-CRP levels were significantly higher in GG genotype subjects when compared to GC and CC. IL-18 was found to be interacting with 100 protein interactants.Our results indicate that Hs-CRP levels and IL-18-137(G/C polymorphism may help to identify risk of future events of CAD in asymptomatic healthy FDRS.

  5. Endothelin-1 receptor antagonists in fetal development and pulmonary arterial hypertension.

    Science.gov (United States)

    de Raaf, Michiel Alexander; Beekhuijzen, Manon; Guignabert, Christophe; Vonk Noordegraaf, Anton; Bogaard, Harm Jan

    2015-08-15

    The Pregnancy Prevention Program (PPP) is in place to prevent drug-induced developmental malformations. Remarkably, among the ten PPP-enlisted drugs are three endothelin-1 (ET-1) receptor antagonists (ERA's: ambrisentan, bosentan and macitentan), which are approved for the treatment of Pulmonary Arterial Hypertension (PAH). This review describes the effects of ERA's in PAH pathobiology and cardiopulmonary fetal development. While ERA's hamper pathological remodeling of the pulmonary vasculature and as such exert beneficial effects in PAH, they disturb fetal development of cardiopulmonary tissues. By blocking ET-1-mediated positive inotropic effects and myocardial fetal gene induction, ERA's may affect right ventricular adaptation to the increased pulmonary vascular resistance in both the fetus and the adult PAH patient.

  6. Growing-Related Changes in Arterial Properties of Healthy Children, Adolescents, and Young Adults Nonexposed to Cardiovascular Risk Factors: Analysis of Gender-Related Differences.

    Science.gov (United States)

    Curcio, S; García-Espinosa, V; Arana, M; Farro, I; Chiesa, P; Giachetto, G; Zócalo, Y; Bia, D

    2016-01-01

    The aims of our work were to determine normal aging rates for structural and functional arterial parameters in healthy children, adolescents, and young adults and to identify gender-related differences in these aging rates. Methods. 161 subjects (mean: 15 years (range: 4-28 years), 69 females) were studied. Subjects included had no congenital or chronic diseases, nor had they been previously exposed to traditional cardiovascular risk factors. Arterial parameters assessed were (1) central blood pressure (BP) and aortic pulse wave analysis, (2) arterial local (pressure-strain elastic modulus) and regional (pulse wave velocity, PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Simple linear regression models (age as the independent variable) were obtained for all the parameters and the resulting rates of change were compared between genders. Results. No gender-related differences were found in mean values of arterial structural and functional parameters in prepubertal ages (4-8 years), but they started to appear at ~15 years. Boys showed a greater rate of change for central systolic BP, central pulse pressure, CIMT, and carotid-femoral PWV. Conclusion. Gender-related differences in arterial characteristics of adults can be explained on the basis of different growing-related patterns between boys and girls, with no existing differences in prepubertal ages.

  7. Effective risk stratification in patients with moderate cardiovascular risk using albuminuria and atherosclerotic plaques in the carotid arteries

    DEFF Research Database (Denmark)

    Greve, Sara V; Blicher, Marie K; Sehestedt, Thomas;

    2015-01-01

    /mmol in men/women. The composite endpoint of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for ischemic heart disease was recorded (n = 229). RESULTS: Both elevated UACR (P = 0.002) and atherosclerotic plaques (P ..., Systematic COronary Risk Evaluation (SCORE), and Framingham risk score (FRS) groups. Subclinical vascular damage was defined as carotid-femoral pulse wave velocity at least 12 m/s, and carotid atherosclerotic plaques or urine albumin/creatinine ratio (UACR) at least 90th percentile of 0.73/1.06 mg...

  8. Like father like son? Sons of patients of European or Indian origin with coronary artery disease reflect their parents' risk factor patterns.

    OpenAIRE

    Shaukat, N.; de Bono, D P; Jones, D R

    1995-01-01

    OBJECTIVE--To investigate the extent to which risk factor patterns associated with coronary artery disease (CAD) in patients of Indian origin and in those of North European origin undergoing coronary angiography for suspected angina were reflected in their apparently healthy sons aged 15-30 years. DESIGN--Prospective study in which risk markers were measured in patients of Indian origin and in matched European patients undergoing angiography and in their sons. SETTING--Patients attending a re...

  9. Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients

    DEFF Research Database (Denmark)

    Jensen, Birte Østergaard; Hughes, Pia; Rasmussen, Lars S;

    2006-01-01

    Previous trials comparing coronary artery bypass grafting (CABG) with or without extracorporeal circulation have mainly enrolled selected patients at younger age and low risk. Patient-reported health-related quality of life has not been significantly different. We compared health-related quality ...... of life in elderly moderate to high-risk patients randomized to either off-pump or on-pump surgery....

  10. Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: ''High-risk'' anatomy and its clinical relevance

    Energy Technology Data Exchange (ETDEWEB)

    Krupinski, Maciej; Urbanczyk-Zawadzka, Malgorzata; Laskowicz, Bartosz; Irzyk, Malgorzata; Banys, Robert; Klimeczek, Piotr [John Paul II Hospital, Department of Radiology and Diagnostic Imaging, Krakow (Poland); Gruszczynska, Katarzyna; Baron, Jan [Medical University of Silesia, Department of Radiology and Nuclear Medicine, Katowice (Poland)

    2014-10-15

    The aim of the study was to assess coronary arteries arising from the wrong coronary sinus, including CT-evaluated high-risk anatomic features, clinical symptoms and cardiac events during follow-up. A total of 7,115 patients scheduled for 64-slice or dual-source cardiac CT were screened for the presence of isolated anomalous origin of the coronary artery from the wrong coronary sinus. Anomalous origin of the coronary artery was found in 54 (0.76 %) patients (29 men, 25 women, mean age 60.9 ± 11.6 years). Sixteen (30 %) patients with abnormal right coronary origin (ARCA) more commonly had a slit-like orifice (15 vs. 3; p < 0.001), intramural course (15 vs. 3; p < 0.001) and interarterial course (11 vs. 0; p < 0.001) than 22 (41 %) and 13 (24 %) individuals with abnormal circumflex artery (ALCx) and left coronary artery (ALCA) origin, respectively. Patients with ALCA presented less frequently with chest pain than subjects with ARCA and ALCx (25 vs. 3; p = 0.03). Patients with ARCA tended to show higher occurrence of cardiac events in the follow-up than individuals with ALCA and ALCx (5 vs. 4; p = NS). High-risk anatomy features are most common in patients with ARCA and these patients also have higher prevalence of chest pain and cardiac events in the follow-up than individuals with ALCA and ALCx. (orig.)

  11. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  12. ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting

    International Nuclear Information System (INIS)

    In patients undergoing coronary artery bypass grafting (CABG) surgery, post-operative atrial fibrillation (AF) occurs with a prevalence of up to 40%. The highest incidence is seen between the second and third day after the operation. Following cardiac surgery AF may cause various complications such as hemodynamic instability, heart attack and cerebral or other thromboembolisms. AF increases morbidity, duration and expense of medical treatments. This study aims at identifying patients at high risk of post-operative AF. Early prediction of AF would provide timely prophylactic treatment and would reduce the incidence of arrhythmia. Patients at low risk of post-operative AF could be excluded on the basis of the contraindications of anti-arrhythmic drugs. The study included 50 patients in whom lead II electrocardiograms were continuously recorded for 48 h following CABG. Univariate statistical analysis was used in the search for signal features that could predict AF. The most promising ones identified were P wave duration, RR interval duration and PQ segment level. On the basis of these, a nonlinear multivariate prediction model was made by deploying a classification tree. The prediction accuracy was found to increase over time. At 48 h following CABG, the measured best smoothed sensitivity was 84.8% and the specificity 85.4%. The positive and negative predictive values were 72.7% and 92.8%, respectively, and the overall accuracy was 85.3%. With regard to the prediction accuracy, the risk assessment and prediction of post-operative AF is optimal in the period between 24 and 48 h following CABG

  13. Reduction in Estimated Glomerular Filtration Rate (eGFR) Results in an Increased Risk of Spontaneous Hemorrhagic Transformation in Patients with Large-artery Atherosclerosis Stroke.

    Science.gov (United States)

    Liu, Bian; Wang, Deren; Hao, Zilong; Li, Dan; Zhang, Junhuai; Liu, Junfeng; Liu, Ming

    2016-01-01

    The association between chronic kidney disease and spontaneous hemorrhagic transformation (HT) in patients with acute ischemic stroke is seldom reported. We performed this study to identify whether reduced estimated glomerular filtration rate (eGFR) is associated with spontaneous HT in acute ischemic stroke patients, and examine whether the association depends on stroke etiology. Patients diagnosed with acute ischemic stroke whose serum creatinine levels at admission were available were consecutively and prospectively enrolled in the Chengdu Stroke Registry Database. All were analyzed on admission by cranial computed tomography (CT) scanning, followed by regular magnetic resonance imaging (MRI) 2-3 days later and afterwards CT scan if neurological symptoms deteriorated. HT was defined based on the MRI or later CT, and eGFR was calculated using the Modification of Diet in Renal Disease equation. Univariate analysis and multivariable logistic regression were performed to determine whether reduced eGFR, defined as < 60 ml/min/1.73m2, was associated with spontaneous HT. The association was also assessed in subgroups of patients classified according to the criteria of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Of the 1,645 patients enrolled, 123 (7.5%) developed spontaneous HT and 215 (13.1%) had reduced eGFR. Reduced eGFR was significantly associated with increased risk of spontaneous HT in all ischemic stroke patients (OR 1.821, 95% CI 1.081 to 3.06, P=0.024), and in the subgroup of large artery atherosclerosis, not in the cardio-embolism stroke group (OR 1.588, 95% CI 0.642 to 3.782, P=0.327). Reduced eGFR did not increase the risk of symptomatic hemorrhagic transformation (OR 0.937, 95%CI 0.247 to 3.577, P=0.924). In conclusion, reduced eGFR was significantly associated with increased risk of spontaneous HT in all ischemic stroke patients, and in large artery atherosclerosis, not in cardio-embolism stroke. Reduced eGFR did not increase the risk of

  14. Association between eNOS polymorphisms and risk of coronary artery disease in a Korean population: a meta-analysis.

    Science.gov (United States)

    Sung, J H; Lee, B E; Kim, J O; Jeon, Y J; Kim, S H; Lim, S W; Moon, J Y; Cha, D H; Kim, O J; Kim, I J; Kim, N K

    2015-01-01

    Coronary artery disease (CAD), a multifactorial disease, is a common cause of mortality in humans. Polymorphisms in the endothelial nitric oxide synthase (eNOS) gene (-786T>C, 4a4b, and 894G>T) have been previously associated with increased CAD risk. However, the sample size of this previous study was too small and limited to comprehensively define an association between eNOS polymorphisms and CAD; therefore, this analysis was duplicated with a larger population. The study was conducted on 559 patients with CAD and 574 healthy controls. Genetic DNA was extracted using the commercial G-DEX blood extraction kit and statistical analyses were performed on the GraphPad prism 4.0 and MedCalc 12.0 statistical software platforms. No single variant of the eNOS polymorphism was associated with CAD risk. The combination genotypes of eNOS -786TT/4a4b+4a4a [adjusted odds ratio (AOR) = 0.122; 95% confidence interval (CI): 0.042-0.358] and eNOS -786TC+CC/4b4b (AOR = 0.379; 95%CI: 0.147-0.979) were associated with decreased CAD incidence. Haplotype analysis revealed that the T-4a haplotype of eNOS -786T>C and 4a4b exerted a protective effect against CAD. The association between eNOS -786T>C and increased CAD risk was not replicated in this (larger) population. However, some combined genotypes showed a meaningful association with CAD risk. PMID:26662450

  15. Major risk-stratification models fail to predict outcomes in patients with multivessel coronary artery disease undergoing simultaneous hybrid procedure

    Institute of Scientific and Technical Information of China (English)

    WANG Hao-ran; ZHENG Zhe; XIONG Hui; XU Bo; LI Li-huan; GAO Run-lin; HU Sheng-shou

    2013-01-01

    Background The hybrid procedure for coronary heart disease combines minimally invasive coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) and is an alternative to revascularization treatment.We sought to assess the predictive value of four risk-stratification models for risk assessment of major adverse cardiac and cerebrovascular events (MACCE) in patients with multivessel disease undergoing hybrid coronary revascularization.Methods The data of 120 patients were retrospectively collected and the SYNTAX score,EuroSCORE,SinoSCORE and the Global Risk Classification (GRC) calculated for each patient.The outcomes of interest were 2.7-year incidences of MACCE,including death,myocardial infarction,stroke,and any-vessel revascularization.Results During a mean of 2.7-year follow-up,actuarial survival was 99.17%,and no myocardial infarctions occurred.The discriminatory power (area under curve (AUC)) of the SYNTAX score,EuroSCORE,SinoSCORE and GRC for 2.7-year MACCE was 0.60 (95% confidence interval 0.42-0.77),0.65 (0.47-0.82),0.57 (0.39-0.75) and 0.65 (0.46-0.83),respectively.The calibration characteristics of the SYNTAX score,EuroSCORE,SinoSCORE and GRC were 3.92 (P=0.86),5.39 (P=0.37),13.81 (P=0.32) and 0.02 (P=0.89),respectively.Conclusions In patients with multivessel disease undergoing a hybrid procedure,the SYNTAX score,EuroSCORE,SinoSCORE and GRC were inaccurate in predicting MACCE.Modifying risk-stratification models to improve the predictive value for a hybrid procedure is needed.

  16. Identifying coronary artery disease in men with type 2 diabetes: osteoprotegerin, pulse wave velocity, and other biomarkers of cardiovascular risk.

    LENUS (Irish Health Repository)

    Davenport, Colin

    2012-02-01

    OBJECTIVES: In patients with type 2 diabetes, high serum levels of osteoprotegerin (OPG) have been associated with a greater risk of cardiovascular events. However, it remains unclear how well OPG performs when compared with traditional biomarkers of cardiovascular risk such as high-sensitivity C-reactive protein (hsCRP). Furthermore, OPG levels are also high in the presence of diabetes-related microvascular disease, and it is unclear whether OPG can distinguish microvascular disease from large-vessel atherosclerosis. The first aim of this study was to compare OPG levels against other biomarkers of cardiovascular risk in the identification of patients with documented multivessel coronary artery disease (CAD). The second aim was to compare OPG levels in patients with microvascular complications (microalbuminuria) against those with established CAD. METHODS: Three groups of male patients with type 2 diabetes were recruited: patients without microvascular complications or large-vessel atherosclerosis (n = 24), patients with microalbuminuria only (n = 23), and patients with microalbuminuria and documented multivessel CAD (n = 25). OPG, hsCRP, interleukin 6, urate, and pulse wave velocity were measured. RESULTS: Serum OPG levels were significantly higher in patients with a combination of microalbuminuria and CAD than in those with microalbuminuria alone. There were no significant differences in any of the other biomarkers between the groups. CONCLUSION: OPG was found to be superior to the other biomarkers studied in identifying patients with documented CAD. The presence of CAD was a greater determinant of serum OPG levels than microalbuminuria in our population. These findings support the use of OPG as a biomarker of cardiovascular risk.

  17. Cardiovascular risk evaluation and prevalence of silent myocardial ischemia in subjects with asymptomatic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Ciccone M

    2011-03-01

    Full Text Available Marco Matteo Ciccone1, Artor Niccoli-Asabella2, Pietro Scicchitano1, Michele Gesualdo1, Antonio Notaristefano2, Domenico Chieppa1, Santa Carbonara1, Gabriella Ricci1, Marco Sassara1, Corinna Altini2, Giovanni Quistelli1, Mario Erminio Lepera1, Stefano Favale1, Giuseppe Rubini21Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO, 2Nuclear Medicine Unit, Department of Internal Medicine and of Public Medicine, University of Bari, Bari, ItalyIntroduction: Silent ischemia is an asymptomatic form of myocardial ischemia, not associated with angina or anginal equivalent symptoms, which can be demonstrated by changes in ECG, left ventricular function, myocardial perfusion, and metabolism. The aim of this study was to evaluate the prevalence of silent myocardial ischemia in a group of patients with asymptomatic carotid stenosis.Methods: A total of 37 patients with asymptomatic carotid plaques, without chest pain or dyspnea, was investigated. These patients were studied for age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of cardiac disease, and underwent technetium-99 m sestamibi myocardial stress-rest scintigraphy and echo-color Doppler examination of carotid arteries.Results: A statistically significant relationship (P = 0.023 was shown between positive responders and negative responders to scintigraphy test when both were tested for degree of stenosis. This relationship is surprising in view of the small number of patients in our sample. Individuals who had a positive scintigraphy test had a mean stenosis degree of 35% ± 7% compared with a mean of 44% ± 13% for those with a negative test. Specificity of our detection was 81%, with positive and negative predictive values of 60% and 63%, respectively.Conclusion: The present study confirms that carotid atherosclerosis is associated with coronary atherosclerosis and highlights the importance of screening for ischemic heart disease in

  18. Fatores de risco modificáveis para doença arterial coronariana nos trabalhadores de enfermagem Factores de riesgo modificables para la enfermedad arterial coronaria en los trabajadores de enfermería Modifiable risk factors for coronary artery disease among nursing staff of a general hospital

    Directory of Open Access Journals (Sweden)

    Cyntia Oliveira Maia

    2007-06-01

    N: este estudio muestra la identificación y cuantificación de los diferentes FR para DAC, pues la partir del conocimiento de la realidad epidemiológica, es posible desarrollar acciones y educación en salud relevantes en la intervención preventiva.OBJECTIVE: to identify the modifiable risk factors for coronary artery disease (CAD among nursing staff of a general hospital. METHODS: the sample consisted of 209 nursing staff. Data included anthropometric and blood pressure measurements, body mass index (BMI, and cholesterol and glucose levels. A questionnaire was also used to measure physical activity and stress level. Risk factors for CAD were identified and quantified. RESULTS: the findings suggest that nursing staff was stressed (19.1% and had high blood pressure (29.7% and total cholesterol >200mg/dl (27.7%. Nursing assistants had higher BMI than nursing licensed practical nurses or registered nurses; and licensed practical nurses had the higher level of stress. Sedentary life style was common in more than half of the nursing staff. CONCLUSION: it is important to identify and quantify risk factors for CAD. This epidemiological knowledge might lead to educational interventions to prevent the development of the disease.

  19. Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial Endothelial function of normotensive adolescents with no risk factors for arterial hypertension

    Directory of Open Access Journals (Sweden)

    Zélia M. de Andrade

    2005-10-01

    Full Text Available OBJETIVO: Definir padrões de normalidade da função endotelial de adolescentes através de avaliação ultra-sonográfica da dilatação vascular dependente do endotélio. MÉTODOS: Estudo descritivo observacional de corte transversal, parte do projeto temático "Estudos Clínicos de Crescimento, Comportamento, Hipertensão Arterial, Obesidade e Saúde Bucal", de sigla ECCCHOS, desenvolvido na Disciplina de Nutrologia da Universidade Federal de São Paulo - Escola Paulista de Medicina. Foram selecionados 31 adolescentes, sendo oito do sexo masculino e 23 do feminino, sem fatores de risco conhecidos para hipertensão arterial sistêmica, entre 1.420 alunos de uma escola de ensino médio da cidade de São Paulo, capital do estado de São Paulo, situado no Sudeste do Brasil. Para apresentação de todos os resultados, utilizaram-se as médias, desvios padrão e percentis. RESULTADOS: A dilatação vascular dependente do endotélio 90 segundos pós-liberação do manguito foi de 20,9±6,7% [média mais ou menos 1 desvio padrão (DP] e o 10° percentil ficou em 12,5% no sexo masculino e de 18,8±12,9% DP e o 10° percentil em 6,6% no sexo feminino. Os valores no grupo todo foram de 19,3±11,7% e 6,7%, respectivamente. CONCLUSÃO: O 10° percentil (6,7% da curva de distribuição dos valores de dilatação vascular dependente do endotélio, em adolescentes do presente estudo, pode ser considerado como limite inferior da normalidade. O conhecimento desse limite é importante para o diagnóstico de disfunções endoteliais que aparecem antes das doenças cardiovasculares.OBJECTIVE: To define standards for normal endothelial function in adolescents by high-resolution ultrasound measurement of endothelium-dependent vascular dilatation. METHODS: This was a cross-sectional, descriptive, observational study and part of the thematic project "Clinical Study of Growth, Behavior, Arterial Hypertension, Obesity and Oral Health" (ECCCHOS that was developed by

  20. Helicobacter pylori Infection is a Significant Factor Risk for Hyperhomocysteinemia in the Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Soudabeh Fallah

    2016-01-01

    Full Text Available ABSTRACT This work aimed to determine whether seropositivity to Helicobacter pylori infection was an independent risk factor for hyperhomocysteinemia patients with cardiovascular disease. The H. pylori IgG, IgA and homocystein levels in 96 patients with cardiovascular disease and 64 participants free of cardiovascular disease as control subjects were determined by ELISA assay. The results showed that seropositivity to H. pylori IgG and IgA levels of coronary artery disease (CADpatients was significantly higher than the controls and CAD patients with H. pylori IgG and IgA negative antibodies. A significant correlation was found between the seropositivity to H. pylori IgG and homocysteine levels of CAD patients in comparison with the controls and CAD patients with seronegativity to H. pylori IgG and IgA (r=0.233, P= 0.019 . The involvement of H. pylori infection in atherosclerosis process was based on the chronic inflammation, which might facilitate the CAD-related pathologies. The effect of the presence of H. pylori infection on homocysteine levels elevation in the CAD patients (as a risk factor independent of other traditional factors was remarkable.

  1. Prevalence and prognosis of asymptomatic coronary artery disease in patients with abdominal aortic aneurysm and minor or no perioperative risks

    International Nuclear Information System (INIS)

    According to the American Heart Association (AHA)/ American College of Cardiology (ACC) guideline 2002, patients with abdominal aortic aneurysm (AAA) with minor or no clinical risk for perioperative cardiovascular events require no preoperative coronary assessment if they have functional capacity greater than 4 METS. Further coronary assessment is not often performed, even after the operation, because of absence of symptoms. The aim of this study was to clarify the prevalence, and prognosis of asymptomatic coronary artery disease (CAD) in such AAA patients. From 2002 to 2006, 201 patients (161 men; mean age 73.1±7.7 years) were classified as minor or no clinical risk for perioperative cardiovascular events. Medical history, and physical, laboratory, plus imaging examinations were evaluated. Prognosis was assessed by telephone canvass. Asymptomatic CAD was found in 59 patients (29.4%). By multivariate analysis, advanced age (≥75 years: odds ratio (OR) 2.43, P=0.018) and family history of CAD (OR 5.27, P=0.001) independently predicted asymptomatic CAD. Asymptomatic CAD did not significantly affect death or cardiac events when treated appropriately. A high prevalence of asymptomatic CAD requiring treatment was shown in these AAA patients. Under appropriate therapies, prognosis was as well preserved as in patients without asymptomatic CAD, which underscored the importance of appropriate assessment and management of asymptomatic CAD. (author)

  2. PREVALENCE AND RISK FACTORS OF PERIPHERAL ARTERIAL DISEASE IN DIABETIC PATIENTS OVER 50 YEARS OLD IN CHINA

    Institute of Scientific and Technical Information of China (English)

    Heng Guan; Zheng-yan Sheng; Hao-ming Tian; Da-long Zhu; De-min Yu; Wei-te Zhuang; Lu-lu Chen; Jian-ping Weng; Yong-jun Li; Zhang-rong Xu; Guang-wei Li; Xiao-hui Guo; Zhi-min Liu; Da-jin Zou; Hui-li Xing; Wei Liu

    2007-01-01

    Objective To investigate the prevalence of peripheral arterial disease (PAD) in China type 2 diabetic patients and to demonstrate the relationships between putative risk factors and PAD.Methods In total 1 397 type 2 diabetic patients aged 50 years and older were enrolled and determined ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) in 15 Class HI Grade A hospitals in 7 major cities of China.Results Mean patient age was 63. 7 ± 8. 2 years and mean duration of diabetes mellitus was 9. 39 ± 7. 4 years. Two hundreds and seventy-two (19. 47% ) patients were diagnosed as PAD by ABI< 0. 9, 122 (18. 37% ) in male and 150 (20. 46% ) in female. PAD patients had a significantly longer duration of diabetes mellitus, higher hemoglobin Ale, and a significantly lower mean body mass index than non-PAD ones. Aging, smoking, and systolic blood pressure were found to be positively related with the prevalence of PAD. In terms of lipid profiles, no variable was found to relate with PAD. Notably, baPWV showed as the same significant guiding index for PAD, almost matched with ABI.Conclusions PAD is a common complication in China type 2 diabetic patients. Therefore, PAD screening and treatment should be emphasized for diabetic patients with high risk factors.

  3. Age as a Risk factor for Atrial Fibrillation and Flutter after Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Prashant Bhave MD

    2012-02-01

    Full Text Available Atrial fibrillation affects approximately 3 million people in the United States and creates a huge burden on the health care system, both in terms of morbidity, mortality, and cost.1 The prevalence of atrial fibrillation rises sharply with increases in age. It is estimated that 8% of people above 70 years of age have atrial fibrillation.2-4 Atrial fibrillation has long been recognized as a powerful risk factor for stroke,5 heart failure,6 and mortality.7 Advancing age amplifies the risk of all of these sequelae of atrial fibrillation.

  4. Age as a Risk factor for Atrial Fibrillation and Flutter after Coronary Artery Bypass Grafting

    OpenAIRE

    Prashant Bhave MD; Rod Passman MD, MSCE

    2012-01-01

    Atrial fibrillation affects approximately 3 million people in the United States and creates a huge burden on the health care system, both in terms of morbidity, mortality, and cost.1 The prevalence of atrial fibrillation rises sharply with increases in age. It is estimated that 8% of people above 70 years of age have atrial fibrillation.2-4 Atrial fibrillation has long been recognized as a powerful risk factor for stroke,5 heart failure,6 and mortality.7 Advancing age amplifies the risk of al...

  5. Infections Increase Risk of Arterial and Venous Thromboses in Danish Patients with Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Baronaite Hansen, Renata; Jacobsen, Søren

    2014-01-01

    OBJECTIVE: Infections and thromboses are known complications of systemic lupus erythematosus (SLE). We investigated if infectious episodes in patients with SLE were followed by an increased risk of thrombotic events. METHODS: A cohort of 571 patients with prevalent or incident SLE was followed......, and ever-presence of antiphospholipid antibodies, thrombotic events were classified as occurring during the time at risk of 1 year after an infection or during the remaining control observation time. RESULTS: Of 271 infections identified, 104 were respiratory, 41 cutaneous herpes zoster, and 126 others...

  6. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  7. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  8. Emerging Cardiovascular Disease Biomarkers and Incident Diabetes Mellitus Risk in Statin-Treated Patients With Coronary Artery Disease (from the Treating to New Targets [TNT] Study).

    Science.gov (United States)

    Arsenault, Benoit J; Kohli, Payal; Lambert, Gilles; DeMicco, David A; Laskey, Rachel; Messig, Michael M; Kastelein, John J P; Waters, David D

    2016-08-15

    Whether biomarkers associated with cardiovascular disease risk also predict incident diabetes mellitus (DM) is unknown. Our objective was to determine if a panel of 18 biomarkers previously associated with risk of cardiovascular disease also predicts incident DM in statin-treated patients with coronary artery disease (CAD). The Treating to New Targets (TNT) study is a randomized trial that compared the efficacy of high (80 mg) versus low (10 mg) dose atorvastatin for the secondary prevention of coronary heart disease events. Fasting plasma levels of standard lipids and of 18 emerging CAD risk biomarkers were obtained after an 8-week run-in period on atorvastatin 10 mg in a random sample of 1,424 TNT patients. After exclusion of patients with DM at baseline (n = 253), 101 patients developed DM during the median follow-up of 4.9 years. Patients with incident DM had lower levels of total and high-molecular weight adiponectin, lipoprotein-associated phospholipase A2 (Lp-PLA2), soluble receptor of advanced glycation end products, and vitamin D compared with patients without incident DM. In contrast, insulin, soluble CD40 ligand, and soluble intercellular adhesion molecule-1 levels were higher in patients with incident DM compared with those without. Plasma levels of C-reactive protein, cystatin C, lipoprotein(a), monocyte chemotactic protein-1, matrix metalloproteinase-9, myeloperoxidase, neopterin, N-terminal fragment of pro-B-type natriuretic peptide, osteopontin, and soluble vascular cell adhesion molecule-1 were comparable in patients with and without incident DM. After multivariate adjustment, total and high-molecular weight adiponectin as well as Lp-PLA2 were negatively associated with incident DM. Results of this study suggest that plasma lipids and some emerging CAD risk biomarkers, such as adiponectin and Lp-PLA2, may be useful for predicting incident DM in statin-treated patients with stable CAD. PMID:27328952

  9. Session: Pre-development project risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Curry, Richard; Linehan, Andy

    2004-09-01

    This second session at the Wind Energy and Birds/Bats workshop consisted of two presentations followed by a discussion/question and answer period. The focus of the presentations was on the practices and methodologies used in the wind energy industry for assessing risk to birds and bats at candidate project sites. Presenters offered examples of pre-development siting evaluation requirements set by certain states. Presentation one was titled ''Practices and Methodologies and Initial Screening Tools'' by Richard Curry of Curry and Kerlinger, LLC. Presentation two was titled ''State of the Industry in the Pacific Northwest'' by Andy Linehan, CH2MHILL.

  10. Development of chronic allograft rejection and arterial hypertension in Brown Norway rats after renal transplantation.

    Science.gov (United States)

    Vaskonen, T; Mervaala, E; Nevala, R; Soots, A; Krogerus, L; Lähteenmäki, T; Karppanen, H; Vapaatalo, H; Ahonen, J

    2000-01-01

    The cardiovascular and renal pathophysiology associated with chronic renal allograft rejection under triple drug immunosuppressive treatment was studied using a recently developed model (Brown Norway (BN) rats) in a 6-week experiment. Renal transplantation was performed to 10-week-old rats in a rat strain combination of Dark Agouti (DA) --> BN. The right kidney was removed from another group of BN rats (uninephrectomized). A triple drug treatment comprising cyclosporine (10 mg/kg subcutaneously, s.c.), azathioprine (2 mg/kg s.c.) and methylprednisolone (1.6 mg/kg s.c.) was given to each rat daily for 6 weeks. A control group underwent no operations nor drug treatment. After the transplantation, the systolic blood pressure in this group was increased from 116 +/- 2 to 166 +/- 2 mmHg, while in the uninephrectomized group the rise was from 115 +/- 4 to 146 +/- 4 mmHg, and no change was observed in the blood pressures of the control group. The vascular relaxation responses of mesenteric arterial rings in vitro to acetylcholine were inhibited in both the transplantation group and the uninephrectomized group as compared with the control group, but few significant differences were found in the contraction responses to noradrenaline and potassium chloride. Graft histology was examined after 6 weeks, quantified by using the chronic allograft damage index (CADI). Changes specific to a chronic rejection reaction were observed in the allografts (CADI mean 6.0) but no injuries were seen in the rats' own kidneys (CADI mean 1.2). Our findings show that allograft rejection in BN rats after renal transplantation is associated with the development of arterial hypertension. The combination of cyclosporine, methylprednisolone and azathioprine also rises blood pressure in uninephrectomized BN rats. The hypertensive effects of the drug treatment and graft rejection are associated with endothelial dysfunction.

  11. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  12. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    International Nuclear Information System (INIS)

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9±9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with ≥50% luminal narrowing was detected in 29.2% of the subjects, and that with ≥75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing ≥50% luminal narrowing was detected in 38.2% of subjects, and that showing ≥75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid lesions were

  13. Utilizing risk scores in determining the optimal revascularization strategy for complex coronary artery disease

    NARCIS (Netherlands)

    V. Farooq (Vasim); S. Brugaletta (Salvatore); P.W.J.C. Serruys (Patrick)

    2011-01-01

    textabstractPercutaneous coronary intervention (PCI) of multivessel and/or left main stem disease have been shown to be potentially legitimate revascularization alternatives in appropriately selected patients. Risk stratification is an important component in guiding patients to identify the most app

  14. Carotid endarterectomy in patients with occlusion of the contralateral carotid artery. Perioperative risk and late results

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Rasmussen, L;

    1987-01-01

    . Compared with a complication rate of about 5% previously reported from this institution, this clearly indicates contralateral carotid occlusion as a major risk factor in carotid surgery. Though not statistically significant, patients with severely reduced cerebral perfusion pressure (CPP) had suffered more...

  15. Risk Factors for Thrombosis

    Institute of Scientific and Technical Information of China (English)

    包承鑫

    2002-01-01

    @@ Thrombotic disease is a multifactorial disease, multiple interactions between genetic and environmental factors contribute to the development of the disease.This review summarized some risk factors reported for arterial thrombosis and venous thrombosis in recent few years.

  16. Cervical artery dissection following a turbulent flight.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2012-01-31

    BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

  17. Combining Personality Traits with Traditional Risk Factors for Coronary Stenosis: An Artificial Neural Networks Solution in Patients with Computed Tomography Detected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Angelo Compare

    2013-01-01

    Full Text Available Background. Coronary artery disease (CAD is a complex, multifactorial disease in which personality seems to play a role but with no definition in combination with other risk factors. Objective. To explore the nonlinear and simultaneous pathways between traditional and personality traits risk factors and coronary stenosis by Artificial Neural Networks (ANN data mining analysis. Method. Seventy-five subjects were examined for traditional cardiac risk factors and personality traits. Analyses were based on a new data mining method using a particular artificial adaptive system, the autocontractive map (AutoCM. Results. Several traditional Cardiovascular Risk Factors (CRF present significant relations with coronary artery plaque (CAP presence or severity. Moreover, anger turns out to be the main factor of personality for CAP in connection with numbers of traditional risk factors. Hidden connection map showed that anger, hostility, and the Type D personality subscale social inhibition are the core factors related to the traditional cardiovascular risk factors (CRF specifically by hypertension. Discussion. This study shows a nonlinear and simultaneous pathway between traditional risk factors and personality traits associated with coronary stenosis in CAD patients without history of cardiovascular disease. In particular, anger seems to be the main personality factor for CAP in addition to traditional risk factors.

  18. KLOTHO Allele Status and the Risk of Early-Onset Occult Coronary Artery Disease

    OpenAIRE

    Arking, Dan E; Becker, Diane M.; Lisa R Yanek; Fallin, Daniele; Judge, Daniel P.; Moy, Taryn F.; Becker, Lewis C.; Dietz, Harry C.

    2003-01-01

    We previously identified a functional variant of KLOTHO (termed “KL-VS”), which harbors two amino acid substitutions in complete linkage disequilibrium and is associated with reduced human longevity when in homozygosity. Klotho-deficient mice display extensive arteriosclerosis when fed a normal diet, suggesting a potent genetic predisposition. To determine whether klotho influences atherosclerotic risk in humans, we performed cross-sectional studies to assess the association between the KL-VS...

  19. HMGB1 promotes the development of pulmonary arterial hypertension in rats.

    Directory of Open Access Journals (Sweden)

    Yukari Sadamura-Takenaka

    Full Text Available Pulmonary arterial hypertension (PAH is characterized by increased pulmonary vascular resistance leading to right ventricular failure and death. Recent studies have suggested that chronic inflammatory processes are involved in the pathogenesis of PAH. However, the molecular and cellular mechanisms driving inflammation have not been fully elucidated.To elucidate the roles of high mobility group box 1 protein (HMGB1, a ubiquitous DNA-binding protein with extracellular pro-inflammatory activity, in a rat model of PAH.Male Sprague-Dawley rats were administered monocrotaline (MCT. Concentrations of HMGB1 in bronchoalveolar lavage fluid (BALF and serum, and localization of HMGB1 in the lung were examined over time. The protective effects of anti-HMGB1 neutralizing antibody against MCT-induced PAH were tested.HMGB1 levels in BALF were elevated 1 week after MCT injection, and this elevation preceded increases of other pro-inflammatory cytokines, such as TNF-α, and the development of PAH. In contrast, serum HMGB1 levels were elevated 4 weeks after MCT injection, at which time the rats began to die. Immunohistochemical analyses indicated that HMGB1 was translocated to the extranuclear space in periarterial infiltrating cells, alveolar macrophages, and bronchial epithelial cells of MCT-injected rats. Anti-HMGB1 neutralizing antibody protected rats against MCT-induced lung inflammation, thickening of the pulmonary artery wall, and elevation of right ventricular systolic pressure, and significantly improved the survival of the MCT-induced PAH rats.Our results identify extracellular HMGB1 as a promoting factor for MCT-induced PAH. The blockade of HMGB1 activity improved survival of MCT-induced PAH rats, and thus might be a promising therapy for the treatment of PAH.

  20. Childhood risk factors for developing fibromyalgia

    Directory of Open Access Journals (Sweden)

    Olivieri P

    2012-12-01

    Full Text Available Patrick Olivieri,1 Bruce Solitar,2,* Michel Dubois3,*1NYU School of Medicine, New York, NY, USA; 2Department of Rheumatology, 3Department of Pain Management, New York University Langone Medical Center, New York, NY, USA*These authors contributed equally to this workBackground: Fibromyalgia is a disease process without an obvious etiology. While some evidence suggests that adverse experiences in childhood contribute to its development, specific evidence has been equivocal.Methods: A total of 36 patients with fibromyalgia from the greater New York area were recruited and surveyed using the Centers for Disease Control's Behavioral Risk Factor Surveillance System survey, and questions from the section on adverse childhood experiences were administered. The results were compared to those obtained from over 400,000 people surveyed by the Centers for Disease control each year, and were monitored for statistically significant differences.Results: A statistically significant difference was noted among the control group, suggesting that individuals reported growing up with someone who was depressed when the respondents were between the ages of 0 and 18 years old. Moreover, respondents reported that they were hit by their parents in some way, were insulted or cursed at by their parents, and had been forced to have sex with someone at least 5 years older than them or with an adult. No correlation was found with the following variables and the development of fibromyalgia: growing up with divorced or separated parents; growing up with someone sentenced to serve time in jail; or having parents that abused each other. Additionally, statistically significant differences were found for the following categories: lack of emotional support; life dissatisfaction; fair or poor health; physical, mental or emotional disability; and being divorced or not married.Discussion: Using this well-validated survey, it became clear that at least six specific adverse childhood

  1. Correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion

    Institute of Scientific and Technical Information of China (English)

    Xue-Jing Guo; Xin Ni; Ying Huang; Hang Gu

    2016-01-01

    Objective:To study the correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion.Methods:A total of 2 800 cases of singleton primiparas who received antenatal examination in Maternal and Child Health Hospital of Pudong New Area Shanghai between April 2014 and October 2015 were selected for prospective study and divided into notch group and non-notch group according to the uterine artery notch at 22-24 weeks of gestation, serum was collected at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation respectively to determine endothelial injury indexes VEGF, PLGF, sFlt-1 and sEng in serum, ultrasonography was conducted to determine uterine spiral arterial resistance index (RI) and pulsatility index (PI), and the levels of apoptosis molecules in placenta tissue were determined after delivery.Results: Preeclampsia incidence rate of notch group was significantly higher than that of non-notch group; at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation, serum VEGF and PLGF levels of notch group were significantly lower than those of non-notch group, sFlt-1 and sEng levels were significantly higher than those of non-notch group, and uterine spiral artery PI and RI were significantly higher than those of non-notch group; after delivery, p57kip2, Bax, Caspase-3, Fas and FasL levels in placenta tissue of notch group were significantly higher than those of non-notch group.Conclusion: The risk of preeclampsia is high in pregnant women with mid-pregnancy (22-24 weeks of gestation) uterine artery notch and it will cause maternal endothelial injury, spiral artery remodeling dysfunction and placental hypoperfusion.

  2. Marine and Hydrokinetic Technology Development Risk Management Framework

    Energy Technology Data Exchange (ETDEWEB)

    Snowberg, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Weber, Jochem [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    Over the past decade, the global marine and hydrokinetic (MHK) industry has suffered a number of serious technological and commercial setbacks. To help reduce the risks of industry failures and advance the development of new technologies, the U.S. Department of Energy (DOE) and the National Renewable Energy Laboratory (NREL) developed an MHK Risk Management Framework. By addressing uncertainties, the MHK Risk Management Framework increases the likelihood of successful development of an MHK technology. It covers projects of any technical readiness level (TRL) or technical performance level (TPL) and all risk types (e.g. technological risk, regulatory risk, commercial risk) over the development cycle. This framework is intended for the development and deployment of a single MHK technology—not for multiple device deployments within a plant. This risk framework is intended to meet DOE’s risk management expectations for the MHK technology research and development efforts of the Water Power Program (see Appendix A). It also provides an overview of other relevant risk management tools and documentation.1 This framework emphasizes design and risk reviews as formal gates to ensure risks are managed throughout the technology development cycle. Section 1 presents the recommended technology development cycle, Sections 2 and 3 present tools to assess the TRL and TPL of the project, respectively. Section 4 presents a risk management process with design and risk reviews for actively managing risk within the project, and Section 5 presents a detailed description of a risk registry to collect the risk management information into one living document. Section 6 presents recommendations for collecting and using lessons learned throughout the development process.

  3. Meta-Analysis for the Association between Polymorphisms in Interleukin-17A and Risk of Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Mei-Hua Bao

    2016-06-01

    Full Text Available Coronary artery disease (CAD is a disease which has become a leading cause of death worldwide. The polymorphisms in Interleukin-17 (IL-17A, including rs2275913, rs3819024, rs3819025, rs3748067, rs8193037, rs4711998, and rs8193036, have been found to be probably associated with the risk of CAD. However, the results were inconsistent and inconclusive. The present study performed a meta-analysis to get a more precise and comprehensive estimation of the association between the IL-17A polymorphisms and CAD risk. The Pubmed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, and Chinese Biomedical Literature Databases were searched for related studies. A total of six studies, including 3542 cases and 3212 controls, were identified for the meta-analysis. The main findings of the present meta-analysis show that the TT genotype of IL-17A rs3748067 is associated with a significant lower risk of CAD in the homozygous model odds ratio (OR (OR = 0.37 in Asians. No significant association was found for rs2275913, rs3819024, rs3819025, rs8193037, rs4711998, and rs8193036 with CAD susceptibility in the overall analysis. However, subgroup analysis indicated a significant decreased risk of CAD for the GG genotype and G allele of rs2275913 in a small sample size group, and a higher risk of CAD for the GG genotype and G allele of rs8193037 in a heterozygous model (OR = 1.56, dominant model (OR = 1.54, and allelic model (OR = 1.47 in Asians. In conclusion, the current meta-analysis suggests a significant relationship between rs3748067, rs8193037, and CAD in Asians, while for rs2275913, rs3819024, rs3819025, rs4711998, rs8193036, no such relations were found. Thus, IL-17A rs3748067 and rs8193037 might be recommended as a predictor for susceptibility of CAD for Asians. However, the results of this meta-analysis are hypothesis-generating results which should be interpreted with caution because of the heterogeneity and

  4. Meta-Analysis for the Association between Polymorphisms in Interleukin-17A and Risk of Coronary Artery Disease

    Science.gov (United States)

    Bao, Mei-Hua; Luo, Huai-Qing; Xiang, Ju; Tang, Liang; Dong, Li-Ping; Li, Guang-Yi; Zeng, Jie; Li, Jian-Ming

    2016-01-01

    Coronary artery disease (CAD) is a disease which has become a leading cause of death worldwide. The polymorphisms in Interleukin-17 (IL-17A), including rs2275913, rs3819024, rs3819025, rs3748067, rs8193037, rs4711998, and rs8193036, have been found to be probably associated with the risk of CAD. However, the results were inconsistent and inconclusive. The present study performed a meta-analysis to get a more precise and comprehensive estimation of the association between the IL-17A polymorphisms and CAD risk. The Pubmed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, and Chinese Biomedical Literature Databases were searched for related studies. A total of six studies, including 3542 cases and 3212 controls, were identified for the meta-analysis. The main findings of the present meta-analysis show that the TT genotype of IL-17A rs3748067 is associated with a significant lower risk of CAD in the homozygous model odds ratio (OR) (OR = 0.37) in Asians. No significant association was found for rs2275913, rs3819024, rs3819025, rs8193037, rs4711998, and rs8193036 with CAD susceptibility in the overall analysis. However, subgroup analysis indicated a significant decreased risk of CAD for the GG genotype and G allele of rs2275913 in a small sample size group, and a higher risk of CAD for the GG genotype and G allele of rs8193037 in a heterozygous model (OR = 1.56), dominant model (OR = 1.54), and allelic model (OR = 1.47) in Asians. In conclusion, the current meta-analysis suggests a significant relationship between rs3748067, rs8193037, and CAD in Asians, while for rs2275913, rs3819024, rs3819025, rs4711998, rs8193036, no such relations were found. Thus, IL-17A rs3748067 and rs8193037 might be recommended as a predictor for susceptibility of CAD for Asians. However, the results of this meta-analysis are hypothesis-generating results which should be interpreted with caution because of the heterogeneity and publication bias

  5. Meta-Analysis for the Association between Polymorphisms in Interleukin-17A and Risk of Coronary Artery Disease.

    Science.gov (United States)

    Bao, Mei-Hua; Luo, Huai-Qing; Xiang, Ju; Tang, Liang; Dong, Li-Ping; Li, Guang-Yi; Zeng, Jie; Li, Jian-Ming

    2016-01-01

    Coronary artery disease (CAD) is a disease which has become a leading cause of death worldwide. The polymorphisms in Interleukin-17 (IL-17A), including rs2275913, rs3819024, rs3819025, rs3748067, rs8193037, rs4711998, and rs8193036, have been found to be probably associated with the risk of CAD. However, the results were inconsistent and inconclusive. The present study performed a meta-analysis to get a more precise and comprehensive estimation of the association between the IL-17A polymorphisms and CAD risk. The Pubmed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, and Chinese Biomedical Literature Databases were searched for related studies. A total of six studies, including 3542 cases and 3212 controls, were identified for the meta-analysis. The main findings of the present meta-analysis show that the TT genotype of IL-17A rs3748067 is associated with a significant lower risk of CAD in the homozygous model odds ratio (OR) (OR = 0.37) in Asians. No significant association was found for rs2275913, rs3819024, rs3819025, rs8193037, rs4711998, and rs8193036 with CAD susceptibility in the overall analysis. However, subgroup analysis indicated a significant decreased risk of CAD for the GG genotype and G allele of rs2275913 in a small sample size group, and a higher risk of CAD for the GG genotype and G allele of rs8193037 in a heterozygous model (OR = 1.56), dominant model (OR = 1.54), and allelic model (OR = 1.47) in Asians. In conclusion, the current meta-analysis suggests a significant relationship between rs3748067, rs8193037, and CAD in Asians, while for rs2275913, rs3819024, rs3819025, rs4711998, rs8193036, no such relations were found. Thus, IL-17A rs3748067 and rs8193037 might be recommended as a predictor for susceptibility of CAD for Asians. However, the results of this meta-analysis are hypothesis-generating results which should be interpreted with caution because of the heterogeneity and publication bias

  6. Hepatic artery aneurysm in a patient with Behcet's disease and segmental pancreatitis developing after its embolization

    Energy Technology Data Exchange (ETDEWEB)

    Oto, A.; Cekirge, S.; Guelsuen, M.; Balkanci, F.; Besim, A. [Department of Radiology, Hacettepe University, Ankara (Turkey)

    2000-08-01

    Segmental pancreatitis is an unusual form of acute pancreatitis mostly seen in the head of pancreas. We present the CT findings of a segmental pancreatitis in the body and tail of the pancreas developed following endovascular embolization of a giant hepatic artery aneurysm and arterioportal fistula in a patient with Behcet's disease. (orig.)

  7. The Risk and Risk Management of Innovation Development of Enterprises in New Economy Era

    Institute of Scientific and Technical Information of China (English)

    秦江萍; 段兴民

    2002-01-01

    The Risk and risk management of innovation and development in enterprises is an inevitable and practical problem depending whether the innovation and development of enterprises in new economy era will be successful or not. This thesis firstly illustrates the concepts and traits of risk, the concepts and times traits of innovation risk in enterprises from the angle of management science; On this basis, it also analyzes the source of risk from the innovation and development in enterprises; at last, it focus on studying the basic thoughts and policies of strengthening the innovation risk management of enterprises in new economy era.

  8. Assessment of Alzheimer's disease risk with structural and functional magnetic resonance imaging : an arterial spin labeling study

    OpenAIRE

    Bangen, Katherine J.

    2010-01-01

    BACKGROUND : There are several risk factors for the development of Alzheimer's disease (AD) including the apolipoprotein E (APOE) e4 allele, an important susceptibility gene for AD, and mild cognitive impairment (MCI). The literature to date generally indicates that nondemented older adults at risk for AD by virtue of their cognitive (i.e., MCI) and/or genetic (i.e., APOE) status demonstrate reduced medial temporal lobe (MTL) volumes and divergent brain response patterns during memory encodin...

  9. Developing risk-based food safety management

    OpenAIRE

    Tuomisto, Pirkko

    2008-01-01

    The drive for risk-based food safety management, systems and control has spread world-wide in recent decades. Since the term is still internationally undefined, its use and implementation vary, producing different realizations. In this Ph.D. thesis, microbiological risk assessment (MRA) was investigated as a basis for risk-based food safety management, which was defined as ‘food safety management based on risk assessment in order to achieve an appropriate level of protection (ALOP)’. Gove...

  10. High thoracic epidural anesthesia in cardiac surgery: risk factors for arterial hypotension.

    Science.gov (United States)

    Casalino, Stefano; Mangia, Fabio; Stelian, Edmond; Novelli, Eugenio; Diena, Marco; Tesler, Ugo F

    2006-01-01

    There is an interest in the use of high thoracic epidural anesthesia in cardiac surgery, because experimental and clinical studies have suggested that central neuroaxial blockade attenuates the response to surgical stress and improves myocardial metabolism and perioperative analgesia-thus enabling earlier extubation and a smoother postoperative course. Matters of major concern in the adoption of high thoracic epidural anesthesia in cardiac surgery are neurologic injury secondary to neuroaxial hematoma and hypotension secondary to sympatholysis. The risk associated with possible neuraxial hematoma caused by high thoracic epidural anesthesia has been thoroughly investigated and largely discounted, but scant attention has been devoted to the onset of hypotensive episodes in the same setting. We analyzed the hypotensive episodes that occurred in a series of 144 patients who underwent on-pump cardiac surgery procedures. Among the patient variables that we tested in a multivariate logistic-regression model, only female sex was found to be significantly correlated with hypotension. In order to decrease the incidence and severity of hypotensive episodes resulting from anesthetic blockade, anesthesiologists need to monitor, with special care, women patients who are under high thoracic epidural anesthesia. Further studies are needed in order to determine why women undergoing open heart surgery under high thoracic epidural anesthesia are at a relatively greater risk of hypotension. PMID:16878616

  11. Intronic Polymorphisms in the CDKN2B-AS1 Gene Are Strongly Associated with the Risk of Myocardial Infarction and Coronary Artery Disease in the Saudi Population

    Directory of Open Access Journals (Sweden)

    Sayed AbdulAzeez

    2016-03-01

    Full Text Available Recent genome-wide association studies identified single nucleotide polymorphisms (SNPs on the chromosome 9p21.3 conferring the risk for CAD (coronary artery disease in individuals of Caucasian ancestry. We performed a genetic association study to investigate the effect of 12 candidate SNPs within 9p21.3 locus on the risk of CAD in the Saudi population of the Eastern Province of Saudi Arabia. A total of 250 Saudi CAD patients who had experienced an myocardial infarction (MI and 252 Saudi age-matched healthy controls were genotyped using TaqMan assay. Controls with evidenced lack of CAD provided 90% of statistical power at the type I error rate of 0.05. Five percent of the results were rechecked for quality control using Sanger sequencing, the results of which concurred with the TaqMan genotyping results. Association analysis of 12 SNPs indicated a significant difference in the genotype distribution for four SNPs between cases and controls (rs564398 p = 0.0315, χ2 = 4.6, odds ratio (OD = 1.5; rs4977574 p = 0.0336, χ2 = 4.5, OD = 1.4; rs2891168 p = 1.85 × 10 − 10, χ2 = 40.6, OD = 2.1 and rs1333042 p = 5.14 × 10 − 9, χ2 = 34.1, OD = 2.2. The study identified three protective haplotypes (TAAG p = 1.00 × 10 − 4; AGTA p = 0.022 and GGGCC p = 0.0175 and a risk haplotype (TGGA p = 2.86 × 10 − 10 for the development of CAD. This study is in line with others that indicated that the SNPs located in the intronic region of the CDKN2B-AS1 gene are associated with CAD.

  12. Nuclear Thermal Rocket (NTR) Development Risk Communication

    Science.gov (United States)

    Kim, Tony

    2014-01-01

    nuclear radiation from Fukushima" which focus on mis-information and fear mongering. Nuclear power and NTR are powerful resources that can open many doors for future prosperity and capability. With great power comes great responsibility. Radiation and its effects need to be better understood, quantified, and communicated. A human mission to mars has its own risks of deep space radiation and is considered a considerable risk at 400 milli-Sieverts per year in deep space and 245 milli-Sieverts per year on the surface of Mars as measured by the Mars Curiosity mission. Although these quantities of ionizing radiation are within the astronaut career limit, it exceeds the yearly average amounts of ionizing radiation. Astronaut crews have experienced these levels of radiation before, but for durations shorter than a year, and a mission to Mars could possibly be 3 years in length. There is also evidence that people can comfortably handle higher levels of ionizing radiation where the radiation occurs naturally like Ramsar, Iran when people can experience 270 milli-Sieverts per year. A risk posture that the development, test, and flight of an NTR will meet opposition from groups who oppose nuclear energy must be likely and the impact can be sever to the effort. Active risk mitigation must be taken for an NTR full-scale development project. The NTR design must take into account safety for transport and off nominal conditions. Nuclear fuel element must consider containment of fission products and Low Enriched Uranium (LEU) that may meet less opposition should be considered for safety and security reasons. Even though testing was conducted on Rover/NERVA safely and successfully in the 60's with exhaust sent heavenward in to open air, modern testing of NTR must consider full containment and no release of ionizing radiation to the public and must meet the current requirement of no more than 0.1 milli-Sieverts per year to the public. 0.1 milli-Sieverts is equivalent to eating one banana or

  13. Patient risk factors for pressure ulcer development: Systematic review

    NARCIS (Netherlands)

    Coleman, S.; Gorecki, C.; Nelson, E.A.; Closs, S.J.; Defloor, T.; Halfens, R.; Farrin, A.; Brown, J.; Schoonhoven, L.; Nixon, J.

    2013-01-01

    OBJECTIVE: To identify risk factors independently predictive of pressure ulcer development in adult patient populations? DESIGN: A systematic review of primary research was undertaken, based upon methods recommended for effectiveness questions but adapted to identify observational risk factor studie

  14. Risk factors for neurological worsening and symptomatic watershed infarction in internal carotid artery aneurysm treated by extracranial-intracranial bypass using radial artery graft.

    Science.gov (United States)

    Matsukawa, Hidetoshi; Tanikawa, Rokuya; Kamiyama, Hiroyasu; Tsuboi, Toshiyuki; Noda, Kosumo; Ota, Nakao; Miyata, Shiro; Oda, Jumpei; Takeda, Rihee; Tokuda, Sadahisa; Kamada, Kyousuke

    2016-08-01

    OBJECT The revascularization technique, including bypass created using the external carotid artery (ECA), radial artery (RA), and M2 portion of middle cerebral artery (MCA), has remained indispensable for treatment of complex aneurysms. To date, it remains unknown whether diameters of the RA, superficial temporal artery (STA), and C2 portion of the internal carotid artery (ICA) and intraoperative MCA blood pressure have influences on the outcome and the symptomatic watershed infarction (WI). The aim of the present study was to evaluate the factors for the symptomatic WI and neurological worsening in patients treated by ECA-RA-M2 bypass for complex ICA aneurysm with therapeutic ICA occlusion. METHODS The authors measured the sizes of vessels (RA, C2, M2, and STA) and intraoperative MCA blood pressure (initial, after ICA occlusion, and after releasing the RA graft bypass) in 37 patients. Symptomatic WI was defined as presence of the following: postoperative new neurological deficits, WI on postoperative diffusion-weighted imaging, and ipsilateral cerebral blood flow reduction on SPECT. Neurological worsening was defined as the increase in 1 or more modified Rankin Scale scores. First, the authors performed receiver operating characteristic curve analysis for continuous variables and the binary end point of the symptomatic WI. The clinical, radiological, and physiological characteristics of patients with and without the symptomatic WI were compared using the log-rank test. Then, the authors compared the variables between patients with and without neurological worsening at discharge and at the 12-month follow-up examination or last hospital visit. RESULTS Symptomatic WI was observed in 2 (5.4%) patients. The mean MCA pressure after releasing the RA graft (< 55 mm Hg; p = 0.017), mean (MCA pressure after releasing the RA graft)/(initial MCA pressure) (< 0.70 mm Hg; p = 0.032), and mean cross-sectional area ratio ([RA/C2 diameter](2) < 0.40 mm [p < 0.0001] and [STA/C2

  15. Investigation of associations between ten polymorphisms and the risk of coronary artery disease in Southern Han Chinese.

    Science.gov (United States)

    Huang, Er-Wen; Peng, Long-Yun; Zheng, Jin-Xiang; Wang, Dan; Tan, Xiao-Hong; Yang, Zhong-Yi; Li, Xue-Mei; Wu, Qiu-Ping; Tang, Shuang-Bo; Luo, Bin; Quan, Li; Liu, Shui-Ping; Liu, Xiao-Shan; Li, Zhao-Hui; Shi, He; Lv, Guo-Li; Zhao, Jian; Liu, Chao; Cheng, Jian-Ding

    2016-05-01

    A large-scale meta-analysis of 14 genome-wide association studies has identified and replicated a series of susceptibility polymorphisms for coronary artery disease (CAD) in European ancestry populations, but evidences for the associations of these loci with CAD in other ethnicities remain lacking. Herein we investigated the associations between ten (rs579459, rs12413409, rs964184, rs4773144, rs2895811, rs3825807, rs216172, rs12936587, rs46522 and rs3798220) of these loci and CAD in Southern Han Chinese (CHS). Genotyping was performed in 1716 CAD patients and 1572 controls using mass spectrography. Both allelic and genotypic associations of rs964184, rs2895811 and rs3798220 with CAD were significant, regardless of adjustment for covariates of gender, age, hypertension, type 2 diabetes, blood lipid profiles and smoking. Significant association of rs12413409 was initially not observed, but after the adjustment for the covariates, both allelic and genotypic associations were identified as significant. Neither allelic nor genotypic association of the other six polymorphisms with CAD was significant regardless of the adjustment. Our results indicated that four loci of the total 10 were associated with CAD in CHS. Therefore, some of the CAD-related loci in European ancestry populations are indeed susceptibility loci for the risk of CAD in Han Chinese. PMID:26740236

  16. Risk Taking Transfer in Development Training.

    Science.gov (United States)

    Goldman, Kathy; Priest, Simon

    1991-01-01

    Twenty-seven corporate managers completed the Priest Attarian Risk Taking Inventory before and after a day of rappelling. Subjects also completed a business version of the inventory a few weeks before and a few weeks after the experience. Subjects appeared to transfer some of their new risk-taking behaviors to their jobs. (KS)

  17. Development of flood risk mapping in Kota Tinggi, Malaysia

    International Nuclear Information System (INIS)

    Flood risk maps provide valuable information for development of flood risk management. Geospatial technology and modeling enable us to monitor natural disasters around the world. Flooding is the most severe natural disaster that causing huge economic losses every year. Flood risk maps are an essential tool for assessing the consequences of flooding. The main aim of this study is to initiate a framework to develop a local-based flood risk map. Flood risk maps can be produced by using integration of geospatial technology and hydrodynamic modeling. Results show that a flood risk map for Kota Tinggi is produced with unsatisfactory information in term of flood damage

  18. Development of Risk Management Technology/Development of Risk-Informed Application Technology

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Joon Eon; Kim, K. Y.; Ahn, K. I.; Lee, Y. H.; Lim, H. G.; Jung, W. S.; Choi, S. Y.; Han, S. J.; Ha, J. J.; Hwang, M. J.; Park, S. Y.; Yoon, C

    2007-06-15

    This project aims at developing risk-informed application technologies to enhance the safety and economy of nuclear power plant altogether. For this, the Integrated Level 1 and 2 PSA model is developed. In addition, the fire and internal flooding PSA models are improved according to the PSA standard of U.S.A. To solve the issues of domestic PSA model, the best-estimate thermal hydraulic analyses are preformed for the ATWS and LSSB. In order to reduce the uncertainty of PSA, several new PSA technologies are developed: (1) more exact quantification of large fault tree, (2) importance measure including the effects of external PSA. As feasibility studies of Option 2 and 3, the class of 6 systems' SSC are re-classified based on the risk information and the sensitivity analyses is performed for the EDG starting time, respectively. It is also improved that the methodology to identify the vital area of NPP. The research results of this project can be used in the regulatory body and the industry projects for risk-informed applications.

  19. Diagnosis of coronary artery disease using myocardial perfusion SPECT in patients with diabetes mellitus: analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ji Hyoung; Kang, Seong Min; Bae, Jin Ho; Jeong, Shin Young; Lee, Sang Woo; Yoo, Jeong Soo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University, Daegu, (Korea, Republic of)

    2006-06-15

    Diabetes mellitus is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is growing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. 203 diabetic patients (64 male, mean age 64.1 {+-} 9.0 years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was 36 {+-} 18 months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the occurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

  20. The measure for problematic case with middle meningeal artery origin ophthalmic artery in front-temporal craniotomy and a part of DSA. Preservation of visual function

    International Nuclear Information System (INIS)

    Because of the recent development of high-performance 3-dimensional computed tomography (3D-CTA), magnetic resonance angiography (MRA) and the consideration of the risk of digital subtraction angiography (DSA), DSA is not always necessary in performing surgery for cerebral aneurysms. However, DSA was necessary in patients in whom the ophthalmic artery from the internal carotid artery (IC) was not visualized on 3D-CTA or MRA, in order to predict the risk of blindness after front-temporal craniotomy. In this study, we investigated the preoperative evaluation and the surgical procedure for 330 cases of front-temporal craniotomy for surgery of aneurysm over the past 4.5 years. There were 5 cases without ophthalmic artery from IC in DSA or 3D-CTA, 4 cases with an anomalous ophthalmic artery arising from the middle meningeal artery and 1 case with an anomalous ophthalmic artery arising from unknown origin. Microsurgical procedure is needed to preserve the middle meningeal artery in front-temporal craniotomy in these cases with an anomalous ophthalmic artery arising from the middle meningeal artery, because this anomaly places the ophthalmic artery at risk during procedures in which the dura is elevated from the greater and lesser wings of the sphenoid or when the sphenoid ridge is removed in front-temporal craniotomy. Front-temporal craniotomy is difficult in cases with an anomalous ophthalmic artery arising from an unknown origin. (author)

  1. Nuclear Waste, Risks and Sustainable Development

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Mikael [Swedish Society for Nature Conservation, Stockholm (Sweden); Swahn, Johan [Swedish NGO Office for Nuclear Waste Review (MKG), Goeteborg (Sweden)

    2006-09-15

    believe it is possible to increase trust in so far as gaining public commitment for a repository, but only as long as long-term environmental safety is made the central objective. Trust will also increase along with continued transfer to a sustainable energy system. The problems of dealing with nuclear waste are often seen as a 'show-stopper' for nuclear power. It must, however, be emphasised that nuclear power does not become compatible with sustainable development even if the best environmental solution is found for the already existing waste. Nuclear power is fundamentally based on finite resources. The technology relies on environmentally harmful mining and creates extremely hazardous waste. It also has an intrinsic risk for catastrophic release of harmful radiation and increases the risk of nuclear weapons proliferation.

  2. Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country.

    Science.gov (United States)

    Nag, Falguni; De, Abhishek; Hazra, Avijit; Chatterjee, Gobinda; Ghosh, Arghyaprasun; Surana, Trupti V

    2014-10-01

    Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries. PMID:23170845

  3. Low-Density Lipoprotein Cholesterol, Non-High-Density Lipoprotein Cholesterol, Triglycerides, and Apolipoprotein B and Cardiovascular Risk in Patients With Manifest Arterial Disease.

    Science.gov (United States)

    van den Berg, M Johanneke; van der Graaf, Yolanda; de Borst, Gert Jan; Kappelle, L Jaap; Nathoe, Hendrik M; Visseren, Frank L J

    2016-09-15

    Low-density lipoprotein cholesterol (LDL-C) only partly represents the atherogenic lipid burden, and a growing body of evidence suggests that non-high-density lipoprotein cholesterol (non-HDL-C), triglycerides, and apolipoprotein B (apoB) are more accurate in estimating lipid-related cardiovascular disease risk. Our objective was to compare the relation among LDL-C, non-HDL-C, triglycerides, and apoB and the occurrence of future vascular events and mortality in patients with manifest arterial disease. This is a prospective cohort study of 7,216 patients with clinically manifest arterial disease in the Secondary Manifestations of Arterial Disease Study. Cox proportional hazard models were used to quantify the risk of major cardiovascular events (MACE; i.e., stroke, myocardial infarction, and vascular mortality) and all-cause mortality. Interaction was tested for type of vascular disease at inclusion. MACE occurred in 1,185 subjects during a median follow-up of 6.5 years (interquartile range 3.4 to 9.9 years). Adjusted hazard ratios (HRs) of MACE per 1 SD higher were for LDL-C (HR 1.15, 95% confidence interval [CI] 1.09 to 1.22), for non-HDL-C (HR 1.17, 95% CI 1.11 to 1.23), for log(triglycerides) (HR 1.12, 95% CI 1.06 to 1.19), and for apoB HR (1.12, 95% CI 0.99 to 1.28). The relation among LDL-C, non-HDL-C, and cardiovascular events was comparable in patients with cerebrovascular disease, coronary artery disease, or polyvascular disease and absent in those with aneurysm of abdominal aorta or peripheral artery disease. In conclusion, in patients with a history of cerebrovascular, coronary artery, or polyvascular disease, but not aneurysm of abdominal aorta or peripheral artery disease, higher levels of LDL-C and non-HDL-C are related to increased risk of future MACE and of comparable magnitude. PMID:27471056

  4. Low-Density Lipoprotein Cholesterol, Non-High-Density Lipoprotein Cholesterol, Triglycerides, and Apolipoprotein B and Cardiovascular Risk in Patients With Manifest Arterial Disease.

    Science.gov (United States)

    van den Berg, M Johanneke; van der Graaf, Yolanda; de Borst, Gert Jan; Kappelle, L Jaap; Nathoe, Hendrik M; Visseren, Frank L J

    2016-09-15

    Low-density lipoprotein cholesterol (LDL-C) only partly represents the atherogenic lipid burden, and a growing body of evidence suggests that non-high-density lipoprotein cholesterol (non-HDL-C), triglycerides, and apolipoprotein B (apoB) are more accurate in estimating lipid-related cardiovascular disease risk. Our objective was to compare the relation among LDL-C, non-HDL-C, triglycerides, and apoB and the occurrence of future vascular events and mortality in patients with manifest arterial disease. This is a prospective cohort study of 7,216 patients with clinically manifest arterial disease in the Secondary Manifestations of Arterial Disease Study. Cox proportional hazard models were used to quantify the risk of major cardiovascular events (MACE; i.e., stroke, myocardial infarction, and vascular mortality) and all-cause mortality. Interaction was tested for type of vascular disease at inclusion. MACE occurred in 1,185 subjects during a median follow-up of 6.5 years (interquartile range 3.4 to 9.9 years). Adjusted hazard ratios (HRs) of MACE per 1 SD higher were for LDL-C (HR 1.15, 95% confidence interval [CI] 1.09 to 1.22), for non-HDL-C (HR 1.17, 95% CI 1.11 to 1.23), for log(triglycerides) (HR 1.12, 95% CI 1.06 to 1.19), and for apoB HR (1.12, 95% CI 0.99 to 1.28). The relation among LDL-C, non-HDL-C, and cardiovascular events was comparable in patients with cerebrovascular disease, coronary artery disease, or polyvascular disease and absent in those with aneurysm of abdominal aorta or peripheral artery disease. In conclusion, in patients with a history of cerebrovascular, coronary artery, or polyvascular disease, but not aneurysm of abdominal aorta or peripheral artery disease, higher levels of LDL-C and non-HDL-C are related to increased risk of future MACE and of comparable magnitude.

  5. Chemical risk evaluation, importance of the risk analysis framework uses: Latin America development restrictions

    International Nuclear Information System (INIS)

    The power point presentation is about reach and results of the risk analysis in Venezuela, chemical dangers in food, human damage, injuries , technologies news in fodd development, toxicity, microbiological risk, technical recommendations

  6. The development of mountain risk governance: challenges for application

    Science.gov (United States)

    Link, S.; Stötter, J.

    2015-01-01

    The complexity the management of mountain risks in the Alps has considerably increased since its institutionalisation in the late nineteenth century. In the history of approaches to dealing with mountain risks four successive paradigms can be distinguished on the basis of key indicators such as guiding principles, characteristic elements and typical instruments: "hazard protection", "hazard management", "risk management", and "risk governance". In this contribution, special attention is paid to the development of hazard zone planning and the growing importance of communication and participation over the course of this transformation. At present, the risk management paradigm has reached maturity. In the Alps, risk governance frameworks are not yet applied to risks from natural hazards. Based on a historical analysis, the suitability and applicability of general risk governance frameworks in the context of mountain risks are discussed. Necessary adaptations (e.g., in administration, educational, and legal structures) are proposed for the upcoming transformation towards mountain risk governance.

  7. Association of Adiponectin Gene Polymorphisms With the Risk of Coronary Artery Disease in Patients With Nonalcoholic Fatty Liver Disease in a Chinese Han Population

    Science.gov (United States)

    Du, Shui-Xian; Lu, Lin-Lin; Liu, Yang; Dong, Quan-Jiang; Xuan, Shi-Ying; Xin, Yong-Ning

    2016-01-01

    Background Cardiovascular events are an independent risk factor for nonalcoholic fatty liver disease (NAFLD), which is the leading cause of mortality in NAFLD patients. Several recent studies demonstrated that adiponectin (Ad) polymorphisms were involved in the progression of NAFLD and coronary artery disease (CAD). However, reports on the association between Ad polymorphisms and the risk of developing CAD in NAFLD patients are lacking in a Northern Han Chinese population. Objectives The present study was designed to evaluate the association between Ad gene polymorphisms (rs266729 and rs2241766) and the risk of developing CAD in Northern Han Chinese patients with NAFLD. Materials and Methods In this case-control study, using the polymerase chain reaction (PCR), Adrs266729 and rs2241766 gene polymorphisms were genotyped in B-type ultrasonography-proven NAFLD patients, with (n = 246) or without (n = 247) CAD and in healthy controls (n = 304). Serum lipid profiles were determined using biochemical methods. Statistical analyses were performed using SPSS 17.0 statistical software. Results There were significant differences in the Adrs266729 G allele between the NAFLD patients with and without CAD (P < 0.05). In addition, there was a significant difference in the Adrs2241766 G allele of the NAFLD patients compared with that of the controls (P < 0.05). In the NAFLD CAD population, carriers of the G allele of Adrs266729 had higher serum triglycerides (TG), total cholesterol (TC), fasting plasma glucose (FPG), and low-density lipoprotein (LDL) levels and a lower Ad level than their noncarrier counterparts (P = 0.031, P = 0.034, P = 0.007, P < 0.001, and P < 0.001, respectively). NAFLD patients without CAD had higher TG and serum FPG values and a lower Ad level than their noncarrier counterparts (P = 0.014, P = 0.038, and P < 0.001, respectively). In the NAFLD patients with/without CAD, the carriers of the G allele of Adrs2241766 had higher TG levels (P = 0.039 and P = 0

  8. Development of an instrument to indirectly monitor arterial pCO2 during cardiopulmonary bypass.

    Science.gov (United States)

    Høgetveit, Jan Olav; Kristiansen, Frode; Pedersen, Thore H

    2006-01-01

    Arterial blood carbon dioxide tension (PaCO2) during cardiopulmonary bypass (CBP) is important to the conduct of perfusion with alpha-stat or pH-stat strategy. Temperature changes during CBP complicate any attempts to monitor carbon dioxide tension in the exhaust outlet of an oxygenator (PexCO2) because CO2 becomes more soluble with decreasing temperatures. Normally, this would have been the obvious and easy choice of method to indirectly measure the patient's PaCO2. Several tests have been performed with ordinary capnographs modified to measure pCO2 at the oxygenator exhaust gas port. These tests have shown varying degrees of precision (Br I Anaesth 1999; 82(6): 843-46; 1 Extra-Corpor Technol 2003; 35(3): 218-23; Br JAnaesth 2000; 84: 536; J Extra-Corpor Technol 1994; 26: 64-67). Some of the best results have been achieved by Potger et al. (JExtra-Corpor Technol 2003; 35(3): 218-23), who found a strong correlation between the arterial temperature-corrected PexCO2 when using a standard capnograph monitoring the PaCO2 measured from a blood gas analyser (PbCO2). Our group has developed a new instrument, especially designed for oxygenator gas exhaust monitoring. The new instrument has automatic temperature correction, enabling it to show both original and corrected pCO2 values, simultaneously. Ordinary capnograph functions, such as zeroing, flow control and calibration routines, are included. The solution consists of a pCO2 sensor module, a temperature sensor, a water trap and a dedicated PC mounted on a heart-lung machine. Since the heart-lung machine was already equipped with a computer for data logging and a temperature sensor, only a box containing the pCO2 sensor module and the water trap had to be added. The PC uses a specially written program designed to collect data, make the necessary calculations and display the results on the computer screen. A temperature correction was developed based on a linear regression analysis for a data-set of 15 patients, assuming

  9. The Interrelationship of Psychosocial Risk Factors for Coronary Artery Disease in a Working Population: Do We Measure Distinct or Overlapping Psychological Concepts?

    OpenAIRE

    Kudielka, Brigitte M.; von Känel, Roland; Gander, Marie-Luise; Fischer, Joachim E.

    2004-01-01

    There is growing evidence that psychosocial factors contribute to the risk of coronary artery disease. Commonly used psychometric scales share several features leading to questions about whether they reflect distinguishable concepts. Study participants were 822 employees of the Augsburg Cohort Study ( mean age 40 years, 89% men). The authors analyzed the interrelationship between the following psychosocial measures by applying Pearson correlations and factor analysis to the Hospital Anxiety a...

  10. Risk loci for coronary artery calcification replicated at 9p21 and 6q24 in the Heinz Nixdorf Recall Study

    OpenAIRE

    Pechlivanis Sonali; Mühleisen Thomas W; Möhlenkamp Stefan; Schadendorf Dirk; Erbel Raimund; Jöckel Karl-Heinz; Hoffmann Per; Nöthen Markus M; Scherag André; Moebus Susanne

    2013-01-01

    Abstract Background Atherosclerosis is the primary cause of coronary heart disease (CHD), preceding the onset of cardiovascular disease by decades in most cases. Here we examine the association between single nucleotide polymorphisms (SNPs) integrated on Metabochip and coronary artery calcification (CAC), a valid risk factor for CHD, in an unselected, population-based German cohort. Methods The Metabochip is a custom iSELECT array containing >195,000 SNPs that was designed to support large-sc...

  11. Increasing severity of cardiovascular risk factors with increasing middle cerebral artery stenotic involvement in type 2 diabetic Chinese patients with asymptomatic cerebrovascular disease

    OpenAIRE

    Thomas, GN; Lin, JW; Lam, WWM; Tomlinson, B; Yeung, V; Chan, JCN; Liu, R; Wong, KS

    2004-01-01

    OBJECTIVE: To identify determinants associated with increasing severity of middle cerebral artery (MCA) stenosis in asymptomatic Chinese type 2 diabetic patients with and without MCA stenosis determined using transcranial Doppler. Conventional risk factors contribute to the pathogenesis of ischemic stroke, and differences in the pattern of these may explain the heterogeneity of disease presentation in different populations. In Chinese patients, MCA stenosis is the most commonly identified int...

  12. Cost and patency rate targets for the development of endovascular devices to treat femoropopliteal arterial disease

    NARCIS (Netherlands)

    G.S. Muradin (Galied); M.G.M. Hunink (Myriam)

    2001-01-01

    textabstractPURPOSE: To determine the criteria that would make use of an endovascular device cost-effective compared with bypass surgery and percutaneous transluminal angioplasty in the treatment of femoropopliteal arterial disease. MATERIALS AND METHODS: A decision mod

  13. Developments in pulmonary arterial hypertension-targeted therapy for chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Hadinnapola, Charaka; Pepke-Zaba, Joanna

    2015-10-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterised by the presence of organised chronic thromboembolic material occluding the proximal pulmonary arteries and a vasculopathy in the distal pulmonary arterial tree. Pulmonary endarterectomy (PEA) is a potential cure for many patients with CTEPH. However, PEA is not suitable for patients with a significant distal distribution of chronic thromboembolic material or with significant comorbidities. Also, a proportion of patients are left with residual CTEPH post PEA. Until recently, pulmonary arterial hypertension-targeted therapies have been used off licence to treat patients with inoperable or residual CTEPH. The CHEST1 study investigated the use of riociguat and was the first randomised controlled trial to show efficacy in inoperable or residual CTEPH. In this review, we explore the pathophysiology of CTEPH and review the current trial evidence for pulmonary arterial hypertension-targeted therapies. We also include a discussion of physiological considerations that require further investigation.

  14. Risk factors for development of critical limb ischemia -- a survey of diabetic vs. nondiabetic population.

    Science.gov (United States)

    Bosevski, M; Meskovska, S; Tosev, S; Peovska, I; Asikov, I; Georgievska-Ismail, L J

    2006-12-01

    The aim of this study is to identify the risk factors for development of chronic critical limb ischemia (CLI) in diabetic and nondiabetic patients with peripheral arterial disease (PAD). 127 patients (pts) with PAD (63 with type 2 diabetes and 64 nondiabetic) were randomly included in a cross sectional study. Out of them 17 were with CLI. Population was investigated for age, height, weight, sex, duration of PAD and diabetes, arterial hypertension, hyperlipidemia, smoking, obesity, systolic blood pressure, value of ankle-brachial index, previous claudicating distance and peripheral intervention, amputation, medical treatment with prostanoids, insulin and antiplatelet drugs and histories of cerebrovascular disease, coronary artery disease and other concomitant diseases. After adjudging linear correlation between mentioned variables and presence of CLI, logistic regression model was built. There were no significant differences in demographic data between both populations. Hyperlipidemia was more frequent in nondiabetic population. Multiple regression model show ankle-brachial index < 0,5, measured in previous 1-3 years (OR 3.39 CI 95% 0.28-40.78), microvascular complication retinopathy (OR 12.98 CI 95% 1.76-95.58), heart failure (OR 1.91 CI 95% 0.29-2.72) and previous prostanoids treatment (OR 15.92 CI 95% 0.53-476.58) as predictors of development of CLI in diabetic population with PAD. After heart failure exclusion of model of nondiabetic pts, previous surgery (OR 3.14 CI 95% 0.61-16.09) and smoking (OR 0.35 CI 95% 0.78-1.62) were presented as prognostic factors for CLI's onset. Our results indicate differences between predictors of CLI's onset in diabetic and nondiabetic population with PAD. Presence of retinopathy, previous measured ankle-brachial index and prostanoids treatment are predictors of development of CLI in diabetic population. Previous surgery is independent predictor for CLI'onset in nondiabetics. Treating concomitant heart failure for both populations

  15. Vascular Effects of Advanced Glycation End-Products: Content of Immunohistochemically Detected AGEs in Radial Artery Samples as a Predictor for Arterial Calcification and Cardiovascular Risk in Asymptomatic Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Katarzyna Janda

    2015-01-01

    Full Text Available Objectives. Our aim was to determine whether vascular deposition of advanced glycation end-products (AGEs is associated with arterial calcification and cardiovascular mortality in chronic kidney disease (CKD patients and to assess the relationships between vascular content of AGEs and selected clinical and biochemical parameters. Materials and Methods. The study comprised 54 CKD patients (33 hemodialyzed, 21 predialyzed. Examined parameters included BMI, incidence of diabetes, plasma fasting glucose, AGEs, soluble receptor for AGEs and 2,2-diphenyl-1-picrylhydrazyl (DPPH scavenging, serum C-reactive protein (hsCRP, plasminogen activator inhibitor-1 (PAI-1, and fetuin-A. Fragments of radial artery obtained during creation of hemodialysis access were stained for calcifications using alizarin red. AGEs deposits were identified immunohistochemically and their relative content was quantified. Results. Vascular content of AGEs was positively correlated with BMI, hsCRP, fetuin-A, PAI-1, and DPPH scavenging in simple regression; only fetuin-A was an independent predictor in multiple regression. There was a significant positive trend in the intensity of AGEs immunostaining among patients with grades 1, 2, and 3 calcifications. AGEs immunostaining intensity predicted 3-year cardiovascular mortality irrespective of patient’s age. Conclusions. The present study demonstrates an involvement of AGEs in the development of medial arterial calcification and the impact of arterial AGE deposition on cardiovascular mortality in CKD patients.

  16. Fatores de risco cardiovasculares em adultos jovens com hipertensão arterial e/ou diabetes mellitus Factores de riesgo cardiovascular en adultos jóvenes con hipertensión y/o diabetes mellitus Cardiovascular risk factors in young adults with arterial hypertension and/or diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Thereza Maria Magalhães Moreira

    2010-12-01

    los eventos posibles, que requieren inversión en la prevención, así como en la formación y mantenimiento del sistema HIPERDIA.In this study we aimed to investigate the risk factors associated with arterial hypertension and diabetes mellitus in young adults assisted in six Family Health Units (UBASF, of Fortaleza, Ceará, Brazil. This is a descriptive and documental study, developed based on the records of the Care Program to Arterial Hypertension and Diabetes Mellitus (HIPERDIA. The sample was composed of 60 records, including hypertensive, diabetics and patients with the two diagnoses. The results showed prevalence of young female adults (78%. Regarding the risk factors, arterial hypertension (n=45, family history (n=33, overweight (n=33 and sedentary lifestyle (n=27 stood out. Regarding the cardiovascular risk stratification, most presented Medium additional risk for cardiovascular disease. We concluded that the individualized evaluation of risk factors supports an action addressed for possible events, being necessary investments in prevention and also in training and maintenance of the HIPERDIA system.

  17. Plaque development, vessel curvature, and wall shear stress in coronary arteries assessed by X-ray angiography and intravascular ultrasound

    OpenAIRE

    Wahle, Andreas; Lopez, John J.; Olszewski, Mark E.; Vigmostad, Sarah C.; Chandran, Krishnan B.; Rossen, James D.; Sonka, Milan

    2006-01-01

    The relationships among vascular geometry, hemodynamics, and plaque development in the coronary arteries are complex and not yet well understood. This paper reports a methodology for the quantitative analysis of in vivo coronary morphology and hemodynamics, with particular emphasis placed on the critical issues of image segmentation and the automated classification of disease severity. We were motivated by the observation that plaque more often developed at the inner curvature of a vessel, pr...

  18. Both paraoxonase-1 genotype and activity do not predict the risk of future coronary artery disease; the EPIC-Norfolk Prospective Population Study.

    Directory of Open Access Journals (Sweden)

    Rakesh S Birjmohun

    Full Text Available BACKGROUND: Paraoxonase-1 (PON1 is an antioxidant enzyme, that resides on high-density lipoprotein (HDL. PON1-activity, is heavily influenced by the PON1-Q192R polymorphism. PON1 is considered to protect against atherosclerosis, but it is unclear whether this relation is independent of its carrier, HDL. In order to evaluate the atheroprotective potential of PON1, we assessed the relationships among PON1-genotype, PON1-activity and risk of future coronary artery disease (CAD, in a large prospective case-control study. METHODOLOGY/PRINCIPAL FINDINGS: Cases (n = 1138 were apparently healthy men and women aged 45-79 years who developed fatal or nonfatal CAD during a mean follow-up of 6 years. Controls (n = 2237 were matched by age, sex and enrollment time. PON1-activity was similar in cases and controls (60.7+/-45.3 versus 62.6+/-45.8 U/L, p = 0.3 and correlated with HDL-cholesterol levels (r = 0.16, p<0.0001. The PON1-Q192R polymorphism had a profound impact on PON1-activity, but did not predict CAD risk (Odds Ratio [OR] per R allele 0.98[0.84-1.15], p = 0.8. Using conditional logistic regression, quartiles of PON1-activity showed a modest inverse relation with CAD risk (OR for the highest versus the lowest quartile 0.77[0.63-0.95], p = 0.01; p-trend = 0.06. PON1-activity adjusted for Q192R polymorphism correlated better with HDL-cholesterol (r = 0.26, p<0.0001 and more linearly predicted CAD risk (0.79[0.64-0.98], p = 0.03; p-trend = 0.008. However, these relationships were abolished after adjustment for HDL (particles-cholesterol-size and apolipoproteinA-I (0.94[0.74-1.18], p-trend = 0.3. CONCLUSIONS/SIGNIFICANCE: This study, shows that PON1-activity inversely relates to CAD risk, but not independent of HDL, due to its close association with the HDL-particle. These data strongly suggest that a low PON1-activity is not a causal factor in atherogenesis.

  19. Risk Management for New Product Development Projects in Food Industry

    Directory of Open Access Journals (Sweden)

    Porananond, D.

    2014-07-01

    Full Text Available Project risk management provides a guideline for decision making in new product development (NPD projects, reducing uncertainty and increasing success rate. However, the acceptance of formal risk management applications in industry, especially for NPD projects is still in question. A study of a food conglomerate in Thailand found that only 9% of NPD projects used a systematic approach for managing risk. 61% of the projects realised the importance of risk management, while the remaining 30% did not involve risk management at all. This study aims to develop a risk management model for NPD projects in the food industry. The first section of this paper reviews the literature on risk management theory, including international standards for risk and project management (ISO31000 and ISO21500, publications for the Project Management Body of Knowledge (PMBOK, by a professional organisation the Project Management Institute (PMI, and also academic research. 182 academic papers, published between January 2002 and August 2012 were selected. The second part interviews conducted with eight NPD experts from five of the major food manufacturers in Thailand to examine their risk management practices and problems. Conclusions are made on five topics : classification of research method, project type and industrial segment, distribution of articles by region, tools & techniques for risk management and risk factors in projects. Specific requirements of risk management for NPD projects in the food industry are identified. A risk management model and the concept of risk management applications for the food industry are proposed.

  20. Peripheral Arterial Disease

    Science.gov (United States)

    Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of ... smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, ...

  1. Polymorphism of the CD36 Gene and Cardiovascular Risk Factors in Patients with Coronary Artery Disease Manifested at a Young Age.

    Science.gov (United States)

    Rać, Monika Ewa; Suchy, Janina; Kurzawski, Grzegorz; Kurlapska, Agnieszka; Safranow, Krzysztof; Rać, Michał; Sagasz-Tysiewicz, Dagmara; Krzystolik, Andrzej; Poncyljusz, Wojciech; Jakubowska, Katarzyna; Olszewska, Maria; Krupa, Beata; Chlubek, Dariusz

    2012-02-01

    This study investigates potential associations between CD36 gene variants and the presence of risk factors in Caucasians with coronary artery disease (CAD) manifested at a young age. The study group consisted of 90 patients; the men were ≤ 50 years old and the women were ≤ 55 years old. Amplicons of exons 4 and 5 including fragments of introns were analyzed by DHPLC. Two polymorphisms were found: IVS3-6 T/C (rs3173798) and IVS4-10 G/A (rs3211892). The C allele of the IVS3-6 T/C polymorphism was associated with higher prevalence of obesity and diabetes, higher hsCRP, lower Lp(a) serum concentrations, and younger age at myocardial infarction. The A allele of the IVS4-10 G/A polymorphism was associated with older age of myocardial infarction and higher white blood cell count. The functional role of CD36 polymorphisms in CAD development needs further research. PMID:22113854

  2. The Juvenile Addiction Risk Rating: Development and Initial Psychometrics

    Science.gov (United States)

    Powell, Michael; Newgent, Rebecca A.

    2016-01-01

    This article describes the development and psychometrics of the Juvenile Addiction Risk Rating. The Juvenile Addiction Risk Rating is a brief screening of addiction potential based on 10 risk factors predictive of youth alcohol and drug-related problems that assists examiners in more accurate treatment planning when self-report information is…

  3. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  4. Exploration Systems Development (ESD) Approach to Enterprise Risk Management

    Science.gov (United States)

    Bauder, Stephen P.

    2014-01-01

    The National Aeronautics and Space Administration (NASA) Exploration Systems Development (ESD) Division has implemented an innovative approach to Enterprise Risk Management under a unique governance structure and streamlined integration model. ESD's mission is to design and build the capability to extend human existence to deep space. The Enterprise consists of three Programs: Space Launch System (SLS), Orion, and Ground Systems Development and Operations (GSDO). The SLS is a rocket and launch system that will be capable of powering humans, habitats, and support systems to deep space. Orion will be the first spacecraft in history capable of taking humans to multiple destinations within deep space. GSDO is modernizing Kennedy's spaceport to launch spacecraft built and designed by both NASA and private industry. ESD's approach to Enterprise Risk Management is commensurate with affordability and a streamlined management philosophy. ESD Enterprise Risk Management leverages off of the primary mechanisms for integration within the Enterprise. The Enterprise integration approach emphasizes delegation of authority to manage and execute the majority of cross-program activities and products to the individual Programs, while maintaining the overall responsibility for all cross-program activities at the Division. The intent of the ESD Enterprise Risk Management approach is to improve risk communication, to avoid replication and/or contradictory strategies, and to minimize overhead process burden. This is accomplished by the facilitation and integration of risk information within ESD. The ESD Division risks, Orion risks, SLS risks, and GSDO risks are owned and managed by the applicable Program. When the Programs have shared risks with multiple consequences, they are jointly owned and managed. When a risk is associated with the integrated system that involves more than one Program in condition, consequence, or mitigation plan, it is considered an Exploration Systems Integration

  5. Risk Management for New Product Development Projects in Food Industry

    OpenAIRE

    Porananond, D.; Thawesaengskulthai, N.

    2014-01-01

    Project risk management provides a guideline for decision making in new product development (NPD) projects, reducing uncertainty and increasing success rate. However, the acceptance of formal risk management applications in industry, especially for NPD projects is still in question. A study of a food conglomerate in Thailand found that only 9% of NPD projects used a systematic approach for managing risk. 61% of the projects realised the importance of risk management, while the remaining 30% d...

  6. Development of Organ-Specific Donor Risk Indices

    OpenAIRE

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in devel...

  7. Development of third Qinshan nuclear power plant risk monitor

    International Nuclear Information System (INIS)

    A risk monitor, an integrated risk analysis tool for real-time monitoring, was widely used in the management of nuclear power plants around the world. A risk monitor prototype system, named RiskAngel, has been developed by FDS Team, China, in which the fault tree analysis engine RiskA was integrated. Based on these, Third Qinshan nuclear power plant Risk Monitor (TQRM) has been developed considering the safety characteristics and the management process of Third Qinshan nuclear power plant. The status and development trend of risk monitor were given in this paper. An overview of the architecture and functions of TQRM was introduced. The key algorithms and technical features were also presented. (authors)

  8. The importance of depression and alcohol use in coronary artery bypass graft surgery patients:risk factors for delirium and poorer quality of life

    Institute of Scientific and Technical Information of China (English)

    Joanne M Humphreys; Linley A Denson; Robert A Baker; Phillip J Tully

    2016-01-01

    ObjectiveToinvestigate whether depression, anxiety and stress increase the risk for delirium and poor quality of life (QOL) after co-ronary artery bypass (CABG) surgery.MethodsA total of 180 CABG patients (mean age of 63.5 ± 10.1 years, 82.2% males) completed baseline and postoperative self-report questionnaires to assess distress and QOL. Incident delirium was diagnosed postoperatively with a structured clinical interview and patients were monitored every day post-operatively for confusion and disturbance in consciousness.Results Delirium developed in 63 persons (35% of sample). After adjustment for covariates, delirium was significantly associated with depression [odds ratio (OR): 1.08; 95% confidence interval (CI): 1.03–1.13,P = 0.003], anxiety (OR: 1.07; 95% CI: 1.02–1.13,P= 0.01) and stress (OR: 1.05; 95% CI: 1.00–1.09,P= 0.03). Preoperative depression scores were associated with poorer QOL including bodily pain (β =-0.39,P = 0.013), vitality (β=-0.32,P = 0.020), social functioning (β=-0.51,P£0.001), emotional role function (β=-0.44,P = 0.003) and general health (β=-0.33,P = 0.038). Among the covariates, harmful levels of alcohol use was consistently associated with poorer QOL.Conclusions Depression and harmful levels of alcohol use were consistently associated with poorer QOL whereas depression, anxiety and stress were associated with delirium risk. These findings point to further research examining depression and harmful levels of alcohol use in coronary heart disease populations undergoing coronary revascularization.

  9. Advanced atherogenic index for the assessment of consolidated lipid risk in premature coronary artery disease patients in India

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar Bansal

    2016-01-01

    Full Text Available Introduction: The high prevalence, severity, and prematurity of coronary artery disease (CAD in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. Aims and Objectives: To calculate newly defined advanced atherogenic index (AAI in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. Material and Methods: One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL, small dense LDL (SD LDL, lipoprotein (a apolipoprotein B (Apo B, and apolipoprotein A1 (Apo A1 were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI and lipid pentad index (LPI. Results: The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20 as compared to controls (305.84 ± 21.80. AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737 as compared to the earlier indices such as AI (P < 0.01, r = 0.52, LTI (P < 0.001, r = 0.677 and LPI (P < 0.001, r = 0.622 in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Conclusion: Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

  10. Making Development Sustainable: The Future of Disaster Risk Management, Global Assessment Report on Disaster Risk Reduction

    OpenAIRE

    Desai, B; Maskrey, A.; Peduzzi, Pascal; De Bono, Andréa; Herold, Christian

    2015-01-01

    The 2015 Global Assessment Report on Disaster Risk Reduction (GAR15), Making Development Sustainable: The Future of Disaster Risk Management, is the fourth in the series coordinated by the United Nations Office for Disaster Risk Reduction (UNISDR) in the context of the Hyogo Frame - work for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters (HFA). This report includes new results regarding the identification of disaster risk. It features a new global characteri...

  11. Development of regulatory technical rationale for risk monitoring program

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Chang Hyun; Kim, Ju Youl; Kim, Yoon Ik; Yang, Hui Chang; Lee, Yong Suk; Ahn, Kwang Won; Kim, Se Hyung [Seoul National Univ., Seoul (Korea, Republic of)

    2002-03-15

    In Korea, the risk monitoring program will be developed and applied to each plants till 2003 by the severe accident management plan to enhance the safety functions of the nuclear power plants. Through this plan, the risk monitoring for the full power and low power and shutdown operation will be performed. Therefore the development of consistent risk monitoring system and overall regulatory guides for the risk monitoring program are necessary. The objective of this study is the development of regulatory technical rationales for the nuclear power plant risk monitoring program and the derivation of the requirements need for the development of risk monitoring system. Through this the improvement of regulatory effectiveness to assure the safe operation of nuclear power plant, is expected.

  12. SERUM LEVEL OF LIPIDS, APOLIPOPROTEINS AND VITAMIN D IN CHILDREN AT HIGH RISK OF CORONARY ARTERY DISEASE

    Directory of Open Access Journals (Sweden)

    M BASHTAM

    2002-06-01

    Full Text Available Introduction. Coronary artery disease (CAD is one of the most prevalent disease in human population that has high prevalence and mortality in lsfahan (Iran. As positive family history and changes in serum lipids and lipoproteins are risk factors of these diseases, and also studies have showed the relationship between serum vitamin D and CAD, we studied serum level of lipids, lipoproteins and vitamin D in high risk children compared with control group, and the relation between serum vitamin D and other factors. Methods. This case-control study was done on 44 subjects (25 boys, 19 girls aged 2-18 years old with positive CAD family history as case group and also 44 persons with negative CAD family history as control group with the same age groups. The subjects were selected by convenience sampling method. Children who consumed antiepilepthic drugs as phenytoin or phenobarbital and those who had positive family histroy for renal stone were excluded for variable vitamin D levels due to drug interaction and genetic susceptibility, respectively. All subjects were invited to Isfahan Cardiovascular Research Center. Using a questionnaire, information on personal characteristics, CVD family history and ... were obtained. A fasting (12-14 hr blood sample was drawn from each one. Serum APOA1, APO B100 and vitamin Dwere measured by radioimmunoassay and serum lipids by ELAN 2000 autoanalyzer. Statistical analysis was done by SPSS. The level of serum APOA1, APO B100 and vitamin D were compared between two groups by independent t test and the relation of the mentioned apolipoproteins with vitamin D was studied using multiple linear regression. Results. Serum vitamin D was significantly lower in case group (P < 0.045. Among studied factors, only triglyceride was significantly higher in control group (P < 0.0001 and also no significant relaitonship was observed between serum APO A1, APO B100 and vitamin D. Sex comparision in case group showed those mean levels

  13. Management of Extracranial Carotid Artery Aneurysm

    NARCIS (Netherlands)

    Welleweerd, J. C.; den Ruijter, H. M.; Nelissen, B. G. L.; Bots, M. L.; Kappelle, L. J.; Rinkel, G. J. E.; Moll, F. L.; de Borst, G. J.

    2015-01-01

    Introduction: Aneurysms of the extracranial carotid artery (ECAA) are rare. Several treatments have been developed over the last 20 years, yet the preferred method to treat ECAA remains unknown. This paper is a review of all available literature on the risk of complications and long-term outcome aft

  14. Risk assessment tools for identifying individuals at risk of developing type 2 diabetes.

    Science.gov (United States)

    Buijsse, Brian; Simmons, Rebecca K; Griffin, Simon J; Schulze, Matthias B

    2011-01-01

    Trials have demonstrated the preventability of type 2 diabetes through lifestyle modifications or drugs in people with impaired glucose tolerance. However, alternative ways of identifying people at risk of developing diabetes are required. Multivariate risk scores have been developed for this purpose. This article examines the evidence for performance of diabetes risk scores in adults by 1) systematically reviewing the literature on available scores and 2) their validation in external populations; and 3) exploring methodological issues surrounding the development, validation, and comparison of risk scores. Risk scores show overall good discriminatory ability in populations for whom they were developed. However, discriminatory performance is more heterogeneous and generally weaker in external populations, which suggests that risk scores may need to be validated within the population in which they are intended to be used. Whether risk scores enable accurate estimation of absolute risk remains unknown; thus, care is needed when using scores to communicate absolute diabetes risk to individuals. Several risk scores predict diabetes risk based on routine noninvasive measures or on data from questionnaires. Biochemical measures, in particular fasting plasma glucose, can improve prediction of such models. On the other hand, usefulness of genetic profiling currently appears limited.

  15. A Dosing/Cross-Development Study of the Multikinase Inhibitor Sorafenib in Patients With Pulmonary Arterial Hypertension

    OpenAIRE

    Gomberg-Maitland, M.; Maitland, ML; Barst, RJ; Sugeng, L; Coslet, S; Perrino, TJ; Bond, L.; LaCouture, ME; Archer, SL; Ratain, MJ

    2009-01-01

    Pulmonary arterial hypertension (PAH) and cancer share elements of pathophysiology. This provides an opportunity for the cross-development of anticancer agents that can be used in improving PAH care. The adaptation of new drugs across these disease populations warrants a structured approach. This study was a 16-week, phase Ib, single-center, open-label trial of the multikinase/angiogenesis inhibitor sorafenib. In order to assess the safety of sorafenib in PAH, patients with advanced but stabl...

  16. ARTERIAL SWITCH OPERATION FOR COMPLETE D-TRANSPOSITION OF THE GREAT ARTERIES:SURGICAL RESULTS AND ANALYSIS

    Institute of Scientific and Technical Information of China (English)

    XU Zhi-wei; DU Xin-wei; SU Zhao-kang; DING Wen-xiang

    2008-01-01

    Objective To review and analyze the surgical results of arterial switch operations in complete D-transposition of the great arteries (TGA ). Methods A total of 113 patients underwent arterial switch operation from Jan. 2001 to Dec. 2005. There were 60 patients with transposition of the great arteries and intact ventricular septum (TGA/IVS) and 53 patients with transposition of the great arteries and ventricular septal defect (TGA/VSD). The lowest body weight was 2.3 kg and the smallest age was 6 h. The arterial switch operation was performed under deep hypothermia with circulatory arrest and low-flow perfusion. Results The total mortality was 9.73%. There were 5 deaths in TGA/IVS (8.3%), 6 deaths in TGA/VSD (11.3%). With the development of surgical technique, peri-operative management and cardiopulmonary bypass, the total mortality significantly decreased from 16.65% in the early times to 5.5% lately. Conclusion The vital risk of the operation is coronary artery malformation. The incidence of coronary artery malformation is higher in TGA/VSD than in TGA/ IVS. The positional relationship of the great arteries does not affect the results of the operation. The arterial switch operation should be prevented when the pressure ratio between the left and right ventricle is less than 0.6, otherwise it is great likely to cause severe low cardiac output postoperatively.

  17. Acoustic detection of coronary artery disease.

    Science.gov (United States)

    Semmlow, John; Rahalkar, Ketaki

    2007-01-01

    Coronary artery disease (CAD) occurs when the arteries to the heart (the coronary arteries) become blocked by deposition of plaque, depriving the heart of oxygen-bearing blood. This disease is arguably the most important fatal disease in industrialized countries, causing one-third to one-half of all deaths in persons between the ages of 35 and 64 in the United States. Despite the fact that early detection of CAD allows for successful and cost-effective treatment of the disease, only 20% of CAD cases are diagnosed prior to a heart attack. The development of a definitive, noninvasive test for detection of coronary blockages is one of the holy grails of diagnostic cardiology. One promising approach to detecting coronary blockages noninvasively is based on identifying acoustic signatures generated by turbulent blood flow through partially occluded coronary arteries. In fact, no other approach to the detection of CAD promises to be as inexpensive, simple to perform, and risk free as the acoustic-based approach. Although sounds associated with partially blocked arteries are easy to identify in more superficial vessels such as the carotids, sounds from coronary arteries are very faint and surrounded by noise such as the very loud valve sounds. To detect these very weak signals requires sophisticated signal processing techniques. This review describes the work that has been done in this area since the 1980s and discusses future directions that may fulfill the promise of the acoustic approach to detecting coronary artery disease.

  18. Development and implementation of a business continuity management risk index.

    Science.gov (United States)

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  19. Triple antithrombotic therapy in patients with atrial fibrillation undergoing coronary artery stenting: hovering among bleeding risk, thromboembolic events, and stent thrombosis

    Directory of Open Access Journals (Sweden)

    Menozzi Mila

    2012-10-01

    Full Text Available Abstract Dual antiplatelet treatment with aspirin and clopidogrel is the antithrombotic treatment recommended after an acute coronary syndrome and/or coronary artery stenting. The evidence for optimal antiplatelet therapy for patients, in whom long-term treatment oral anticoagulation is mandatory, is however scarce. To evaluate the safety and efficacy of the various antithrombotic strategies adopted in this population, we reviewed the available evidence on the management of patients receiving oral anticoagulation, such as a vitamin-k-antagonists, referred for coronary artery stenting. Atrial fibrillation is the most frequent indication for oral anticoagulation. The need of starting antiplatelet therapy in this clinical scenario raises concerns about the combination to choose: triple therapy with warfarin, aspirin, and a thienopyridine being the most frequent and advised. The safety of this regimen appeared suboptimal because of an increased risk in hemorrhagic complications. On the other hand, the combination of oral anticoagulation and an antiplatelet agent is suboptimal in preventing thromboembolic events and stent thrombosis; dual antiplatelet therapy may be considered only when a high hemorrhagic risk and low thromboembolic risk are perceived. Indeed, the need for prolonged multiple-drug antithrombotic therapy increases the bleeding risks when drug eluting stents are used. Since current evidence derives mainly from small, single-center and retrospective studies, large-scale prospective multicenter studies are urgently needed.

  20. Risk loci for coronary artery calcification replicated at 9p21 and 6q24 in the Heinz Nixdorf Recall Study

    Directory of Open Access Journals (Sweden)

    Pechlivanis Sonali

    2013-02-01

    Full Text Available Abstract Background Atherosclerosis is the primary cause of coronary heart disease (CHD, preceding the onset of cardiovascular disease by decades in most cases. Here we examine the association between single nucleotide polymorphisms (SNPs integrated on Metabochip and coronary artery calcification (CAC, a valid risk factor for CHD, in an unselected, population-based German cohort. Methods The Metabochip is a custom iSELECT array containing >195,000 SNPs that was designed to support large-scale follow-up of putative associations for metabolic and cardiovascular-associated traits. We used generalized linear regression models to explore the impact of Metabochip SNPs on quantitative CAC in 4,329 participants. Results The 9p21 variant, rs1537373, was most strongly associated (Beta = 0.30; 95% confidence interval (CI = 0.21-0.39; p = 4.05x10-11 with quantitative CAC. The second strongest association with CAC was with rs9349379 in the phosphatase and actin regulator 1 gene, PHACTR1, (Beta = 0.30; 95% CI = 0.22-0.40; p = 4.67x10-11. Both SNPs remained nominally significant in dichotomized analyses for the presence of any CAC (odds ratiors1537373 (OR = 1.19; 95% CI = 1.07-1.31; p = 0.001 and ORrs9349379 = 1.26; 95% CI = 1.14-1.40; p = 1.5x10-5. Fine mapping of the 9p21 and PHACTR1 gene region revealed several other SNPs that were strongly associated with CAC. Conclusion We demonstrate that SNPs near 9p21 and in PHACTR1 that have previously been shown to be associated with CHD are strongly associated with CAC in the Heinz Nixdorf Recall Study cohort. Our findings suggest that the 9p21 and 6q24 loci might be involved in cardiac outcome via promoting development of atherosclerosis in the coronary arteries.

  1. Seven elements for capacity development for disaster risk reduction

    OpenAIRE

    Hagelsteen, Magnus; Becker, Per

    2012-01-01

    Capacity development for disaster risk reduction is an important process to substantially reduce disaster losses, which threaten sustainable development and the achievement of the Millennium Development Goals. This paper presents a theoretical framework with seven elements for capacity development for disaster risk reduction that has been tested in practise with noteworthy results. The seven elements are: (1) Terminology, (2) Local context, (3) Ownership, (4) Capacity assessment, (5) Roles an...

  2. Clinical risk factors for gestational hypertensive disorders in pregnant women at high risk for developing preeclampsia

    NARCIS (Netherlands)

    Wong, Tsz Y.; Groen, Henk; Faas, Marijke M.; van Pampus, Maria G.

    2013-01-01

    Objectives: To evaluate clinical risk factors for the development of gestational hypertensive disorders in a group of pregnant women at high risk for developing preeclampsia. Secondly we evaluated the incidence and recurrence rate of preeclampsia and pregnancy-induced hypertension. Study design: A p

  3. Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Zeeshan Anwar

    2011-01-01

    Full Text Available Background and Purpose: Extracranial superficial temporal artery (STA calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Materials and Methods: Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD. CT head examinations were reviewed to identify and associate STA calcification with 1 risk factors for the vascular calcification, 2 intracranial artery calcification, and 3 cerebral ischemia (white matter and/or cortical ischemic changes. Results: STA calcification was present in 9.9% (45/453 of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45 in patients with STA calcification and 9.3% (38/408 in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037 was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221. Conclusion: The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus.

  4. Risk identification and evaluation of customer collaboration in product development

    Directory of Open Access Journals (Sweden)

    Xuefeng Zhang

    2015-05-01

    Full Text Available Purpose: The purpose of this paper is to identify risk factors that caused by customer collaboration in new product development systematically, and propose an approach to judge which risk factors are critical and catch substantial attention. Design/methodology/approach: This study identifies risk factors according to the results of case studies of enterprises in china. On this basis, an improved rough number approach is put forward to evaluate the importance of risk factors. Findings: Firstly, classify risk factors into three aspects. Then, present a risk factor set, which include thirty-seven risk factors. At last, determine which risk factors are critical by using an improved rough number approach. Originality/value: Considering there are few researches studying comprehensive risk factors of customer collaboration and assessing them, this paper explores a risk factor set of customer collaboration in product development stage, and proposes a novel approach, which can help to solve the problem of subjective, vague and lack of prior information of evaluation, to evaluate risk factors.

  5. Natural killer cells and CD4+ T-cells modulate collateral artery development

    NARCIS (Netherlands)

    Weel, V. van; Toes, R.E.M.; Seghers, L.; Deckers, M.M.L.; Vries, M.R. de; Eilers, P.H.; Sipkens, J.; Schepers, A.; Eefting, D.; Hinsbergh, V.W.M. van; Bockel, J.H. van; Quax, P.H.A.

    2007-01-01

    OBJECTIVE - The immune system is thought to play a crucial role in regulating collateral circulation (arteriogenesis), a vital compensatory mechanism in patients with arterial obstructive disease. Here, we studied the role of lymphocytes in a murine model of hindlimb ischemia. METHODS AND RESULTS -

  6. Is arterial hypertension crucial for the development of cerebral haemorrhage in premature infants?

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    . It is suggested that premature neonates are hypertensive when their blood-pressure is compared with that in utero, and that events that lead to further rises in pressure are common. Their capillaries are not protected against rises in arterial pressure because autoregulation is impaired. Furthermore...

  7. Development of Improved Caprock Integrity and Risk Assessment Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bruno, Michael [Geomechanics Technologies, Incorporated, Monrovia, CA (United States)

    2014-09-30

    GeoMechanics Technologies has completed a geomechanical caprock integrity analysis and risk assessment study funded through the US Department of Energy. The project included: a detailed review of historical caprock integrity problems experienced in the natural gas storage industry; a theoretical description and documentation of caprock integrity issues; advanced coupled transport flow modelling and geomechanical simulation of three large-scale potential geologic sequestration sites to estimate geomechanical effects from CO₂ injection; development of a quantitative risk and decision analysis tool to assess caprock integrity risks; and, ultimately the development of recommendations and guidelines for caprock characterization and CO₂ injection operating practices. Historical data from gas storage operations and CO₂ sequestration projects suggest that leakage and containment incident risks are on the order of 10-1 to 10-2, which is higher risk than some previous studies have suggested for CO₂. Geomechanical analysis, as described herein, can be applied to quantify risks and to provide operating guidelines to reduce risks. The risk assessment tool developed for this project has been applied to five areas: The Wilmington Graben offshore Southern California, Kevin Dome in Montana, the Louden Field in Illinois, the Sleipner CO₂ sequestration operation in the North Sea, and the In Salah CO₂ sequestration operation in North Africa. Of these five, the Wilmington Graben area represents the highest relative risk while the Kevin Dome area represents the lowest relative risk.

  8. Perceived Likelihood of Developing Diabetes Among High-Risk Oregonians

    Directory of Open Access Journals (Sweden)

    Angela M. Kemple, MS

    2005-11-01

    Full Text Available Introduction Prevention of diabetes in people at highest risk for developing the disease is an important public health opportunity, considering the disease’s increasing prevalence, its devastating impact on health and its high economic cost, the availability of efficacious and cost-effective treatments to reduce complications, and recent evidence that it can be delayed or prevented with lifestyle interventions. Methods The Oregon Diabetes Prevention and Control Program collected and analyzed responses from a statewide telephone survey conducted in 2003 to determine whether Oregon adults at highest risk for diabetes 1 believed that they were at risk for developing diabetes in the future, 2 had talked with a health care professional about diabetes, and 3 had been tested for the disease. Pearson chi-square tests and logistic regression analyses were conducted to identify independent associations of select characteristics with the study factors of interest. Results Even among respondents at highest risk for developing diabetes, at most one third reported being concerned about developing diabetes, one fifth reported having discussed their risk with a health professional in the previous year, and less than half reported having been tested for diabetes by a health provider in the previous year. After adjusting for multiple factors, we found that having a family history of diabetes was consistently associated with perceived risk of developing diabetes, discussion about diabetes with a health professional, and diabetes testing. Conclusion Many Oregon adults at high risk for developing diabetes are unconcerned about their risk for developing the disease, and few have discussed their risk of diabetes with a health professional. Findings from this study suggest the need for increased recognition of future diabetes risk by high-risk individuals and health professionals to help translate diabetes prevention into practice.

  9. Haptoglobin genotype predicts development of coronary artery calcification in a prospective cohort of patients with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Simpson Melissa

    2011-11-01

    Full Text Available Abstract Background Coronary artery disease has been linked with genotypes for haptoglobin (Hp which modulates extracorpuscular hemoglobin. We hypothesized that the Hp genotype would predict progression of coronary artery calcification (CAC, a marker of subclinical atherosclerosis. Methods CAC was measured three times in six years among 436 subjects with type 1 diabetes and 526 control subjects participating in the Coronary Artery Calcification in Type 1 Diabetes (CACTI study. Hp typing was performed on plasma samples by polyacrylamide gel electrophoresis. Results The Hp 2-2 genotype predicted development of significant CAC only in subjects with diabetes who were free of CAC at baseline (OR: 1.95, 95% CI: 1.07-3.56, p = 0.03, compared to those without the Hp 2-2 genotype, controlling for age, sex, blood pressure and HDL-cholesterol. Hp 2 appeared to have an allele-dose effect on development of CAC. Hp genotype did not predict CAC progression in individuals without diabetes. Conclusions Hp genotype may aid prediction of accelerated coronary atherosclerosis in subjects with type 1 diabetes.

  10. Environmental risks of shale gas development in China

    International Nuclear Information System (INIS)

    Shale gas development in China can generate great potential economic benefits, but also poses serious environmental risks. In this paper, we offer a macro assessment of the environmental risks of shale gas development in China. We use the US experience to identify the nature of shale gas development activities and the types of potential burdens these activities may create. We then review the baseline environmental conditions and the effectiveness of environmental regulations in China and discuss the implications of these China-specific factors for risk assessment. We recommend China to conduct a strategic environmental assessment and to consider sector-specific environmental regulations. - Highlights: • We assess the environmental risks of shale gas development in China. • We use the US experience to identify the potential environmental burdens. • The effectiveness of environmental regulations in China is generally weak. • China lacks environmental regulations specific to the oil and gas sector. • We recommend China to adopt policies to reduce environmental risks

  11. [Thr arteries of the male sex organs of Japanese quail (Coturnix coturnix japonica) and their development after hatching].

    Science.gov (United States)

    Okamoto, T; Vollmerhaus, B; Roos, H; Waibl, H; König, H E

    1992-06-01

    A total of 83 male Japanese quails of the following age groups were used for this study: 11, 18, 25, 32, 35, 37, 39, 41, 43 days, and 7, 9, 17 weeks after hatching. Neoprene-Latex, Tensol-Cement, and the china ink were injected via the aortic arch. In most of male Japanese quails, the testes are supplied by the A. testicularis originated from the Aorta descendens through a common trunk with the A. renalis cranialis. But in only 3 quails had this artery originated directly from the Aorta descendens on either side. In 9 quails had the A. testicularis accessoria originating independently from the Aorta descendens and running cranially or caudally in short distance to the normal A. testicularis. The arteries for the Ductus deferens were divided into 3 categories. The Rami ureterodeferentiales craniales were spread out from A. testicularis or Rami epididymales. The Rami ureterodeferentiales medii came from the A. renalis media and the A. renalis caudalis. The Rami ureterodeferentiales caudales originated from the A. caudae lateralis and A. pudenda. The Receptaculum ductus deferentis, the Corpus vasculare paracloacalis and the Phallus nonprotrudens in the Cloaca were supplied from the thick Ramus cloacalis of the A. pudenda. The Ramus bursalis of this artery supplied the Glandula proctodaealis and the Bursa cloacalis, and was also thick. The arteries to the genital organs were observed in the 11 day old male quail. The A. pudenda began developing at about 30 days after hatching when the quail's body matured. While the A. testicularis began developing at about 40 days after hatching when the male Japanese quail was full of the spermatogenic activity. PMID:1497141

  12. The development of risk acceptance and moral valuation

    Energy Technology Data Exchange (ETDEWEB)

    Sjoeberg, L. [Stockholm School of Economics, Center for Risk Research, Stockholm (Sweden); Torell, G. [Univ. of Gothenburg, Dept. of Psychology (Sweden)

    1991-12-01

    The relationship between acceptability of risk and moral valuation of risky activities was investigated in children, 10-16 years old. It was found that all age groups exhibited a strong correlation between the two dimensions of risky activities. Older children were more tolerant of risk taking than younger children. Individual actions were judged in a more lenient manner than collective actions. Girls tended to be more morally condemning towards risk taking, but the youngest girls were not less prone to accept risks than boys. General measures of moral development according to Piaget and Kohlberg were not associated with perceived acceptability of risk or the judged morality of risky activities but relations were found between risk taking and assertiveness and perceived freedom, which were the most important factors in accounting for risk and morality attitudes. 22 refs, 9 figs, 4 tabs.

  13. The development of risk acceptance and moral valuation

    International Nuclear Information System (INIS)

    The relationship between acceptability of risk and moral valuation of risky activities was investigated in children, 10-16 years old. It was found that all age groups exhibited a strong correlation between the two dimensions of risky activities. Older children were more tolerant of risk taking than younger children. Individual actions were judged in a more lenient manner than collective actions. Girls tended to be more morally condemning towards risk taking, but the youngest girls were not less prone to accept risks than boys. General measures of moral development according to Piaget and Kohlberg were not associated with perceived acceptability of risk or the judged morality of risky activities but relations were found between risk taking and assertiveness and perceived freedom, which were the most important factors in accounting for risk and morality attitudes. 22 refs, 9 figs, 4 tabs

  14. ADDRESSING THE RISKS OF GLOBAL PRODUCT DEVELOPMENT

    DEFF Research Database (Denmark)

    Hansen, Zaza Nadja Lee; Ahmed-Kristensen, Saeema

    2011-01-01

    Offshoring various stages in the product development process – from engineering tasks like R&D and design to manufacturing activities - can impact the development process, the product and the organisation. Some of these impacts are positive while some are negative. The negative impacts are relate...

  15. Development of risk monitoring tool for nuclear power plant applications using probabilistic risk assessment

    International Nuclear Information System (INIS)

    Systematic and comprehensive Probabilistic Risk Assessment (PRA) uses to evaluate risks for the Nuclear Power Plant (NPP), and the risk information is also used to enhance the rationality and accountability of safety related activities, and to realize efficient management in NPPs. The regulatory and the industry are discussing the standard and guideline for the various types of PRA and management for the near-future actual usage. 'Risk Monitoring' is the essential item for the PRA usage and risk-informed activities, and we assume 'At-power risk monitoring in case of On-Line Maintenance' and 'Shutdown risk evaluation for every outage' are 2 key issues for 'Risk Monitoring'. Our company NEL has developed a risk monitoring tool called COSMOS to support above 2 issues. The evaluation objective is different among above 2 issues, and COSMOS has 2 separated modules COSMOS-FP (for at-power) and COSMOS-SD (for shutdown) with the different quantification manners. This paper describes the detailed contents of COSMOS as the risk monitoring tool, and also describes the actual usages of 'At-power risk monitoring in case of On-Line Maintenance' and 'Shutdown risk evaluation for every outage'. (author)

  16. Information Disclosure in Environmental Risk Management: Developments in China

    OpenAIRE

    Arthur P.J. Mol; Guizhen He; Lei Zhang

    2011-01-01

    Entering the twenty-first century, China has been the site of many serious environmental disasters and accidents. These have strengthened the call for the establishment of an environmental risk management system and for the development of new policies to effectively manage risk. Among the new policies in China’s environmental risk management strategy are pollution insurance and information disclosure. This paper explores information disclosure policies through the implementation of the Enviro...

  17. Correlation Between Biophysical Profile and Middle Cerebral/Umbilical Artery Resistance Index Ratio in the Assessment of Prenatal Outcome in High Risk Pregnancies

    Directory of Open Access Journals (Sweden)

    Nazanin Eshraghi

    2009-01-01

    Full Text Available  Introduction: Antenatal fetal surveillance tests have led to a significant decrease in perinatal mortality and morbidity rates, especially in high risk pregnancies (e.g placenta previa, intrauterine growth retardation. But there is no concurrence on the best and accurate modality yet. The aim of this study is to evaluate the accuracy of antenatal assessment with biophysical profile and Doppler sonography (cerebral and umbilical artery regarding fetal acidosis and asphyxia. "nMaterials and Methods: This is a cross-sectional study on fetuses of seventy women with a 28-42 week singleton pregnancy who had hypertension (pre eclampsia, diabetes mellitus or intra uterine growth retardation and were admitted as high risk pregnancies to AL-Zahra hospital. The study population routinely underwent sonographic evaluation of cerebral and umbilical arteries and a biophysical profile twice a week until the end of pregnancy. "nResults: Infants who had a lower score of biophysical profile, had a lower umbilical PH and a negative base deficit. Fetuses with a lower MCA/Umb. A RI had a higher base deficit and acidosis (measured from umbilical blood after birth. Apgar on minute 5 was higher in infants with a history of higher profile score as well as a higher MCA/Umb. A. RI ratio. On the other hand; there was no significant correlation between MCA RI and umbilical PH. Correlation between Umb. A. RI and umbilical PH was not significant either. "nConclusion: Biophysical profile and assessment of the umbilical and cerebral arteries are valuable modalities for predicting the fetal condition and the outcome in high risk pregnancies. MCA/Umb. A RI Index ratio is a better indicator compared to its components.

  18. Comparison of common carotid artery intima-media thickness between Brazilian Euro-descendants and Afro-descendants with atherosclerosis risk factors

    Directory of Open Access Journals (Sweden)

    Ivan Benaduce Casella

    2009-01-01

    Full Text Available OBJECTIVE: To compare common carotid intima-media thickness (IMT between the two major Brazilian ethnic groups (those of African descent and those of European descent among individuals with one or more risk factors for atherosclerotic disease. METHOD: Two hundred and six patients with one or more risk factors for atherosclerotic disease were evaluated in a cross-sectional study in which their clinical, ethnic and Demographic characteristics were collected. All patients underwent duplex ultrasound examination of their carotid vessels to obtain IMT measurements. RESULTS: One hundred and fifty-three patients (74.3% had a carotid IMT greater than 1.0 mm at one or more point of measurement in at least one common carotid artery. There was a significant correlation between older age and mean carotid wall thickness (R=0.479 / P<0.01. Multivariate analysis identified male sex, arterial hypertension and older age as variables associated with increased IMT (P<0.05 for all variables. When IMT was compared between the two ethnic groups in this study, no significant differences were noted. Euro-descendants and Afro-descendants had similar IMT values, even when the groups were stratified by degree of IMT (normal vs. increased and presence of stroke and/or transient ischemic attack (yes vs. no. CONCLUSIONS: The risk factors associated with increased common carotid artery IMT in Brazilian individuals are similar to those in previously described populations. No differences were observed between the two main Brazilian ethnic groups. Longitudinal studies are required for a better evaluation of the incidence, etiologic factors and evolution of carotid intimomedial thickening in this population.

  19. Long-Term Prospective Study of the Influence of Estrone Levels on Events in Postmenopausal Women with or at High Risk for Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Antonio de Padua Mansur

    2012-01-01

    Full Text Available Background. The link between endogenous estrogen, coronary artery disease (CAD, and death in postmenopausal women is uncertain. We analyzed the association between death and blood levels of estrone in postmenopausal women with known coronary artery disease (CAD or with a high-risk factor score for CAD. Methods. 251 postmenopausal women age 50–90 years not on estrogen therapy. Fasting blood for estrone and heart disease risk factors were collected at baseline. Women were grouped according to their estrone levels (<15 and ≥15 pg/mL. Fatal events were recorded after 5.8±1.4 years of followup. Results. The Kaplan-Meier survival curve showed a significant trend (P=0.039 of greater all-cause mortality in women with low estrone levels (<15 pg/mL. Cox multivariate regression analysis model adjusted for body mass index, diabetes, dyslipidemia, family history, and estrone showed estrone (OR=0.45; P=0.038 as the only independent variable for all-cause mortality. Multivariate regression model adjusted for age, body mass index, hypertension, diabetes, dyslipidemia, family history, and estrone showed that only age (OR=1.06; P=0.017 was an independent predictor of all-cause mortality. Conclusions. Postmenopausal women with known CAD or with a high-risk factor score for CAD and low estrone levels (<15 pg/mL had increased all-cause mortality.

  20. Radiation risks to the developing nervous system

    International Nuclear Information System (INIS)

    The present abstract book contains the abstracts of 23 papers presented at the meeting. They are dealing with the effect of pre- or postnatal irradiation on the brain morphology metabolism or development studied in mice, rats or rabbits. (MG)

  1. Developing a Pedagogy of Risk in Socio-Scientific Issues

    Science.gov (United States)

    Levinson, Ralph; Kent, Phillip; Pratt, David; Kapadia, Ramesh; Yogui, Cristina

    2011-01-01

    The aim of this research is to develop principles for a pedagogy of risk in socio-scientific issues. Risk is challenging to teach because of its contested conceptual basis incorporating epistemic and non-epistemic values, its situated nature and its mathematical basis in probability and statistics. In our project--"Promoting Teachers'…

  2. Polymorphism of the CD36 Gene and Cardiovascular Risk Factors in Patients with Coronary Artery Disease Manifested at a Young Age

    OpenAIRE

    Rać, Monika Ewa; Suchy, Janina; Kurzawski, Grzegorz; Kurlapska, Agnieszka; Safranow, Krzysztof; Rać, Michał; Sagasz-Tysiewicz, Dagmara; Krzystolik, Andrzej; Poncyljusz, Wojciech; Jakubowska, Katarzyna; Olszewska, Maria; Krupa, Beata; Chlubek, Dariusz

    2011-01-01

    This study investigates potential associations between CD36 gene variants and the presence of risk factors in Caucasians with coronary artery disease (CAD) manifested at a young age. The study group consisted of 90 patients; the men were ≤ 50 years old and the women were ≤ 55 years old. Amplicons of exons 4 and 5 including fragments of introns were analyzed by DHPLC. Two polymorphisms were found: IVS3-6 T/C (rs3173798) and IVS4-10 G/A (rs3211892). The C allele of the IVS3-6 T/C polymorphism w...

  3. Metabolic Syndrome-Associated Risk Factors and High-Sensitivity C-Reactive Protein Independently Predict Arterial stiffness in 9903 Subjects With and Without Chronic Kidney Disease

    OpenAIRE

    Tsai, Sung-Sheng; Lin, Yu-Sheng; Lin, Chia-Pin; Hwang, Jawl-Shan; Wu, Lung-Sheng; Chu, Pao-Hsien

    2015-01-01

    Abstract Metabolic syndrome (MS), high-sensitivity C-reactive protein (hs-CRP), and chronic kidney disease (CKD) are related to cardiovascular diseases. Although MS is common in CKD subjects, the contribution of MS-associated risk factors and hs-CRP to arterial stiffness in CKD has not been well studied. In this cross-sectional cohort study, we enrolled 9903 subjects who underwent brachial-ankle pulse wave velocity (baPWV) measurements from our database of Health Care Center. CKD was defined ...

  4. New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease

    OpenAIRE

    Patel, Mitul

    2016-01-01

    Jesse Naghi, Ethan A Yalvac, Ali Pourdjabbar, Lawrence Ang, John Bahadorani, Ryan R Reeves, Ehtisham Mahmud, Mitul Patel Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, CA, USA Abstract: Peripheral arterial disease (PAD) involving the lower extremity is a major source of morbidity and mortality. Clinical manifestations of PAD span the spectrum from lifestyle limiting claudication to ulceration and gangrene leading to amputation. Advanc...

  5. Development of a tonometric sensor for measurement and recording of arterial pressure waveform

    Science.gov (United States)

    Tomczuk, K.; Werszko, M.; Sasiadek, J. Z.; Kosek, J.; Berny, W.; Weiser, A.; Feder-Kubis, J.

    2013-09-01

    There are many techniques and devices for measurement and recording of arterial blood pressure. Some of them allow (enable) additionally to observe the shape of a wave of arterial pressure, which can be regarded as one of the most important diagnostic parameters of human cardiovascular system. This paper presents a novel design and prototype of a new, non-invasive blood waveform measuring device. It expounds theoretical and experimental (including latest preliminary clinical) results obtained during several years of extensive investigations into blood pressure waveform measuring and monitoring problem. According to investigations performed in the laboratory and preliminary clinical evaluation, the sensor has linear steady-state characteristics and satisfactory dynamic properties. It is an efficient and accurate tool for blood pressure waveform monitoring and assessing the cardiovascular condition of the patients. The novelty of this solution is that the device is equipped with a pneumatic pressure sensor based on the pneumatic nozzle flapper amplifier principle with negative feedback. Due to such a technical solution, the device does not require any cuff, which remains an essential component of the majority of contemporary non-invasive blood pressure measurement devices; therefore, it can be used on the artery where the application of a cuff would be impossible (e.g., carotid artery). This advantage makes possible to obtain an accurate shape of blood pressure waveform with high fidelity, comparable to a direct measurement method. Moreover, during the measurement the device converts directly "pressure into pressure." Such a principle of operation makes possible to eliminate additional calibration (at the current stage of research we have eliminated the necessity of calibration in laboratory conditions).

  6. Development of a system utilizing data of risk assessment

    International Nuclear Information System (INIS)

    This report deals with a concrete method of utilizing data of risk assessment. First, the authors point out the necessity to assess all stages of jobs (planning, meeting with contractors, performing phase of task, etc.) in risk assessment bout jobs in electric power company, because most jobs are performed by contract system and risks of a job are distributed over electric company, contractors and subcontractors. Secondly, risks estimated from past accidents and near-miss events must be included. If these 2 requirements are fulfilled, data of risk assessment can be more useful. Then below 4 forms of present data of risk assessment were developed. A form to be used in job planning stage in electric companies for efficient investment planning in safety measures. A form to be used in meetings between electric companies and contractors for checking accident prevention methods. A form to be used in meetings between contractors and subcontractors for enhancing a shared awareness of risk. A form to be used in tool box meetings for confirming safe condition and inheriting of ability of risk perception. Additionally, a data base system of risk assessment about 4 jobs was developed. This system prints out about 4 forms for each job and is useful for PDCA of safety activities. (author)

  7. Neurocognitive development of risk aversion from early childhood to adulthood

    Directory of Open Access Journals (Sweden)

    David ePaulsen

    2012-01-01

    Full Text Available Human adults tend to avoid risk. In behavioral economic studies, risk aversion is manifest as a preference for sure gains over uncertain gains. However, children tend to be less averse to risk than adults. Given that many of the brain regions supporting decision making under risk do not reach maturity until late adolescence or beyond it is possible that mature risk-averse behavior may emerge from the development of decision-making circuitry. To explore this hypothesis, we tested 6- to 8-year-old children, 14- to 16-year-old adolescents, and young adults in a risky-decision task during functional magnetic resonance imaging (fMRI data acquisition. We found a number of decision-related brain regions to increase in activation with age during decision making, including areas associated with contextual memory retrieval and the incorporation of prior outcomes into the current decision-making strategy, e.g. insula, hippocampus and amygdala. Further, children who were more risk averse showed increased activation during decision making in vmPFC and ventral striatum. Our findings indicate that the emergence of adult levels of risk aversion co-occurs with the recruitment of regions supporting decision making under risk, including the integration of prior outcomes into current decision-making behavior. This pattern of results suggests that individual differences in the development of risk aversion may reflect differences in the maturation of these neural processes.

  8. Dengue: the risk to developed and developing countries.

    OpenAIRE

    Monath, T P

    1994-01-01

    Dengue viruses are members of the Flaviviridae, transmitted principally in a cycle involving humans and mosquito vectors. In the last 20 years the incidence of dengue fever epidemics has increased and hyperendemic transmission has been established over a geographically expanding area. A severe form, dengue hemorrhagic fever (DHF), is an immunopathologic disease occurring in persons who experience sequential dengue infections. The risk of sequential infections, and consequently the incidence o...

  9. Efficacy of optimal long-term management of multiple cardiovascular risk factors (CVD) on walking and quality of life in patients with peripheral artery disease (PAD): Protocol for randomized controlled trial

    OpenAIRE

    Oka, Roberta K; Conte, Michael S; Owens, Christopher D; Rapp, Joseph; Fung, Gordon; Alley, Hugh F.; Giacomini, John C; Myers, Jonathan; Mohler, Emile R.

    2012-01-01

    Peripheral artery disease (PAD) is an understudied chronic illness most prevalent in elderly individuals. PAD patients experience substantial walking impairment due to symptoms of limb ischemia that significantly diminishes quality of life (QOL). Cardiovascular disease (CVD) morbidity and mortality is increased in this population because of aggressive atherosclerosis resulting from untreated CVD risk factors. Despite current national guidelines recommending intensive CVD risk factor managemen...

  10. Defining the residual risk of adverse perinatal outcome in growth restricted fetuses with normal umbilical artery blood flow.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2014-07-25

    To determine the cause of adverse perinatal outcome in fetal growth restriction(FGR) where umbilical artery Doppler(UA) was normal, as identified from the Prospective Observational Trial to Optimize Pediatric Health(PORTO). We compared cases of adverse outcome where UA Doppler was normal and abnormal.

  11. Data density curves of B-mode ultrasound arterial wall thickness measurements in unaffected control and at-risk populations

    NARCIS (Netherlands)

    de Groot, E; Hovingh, GK; Zwinderman, AH; Wiegman, A; Smit, AJ; Kastelein, JJP

    2005-01-01

    Aim. Atherosclerosis is a slow disease process of arterial walls with onset decades prior to its clinical manifestations. Lifelong follow-up data may help to identify and understand the pathophysiology of this process. These longitudinal data are scarce. Using a standardized imaging and image analys

  12. Effects of angiotensin-converting enzyme inhibition in low-risk patients early after coronary artery bypass surgery

    NARCIS (Netherlands)

    Rouleau, Jean L.; Warnica, Wayne J.; Baillot, Richard; Block, Pierre J.; Chocron, Sidney; Johnstone, David; Myers, Martin G.; Calciu, Cristina-Dana; Dalle-Ave, Sonia; Martineau, Pierre; Mormont, Christine; van Gilst, Wiek H.

    2008-01-01

    Background-Early after coronary artery bypass surgery (CABG), activation of numerous neurohumoral and endogenous vasodilator systems occurs that could be influenced favorably by angiotensin-converting enzyme inhibitors. Methods and Results-The Ischemia Management with Accupril post -bypass Graft via

  13. Development of Integrated Assessment Technology of Risk and Performance

    International Nuclear Information System (INIS)

    The main idea and contents are summarized as below 1) Development of new risk/performance assessment system innovating old labor-intensive risk assessment structure - New consolidated risk assessment technology from various hazard(flood, fire, seismic in NPP) - BOP model development for performance monitoring - Consolidated risk/performance management system for consistency and efficiency of NPP 2) Resolution technology for pending issues in PSA - Base technology for PSA of digital I and C system - Base technology for seismic PSA reflecting domestic seismic characteristics and aging effect - Uncertainty reduction technology for level 2 PSA and best estimation of containment failure frequency 3) Next generation risk/performance assessment technology - Human-induced error reduction technology for efficient operation of a NPP

  14. About risk factors in the development of thrombotic complications in patients with chronic myeloprolipherative diseases

    Directory of Open Access Journals (Sweden)

    Nikolayenko-Kamyshova T.P.

    2013-03-01

    Full Text Available Steady increasing number of patients with the diseases com¬plicated by thromboses and embolisms requires intensified study. Practically in all oncologic and oncogematologic patients readiness for the development of thrombotic complications is formed even before changes in hemo¬stasiogramm. In the hematologic clinic the problem of thrombotic compli¬cations especially acute in patients with chronic myeloprolipherative diseases (CMD: the manifestation of disease at the age of 50-70 years, its benign prolonged course with factors, which burden vascularly - thrombocytic changes – hypertonic disease, ischemic heart disease, metabolic syndrome - they aggravate the forecast of disease. The purpose of the work was to estimate influence of the risk factors of thrombotic complications in patients with CMD. Possible risk factors in the development of thrombotic complication in 110 patients with CMD were investigated. In 38 of them vascular complications, occurred which manifested in the age group of 50 years and over. During the expressed plethora and or progression of myelopro¬lipherative syndrome in combination with arterial hypertension, coronary heart disease, atherothrombosis of lower extremities vessels as well as changed laboratory data (significant increase of Hb, RBC,WBC,PLT; high level of cholesterol, LDH, uric acid in connection with high level of throm¬botic aggregation greatly enhance the risk of thrombotic complications. Taking into account complex of these changes and administration of the corresponding complex therapy it is possible to warn life threatening states.

  15. Determinants of exercise peak arterial blood pressure, circulatory power, and exercise cardiac power in a population based sample of Finnish male and female aged 30 to 47 years: the Cardiovascular Risk in Young Finns Study

    OpenAIRE

    Hulkkonen, Janne; Aatola, Heikki; Pälve, Kristiina; Lehtimäki, Terho; Hutri-Kähönen, Nina; Viikari, Jorma SA; Raitakari, Olli T.; Kähönen, Mika

    2014-01-01

    Background Novel parameters derived from peak maximal oxygen uptake (VO2) and exercise arterial blood pressure, such as peak circulatory power (CP) and exercise cardiac power (ECP), can be used in the risk assessment of cardiovascular disease and stroke. However, the determinants of these factors are poorly characterized in the general population. Methods We assessed peak arterial blood pressure, CP and ECP with standardized cardiopulmonary exercise test (CPET) on 281 female and 257 male part...

  16. Transportation risk management program: A strategy for development and communication

    International Nuclear Information System (INIS)

    The U.S. Department of Energy's Office of Civilian Radioactive Waste Management (OCRWM) has been engaged in designing a comprehensive system for the shipment of civilian spent nuclear fuel and high-level radioactive waste for many years. Now that Yucca Mountain, Nevada, has been approved for development as the site for the Nation's first geologic repository, a comprehensive approach to risk management for the transportation program is timely and appropriate. This paper briefly describes the approach OCRWM will take to ensure that it develops a transportation risk management program that is effective in addressing the potential risks to the program and is also inclusive of and transparent to its stakeholders. (author)

  17. Developing points-based risk-scoring systems in the presence of competing risks.

    Science.gov (United States)

    Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

    2016-09-30

    Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:27197622

  18. Design and Development of Ontology Suite for Software Risk Planning, Software Risk Tracking and Software Risk Control

    Directory of Open Access Journals (Sweden)

    C. R.R. Robin

    2011-01-01

    Full Text Available Problem statement: Ontology as a conceptual courseware structure may work as a mind tool for effective teaching and as a visual navigation interface to the learning objects. Knowledge visualization is defined as the use of visual representations to transfer knowledge between at least two persons. This study presents the design, development and visualization of ontologies for Software Risk Planning, Software Risk Tracking and Software Risk Controlling. Approach: The ontologies are developed using protégé tool, an effective ontology editor and it is represented by the formal knowledge representational language OWL. In order to increase the richness of the knowledge available in the ontologies, its semantic representation is presented using ontology document generator. Finally the ontologies are effectively visualised using OntoViz. Results: The ontologies represent the domain knowledge Software Risk Planning, Software Risk Tracking and Software Risk Controlling respectively and is developed with the indention to use it as a knowledge base for effective knowledge representation, Knowledge Management and E-Learning applications. The constructed ontologies are evaluated using quantitative analysis and qualitative analysis. Conclusion: Since the average reuse ratio is 0.95, the developed ontologies are highly cohesive. Comparison of concepts and properties used in the ontologies proved that the developed ontologies are concept oriented ontology. The both quantitative and qualitative analysis says, the developed ontologies are ready to use for applications such as E-Learning, Knowledge Management.

  19. Anterior Tibial Artery Pseudoaneurysm following Ankle Arthroscopy in a Hemophiliac Patient.

    Science.gov (United States)

    Chamseddin, Khalil H; Kirkwood, Melissa L

    2016-07-01

    Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We present the second case of anterior tibial artery pseudoaneurysm formation secondary to ankle arthroscopy in a hemophiliac patient and suggest that these individuals are at higher risk for developing complications associated with arterial injury. Furthermore, potential risk factors include port placement, anatomic variation of the vessels, and nature of the arthroscopic procedure. We recommend steps to prevent complications in hemophiliac patients. PMID:27174350

  20. Fatores de risco associados à pressão arterial elevada em adolescentes Risk factors associated with high blood pressure in adolescents

    Directory of Open Access Journals (Sweden)

    Kelly Samara da Silva

    2007-08-01

    Full Text Available Níveis elevados de pressão arterial (PA na infância e adolescência têm sido freqüentemente associados a outros fatores de risco cardiovasculares, além de hipertensão arterial na fase adulta da vida. O presente estudo objetivou identificar fatores de risco associados à PA elevada em adolescentes. Participaram do estudo 674 adolescentes de escolas públicas e privadas, de ambos os sexos (303 rapazes e 371 moças, com idade de 14 a 17 anos (16,5 DP 0,9, da cidade de João Pessoa, Paraíba. Mediante aplicação de um questionário, foram levantadas informações sobre: a indicadores sociodemográficos; b nível de prática da atividade física; c hábitos alimentares; c índice de massa corporal; e fumo e bebidas alcoólicas; e foram realizadas medidas de PA. A prevalência de PA elevada foi de 7,4%, sendo maior nos rapazes (10,2% quando comparada com a das moças (5,1%, p High levels of arterial blood pressure in childhood and adolescence have been often associated with other cardiovascular risk factors apart from arterial hypertension in the adult stage of life. The present study aimed at identifying risk factors associated with high blood pressure in adolescents. The subjects were 674 adolescents from public and private schools in the city of João Pessoa, Paraíba. These subjects were of both sexes (i.e., 303 boys and 371 girls and their ages spanned from 14 to 17 years old. By means of a questionnaire, information about the following aspects was gathered: a socio-demographic status; b physical activity levels; c eating habits; d body mass index; e consumption of alcohol and smoking. Moreover, measurements of arterial pressure (AP showed that the prevalence of high AP was 7.4 %, being higher in boys (10.2% when compared with girls (5.1%, p < 0.01. The results of the multivaried analysis indicated that overweight adolescents displayed from five to six times more chance of having high AP than adolescents with light/normal weight (boys: OR

  1. Evaluation of variation in the lipid profile and risk for coronary artery disease in healthy male individuals with respect to age

    Directory of Open Access Journals (Sweden)

    Gino Abraham

    2014-04-01

    Full Text Available Background: Coronary Artery Disease (CAD is one of the commonest causes of death affecting both sexes worldwide. It is the leading cause of mortality in developed countries. The measurement of lipids, lipoproteins and apolipoproteins has long been recognized as necessary for the diagnosis and clinical management of disorders of lipoprotein metabolism. On the basis of this, the present study was performed to compare the serum lipid profile in males of different age groups. Methods: The present cross-sectional study was conducted after the institutional ethical clearance. The male subjects between the ages of 20-59 were included in the study. Blood was collected from the subjects after an overnight fast of 12 hours who were also advised to refrain from non-vegetarian food for 3 days. Estimation of serum total cholesterol was done by using the cholesterol kit which uses modified Allain's method for estimating serum cholesterol. Serum triglyceride was estimated using the triglyceride kit which is based on GPO-POD method. Estimation of serum HDL cholesterol was done using cholesterol kit which uses modified Allain's method. Serum LDL cholesterol level was calculated using the Friedewald's formula, LDL cholesterol = Total cholesterol - (HDL-C + TG/5. Estimation of fasting blood sugar was done using GOD-POD method. The lipid levels with risk for CAD were performed based on Framingham heart study. Statistical analysis was done by unpaired t-test for group wise comparison and P value <0.05 was considered statistically significant. Results: The lipid levels on comparison in 2 successive age groups of males, that is 20-29 and 30-39 years; and 30-39 and 40-49years; 40-49 and 50-59 years, it was found that the mean values of total cholesterol, triglyceride, LDL-C and the ratio of TC/HDL-C and LDL-C/HDL-C are increased while HDL-C is decreased in the older age group. Conclusion: From the present study it is understood that as age advances total cholesterol

  2. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants : risk factors, risk predictors and risk determinants

    NARCIS (Netherlands)

    Van der Velden, U.; Abbas, F.; Armand, S.; Loos, B. G.; Timmerman, M. F.; Van der Weijden, G. A.; Van Winkelhoff, A. J.; Winkel, E. G.

    2006-01-01

    Objective: To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. Material and Methods: For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on Wes

  3. Relations of Digital Vascular Function, Cardiovascular Risk Factors, and Arterial Stiffness: The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) Cohort Study

    Science.gov (United States)

    Brant, Luisa C. C.; Hamburg, Naomi M.; Barreto, Sandhi M.; Benjamin, Emelia J.; Ribeiro, Antonio L. P.

    2014-01-01

    Background Vascular dysfunction is an early expression of atherosclerosis and predicts cardiovascular (CV) events. Peripheral arterial tonometry (PAT) evaluates basal pulse amplitude (BPA), endothelial function (PAT ratio), and wave reflection (PAT‐AIx) in the digital microvessels. In Brazilian adults, we investigated the correlations of PAT responses to CV risk factors and to carotid‐femoral pulse wave velocity (PWV), a measure of arterial stiffness. Methods and Results In a cross‐sectional study, 1535 participants of the ELSA‐Brasil cohort underwent PAT testing (52±9 years; 44% women). In multivariable analyses, more‐impaired BPA and PAT ratios were associated with male sex, higher body mass index (BMI), and total cholesterol/high‐density lipoprotein. Higher age and triglycerides were related to higher BPA, whereas lower systolic blood pressure, hypertension (HTN) treatment, and prevalent CV disease (CVD) were associated with lower PAT ratio. PAT‐AIx correlated positively with female sex, advancing age, systolic and diastolic blood pressures, and smoking and inversely to heart rate, height, BMI, and prevalent CVD. Black race was associated with lower BPA, higher PAT ratio, and PAT‐AIx. Microvessel vasodilator function was not associated with PWV. Higher PAT‐AIx was modestly correlated to higher PWV and PAT ratio and inversely correlated to BPA. Conclusion Metabolic risk factors are related to impaired microvessel vasodilator function in Brazil. However, in contrast to studies from the United States, black race was not associated with an impaired microvessel vasodilator response, implying that vascular function may vary by race across populations. PAT‐AIx relates to HTN, may be a valid measure of wave reflection, and provides distinct information from arterial stiffness. PMID:25510401

  4. Risk Management In Construction Projects Of Developing Countries

    Directory of Open Access Journals (Sweden)

    Divya Gupta

    2015-11-01

    Full Text Available Managing risks in construction projects has been perceived as a very important management process so as to accomplish the undertaking goals as far as time, cost, quality, safety and environmental sustainability. Projects have become shared effort of multiple parties and construction industry is a good example of an area, where the project outcome is delivered in an extremely complex actor network. By adopting risk management, savings’ potentials can be realized in construction projects. For this reason, consideration of the risk management process is worthwhile for project managers as well as real estate developers. The implementation of risk management system in construction projects must be oriented towards the progress of the project and pervade all areas, functions and processes of the project. For analyzing the levels of various risk factors in construction industry, questionnaire surveys were used to collect data. Based on a comprehensive assessment of the likelihood of occurrence of various risks and their impacts on the project objectives, this paper identifies twenty major risk factors. This research found that these risks are mainly related to (in ranking contractors, clients and designers, with a few related to government bodies, subcontractors/suppliers and external issues. Among them, “Financial Risk” is recognized to influence all project destinations maximally, whereas working in hot areas, closure, defective design and delayed payments on contract are also some important risk factors. This research also found that these risks spread through the whole project life cycle and many risks occur in more than one phase, with the construction stage as the most risky phase, followed by the feasibility stage. It is concluded that clients, designers and government bodies must work cooperatively from the feasibility phase onwards to address potential risks in time. Also contractors and subcontractors with robust construction and

  5. Risks as a category of evaluation of innovative development: construction

    Directory of Open Access Journals (Sweden)

    Korol' Svetlana Pavlovna

    2016-02-01

    Full Text Available Construction sector of the economy is an open system, which operates under conditions of uncertainty and risks caused by environmental factors and direct the activities of the elements of this system. The development of the construction industry at all levels of regulated strategic, medium-term and operational plans of socio-economic development and annual plans of production, including innovation and development. Planned activities can initiate innovative appearance of the risks not only directly in their implementation, but also in the elements of the system, providing various combinations of risk situations. Determination of the existing combination of uncertainties and risks is performed in order to assess their effect on the innovation activities and economic efficiency.

  6. DEVELOPMENT OF A RISK SCREENING METHOD FOR CREDITED OPERATOR ACTIONS

    International Nuclear Information System (INIS)

    DEVELOPMENT OF A RISK SCREENING METHOD FOR CREDITED OPERATOR ACTIONS. THE U.S. NUCLEAR REGULATORY COMMISSION (NRC) REVIEWS THE HUMAN FACTORS ASPECTS OF PROPOSED LICENSE AMENDMENTS THAT IMPACT HUMAN ACTIONS THAT ARE CREDITED IN A PLANTS SAFETY ANALYSIS. THE STAFF IS COMMITTED TO A GRADED APPROACH TO THESE REVIEWS THAT FOCUS RESOURCES ON THE MOST RISK IMPORTANT CHANGES. THEREFORE, A RISK INFORMED SCREENING METHOD WAS DEVELOPED BASED ON AN ADAPTATION OF EXISTING GUIDANCE FOR RISK INFORMED REGULATION AND HUMAN FACTORS. THE METHOD USES BOTH QUANTITATIVE AND QUALITATIVE INFORMATION TO DIVIDE THE AMENDMENT REQUESTS INTO DIFFERENT LEVELS OF REVIEW. THE METHOD WAS EVALUATED USING A VARIETY OF TESTS. THIS PAPER WILL SUMMARIZE THE DEVELOPMENT OF THE METHODOLOGY AND THE EVALUATIONS THAT WERE PERFORMED TO VERIFY ITS USEFULNESS

  7. Polygenic Risk, Rapid Childhood Growth, and the Development of Obesity

    Science.gov (United States)

    Belsky, Daniel W.; Moffitt, Terrie E.; Houts, Renate; Bennett, Gary G.; Biddle, Andrea K.; Blumenthal, James A.; Evans, James P.; Harrington, HonaLee; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Caspi, Avshalom

    2012-01-01

    Objective To test how genomic loci identified in genome-wide association studies influence the development of obesity. Design A 38-year prospective longitudinal study of a representative birth cohort. Setting The Dunedin Multidisciplinary Health and Development Study, Dunedin, New Zealand. Participants One thousand thirty-seven male and female study members. Main Exposures We assessed genetic risk with a multilocus genetic risk score. The genetic risk score was composed of single-nucleotide polymorphisms identified in genome-wide association studies of obesity-related phenotypes. We assessed family history from parent body mass index data collected when study members were 11 years of age. Main Outcome Measures Body mass index growth curves, developmental phenotypes of obesity, and adult obesity outcomes were defined from anthropometric assessments at birth and at 12 subsequent in-person interviews through 38 years of age. Results Individuals with higher genetic risk scores were more likely to be chronically obese in adulthood. Genetic risk first manifested as rapid growth during early childhood. Genetic risk was unrelated to birth weight. After birth, children at higher genetic risk gained weight more rapidly and reached adiposity rebound earlier and at a higher body mass index. In turn, these developmental phenotypes predicted adult obesity, mediating about half the genetic effect on adult obesity risk. Genetic associations with growth and obesity risk were independent of family history, indicating that the genetic risk score could provide novel information to clinicians. Conclusions Genetic variation linked with obesity risk operates, in part, through accelerating growth in the early childhood years after birth. Etiological research and prevention strategies should target early childhood to address the obesity epidemic. PMID:22665028

  8. Accounting for Risk: developing a new research agenda for risk appraisal in high-technology ventures

    OpenAIRE

    Gavin C Reid; Julia A Smith

    1999-01-01

    This work concerns the development of new methods of accounting for risk in high-technology ventures. The paper enquires into attitudes to risk and skills at risk management, in the relationship between high-technology firms and their venture capital backers. The basic prescription behind the proposed approach, building on work by the authors and co-workers [Reid (1996,1999), Reid, Terry and Smith (1997)], and other recent developments [e.g. Fiet (1995a,b)], is that as the venture capital ind...

  9. Risk Analysis of New Product Development Using Bayesian Networks

    Directory of Open Access Journals (Sweden)

    MohammadRahim Ramezanian

    2012-06-01

    Full Text Available The process of presenting new product development (NPD to market is of great importance due to variability of competitive rules in the business world. The product development teams face a lot of pressures due to rapid growth of technology, increased risk-taking of world markets and increasing variations in the customers` needs. However, the process of NPD is always associated with high uncertainties and complexities. To be successful in completing NPD project, existing risks should be identified and assessed. On the other hand, the Bayesian networks as a strong approach of decision making modeling of uncertain situations has attracted many researchers in various areas. These networks provide a decision supporting system for problems with uncertainties or probable reasoning. In this paper, the available risk factors in product development have been first identified in an electric company and then, the Bayesian network has been utilized and their interrelationships have been modeled to evaluate the available risk in the process. To determine the primary and conditional probabilities of the nodes, the viewpoints of experts in this area have been applied. The available risks in this process have been divided to High (H, Medium (M and Low (L groups and analyzed by the Agena Risk software. The findings derived from software output indicate that the production of the desired product has relatively high risk. In addition, Predictive support and Diagnostic support have been performed on the model with two different scenarios..

  10. Risk Analysis of New Product Development Using Bayesian Networks

    Directory of Open Access Journals (Sweden)

    Mohammad Rahim Ramezanian

    2012-01-01

    Full Text Available The process of presenting new product development (NPD to market is of great importance due to variability of competitive rules in the business world. The product development teams face a lot of pressures due to rapid growth of technology, increased risk-taking of world markets and increasing variations in the customers` needs. However, the process of NPD is always associated with high uncertainties and complexities. To be successful in completing NPD project, existing risks should be identified and assessed. On the other hand, the Bayesian networks as a strong approach of decision making modeling of uncertain situations has attracted many researchers in various areas. These networks provide a decision supporting system for problems with uncertainties or probable reasoning. In this paper, the available risk factors in product development have been first identified in an electric company and then, the Bayesian network has been utilized and their interrelationships have been modeled to evaluate the available risk in the process. To determine the primary and conditional probabilities of the nodes, the viewpoints of experts in this area have been applied. The available risks in this process have been divided to High (H, Medium (M and Low (L groups and analyzed by the Agena Risk software. The findings derived from software output indicate that the production of the desired product has relatively high risk. In addition, Predicti