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Sample records for include coronary heart

  1. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

  2. Exercise Benefits Coronary Heart Disease.

    Science.gov (United States)

    Wang, Lei; Ai, Dongmei; Zhang, Ning

    2017-01-01

    Coronary heart disease (CHD) is a group of diseases that include: no symptoms, angina, myocardial infarction, ischemia cardiomyopathy and sudden cardiac death. And it results from multiple risks factors consisting of invariable factors (e.g. age, gender, etc.) and variable factors (e.g. dyslipidemia, hypertension, diabetes, smoking, etc.). Meanwhile, CHD could cause impact not only localized in the heart, but also on pulmonary function, whole-body skeletal muscle function, activity ability, psychological status, etc. Nowadays, CHD has been the leading cause of death in the world. However, many clinical researches showed that exercise training plays an important role in cardiac rehabilitation and can bring a lot of benefits for CHD patients.

  3. Dietary fiber and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Pereira, Mark A; O'Reilly, Eilis; Augustsson, Katarina

    2004-01-01

    BACKGROUND: Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk...... of coronary heart disease. METHODS: We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease. RESULTS: Over 6 to 10 years of follow-up, 5249 incident total coronary cases...... associated with risk of coronary heart disease....

  4. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... not as great as men's. Heredity (Including Race) Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart ...

  5. NEUROTICISM PROFILE IN CORONARY HEART DISEASE

    OpenAIRE

    Bhargava, S. C.; Sharma, S. N.; Agarwal, B. V.

    1980-01-01

    SUMMARY Thirty seven cases of coronary heart disease and 30 normal healthy controls were administered Hindi version of MHQ. The coronary heart disease patients scored significantly higher on total neuroticism, free-floating anxiety and somatic anxiety subscales of MHQ.

  6. Homocysteine and coronary heart disease

    DEFF Research Database (Denmark)

    Clarke, Robert; Bennett, Derrick A; Parish, Sarah

    2012-01-01

    Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR) appreci......Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR...

  7. Coronary Heart Disease and Exercises

    Directory of Open Access Journals (Sweden)

    Tolga SAKA

    2016-06-01

    Full Text Available Coronary heart disease is a chronic process, of which the progression can rapidly change the functional capacity of patients. In CAD patients, the quality of life can be improved with an appropriate exercise prescription. This article explains how a safe exercise program for CAD patients can be prescribed.

  8. Behavior patterns and coronary heart disease

    Science.gov (United States)

    Townsend, J. C.; Cronin, J. P.

    1975-01-01

    The relationships between two behavioral patterns, cardiac risk factors, and coronary heart disease are investigated. Risk factors used in the analysis were family history of coronary disease, smoking, cholesterol, obesity, systotic blood pressure, diastolic blood pressure, blood sugar, uric acid, erythrocyte sedimentation rate, and white blood unit. It was found that conventional, non-behavioral pattern risk factors alone were not significantly related to coronary heart disease.

  9. Chelation for Coronary Heart Disease

    Science.gov (United States)

    ... more rare are serious and potentially fatal side effects that can include heart failure, a sudden drop in blood pressure, abnormally low calcium levels in the blood (hypocalcemia), permanent kidney damage, and bone marrow depression (blood ...

  10. Congenital Heart Defects and Coronary Anatomy

    OpenAIRE

    Mawson, John B.

    2002-01-01

    Coronary artery anomalies are a well recognized feature of many cardiac malformations and have been catalogued in a number of reviews. This overview concentrates on 1) the interplay between congenital heart defects and coronary morphogenesis, examining how some of the embryology fits with the experiments of nature encountered in clinical practice; and 2) the influence of coronary anatomy on patient management. This overview uses, as examples, pulmonary atresia with intact ventricular septum, ...

  11. PLACENTAL GROWTH FACTOR AND CORONARY NEOANGIOGENESIS IN CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    M. V. Tulikov

    2013-01-01

    Full Text Available Neoangiogenesis in coronary heart disease is a protective reaction aimed to improve ischemic myocardial perfusion, by increasing the number and size of arterial collaterals. Placental growth factor (PlGF is one of the key peptides regulating angiogenic processes in atherosclerosis. In particular, a number of investigators have shown that injection of recombinant PlGF into the system or regional blood flow can stimulate neoangiogenesis. On the other hand, there is evidence confirming the involvement of PlGF in the progression of atherosclerosis and in the development of acute coronary syndrome. In this connection, the problem of investigating the efficiency and safety of possible use of PlGF preparations, as well as its place in the diagnosis of coronary heart disease and acute coronary syndrome remains urgent

  12. Psychosocial factors in coronary heart disease

    Science.gov (United States)

    French, J. R. P., Jr.; Chaplan, R. D.

    1969-01-01

    The relationship between job satisfaction and coronary heart disease is explored for blue and white collar groups, different personalities and physiological risk factors. Differences found among administrators, engineers and scientists with regard to variables associated with heart disease are in terms of physiology, personality, reported job stress, and smoking.

  13. Smoking, Stress, and Coronary Heart Disease.

    Science.gov (United States)

    Epstein, Leonard H.; Perkins, Kenneth A.

    1988-01-01

    Focuses on the interrelation between stressors and smoking, and on its potential impact on coronary heart disease risk beyond that due to stressors or to smoking alone. Reviews evidence supporting the stress-smoking interrelationship, its relevance to the risk of heart disease, and mechanisms explaining why smokers smoke more during stress and why…

  14. Cyanotic Congenital Heart Disease The Coronary Arterial Circulation

    Science.gov (United States)

    Perloff, Joseph K

    2012-01-01

    Background: The coronary circulation in cyanotic congenital heart disease (CCHD) includes the extramural coronary arteries, basal coronary blood flow, flow reserve, the coronary microcirculation, and coronary atherogenesis. Methods: Coronary arteriograms were analyzed in 59 adults with CCHD. Dilated extramural coronaries were examined histologically in six patients. Basal coronary blood flow was determined with N-13 positron emission tomography in 14 patients and in 10 controls. Hyperemic flow was induced by intravenous dipyridamole pharmacologic stress. Immunostaining against SM alpha-actin permitted microcirculatory morphometric analysis. Non-fasting total cholesterols were retrieved in 279 patients divided into four groups: Group A---143 cyanotic unoperated, Group B---47 rendered acyanotic by reparative surgery, Group C---41 acyanotic unoperated, Group D---48 acyanotic before and after operation. Results: Extramural coronary arteries were mildly or moderately dilated to ectatic in 49/59 angiograms. Histologic examination disclosed loss of medial smooth muscle, increased medial collagen, and duplication of internal elastic lamina. Basal coronary flow was appreciably increased. Hyperemic flow was comparable to controls. Remodeling of the microcirculation was based upon coronary arteriolar length, volume and surface densities. Coronary atherosclerosis was absent in both the arteriograms and the necropsy specimens. Conclusions: Extramural coronary arteries in CCHD dilate in response to endothelial vasodilator substances supplemented by mural attenuation caused by medial abnormalities. Basal coronary flow was appreciably increased, but hyperemic flow was normal. Remodeling of the microcirculation was responsible for preservation of flow reserve. The coronaries were atheroma-free because of the salutory effects of hypocholesterolemia, hypoxemia, upregulated nitric oxide, low platelet counts, and hyperbilirubinrmia. PMID:22845810

  15. Sedentary lifestyle and state variation in coronary heart disease mortality.

    Science.gov (United States)

    Yeager, K K; Anda, R F; Macera, C A; Donehoo, R S; Eaker, E D

    1995-01-01

    Using linear regression, the authors demonstrated a strong association between State-specific coronary heart disease mortality rates and State prevalence of sedentary lifestyle (r2 = 0.34; P = 0.0002) that remained significant after controlling for the prevalence of diagnosed hypertension, smoking, and overweight among the State's population. This ecologic analysis suggests that sedentary lifestyle may explain State variation in coronary heart disease mortality and reinforces the need to include physical activity promotion as a part of programs in the States to prevent heart disease. PMID:7838933

  16. Antioxidant vitamins and coronary heart disease risk

    DEFF Research Database (Denmark)

    Knekt, Paul; Ritz, John; Pereira, Mark A

    2004-01-01

    BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake...

  17. Dyslipidaemia and coronary heart disease: nature vs nurture.

    Science.gov (United States)

    Hegele, R A

    In order to enhance health care for patients with coronary heart disease (CHD), genetic markers of susceptibility could be incorporated into a formula for risk evaluation that includes traditional factors. Preventive measures could then be targeted towards 'high-risk' subjects. But can the genetic component be dissected from the environmental component in an intermediate CHD phenotype, such as plasma lipoproteins.

  18. Tea and coronary heart disease : protection through estrogenlike activity?

    NARCIS (Netherlands)

    Geleijnse, J.M.; Witteman, J.C.; Launer, L.J.; Lamberts, S.J.; Pols, H.A.

    2000-01-01

    Tea drinking appears to be protective against coronary heart disease in a number of epidemiologic studies. It has been suggested that tea flavonols with antioxidative activity, including quercetin, kaempferol, and myricetin,1 could account for the favorable effect on cardiovascular health. In the

  19. Environmental Stress and Biobehavioral Antecedents of Coronary Heart Disease.

    Science.gov (United States)

    Krantz, David S.; And Others

    1988-01-01

    Provides an overview of research on the biobehavioral antecedents of coronary heart disease, including stressful occupational settings characterized by high demands and little control over the job, and the Type A pattern, particularly hostility and mode of anger expression (anger-in). Discusses research on physiologic responsiveness (reactivity)…

  20. Inflammatory cytokines and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Kaptoge, Stephen; Seshasai, Sreenivasa Rao Kondapally; Gao, Pei

    2014-01-01

    Because low-grade inflammation may play a role in the pathogenesis of coronary heart disease (CHD), and pro-inflammatory cytokines govern inflammatory cascades, this study aimed to assess the associations of several pro-inflammatory cytokines and CHD risk in a new prospective study, including meta...

  1. High density lipoproteins, dyslipidemia, and coronary heart disease

    National Research Council Canada - National Science Library

    2010-01-01

    ... with premature coronary heart disease (CHD). These familial disorders include lipoprotein(a) excess, dyslipidemia (high triglycerides and low HDL), combined hyperlipidemia (high cholesterol and high triglycerides often with low HDL), hypoalphalipoproteinemia (low HDL), and hypercholesterolemia. We discuss the management of these disorders. W...

  2. Carbon monoxide and coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Scheidemandel, V

    1974-01-01

    Studies on the relationship between increased carboxyhemoglobin levels in the blood and coronary heart disease in smokers and city dwellers are reviewed. The evidence of myocardial infarction is significantly higher in smokers than in nonsmokers which is due, apart from nicotine which promotes coronary arteriosclerosis, to inhaled carbon monoxide which leads to increased carboxyhemoglobin levels and most likely plays a role in the risk of arteriosclerosis and the coronary heart disease. Apart from combining with hemoglobin, CO increases the circulation rate and the coronary blood flow, and reduces the coronary arteriovenous oxygen difference, which is indicative of a reduced rate of oxygen extraction by the myocardium against an increased myocardial oxygen demand. The reduction of the oxygen extraction correlates with the increased COHb level. Inhaled CO lowers the threshold of angina pectoris due to the reduced myocardial oxygen tension. Also, considerable reduction of the oxygen diffusion from the capillaries toward the mitochondria due to the combination of CO with myoglobin is observed. Chronically increased CO levels in the blood and tissues not only accelerate the development of arteriosclerosis, but also induce a process directly injurious to the myocardial metabolism. (Air Pollut. Abstr.)

  3. What Is Coronary Heart Disease?

    Science.gov (United States)

    ... is: 12 ounces of beer 5 ounces of wine 1½ ounces of liquor Maintaining a Healthy Weight ... Your Heart U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans Talk with ...

  4. [Coronary heart disease: epidemiologic-genetic aspects].

    Science.gov (United States)

    Epstein, F H

    1985-01-01

    Coronary heart disease and the risk factors which predispose to it aggregate in families. How much of this clustering of disease is "explained" by the familial resemblance in predisposing factors? The published reports which bear on this question fall into six distinct study designs: prospective studies, persons at high or low risk or persons with and without a positive family history as points of departure, case-control studies, studies of patients who had a coronary angiogram and studies in different ethnic groups. The findings of the 16 investigations reviewed suggest that there are as yet unidentified factors - genetic, environmental or both - which are responsible for familial clustering of coronary heart disease, apart from the three main risk factors (serum lipids, blood pressure, smoking) and diabetes. Future research must put greater emphasis on studies of families rather than individuals and on closer collaboration between epidemiologists and geneticists, in order to fill these gaps in knowledge. It is likely that the individual predisposition to coronary heart disease is due in part to genetic influences which remain to be discovered in the course of such studies. They would help in identifying susceptible person in the population with greater precision than is now possible. The "high-risk strategy" of coronary heart disease prevention will become more efficient as more specific and sensitive tests of disease prediction are developed. In the meantime, preventive programmes must be put into action on the basis of what is already known, on the level of both the high-risk and the community-wide mass strategy.

  5. Coronary heart disease is not significantly linked to acute kidney injury identified using Acute Kidney Injury Group criteria.

    Science.gov (United States)

    Yayan, Josef

    2012-01-01

    Patients with unstable angina or myocardial infarction are at risk of acute kidney injury, which may be aggravated by the iodine-containing contrast agent used during coronary angiography; however, the relationship between these two conditions remains unclear. The current study investigated the relationship between acute kidney injury and coronary heart disease prior to coronary angiography. All patients were evaluated after undergoing coronary angiography in the cardiac catheterization laboratory of the Vinzentius Hospital in Landau, Germany, in 2011. The study group included patients with both acute coronary heart disease and acute kidney injury (as defined according to the classification of the Acute Kidney Injury Group); the control group included patients without acute coronary heart disease. Serum creatinine profiles were evaluated in all patients, as were a variety of demographic and health characteristics. Of the 303 patients examined, 201 (66.34%) had coronary artery disease. Of these, 38 (18.91%) also had both acute kidney injury and acute coronary heart disease prior to and after coronary angiography, and of which in turn 34 (16.91%) had both acute kidney injury and acute coronary heart disease only prior to the coronary angiography. However, the occurrence of acute kidney injury was not significantly related to the presence of coronary heart disease (P = 0.95, Chi-square test). The results of this study indicate that acute kidney injury is not linked to acute coronary heart disease. However, physicians should be aware that many coronary heart patients may develop kidney injury while hospitalized for angiography.

  6. Coronary Heart Disease and Emotional Intelligence.

    Science.gov (United States)

    Vlachaki, Chrisanthy; Maridaki Kassotaki, Katerina

    2013-09-23

    Coronary Heart Disease (CHD) is associated with emotions, especially negative ones, namely anxiety and depression. Emotional Intelligence (EI) is a psychological model that consists of a variety of emotional skills. The aim of the present study was to examine the relation between different dimensions of Emotional Intelligence and coronary heart disease. A total of 300 participants were studied during a 3-year period in an attempt to partially replicate and further expand a previous study conducted in Greece among CHD patients, which indicated a strong association between certain dimensions of Emotional Intelligence and the incidence of CHD. All participants completed a self-report questionnaire, assessing several aspects of Emotional Intelligence. The results showed that there is a link between the regulation of emotions and the occurrence of CHD. The evidence reported in the present study makes stronger the claim that EI plays a significant role in the occurrence of CHD.

  7. [THE INFLUENCE OF MONO- AND MULTIVASCULAR LESIONS OF CORONARY ARTERIES ON THE COURSE OF CORONARY HEART DISEASE IN PATIENTS WITH DIABETES MELLITUS TYPE 2].

    Science.gov (United States)

    Sypalo, A; Kravchun, P; Kadykova, O

    2017-03-01

    The article assesses the influence of mono- and multivascular lesions of coronary arteries on the course of coronary heart disease at patients with diabetes mellitus type 2. For this purpose, a comprehensive survey of 75 patients with coronary heart disease and diabetes mellitus type 2 was arranged. Depending on the number of vascular lesions of the coronary arteries, according to the data of coronary arteries computer tomography, all patients were divided into two subgroups. The first subgroup included 27 patients with coronary heart disease and diabetes mellitus type 2 with monovascular lesions of coronary arteries. To the second subgroup were included 48 patients with coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries. During the analysis of carbohydrate metabolism in cases of coronary heart disease and diabetes mellitus type 2 the HOMA index increase by 25.40% and insulin level increase by 17.05% were revealed at patients with multivascular lesions of coronary arteries in comparison with patients with monovascular lesions of coronary arteries, respectively. The combination of coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries was associated with an increase of sortilin level (233,47±47,85 ng/l). A significant increase in triglycerides, lipoprotein cholesterol of very low density influences greatly on the progression of coronary atherosclerosis with lesions of greater number of coronary arteries at patients surveyed. At patients with coronary heart disease and diabetes mellitus type 2 with multivascular lesions of coronary arteries the left ventricle myocardial re-modeling occurred through the increase of left ventricle's size and cavity.

  8. Association of heart rate profile during exercise with the severity of coronary artery disease.

    Science.gov (United States)

    Cay, Serkan; Ozturk, Sezgin; Biyikoglu, Funda; Yildiz, Abdulkadir; Cimen, Tolga; Uygur, Belma; Tuna, Funda

    2009-05-01

    Coronary artery disease is the leading cause of morbidity and mortality around the world. Autonomic nervous system abnormalities are associated with coronary artery disease and its complications. Exercise stress tests are routinely used for the detection of the presence of coronary artery disease. In this study, we observed the association between heart rate profile during exercise and the severity of coronary artery disease. One hundred and sixty patients with abnormal exercise treadmill test (> or =1 mm horizontal or downsloping ST-segment depression; 119 men, 41 women; mean age = 57 +/- 9 years) were included in the study. Use of any drug affecting heart rate was not permitted. Resting heart rate before exercise, maximum heart rate during exercise, and resting heart rate after exercise (5 min later) were measured and two parameters were calculated: heart rate increment (maximum heart rate - resting heart rate before exercise) and heart rate decrement (maximum heart rate - resting heart rate after exercise). All patients underwent selective coronary angiography and subclassified into two groups according to stenotic lesion severity. Group 1 had at least 50% of stenotic lesion and group 2 had less than 50%. Patients in the first group had increased resting heart rate, decreased maximum heart rate, decreased heart rate increment, and decreased heart rate decrement compared with second group. All patients were classified into tertiles of resting heart rate, heart rate increment, and heart rate decrement level to evaluate whether these parameters were associated with severity of coronary artery stenosis in the study. The multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 21.888 (95% confidence interval 6.983-68.606) for the highest tertile of resting heart rate level compared with the lowest tertile. In addition, the multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 20.987 (95% confidence interval 6

  9. Comparative assessment of the diets of healthy individuals, subjects with preclinical coronary heart disease and patients with severe heart diseases

    International Nuclear Information System (INIS)

    Aronov, D.M.; Eganyan, R.A.; Kovaleva, O.F.; Zhidko, N.I.; Danielov, G.Eh.; Rozhnov, A.V.; Shcherbakova, I.A.

    1991-01-01

    92 males aged 26 to 55 (28 healthy individuals, 45 persons with preclinical coronary heart disease and 19 patients with functional class 1-2 coronary heart disease) were examined to study the peculiarities and dietary patterns of persons with a high physical working capacity and having no typical clinical signs of the disease. All persons were subjected to a complex examination which included questionnarire, myocardial scintigraphy with 201 Tl at a maximum physical loading, echocardiography, coronaroangiography. Certain dietary peculiarities are established in persons with preclinical coronary heart disease

  10. Psychological factors and coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hadži-Pešić Marina

    2007-01-01

    Full Text Available Coronary heart disease (CAD results from an interaction of different somatic, environmental and behavioral risk factors. Commonly, development of CAD is associated with arterial hypertension, dyslipidemia, diabetes mellitus, smoking, sedentary life style and the like. Psychological factors in their own sake or in combination with other risk factors are also important for genesis of CAD. In this study, 170 people that were diagnosed with CAD and 170 healthy controls of corresponding sex and age were compared for anxiety, aggressiveness and Eysenck's two personality dimension. The data indicate that patients with CAD have very low level of anxiety and aggressiveness and very high level of neuroticism relative to the controls. .

  11. Imaging diagnosis of congenital heart disease with single coronary artery

    International Nuclear Information System (INIS)

    Zhu Ming; Li Yuhua; Zhong Yumin; Sun Aimin

    2003-01-01

    Objective: To report 56 cases of congenital heart disease with congenital single coronary artery and to evaluate the imaging diagnostic techniques. Methods: All 56 patients with congenital single coronary artery underwent angiocardiography. Contrast enhancement magnetic resonance angiography (CE MRA) was performed in 4 cases. 48 cases were confirmed by operation. Results: In these 56 cases, single left coronary artery was found in 44 cases and single right coronary artery was found in 12. Conclusion: Congenital heart disease with congenital single coronary artery is not rare and correct diagnosis is very important for surgery

  12. Vital Exhaustion and Coronary Heart Disease Risk

    DEFF Research Database (Denmark)

    Frestad, Daria; Prescott, Eva

    2017-01-01

    INFO (1980 to July 2015; articles in English and published articles only), and bibliographies. Information on aim, study design, sample size, inclusion and exclusion criteria, assessment methods of psychological risk factors, and results of crude and adjusted regression analyses were abstracted independently......OBJECTIVES: The construct of vital exhaustion has been identified as a potential independent psychological risk factor for incident and recurrent coronary heart disease (CHD). Despite several decades of research, no systematic review or meta-analysis has previously attempted to collate.......22-1.85) for prospective studies, and 2.61 (95% CI = 1.66-4.10) for case-control studies using hospital controls. Risk of recurrent events in patients with CHD was 2.03 (95% CI = 1.54-2.68). The pooled adjusted risk of chronic heart failure in healthy populations was 1.37 (95% CI = 1.21-1.56), but this was based...

  13. Changing Trend in Coronary Heart Disease in Nigeria | Nwaneli ...

    African Journals Online (AJOL)

    Background: Coronary Heart Disease (CHD) is the greatest cause of death in Western countries but reported to be rare in sub-Saharan Africa. There are suggestions that the incidence of coronary heart disease is rising in Nigeria as a result of many factors. This review looks at the burden of CHD in Nigeria and its risk ...

  14. Is diet an essential risk factor for coronary heart disease?

    OpenAIRE

    Ball, K. P.

    1980-01-01

    Cigarette smoking, hypertension and diet each play a major role in the development of coronary heart attacks in most industrialized nations. In some countries where cigarette smoking and hypertension are prevalent there is a low risk of coronary heart disease (CHD). Hyperlipidaemia resulting from national food habits appears to be the essential factor in the high rates of CHD in developed countries.

  15. Job strain as a risk factor for coronary heart disease

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Nyberg, Solja T; Batty, G David

    2012-01-01

    Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished...

  16. Obesity and Hypertension, Heart Failure, and Coronary Heart Disease—Risk Factor, Paradox, and Recommendations for Weight Loss

    OpenAIRE

    Artham, Surya M.; Lavie, Carl J.; Milani, Richard V.; Ventura, Hector O.

    2009-01-01

    Obesity prevalence has reached epidemic proportions and is independently associated with numerous cardiovascular disease (CVD) risk factors, including diabetes mellitus, hypertension, dyslipidemia, cancers, sleep apnea, and other major CVDs. Obesity has significant negative impact on CVD, including hypertension, coronary heart disease, heart failure, and arrhythmias via its maladaptive effects on individual CVD risk factors and cardiac structure and function. Despite this negative association...

  17. Coronary Artery Calcium Distribution and Interscan Measurement Variability in End-Stage Renal and Coronary Heart Disease Patients

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Z.; Laskowska, K.; Marzec, M.; Lasek, W. (Dept. of Radiology and Diagnostic Imaging, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland)); Sinjab, T.A.; Wlodarczyk, Z. (Dept. of Transplantology, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

    2009-04-15

    Background: Coronary heart disease patients and end-stage renal disease patients have been documented to have an increased amount of coronary artery calcifications (CAC). Purpose: To evaluate the distribution of CAC and its influence on interscan variability of measurement in end-stage renal disease and coronary heart disease patients, proven to have calcifications. Material and Methods: 69 patients having CAC, including 34 with coronary heart disease and 35 with end-stage renal disease, were scanned twice with multidetector-row computed tomography (MDCT). Amount of CAC was determined as the number of calcified lesions (CN), total calcium score (CS), calcium volume (CV), and calcium mass (CM). Distribution of CAC was evaluated on a per-patient basis as the median CS and CM of a single lesion. Density of the calcifications was calculated as the patient's CM divided by CV. Results: The overall median CS was 457.2, and the median CM was 75.6 mg. There were no significant differences in the number of calcified lesions, CS, or CM between the two groups. Both CS and CM of a single lesion, as well as the mean calcium density were lower in renal disease patients (P<0.05) than in coronary heart disease subjects. The relative interscan variability of coronary calcium measurement was higher in the renal disease group (P<0.05). There was a negative correlation between the calcium concentration and the relative interscan variability. Conclusion: The results indicate that the coronary calcium distribution influences the measurement interscan reproducibility, and the distribution may differ between end-stage renal disease patients and coronary heart disease patients, reflecting the dissimilar nature of coronary calcifications in those groups.

  18. Coronary Artery Calcium Distribution and Interscan Measurement Variability in End-Stage Renal and Coronary Heart Disease Patients

    International Nuclear Information System (INIS)

    Serafin, Z.; Laskowska, K.; Marzec, M.; Lasek, W.; Sinjab, T.A.; Wlodarczyk, Z.

    2009-01-01

    Background: Coronary heart disease patients and end-stage renal disease patients have been documented to have an increased amount of coronary artery calcifications (CAC). Purpose: To evaluate the distribution of CAC and its influence on interscan variability of measurement in end-stage renal disease and coronary heart disease patients, proven to have calcifications. Material and Methods: 69 patients having CAC, including 34 with coronary heart disease and 35 with end-stage renal disease, were scanned twice with multidetector-row computed tomography (MDCT). Amount of CAC was determined as the number of calcified lesions (CN), total calcium score (CS), calcium volume (CV), and calcium mass (CM). Distribution of CAC was evaluated on a per-patient basis as the median CS and CM of a single lesion. Density of the calcifications was calculated as the patient's CM divided by CV. Results: The overall median CS was 457.2, and the median CM was 75.6 mg. There were no significant differences in the number of calcified lesions, CS, or CM between the two groups. Both CS and CM of a single lesion, as well as the mean calcium density were lower in renal disease patients (P<0.05) than in coronary heart disease subjects. The relative interscan variability of coronary calcium measurement was higher in the renal disease group (P<0.05). There was a negative correlation between the calcium concentration and the relative interscan variability. Conclusion: The results indicate that the coronary calcium distribution influences the measurement interscan reproducibility, and the distribution may differ between end-stage renal disease patients and coronary heart disease patients, reflecting the dissimilar nature of coronary calcifications in those groups

  19. Radial artery spasm occurred in transradial coronary intervention for coronary heart disease: its occurrence and predictors

    International Nuclear Information System (INIS)

    Zhong Jiming; Li Lang; Lu Yongguang; Zeng Shuyi

    2011-01-01

    Objective: To discuss the incidence and clinical predictors of radial artery spasm occurred in performing transradial coronary intervention for coronary heart disease. Methods: A total of 1020 patients, who underwent transradial coronary procedures for coronary heart disease during the period of May 2007 Jan 2010 in authors' hospital, were enrolled in this study. All clinical information and medication were recorded in detail. Arteriography via radial artery was performed in all patients. The diameter of the radial artery as well as the arterial anatomy, including arterial variations, were determined and observed, which was follow by coronary angiography or percutaneous coronary intervention. Multivariate Logistic regression analysis was adopted to evaluate the variables, such as clinical parameters, angiographic characteristics of the radial artery and procedure-related factors, in predicting the occurrence of radial artery spasm. Results: Radial artery spasm occurred in 209 (20.5%) patients. Multivariate Logistic regression analysis showed that the following eight factors were independently associated with the occurrence of radial artery spasm. These factors were as follows: female gender (OR=2.8, 95% CI 2.5-5.8; P=0.001), age (OR=0.68, 95% CI 0.60-0.92; P=0.003), smoking (OR=2.3, 95% CI 1.8-4.1; P=0.026), moderate-to-severe pain of forearm during radial artery cannulation (OR=3.0, 95% CI 2.3-4.8; P=0.006), radial artery anatomical abnormalities (OR=4.7, 95% CI 3.6-7.2; P=0.002), the ratio of radial artery diameter to patient's height (RAH) (OR=5.2, 95% CI 3.7-8.1; P=0.012), the ratio of radial artery diameter to outer diameter of the sheath (RAOD) (OR=5.8, 95% CI 4.2-6.9; P=0.006) and the number of catheter exchange (OR=2.3, 95% CI 1.4-4.3; P=0.038). Conclusion: Radial artery spasm occurred in performing transradial coronary intervention for coronary heart disease is frequently seen in clinical practice. Female gender, younger age, smoking, forearm pain during

  20. The independent relationship between triglycerides and coronary heart disease

    Science.gov (United States)

    Morrison, Alan; Hokanson, John E

    2009-01-01

    Aims: The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD). Methods and results: We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically significant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not significantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD. Conclusions: Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention. PMID:19436658

  1. The independent relationship between triglycerides and coronary heart disease.

    Science.gov (United States)

    Morrison, Alan; Hokanson, John E

    2009-01-01

    The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD). We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically significant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not significantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD. Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention.

  2. Explaining the Decline in Coronary Heart Disease Mortality in the Czech Republic between 1985 and 2007

    Czech Academy of Sciences Publication Activity Database

    Bruthans, J.; Cifková, R.; Lánská, V.; O'Flaherty, M.; Critchley, J.A.; Holub, J.; Janský, P.; Zvárová, Jana; Capewell, S.

    2014-01-01

    Roč. 21, č. 7 (2014), s. 829-839 ISSN 2047-4873 Institutional support: RVO:67985807 Keywords : coronary heart disease * Czech MONICA and Czech post-MONICA * coronary heart disease management * coronary heart disease mortality * coronary heart disease risk factors Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery Impact factor: 3.319, year: 2014

  3. Very late coronary spasm inducing acute myocardial infarction in a heart transplant recipient.

    Science.gov (United States)

    Santoro, Francesco; Lopizzo, Agostino; Centola, Antonio; Cuculo, Andrea; Ruggiero, Antonio; Di Biase, Matteo; Brunetti, Natale Daniele

    2016-12-01

    : We report coronary angio findings of very late (10-year) coronary spasm inducing acute myocardial infarction with typical chest pain in a heart transplant recipient. Coronary spasm was promptly relieved by intra-coronary infusion of nitrates.

  4. Psychological Perspectives on the Development of Coronary Heart Disease

    Science.gov (United States)

    Matthews, Karen A.

    2005-01-01

    Psychological science has new opportunities to have major input into the understanding of the development of coronary heart disease. This article provides an overview of advances in understanding the etiology of heart disease, recently applied technologies for measuring early stages of heart disease, and an accumulating base of evidence on the…

  5. European Consensus on Primary Prevention of Coronary Heart Disease.

    Science.gov (United States)

    Assmann, G

    1988-07-01

    The European Consensus on Primary Prevention of Coronary Heart Disease has recommended that providing care for individuals at particular risk for coronary artery disease (CAD) requires case finding through medical examinations in primary care, hospital and employment health examination settings. Decisions concerning management of elevated lipid levels should be based on overall cardiovascular risk. The goal of reducing cholesterol levels through risk reduction can ultimately be accomplished only with the implementation of health education efforts directed toward all age groups and actions by government and supranational agencies, including adequate food labelling to identify fat content, selective taxation to encourage healthful habits and wider availability of exercise facilities. Only measures directed at the overall population can eventually reach the large proportion of individuals at mildly to moderately increased risk for CAD. The European Policy Statement on the Prevention of Coronary Heart Disease recognizes that the question of lipid elevation as a risk factor for CAD involves assessment, not only of cholesterol level alone, but also of triglycerides and the HDL cholesterol lipid fraction. Five specific categories of dyslipidemia have been identified, with individualized screening and treatment strategies advised for each. It is the consensus of the study group panel members that these procedures are both practical and feasible. They begin the necessary long term process to reduce the unacceptably high levels of morbidity and mortality due to CAD throughout the European community.

  6. Coronary microvasculopathy in heart transplantation: Consequences and therapeutic implications.

    Science.gov (United States)

    Vecchiati, Alessandra; Tellatin, Sara; Angelini, Annalisa; Iliceto, Sabino; Tona, Francesco

    2014-06-24

    Despite the progress made in the prevention and treatment of rejection of the transplanted heart, cardiac allograft vasculopathy (CAV) remains the main cause of death in late survival transplanted patients. CAV consists of a progressive diffuse intimal hyperplasia and the proliferation of vascular smooth muscle cells, ending in wall thickening of epicardial vessels, intramyocardial arteries (50-20 μm), arterioles (20-10 μm), and capillaries (system. The non-immunological factors are older donor age, ischemia-reperfusion time, hyperlipidemia and CMV infections. Diagnostic techniques that are able to assess microvascular function are lacking. Intravascular ultrasound and fractional flow reserve, when performed during coronary angiography, are able to detect epicardial coronary artery disease but are not sensitive enough to assess microvascular changes. Some authors have proposed an index of microcirculatory resistance during maximal hyperemia, which is calculated by dividing pressure by flow (distal pressure multiplied by the hyperemic mean transit time). Non-invasive methods to assess coronary physiology are stress echocardiography, coronary flow reserve by transthoracic Doppler echocardiography, single photon emission computed tomography, and perfusion cardiac magnetic resonance. In this review, we intend to analyze the mechanisms, consequences and therapeutic implications of microvascular dysfunction, including an extended citation of relevant literature data.

  7. Alcohol Intake and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla A; Tolstrup, Janne S; Jakobsen, Marianne U

    2010-01-01

    prospective studies from North America and Europe including 192 067 women and 74 919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol......BACKGROUND: -Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men ... of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age. Methods and Results-In this pooled analysis of 8...

  8. Congenital heart disease with high origin of coronary artery

    International Nuclear Information System (INIS)

    Zhu Ming; Li Yuhua; Zhong Yumin

    2002-01-01

    Objective: To report 6 cases of congenital heart disease with high origin of coronary artery and to evaluate the imaging method for diagnosis of congenital high origin of coronary artery. Methods: Six patients with congenital high origin of coronary artery underwent angiocardiography, echocardiography, and 2 patients also underwent magnetic resonance examination. All 6 cases were confirmed by operation. Results: All 6 cases were congenital high origin of right coronary artery. Angiocardiography made correct diagnosis in all 6 cases; MRI made the correct diagnosis in 1 of the 2 cases; echocardiography made 1 correct diagnosis. Conclusion: Correct diagnosis of congenital high origin of coronary artery was very important for patients with congenital heart disease. Angiocardiography was a very reliable imaging method and MRI can play an important role in preoperative diagnosis of congenital high origin of coronary artery

  9. Changing Trend In Coronary Heart Disease In Nigeria

    African Journals Online (AJOL)

    Buchi

    lifestyle. Conclusion: Coronary Heart disease is still relatively uncommon in ... the world where most health resources are channeled into .... cholesterol in the elderly population in Benin, Nigeria, .... Reducing risks, promoting healthy life.

  10. Digital subtraction angiography (DSA) of the heart and coronary arteries

    International Nuclear Information System (INIS)

    Struyven, J.J.; Delcour, C.; Brion, J.P.; Vandenbosch, G.; Claessens, J.

    1986-01-01

    Digital subtraction angiography has potential advantages over conventional radiography. The removal of background structures makes possible to visualize chambers of the heart, great vessels and coronary arteries with a lower iodine signal than with conventional cineangiography. Digital data used for imaging can been manipulated for assessment and quantitation of the ventricular fonction and the coronary circulation

  11. Socio-economic status, risk factors and coronary heart disease ...

    African Journals Online (AJOL)

    The relationship of socio-economic status (SES) indicators and coronary risk factors (RFs) with coronary heart disease (CHD) prevalence was examined in 5620 subjects aged 20 ... The SES indicators had Iitlle or no independent effect on CHD prevalence in multivariate logistic analyses after, inclusion of the standard RFs.

  12. Imaging techniques in the diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Frank, H.

    1997-01-01

    Coronary heart disease is the leading cause of death and disability worldwide. Coronary angiography makes it possible to visualize coronary artery stenosis and can be used for angioplasty and stent implantation; however, it does not allow the assessment of changes in myocardial microcirculation. The severity of an angiographically evaluated coronary stenosis does not always correspond to the extent of myocardial ischemia. Nonivasive techniques are needed to reexamine our reliance on coronary angiography and to explore the clinical value fo the physiological assessment of coronary artery stenoses. Such noninvasive techniques might become important tools in the future following an overal evaluation of coronary morphology, myocardial function and perfusion ascertained by all available methods. (orig.) [de

  13. Diagnosing Coronary Heart Disease using Ensemble Machine Learning

    OpenAIRE

    Kathleen H. Miao; Julia H. Miao; George J. Miao

    2016-01-01

    Globally, heart disease is the leading cause of death for both men and women. One in every four people is afflicted with and dies of heart disease. Early and accurate diagnoses of heart disease thus are crucial in improving the chances of long-term survival for patients and saving millions of lives. In this research, an advanced ensemble machine learning technology, utilizing an adaptive Boosting algorithm, is developed for accurate coronary heart disease diagnosis and outcome predictions. Th...

  14. Perceptions of risk of coronary heart disease among people living with type 2 diabetes mellitus.

    Science.gov (United States)

    Ammouri, Ali Ahmad; Abu Raddaha, Ahmad H; Natarajan, Jansi; D'Souza, Melba Sheila

    2018-02-01

    Our aim is to assess perception of risk of developing coronary heart disease and to examine its associations with individuals' characteristics and health behaviours among Omani people with type 2 diabetes mellitus (T2DM). Evaluating perceptions of being at risk of developing a disease may give insight into health promotion behaviours. People with diabetes are at high risk of coronary heart disease. The management of diabetes mellitus should include prevention and control of coronary heart disease. A cross-sectional correlational study was conducted. A convenience sample of 160 adults with T2DM was invited to participate in this study between November 2014 and March 2015. Descriptive and regression analyses were performed to examine associations between study variables. Perception of risk of developing coronary heart disease was significantly associated with low educational level (β = 0.191, P diabetes mellitus (β = 0.200, P healthy diet more frequently. Teaching people with T2DM about the risk of developing coronary heart disease is essential as it could motivate them to perform health promotion behaviours, which may assist in controlling and reducing coronary heart disease. © 2017 John Wiley & Sons Australia, Ltd.

  15. Correlation study on waist circumference-triglyceride (WT) index and coronary artery scores in patients with coronary heart disease.

    Science.gov (United States)

    Yang, R-F; Liu, X-Y; Lin, Z; Zhang, G

    2015-01-01

    Coronary disease is analyzed through common lipid profiles, but these analyses fail to account for residual risk due to abdominal weight and elevated TG levels. We aimed to investigate the relationship between the waist circumference × triglyceride index (WT index) and the Coronary Artery Score (CAS) in patients with coronary heart disease. 346 patients in our Cardiology Department were recruited from September 2007 to August 2011 and divided into two groups according to whether the patients presented with metabolic syndrome. We performed coronary angiography using the standard Judkins method. The severity of coronary artery stenosis and the CAS were calculated and analyzed with a computerized quantitative analysis system. The signs index, which includes the body mass index (BMI), waist circumference, hip circumference, waist-hip-ratio, and waist-height-ratio, the blood glucose and blood lipid index of all the patients were collected and used to calculate the WT index (waist circumference x triglyceride index. We performed a correlative analysis with age, gender, body mass index, blood glucose and blood lipid, blood pressure and other risk indicators of all patients as the dependent variables and the CAS as the independent variable. We show that the CAS is positively correlated to the WT index. Several lipid profiles and waist circumference were significantly associated with the CAS. The WT index is correlated to the CAS and is a good predictor for the development of coronary artery disease; it can be applied in the clinic for early intervention in populations at risk for coronary heart disease.

  16. The educational gradient in coronary heart disease

    DEFF Research Database (Denmark)

    Ariansen, Inger; Mortensen, Laust Hvas; Igland, Jannicke

    2015-01-01

    BACKGROUND: Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated...... with the educational gradient in CHD in Norway. METHODS: In a cohort of 57 279 men born during 1949-1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project...... and to the Norwegian Cause of Death Registry. RESULTS: Age and period adjusted HR for incident CHD events was 3.62 (95% CI 2.50 to 5.24) for basic relative to tertiary education, and was attenuated after adjustment; to 2.86 (1.87 to 4.38) for cognitive ability, to 1.90 (1.30 to 2.78) for CVD risk factors, and to 1...

  17. A Prospective Trial of Ayurveda for Coronary Heart Disease: A Pilot Study.

    Science.gov (United States)

    DuBroff, Robert; Lad, Vasant; Murray-Krezan, Cristina

    2015-01-01

    Coronary heart disease is the leading cause of death worldwide, and its incidence is rapidly accelerating in developing nations. Patients often search for therapies that are alternatives to traditional treatments, such as heart medicines, coronary bypass surgery, or coronary stenting. Ayurveda is an ancient, East Indian, holistic approach to health care, and its use has never been formally evaluated for patients with coronary heart disease. The study intended to examine the feasibility and effectiveness of comprehensive ayurvedic therapy-incorporating diet, meditation, breathing exercises, yoga, and herbs-for patients with established coronary heart disease. The study was a prospective, single-group, pilot study. The study took place at the University of New Mexico Cardiology Clinic and at the Ayurvedic Institute in Albuquerque, NM, USA. The participants were adults with a history of a prior heart attack, coronary bypass surgery, or a coronary intervention (ie, a coronary angioplasty and/or stent). All enrolled patients were evaluated by a single ayurvedic physician with >40 y of experience, and each received therapy consisting of a calorically unrestricted ayurvedic diet; instruction in yoga, meditation, and breathing; and use of ayurvedic herbs. The primary endpoint was arterial pulse wave velocity, a marker of arterial function and vascular health. Secondary endpoints included the following measurements: (1) body mass index (BMI); (2) blood pressure (BP) and amount of reduction in BP medications; and (3) levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. All parameters were measured at baseline and after 90 d of therapy. Twenty-two patients were enrolled in the study, and 19 patients completed it. The research team observed significant improvements in arterial pulse wave velocity (P = .015), and favorable reductions in BMI (P ayurveda on arterial function and multiple risk

  18. Education and coronary heart disease: mendelian randomisation study.

    Science.gov (United States)

    Tillmann, Taavi; Vaucher, Julien; Okbay, Aysu; Pikhart, Hynek; Peasey, Anne; Kubinova, Ruzena; Pajak, Andrzej; Tamosiunas, Abdonas; Malyutina, Sofia; Hartwig, Fernando Pires; Fischer, Krista; Veronesi, Giovanni; Palmer, Tom; Bowden, Jack; Davey Smith, George; Bobak, Martin; Holmes, Michael V

    2017-08-30

    factor in the development of coronary heart disease. Potential mechanisms could include smoking, body mass index, and blood lipids. In conjunction with the results from studies with other designs, these findings suggest that increasing education may result in substantial health benefits.

  19. The 'diet heart' hypothesis in secondary prevention of coronary heart disease.

    Science.gov (United States)

    de Lorgeril, M; Salen, P; Monjaud, I; Delaye, J

    1997-01-01

    From this detailed analysis of the main dietary trials conducted over the last 30 years in the secondary prevention of coronary heart disease, it can be said that the older trials were conducted on low risk patients and used high fat diets (about 40% of energy as lipids), comprising low saturated fat and cholesterol intake but very high (15 to 20% of energy) polyunsaturated fat intake, particularly from the omega-6 fatty acid family. These experimental diets were designed to reduce blood cholesterol and failed to improve prognosis. By contrast, recent trials were not primarily designed to reduce cholesterol, were conducted in medium- and high-risk patients and used low fat diets supplemented by omega-3 fatty acids from various sources. In two of these trials, the consumption of natural antioxidants, oligoelements and vegetable proteins was increased. Recurrence rate was reduced in the range of 30 to 70%. One conclusion from these well-conducted recent experiments on more than 3000 patients is that new and more specific dietary recommendations are clearly warranted in secondary prevention of coronary heart disease. They should be more specific and more clearly defined and therefore different from those generally provided in the U.S.A. and Europe at present. In a recent Consensus Panel statement, authors wrote less than one line to describe a cardioprotective diet in patients with coronary heart disease, summarized as diet and coronary heart disease is more complex than the current cholesterol hypothesis. They identified at least seven major dietary factors, including fibres, although the evidence of an effect on coronary heart disease is weak. However, they did not mention vegetable and fish proteins which are rich in arginine and L-glutamine, major regulators of cardiovascular function. Thus, new dietary advice should include: reduce intake of total (not more than 30% of energy) and saturated (less than 10%) fats maintain intake at least minimally, of the essential

  20. [Secondary prevention of coronary heart disease is less agressive in patients over 64 years].

    Science.gov (United States)

    Muñoz, Miguel A; Marrugat, Jaume

    2003-06-01

    Although elderly people has a higher incidence of coronary heart disease, this group is seldom included in clinical trials. Studies performed in Spain on elderly coronary heart disease patients have been conducted in hospital settings. The aim of our study was to analyse wether the management of coronary heart disease patients over 64 years of age cared by family physicians differed from that of the rest. Cross-sectional multicentre study embedded in a clinical trial on 1,022 patients with stable coronary heart disease in which socio-demographic variables, comorbidity, treatment and cardiovascular risk- factor control were collected. Mean age was 64 10, 74.0% were men and 53.8% of subjects were over 64 years. Patients over 64 years had a greater cardiovascular comorbidity (87.7 vs 82.6%; p = 0.002) and received lower number of drugs than the rest in the prevention of recurrences (60.4 vs 70.9%; p < 0.001). Probability to receive less than two drugs on secondary prevention by subjects over 64 years was 0.45 (95% CI, 0.30-0.68) despite comorbidity, sex and cardiovascular risk profile.Conclusions. Coronary heart disease patients over 64 years receive less drugs for coronary event recurrence prevention than their younger counterparts despite their worse cardiovascular risk profile.

  1. Dual-source CT coronary imaging in heart transplant recipients: image quality and optimal reconstruction interval

    International Nuclear Information System (INIS)

    Bastarrika, Gorka; Arraiza, Maria; Pueyo, Jesus C.; Cecco, Carlo N. de; Ubilla, Matias; Mastrobuoni, Stefano; Rabago, Gregorio

    2008-01-01

    The image quality and optimal reconstruction interval for coronary arteries in heart transplant recipients undergoing non-invasive dual-source computed tomography (DSCT) coronary angiography was evaluated. Twenty consecutive heart transplant recipients who underwent DSCT coronary angiography were included (19 male, one female; mean age 63.1±10.7 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent observers assessed the image quality of each coronary segments using a five-point scale (from 0 = not evaluative to 4=excellent quality). A total of 289 coronary segments in 20 heart transplant recipients were evaluated. Mean heart rate during the scan was 89.1±10.4 bpm. At the best reconstruction interval, diagnostic image quality (score ≥2) was obtained in 93.4% of the coronary segments (270/289) with a mean image quality score of 3.04± 0.63. Systolic reconstruction intervals provided better image quality scores than diastolic reconstruction intervals (overall mean quality scores obtained with the systolic and diastolic reconstructions 3.03±1.06 and 2.73±1.11, respectively; P<0.001). Different systolic reconstruction intervals (35%, 40%, 45% of RR interval) did not yield to significant differences in image quality scores for the coronary segments (P=0.74). Reconstructions obtained at the systolic phase of the cardiac cycle allowed excellent diagnostic image quality coronary angiograms in heart transplant recipients undergoing DSCT coronary angiography. (orig.)

  2. [Prevention of coronary heart disease: smoking].

    Science.gov (United States)

    Heitzer, T; Meinertz, T

    2005-01-01

    Smoking is the leading preventable cause of illness and premature death in Germany, claiming over 110,000 lives a year because it directly increases the risk of dying from heart disease, stroke, emphysema and a variety of cancers. The overwhelming majority of smokers begin tobacco use before they reach adulthood. Among those young people who smoke, the average age is now 13-14. In Germany, about 39% of male and 31% of female adults (age 18-60 years) continue to smoke, despite information about the unequivocally negative health consequences of smoking. The exact mechanisms of smoking-related vascular disease are not yet known. Smoking causes acute hemodynamic alterations such as increase in heart rate, systematic and coronary vascular resistance, myocardial contractility, and myocardial oxygen demand. These short-term effects could lower the ischemic threshold in smokers with coronary artery disease and contribute to the increased risk for acute cardiovascular events. Endothelial damage is thought to be an initiating event in atherosclerosis and early studies have demonstrated that long-term smoking has direct toxic effects with structural changes of human endothelial cells. Recent research has shown the importance of the functional role of the endothelium in regulating vascular tone, platelet-endothelial interactions, leukocyte adhesion and smooth muscle cell proliferation via synthesis and release of a variety of substances such as nitric oxide. There is strong evidence that smoking leads to endothelial dysfunction mainly by increased inactivation of nitric oxide by oxygen-derived free radicals. Smoking also increases oxidative modification of LDL and is associated with lower HDL plasma levels. Smoking induces a systemic inflammatory response with increased leukocyte count and elevation of the C-reactive protein level. Importantly, the prothrombotic effects of smoking have been repeatedly demonstrated to cause alterations in platelet function, imbalance of

  3. Ivabradine in stable coronary artery disease without clinical heart failure

    DEFF Research Database (Denmark)

    Fox, Kim; Ford, Ian; Steg, Philippe Gabriel

    2014-01-01

    minute or more. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of ivabradine, added to standard background therapy, in 19,102 patients who had both stable coronary artery disease without clinical heart failure and a heart rate of 70 beats per minute or more (including 12......,049 patients with activity-limiting angina [class ≥II on the Canadian Cardiovascular Society scale, which ranges from I to IV, with higher classes indicating greater limitations on physical activity owing to angina]). We randomly assigned patients to placebo or ivabradine, at a dose of up to 10 mg twice daily......, with the dose adjusted to achieve a target heart rate of 55 to 60 beats per minute. The primary end point was a composite of death from cardiovascular causes or nonfatal myocardial infarction. RESULTS: At 3 months, the mean (±SD) heart rate of the patients was 60.7±9.0 beats per minute in the ivabradine group...

  4. Behavioral interventions for coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Orth-Gomér Kristina

    2012-02-01

    Full Text Available Abstract Introduction There is a strong clinical need to provide effective stress reduction programs for patients with an acute coronary syndrome. Such programs for men have been implemented and their cardiovascular health benefit documented. For women such programs are scarce. In this report, The feasibility of a cognitive method that was recently demonstrated to prolong lives of women is tested. A setting with gender segregated groups was applied. Method The principles of a behavioural health educational program originally designed to attenuate the stress of patients with coronary prone behaviours were used as a basis for the intervention method. For the groups of female patients this method was tailored according to female stressors and for the groups of men according to male stressors. The same core stress reduction program was used for women and men, but the contents of discussions and responses to the pre planned program varied. These were continuously monitored throughout the fifteen sessions. Implementation group: Thirty consecutive patients, eleven women and nineteen men, hospitalized for an acute coronary syndrome were included in this intervention. All expressed their need to learn how to cope with stress in daily life and were highly motivated. Five groups, three groups of men and two groups of women were formed. Psychological assessments were made immediately before and after completion of the program. Results No gender differences in the pre planned programs were found, but discussion styles varied between the women and men, Women were more open and more personal. Family issues were more frequent than job issues, although all women were employed outside their homes. Men talked about concrete and practical things, mostly about their jobs, and not directly about their feelings. Daily stresses of life decreased significantly for both men and women, but more so for women. Depressive thoughts were low at baseline, and there was no

  5. Behavioral interventions for coronary heart disease patients.

    Science.gov (United States)

    Orth-Gomér, Kristina

    2012-02-02

    There is a strong clinical need to provide effective stress reduction programs for patients with an acute coronary syndrome. Such programs for men have been implemented and their cardiovascular health benefit documented. For women such programs are scarce.In this report, The feasibility of a cognitive method that was recently demonstrated to prolong lives of women is tested. A setting with gender segregated groups was applied. The principles of a behavioural health educational program originally designed to attenuate the stress of patients with coronary prone behaviours were used as a basis for the intervention method. For the groups of female patients this method was tailored according to female stressors and for the groups of men according to male stressors. The same core stress reduction program was used for women and men, but the contents of discussions and responses to the pre planned program varied. These were continuously monitored throughout the fifteen sessions. Implementation group: Thirty consecutive patients, eleven women and nineteen men, hospitalized for an acute coronary syndrome were included in this intervention. All expressed their need to learn how to cope with stress in daily life and were highly motivated. Five groups, three groups of men and two groups of women were formed. Psychological assessments were made immediately before and after completion of the program. No gender differences in the pre planned programs were found, but discussion styles varied between the women and men, Women were more open and more personal. Family issues were more frequent than job issues, although all women were employed outside their homes. Men talked about concrete and practical things, mostly about their jobs, and not directly about their feelings. Daily stresses of life decreased significantly for both men and women, but more so for women. Depressive thoughts were low at baseline, and there was no change over time. In contrast, anxiety scores were high at

  6. Heart and coronary artery damage related to Kawasaki syndrome

    Directory of Open Access Journals (Sweden)

    A. A. Leontyeva

    2014-01-01

    Full Text Available Kawasaki syndrome is an acute systemic vasculitis of unknown etiology, which mainly affects children within the first 5 years of fife. At the present time, Kawasaki syndrome is recognized to be a leading cause of acquired organic heart diseases in children, which may result in coronary heart disease, myocardial infarction, and sudden death in children and young people. Most complications are associated with the cardiovascular system, with coronary artery changes in particular. Transthoracic echocardiography, which, besides coronary artery assessment, makes it possible to evaluate right and left ventricular systolic and diastolic functions and to study the cardiac valves and changes in pericardial effusion, is a major technique in Kawasaki syndrome. The paper outlines an update on the epidemiology, etiology, pathogenetic mechanisms, and pathomorphology of Kawasaki syndrome and considers possible coronary and noncoronary changes, outcomes, and clinical manifestations.

  7. Electron-beam CT coronary angiography in the patients with high heart rate arrhythmia or pacemaker

    International Nuclear Information System (INIS)

    Dong Zhi; Zhu Jiemin; Liu Zhe; Liu Junbo; Li Youjie; Qi Ji

    2006-01-01

    Objective: To report the clinical applicability of coronary angiography for patients with high heart rate, arrhythmia or cardiac pacing using the new-generation of electron-beam CT (e-Speed). Methods: EBCT (GE e-Speed) coronary angiography was performed in 36 eases (male 27, female 9, mean age 58), including the heart rate more than 90 bpm in 20 patients, frequent ectopic beats in 11 cases, implantation of cardiac pacemaker in 4 patients and the unacceptable MSCT image quality due to variability of interscan heart rate (from 82 bpm to 104 bpm) in 1 case. After volume data set was acquired using spiral mode with prospective ECG-gating, the reconstructions of MIP, CPR, VR and Cine were performed. The VR quality was evaluated using a five-point scale. Results: The quality of coronary imaging in all of 36 cases were acceptable. The total visualization rate of coronary artery branches was 80.0%. Left main, left anterior artery and right coronary artery were visualized in all patients and in 94.3% of all cases circumflex artery were visible. Conclusion: EBCT (e-Speed) is applicable in noninvasive coronary angiography for patients with high heart rate, arrhythmia or implanted cardiac pacemaker', and this examination can obtain satisfied diagnosis. (authors)

  8. Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings

    International Nuclear Information System (INIS)

    Goo, Hyun Woo; Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun; Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee

    2009-01-01

    In patients with congenital heart disease, coronary artery anomalies are common and have different clinical importance from individuals with structurally normal hearts. Visibility of the coronary arteries by CT has markedly improved due to high temporal resolution and ECG-synchronized data acquisition. In this article we describe current multislice CT techniques for coronary artery imaging and illustrate coronary artery anomalies and clinically important coronary artery anatomy from the point of view of congenital heart disease. (orig.)

  9. Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea); Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun [University of Ulsan College of Medicine, Department of Pediatric Cardiac Surgery, Asan Medical Center, Seoul (Korea); Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee [University of Ulsan College of Medicine, Department of Pediatric Cardiology, Asan Medical Center, Seoul (Korea)

    2009-03-15

    In patients with congenital heart disease, coronary artery anomalies are common and have different clinical importance from individuals with structurally normal hearts. Visibility of the coronary arteries by CT has markedly improved due to high temporal resolution and ECG-synchronized data acquisition. In this article we describe current multislice CT techniques for coronary artery imaging and illustrate coronary artery anomalies and clinically important coronary artery anatomy from the point of view of congenital heart disease. (orig.)

  10. Early biomarkers of acute kidney failure after heart angiography or heart surgery in patients with acute coronary syndrome or acute heart failure.

    Science.gov (United States)

    Torregrosa, Isidro; Montoliu, Carmina; Urios, Amparo; Elmlili, Nisrin; Puchades, María Jesús; Solís, Miguel Angel; Sanjuán, Rafael; Blasco, Maria Luisa; Ramos, Carmen; Tomás, Patricia; Ribes, José; Carratalá, Arturo; Juan, Isabel; Miguel, Alfonso

    2012-01-01

    Acute kidney injury (AKI) is a common complication in cardiac surgery and coronary angiography, which worsens patients' prognosis. The diagnosis is based on the increase in serum creatinine, which is delayed. It is necessary to identify and validate new biomarkers that allow for early and effective interventions. To assess the sensitivity and specificity of neutrophil gelatinase-associated lipocalin in urine (uNGAL), interleukin-18 (IL-18) in urine and cystatin C in serum for the early detection of AKI in patients with acute coronary syndrome or heart failure, and who underwent cardiac surgery or catheterization. The study included 135 patients admitted to the intensive care unit for acute coronary syndrome or heart failure due to coronary or valvular pathology and who underwent coronary angiography or cardiac bypass surgery or valvular replacement. The biomarkers were determined 12 hours after surgery and serum creatinine was monitored during the next six days for the diagnosis of AKI. The area under the ROC curve (AUC) for NGAL was 0.983, and for cystatin C and IL-18 the AUCs were 0.869 and 0.727, respectively. At a cut-off of 31.9 ng/ml for uNGAL the sensitivity was 100% and the specificity was 91%. uNGAL is an early marker of AKI in patients with acute coronary syndrome or heart failure and undergoing cardiac surgery and coronary angiography, with a higher predictive value than cystatin C or IL-18.

  11. Trends in Coronary Revascularization and Ischemic Heart Disease?Related Mortality in Israel

    OpenAIRE

    Blumenfeld, Orit; Na'amnih, Wasef; Shapira?Daniels, Ayelet; Lotan, Chaim; Shohat, Tamy; Shapira, Oz M.

    2017-01-01

    Background We investigated national trends in volume and outcomes of percutaneous coronary angioplasty (PCI), coronary artery bypass grafting (CABG), and ischemic heart disease?related mortality in Israel. Methods and Results Using International Classification of Diseases 9th and 10th revision codes, we linked 5 Israeli national databases, including the Israel Center for Disease Control National PCI and CABG Registries, the Ministry of Health Hospitalization Report, the Center of Bureau of St...

  12. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David

    2013-01-01

    To determine the association between self reported job insecurity and incident coronary heart disease.......To determine the association between self reported job insecurity and incident coronary heart disease....

  13. Kazakhstan: coronary and structural heart interventions from 2010 to 2015.

    Science.gov (United States)

    Sakhov, Orazbek S; Kuzhukeyev, Murat E; Kodasbayev, Almat T; Egemberdiev, Tolegen Zh; Berkinbayev, Salim F; Zholdin, Bekbolat K; Alimbaev, Serik A; Zhangelova, Sholpan B; Rakhimov, Rustam A; Makhanov, Daniyar I; Sabitov, Yersyn T; Teleuov, Dauren A; Baisebenov, Ruslan K; Kuzhukeyev, Arystan M

    2017-05-15

    This paper presents data on the nascence and development of the interventional cardiology service in Kazakhstan. It provides details of the structure of the Kazakhstan interventional cardiology service, staff training, the number of coronary and structural heart interventions for the period of 2010-2015, as well as the peculiarities of the capitation payment method. The number of coronary interventions is increasing year by year, though the number of intracoronary imaging techniques and intracoronary flow/pressure techniques remains inadequate. Structural heart interventions are mostly performed at tertiary hospital level, with an ever increasing number of transcatheter aortic valve implantation (TAVI) procedures.

  14. 77 FR 9842 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2012-02-21

    ... (formerly 2006P-0316)] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug... concerning the use of the health claim for phytosterols and risk of coronary heart disease (CHD), in a manner... risk of coronary heart disease (CHD) for phytosterol-containing conventional food and dietary...

  15. Coronary Calcification and the Risk of Heart Failure in the Elderly The Rotterdam Study

    NARCIS (Netherlands)

    Leening, Maarten J. G.; Elias-Smale, Suzette E.; Kavousi, Maryam; Felix, Janine F.; Deckers, Jaap W.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; Hofman, Albert; Steyerberg, Ewout W.; Stricker, Bruno H. Ch; Witteman, Jacqueline C. M.

    OBJECTIVES The purpose of this study was to determine the association of coronary artery calcification (CAC) with incident heart failure in the elderly and examine its independence of overt coronary heart disease (CHD). BACKGROUND Heart failure is often observed as a first manifestation of coronary

  16. In-hospital management and outcomes of acute coronary syndromes in relation to prior history of heart failure.

    Science.gov (United States)

    Zhang, Hanfei; Goodman, Shaun G; Yan, Raymond T; Steg, Ph Gabriel; Kornder, Jan M; Gyenes, Gabor T; Grondin, Francois R; Brieger, David; DeYoung, J Paul; Gallo, Richard; Yan, Andrew T

    2016-06-01

    The prognostic significance of prior heart failure in acute coronary syndromes has not been well studied. Accordingly, we evaluated the baseline characteristics, management patterns and clinical outcomes in patients with acute coronary syndromes who had prior heart failure. The study population consisted of acute coronary syndrome patients in the Global Registry of Acute Coronary Events, expanded Global Registry of Acute Coronary Events and Canadian Registry of Acute Coronary Events between 1999 and 2008. Of the 13,937 eligible patients (mean age 66±13 years, 33% female and 28.3% with ST-elevation myocardial infarction), 1498 (10.7%) patients had a history of heart failure. Those with prior heart failure tended to be older, female and had lower systolic blood pressure, higher Killip class and creatinine on presentation. Prior heart failure was also associated with significantly worse left ventricular systolic function and lower rates of cardiac catheterization and coronary revascularization. The group with previous heart failure had significantly higher rates of acute decompensated heart failure, cardiogenic shock, myocardial (re)infarction and mortality in hospital. In multivariable analysis, prior heart failure remained an independent predictor of in-hospital mortality (odds ratio 1.48, 95% confidence interval 1.08-2.03, p=0.015). Prior heart failure was associated with high risk features on presentation and adverse outcomes including higher adjusted in-hospital mortality in acute coronary syndrome patients. However, acute coronary syndrome patients with prior heart failure were less likely to receive evidence-based therapies, suggesting potential opportunities to target more intensive treatment to improve their outcome. © The European Society of Cardiology 2015.

  17. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R

    2016-01-01

    BACKGROUND: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). OBJECTIVES: The goal of this study is to update the Cochrane...... systematic review and meta-analysis of exercise-based CR for CHD. METHODS: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included...... randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk...

  18. Coronary heart disease index based on longitudinal electrocardiography

    Science.gov (United States)

    Townsend, J. C.; Cronin, J. P.

    1977-01-01

    A coronary heart disease index was developed from longitudinal ECG (LCG) tracings to serve as a cardiac health measure in studies of working and, essentially, asymptomatic populations, such as pilots and executives. For a given subject, the index consisted of a composite score based on the presence of LCG aberrations and weighted values previously assigned to them. The index was validated by correlating it with the known presence or absence of CHD as determined by a complete physical examination, including treadmill, resting ECG, and risk factor information. The validating sample consisted of 111 subjects drawn by a stratified-random procedure from 5000 available case histories. The CHD index was found to be significantly more valid as a sole indicator of CHD than the LCG without the use of the index. The index consistently produced higher validity coefficients in identifying CHD than did treadmill testing, resting ECG, or risk factor analysis.

  19. Coronary heart disease mortality after irradiation for Hodgkin's disease

    International Nuclear Information System (INIS)

    Boivin, J.F.; Hutchison, G.B.

    1982-01-01

    The authors conducted a study designed to evaluate the hypothesis that irradiation to the heart in the treatment for Hodgkin's disease (HD) is associated with increased coronary heart disease (CHD) mortality. This report describes 957 patients diagnosed with HD in 1942-75 and analyzes follow-up findings through December 1977. Twenty-five coronary heart disease deaths have been observed, and 4258.2 person-years of experience at risk have been accrued. The relative death rate (RDR), defined as the CHD mortality for heart-irradiated subjects divided by the mortality for nonirradiated subjects, was estimated. After adjustment for the effect of interval of observation, age, stage, and class, the RDR estimate is 1.5 but does not differ significantly from unit

  20. Health actions and disease patterns related to coronary heart ...

    African Journals Online (AJOL)

    The health-related behaviour of the Cape Peninsula coloured population, which has been shown to have an adverse coronary heart disease (CHO) risk factor profile, is reported. Private medical services were used most often by participants: 54,1% and 51,6% of males and females respectively had made use of these ...

  1. Attentional bias and anxiety in individuals with coronary heart disease

    NARCIS (Netherlands)

    Ginting, H.; Näring, G.W.B.; Becker, E.S.

    2013-01-01

    This study examined whether in an emotional Stroop task, individuals with coronary heart disease (CHD) would show greater attention towards the threatening words related to their disease than healthy persons, and if such an attentional bias is associated with anxiety. An emotional Stroop task with

  2. Spirituality and negative emotions in individuals with coronary heart disease

    NARCIS (Netherlands)

    Ginting, H.; Näring, G.W.B.; Kwakkenbos, C.M.C.; Becker, E.S.

    2015-01-01

    Many individuals with coronary heart disease (CHD) experience disease-related anxiety, depressive symptoms, and anger. Spirituality may be helpful to cope with these negative emotions. Research findings on the role of spirituality in dealing with negative emotions are inconsistent. In this study, we

  3. Interleukin-6 receptor pathways in coronary heart disease

    DEFF Research Database (Denmark)

    Sarwar, Nadeem; Butterworth, Adam S; Freitag, Daniel F

    2012-01-01

    Persistent inflammation has been proposed to contribute to various stages in the pathogenesis of cardiovascular disease. Interleukin-6 receptor (IL6R) signalling propagates downstream inflammation cascades. To assess whether this pathway is causally relevant to coronary heart disease, we studied ...

  4. Effectiveness of Interventions to Reduce Coronary Heart Disease Risk

    African Journals Online (AJOL)

    Objective: To determine the effectiveness of coronary heart disease risk reduction interventions. Methods: The effects of lipid lowering interventions as well as dietary and lifestyle modifications on some risk factors of CHD were studied retrospectively in 47 males and 53 female patients [aged 33 to 61 years; mean age 47.20 ...

  5. An assessment of the physical fitness and coronary heart disease ...

    African Journals Online (AJOL)

    Health and fitness clubs play an important role in addressing the causes of hypokinetic diseases and coronary heart disease (CHD). In order to be well prepared, service providers should be aware of the health and fitness profiles of their clients when they join their clubs. In the current study 243 white female subjects ...

  6. Association between height and coronary heart disease mortality

    DEFF Research Database (Denmark)

    Silventoinen, Karri; Zdravkovic, Slobodan; Skytthe, Axel

    2006-01-01

    An inverse association between height and risk of coronary heart disease (CHD) is well demonstrated, but it is not known whether this association is because of genetic factors, socioeconomic background, or other environmental factors. Four population-based twin cohorts with register-based follow...

  7. What is killing? People's knowledge about coronary heart disease ...

    African Journals Online (AJOL)

    From which nearly 80% can be because of modifiable risks. In Egypt, there is a lack of studies on the knowledge of people about coronary heart diseases and its modifiable risks. So, this research reported here we designed to measure the dimensions of peoples knowledge about CHD and their attitude towards prevention, ...

  8. Antibiotics for secondary prevention of coronary heart disease

    DEFF Research Database (Denmark)

    Sethi, Naqash J.; Safi, Sanam; Korang, Steven Kwasi

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of antibiotics for the secondary prevention of coronary heart disease. As a secondary objective, we plan to assess the effects of individual types of antibiotics...

  9. Resistance training and predicted risk of coronary heart disease in ...

    African Journals Online (AJOL)

    The purpose of this study was to determine the impact of resistance training, designed to prevent the development of coronary heart disease (CHD) based on the Framingham Risk Assessment (FRA) score. Twenty-five healthy sedentary men with low CHD risk were assigned to participate in a 16-week (three days per week) ...

  10. Coronary Heart Disease Mortality in Czech Men, 1980-2004

    Czech Academy of Sciences Publication Activity Database

    Reissigová, Jindra; Tomečková, Marie

    2008-01-01

    Roč. 4, č. 1 (2008), s. 12-16 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : coronary heart disease * cardiovascular * mortality * 1980-2004 Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/articles/200812/33/1.html

  11. GRACE score predicts heart failure admission following acute coronary syndrome.

    Science.gov (United States)

    McAllister, David A; Halbesma, Nynke; Carruthers, Kathryn; Denvir, Martin; Fox, Keith A

    2015-04-01

    Congestive heart failure (CHF) is a common and preventable complication of acute coronary syndrome (ACS). Nevertheless, ACS risk scores have not been shown to predict CHF risk. We investigated whether the at-discharge Global Registry of Acute Coronary Events (GRACE) score predicts heart failure admission following ACS. Five-year mortality and hospitalization data were obtained for patients admitted with ACS from June 1999 to September 2009 to a single centre of the GRACE registry. CHF was defined as any admission assigned WHO International Classification of Diseases 10 diagnostic code I50. The hazard ratio (HR) for CHF according to GRACE score was estimated in Cox models adjusting for age, gender and the presence of CHF on index admission. Among 1,956 patients, CHF was recorded on index admission in 141 patients (7%), and 243 (12%) were admitted with CHF over 3.8 median years of follow-up. Compared to the lowest quintile, patients in the highest GRACE score quintile had more CHF admissions (116 vs 17) and a shorter time to first admission (1.2 vs 2.0 years, HR 9.87, 95% CI 5.93-16.43). Per standard deviation increment in GRACE score, the instantaneous risk was more than two-fold higher (HR 2.28; 95% CI 2.02-2.57), including after adjustment for CHF on index admission, age and gender (HR 2.49; 95% CI 2.06-3.02). The C-statistic for CHF admission at 1-year was 0.74 (95% CI 0.70-0.79). The GRACE score predicts CHF admission, and may therefore be used to target ACS patients at high risk of CHF with clinical monitoring and therapies. © The European Society of Cardiology 2014.

  12. Plasma urate concentration and risk of coronary heart disease: a Mendelian randomisation analysis

    Science.gov (United States)

    White, Jon; Sofat, Reecha; Hemani, Gibran; Shah, Tina; Engmann, Jorgen; Dale, Caroline; Shah, Sonia; Kruger, Felix A; Giambartolomei, Claudia; Swerdlow, Daniel I; Palmer, Tom; McLachlan, Stela; Langenberg, Claudia; Zabaneh, Delilah; Lovering, Ruth; Cavadino, Alana; Jefferis, Barbara; Finan, Chris; Wong, Andrew; Amuzu, Antoinette; Ong, Ken; Gaunt, Tom R; Warren, Helen; Davies, Teri-Louise; Drenos, Fotios; Cooper, Jackie; Ebrahim, Shah; Lawlor, Debbie A; Talmud, Philippa J; Humphries, Steve E; Power, Christine; Hypponen, Elina; Richards, Marcus; Hardy, Rebecca; Kuh, Diana; Wareham, Nicholas; Ben-Shlomo, Yoav; Day, Ian N; Whincup, Peter; Morris, Richard; Strachan, Mark W J; Price, Jacqueline; Kumari, Meena; Kivimaki, Mika; Plagnol, Vincent; Whittaker, John C; Smith, George Davey; Dudbridge, Frank; Casas, Juan P; Holmes, Michael V; Hingorani, Aroon D

    2016-01-01

    Summary Background Increased circulating plasma urate concentration is associated with an increased risk of coronary heart disease, but the extent of any causative effect of urate on risk of coronary heart disease is still unclear. In this study, we aimed to clarify any causal role of urate on coronary heart disease risk using Mendelian randomisation analysis. Methods We first did a fixed-effects meta-analysis of the observational association of plasma urate and risk of coronary heart disease. We then used a conventional Mendelian randomisation approach to investigate the causal relevance using a genetic instrument based on 31 urate-associated single nucleotide polymorphisms (SNPs). To account for potential pleiotropic associations of certain SNPs with risk factors other than urate, we additionally did both a multivariable Mendelian randomisation analysis, in which the genetic associations of SNPs with systolic and diastolic blood pressure, HDL cholesterol, and triglycerides were included as covariates, and an Egger Mendelian randomisation (MR-Egger) analysis to estimate a causal effect accounting for unmeasured pleiotropy. Findings In the meta-analysis of 17 prospective observational studies (166 486 individuals; 9784 coronary heart disease events) a 1 SD higher urate concentration was associated with an odds ratio (OR) for coronary heart disease of 1·07 (95% CI 1·04–1·10). The corresponding OR estimates from the conventional, multivariable adjusted, and Egger Mendelian randomisation analysis (58 studies; 198 598 individuals; 65 877 events) were 1·18 (95% CI 1·08–1·29), 1·10 (1·00–1·22), and 1·05 (0·92–1·20), respectively, per 1 SD increment in plasma urate. Interpretation Conventional and multivariate Mendelian randomisation analysis implicates a causal role for urate in the development of coronary heart disease, but these estimates might be inflated by hidden pleiotropy. Egger Mendelian randomisation analysis, which accounts for

  13. Recovery free of heart failure after acute coronary syndrome and coronary revascularization.

    Science.gov (United States)

    Falkenham, Alec; Saraswat, Manoj K; Wong, Chloe; Gawdat, Kareem; Myers, Tanya; Begum, Jahanara; Buth, Karen J; Haidl, Ian; Marshall, Jean; Légaré, Jean-Francois

    2018-02-01

    Previous studies have examined risk factors for the development of heart failure (HF) subsequent to acute coronary syndrome (ACS). Our study seeks to clarify the clinical variables that best characterize patients who remain free from HF after coronary artery bypass grafting (CABG) surgery for ACS to determine novel biological factors favouring freedom from HF in prospective translational studies. Nova Scotia residents (1995-2012) undergoing CABG within 3 weeks of ACS were included. The primary outcome was freedom from readmission to hospital due to HF. Descriptive statistics were generated, and a Cox proportional hazards model assessed outcome with adjustment for clinical characteristics. Of 11 936 Nova Scotians who underwent isolated CABG, 3264 (27%) had a recent ACS and were included. Deaths occurred in 210 (6%) of subjects prior to discharge. A total of 3054 patients were included in the long-term analysis. During follow-up, HF necessitating readmission occurred in 688 (21%) subjects with a hazard ratio of 12% at 2 years. The adjusted Cox model demonstrated significantly better freedom from HF for younger, male subjects without metabolic syndrome and no history of chronic obstructive pulmonary disease, renal insufficiency, atrial fibrillation, or HF. Our findings have outlined important clinical variables that predict freedom from HF. Furthermore, we have shown that 12% of patients undergoing CABG after ACS develop HF (2 years). Our findings support our next phase in which we plan to prospectively collect blood and tissue specimens from ACS patients undergoing CABG in order to determine novel biological mechanism(s) that favour resolution of post-ACS inflammation. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  14. State of the Art Coronary Heart Disease Risk Estimation based on the Framingham Heart Study

    Czech Academy of Sciences Publication Activity Database

    Reissigová, Jindra; Tomečková, Marie

    2005-01-01

    Roč. 13, č. 4 (2005), s. 180-186 ISSN 0022-1732 Institutional research plan: CEZ:AV0Z10300504 Keywords : Framingham heart study * coronary heart disease * risk validation study * calibration * discrimination Subject RIV: BA - General Mathematics

  15. The relationship between heart rate and mortality of patients with acute coronary syndromes in the coronary intervention era: Meta-analysis.

    Science.gov (United States)

    Xu, Tan; Zhan, Youqin; Xiong, Jianping; Lu, Nan; He, Zhuoqiao; Su, Xi; Tan, Xuerui

    2016-11-01

    Most of acute coronary syndromes (ACS) were receiving intervention treatment a high overall rate of coronary angiography in the modern medical practice.Consequently, we conduct a review to determine the heart rate (HR) on the prognosis of ACS in the coronary intervention era. PubMed, EMBASE, MEDLINE, and the Cochrane Library was systematically searched up to May 2016 using the search terms "heart rate," "acute coronary syndrome," "acute myocardial infarction," "ST elevation myocardial infarction," "non-ST-segment elevation." The outcome of interest was all-cause mortality. All analyses were performed using Review Manager. Database searches retrieved 2324 citations. Eleven studies enrolling 156,374 patients were included. In-hospital mortality was significantly higher in the elevated HR group compared to the lower HR group (pooled RR 2.04, 95%CI 1.80-2.30, P coronary intervention era.

  16. Coronary Heart Disease Risk Factors in Young People of Differing Socio-Economic Status

    Science.gov (United States)

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Williams, Simon P.; Baker, Julien S.; Davies, Bruce

    2005-01-01

    This study determined the prevalence of coronary heart disease (CHD) risk factors in young people of differing socio-economic status (SES). A cohort of 100 boys and 108 girls, aged 12.9, SD 0.3 years drawn of differing SES were assessed for CHD risk factors. Measurements included indices of obesity, blood pressure, aerobic fitness, diet, blood…

  17. Whole-heart MR coronary angiography - first results

    International Nuclear Information System (INIS)

    Ozgun, M.; Quante, M.; Fischbach, R.; Heindel, W.; Maintz, D.; Hoffmeier, A.; Botnar, R.

    2006-01-01

    Purpose: To evaluate a new coronary MR angiography technique covering the whole coronary artery tree in one data set acquisition. Materials and methods: Six healthy volunteers and 15 patients with known CAD were examined with a navigator gated and corrected (NAV) free-breathing 3D steady-state free precession sequence covering the whole heart (WH-MRA) (TR=5.4, TE-2.7, SENSE factor=2, 160 slices, 0.75 mm reconstructed slice thickness, in-plane resolution =0.99 x 0.99 mm 2 , scan time 14 min [50% NAV efficiency]) and a vessel targeted 3D SSFP MRA sequence (t-MRA) (TR=5.6 ms, TE-2.8 ms, 20 slices of 1.5 mm reconstructed slice thickness, in-plane resolution =0.99 x 0.99 mm 2 , scan time=7 min [50% NAV efficiency]). Subjective image quality (4-point scale) and objective image quality parameters including vessel sharpness, vessel diameter and CNR were calculated for WH-MRA and t-MRA. In patients, the accuracy for detection of stenosis larger than 50% was compared to the accuracy of X-ray coronary angiography (XA), which was considered the standard. Results: WH-MRA demonstrated good vessel visibility in healthy subjects (100%) whereas vessel visibility in patients was limited (78% in an 8 segment evaluation). Vessel sharpness was inferior to that of t-MRA in patients (37 vs. 42%) but equal in healthy subjects (42%). Vessel diameter did not differ significantly between WH-MRA and t-MRA. CNR was significantly reduced for WH-MRA (CNR 7.4 vs. 11.5). The diagnostic accuracy for the detection of CAD was comparable for both MRA approaches (85.5 vs. 86.2%). Conclusion: WH-MRA allows good coronary artery visualization in healthy subjects and patients and provides a simplified scanning procedure and advantages in 3D post-processing. Regarding image parameters and the detection of CAD, the results are comparable to those acquired with t-MRA. The major disadvantage remains the high number of diagnostically insufficient images. (orig.)

  18. Nationwide trends in use and timeliness of diagnostic coronary angiography in acute coronary syndromes from 2005 to 2011: Does distance to invasive heart centres matter?

    Science.gov (United States)

    Hansen, Kim W; Sørensen, Rikke; Madsen, Mette; Madsen, Jan K; Jensen, Jan S; von Kappelgaard, Lene M; Mortensen, Poul E; Galatius, Søren

    2015-08-01

    To examine trends in the use of diagnostic coronary angiography according to distance from home to the nearest invasive heart centre following implementation of fast-track protocols and extensive pre-hospital triaging of acute coronary syndrome patients. We performed a register-based cohort study of all patients admitted to Danish hospitals with incident acute coronary syndrome in 2005-2011. Diagnostic coronary angiography within 60 days of admission was investigated according to distance tertiles (DTs) calculated as range from each patient's home to the nearest invasive heart centre (short DT: 65 km). Cox proportional hazards models were applied.Among the 52,409 patients included, diagnostic coronary angiography was increasingly used during 2005-2011 (short DT: 76% to 81%; medium DT: 74% to 81%; long DT: 69% to 78%; all p-values for trend coronary angiography, and 60-day mortality decreased in all DT. This nationwide study found significant increases in diagnostic coronary angiography use over time in incident acute coronary syndrome patients with a relatively larger increase in patients residing farthest from an invasive heart centre. Additionally, selected quality of care measures improved in the entire cohort, suggesting a benefit of national clinical protocols. © The European Society of Cardiology 2014.

  19. Screening for Coronary Heart Disease with Electrocardiography

    Science.gov (United States)

    ... resting and completely still or while you are exercising. ECG is used to see whether the heart is beating and functioning normally. Potential Benefits and Harms The Task Force reviewed evidence to ...

  20. Job Dissatisfaction and Coronary Heart Disease

    Science.gov (United States)

    Friis, Robert

    1976-01-01

    Based on the psychosocial factor that life dissatisfactions may be associated with physical illnesses, this research examines the relationship between job dissatisfaction and its causal link to premature death from heart disease. (Author/RK)

  1. Predictors of incident heart failure in patients after an acute coronary syndrome: The LIPID heart failure risk-prediction model.

    Science.gov (United States)

    Driscoll, Andrea; Barnes, Elizabeth H; Blankenberg, Stefan; Colquhoun, David M; Hunt, David; Nestel, Paul J; Stewart, Ralph A; West, Malcolm J; White, Harvey D; Simes, John; Tonkin, Andrew

    2017-12-01

    Coronary heart disease is a major cause of heart failure. Availability of risk-prediction models that include both clinical parameters and biomarkers is limited. We aimed to develop such a model for prediction of incident heart failure. A multivariable risk-factor model was developed for prediction of first occurrence of heart failure death or hospitalization. A simplified risk score was derived that enabled subjects to be grouped into categories of 5-year risk varying from 20%. Among 7101 patients from the LIPID study (84% male), with median age 61years (interquartile range 55-67years), 558 (8%) died or were hospitalized because of heart failure. Older age, history of claudication or diabetes mellitus, body mass index>30kg/m 2 , LDL-cholesterol >2.5mmol/L, heart rate>70 beats/min, white blood cell count, and the nature of the qualifying acute coronary syndrome (myocardial infarction or unstable angina) were associated with an increase in heart failure events. Coronary revascularization was associated with a lower event rate. Incident heart failure increased with higher concentrations of B-type natriuretic peptide >50ng/L, cystatin C>0.93nmol/L, D-dimer >273nmol/L, high-sensitivity C-reactive protein >4.8nmol/L, and sensitive troponin I>0.018μg/L. Addition of biomarkers to the clinical risk model improved the model's C statistic from 0.73 to 0.77. The net reclassification improvement incorporating biomarkers into the clinical model using categories of 5-year risk was 23%. Adding a multibiomarker panel to conventional parameters markedly improved discrimination and risk classification for future heart failure events. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Rural-urban disparities in the prevalence of diabetes and coronary heart disease.

    Science.gov (United States)

    O'Connor, A; Wellenius, G

    2012-10-01

    To examine the rural-urban differences in the prevalence of diabetes and coronary heart disease, and the extent to which they are explained by the presence of established risk factors including poverty. Cross-sectional study of more than 214,000 respondents using data from the US Centers for Disease Control and Prevention's (CDC's) 2008 Behavioral Risk Factor Surveillance System. Logistic regression models were utilized; prevalence odds ratios with corresponding confidence intervals and P-values are provided. The crude prevalence rates of diabetes and coronary heart disease were 8.6% (P = 0.001) and 38.8% (P rural areas compared with urban areas, respectively. The higher prevalence in rural areas of many of the common risk factors for these conditions, including poverty (P rural areas [prevalence odds ratio (POR) = 0.94, P = 0.032], but the prevalence of coronary heart disease was higher (POR = 1.09, P = 0.011). The higher prevalence of diabetes and coronary heart disease in rural populations in the USA presents a formidable public health challenge. It exacerbates many of the pre-existing rural health disparities, including a lack of access to financial resources and primary care providers. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Acute Heart Failure Triggered by Coronary Spasm With Transient Left Ventricular Dysfunction.

    Science.gov (United States)

    Adachi, Yusuke; Sakakura, Kenichi; Ibe, Tatsuro; Yoshida, Nanae; Wada, Hiroshi; Fujita, Hideo; Momomura, Shin-Ichi

    2017-04-06

    Coronary spasm is abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia. Coronary spasm induces not only depressed myocardial contractility, but also incomplete myocardial relaxation, which leads to elevated ventricular filling pressure. We herein report the case of a 55-year-old woman who had repeated acute heart failure caused by coronary spasm. Acetylcholine provocation test with simultaneous right heart catheterization was useful for the diagnosis of elevated ventricular filling pressure as well as coronary artery spasm. We should add coronary spasm to a differential diagnosis for repeated acute heart failure.

  4. Higher coronary heart disease and heart attack morbidity in Appalachian coal mining regions.

    Science.gov (United States)

    Hendryx, Michael; Zullig, Keith J

    2009-11-01

    This study analyzes the U.S. 2006 Behavioral Risk Factor Surveillance System survey data (N=235,783) to test whether self-reported cardiovascular disease rates are higher in Appalachian coal mining counties compared to other counties after control for other risks. Dependent variables include self-reported measures of ever (1) being diagnosed with cardiovascular disease (CVD) or with a specific form of CVD including (2) stroke, (3) heart attack, or (4) angina or coronary heart disease (CHD). Independent variables included coal mining, smoking, BMI, drinking, physician supply, diabetes co-morbidity, age, race/ethnicity, education, income, and others. SUDAAN Multilog models were estimated, and odds ratios tested for coal mining effects. After control for covariates, people in Appalachian coal mining areas reported significantly higher risk of CVD (OR=1.22, 95% CI=1.14-1.30), angina or CHD (OR=1.29, 95% CI=1.19-1.39) and heart attack (OR=1.19, 95% CI=1.10-1.30). Effects were present for both men and women. Cardiovascular diseases have been linked to both air and water contamination in ways consistent with toxicants found in coal and coal processing. Future research is indicated to assess air and water quality in coal mining communities in Appalachia, with corresponding environmental programs and standards established as indicated.

  5. Higher coronary heart disease and heart attack morbidity in Appalachian coal mining regions

    Energy Technology Data Exchange (ETDEWEB)

    Hendryx, M.; Zullig, K.J. [West Virginia University, Morgantown, WV (United States). Dept. of Community Medicine

    2009-11-15

    This study analyzes the U.S. 2006 Behavioral Risk Factor Surveillance System survey data (N = 235,783) to test whether self-reported cardiovascular disease rates are higher in Appalachian coal mining counties compared to other counties after control for other risks. Dependent variables include self-reported measures of ever (1) being diagnosed with cardiovascular disease (CVD) or with a specific form of CVD including (2) stroke, (3) heart attack, or (4) angina or coronary heart disease (CHD). Independent variables included coal mining, smoking, BMI, drinking, physician supply, diabetes co-morbidity, age, race/ethnicity, education, income, and others. SUDAAN Multilog models were estimated, and odds ratios tested for coal mining effects. After control for covariates, people in Appalachian coal mining areas reported significantly higher risk of CVD (OR = 1.22, 95% CI = 1.14-1.30), angina or CHO (OR = 1.29, 95% C1 = 1.19-1.39) and heart attack (OR = 1.19, 95% C1 = 1.10-1.30). Effects were present for both men and women. Cardiovascular diseases have been linked to both air and water contamination in ways consistent with toxicants found in coal and coal processing. Future research is indicated to assess air and water quality in coal mining communities in Appalachia, with corresponding environmental programs and standards established as indicated.

  6. Correlation between serum Hcy content and coronary atherosclerosis severity in patients with H-type hypertension and coronary heart disease

    Directory of Open Access Journals (Sweden)

    Xiao-Mei Li

    2017-03-01

    Full Text Available Objective: To analyze the correlation between serum Hcy content and coronary atherosclerosis severity in patients with H-type hypertension and coronary heart disease. Methods: 48 patients with H-type hypertension and coronary heart disease were selected as observation group, and 57 patients with normal hypertension and coronary heart disease were selected as control group. Echocardiography was used to determine coronary lesion parameters, enzymelinked immunosorbent assay (ELISA was used to determine serum levels of homocysteine (Hcy and coronary heart disease-related indexes, and the correlation between Hcy levels and coronary heart disease was further analyzed. Results: Serum Hcy level of observation group was higher than that of control group (P<0.05, absolute GLPSS value and E/A value under echocardiography were less than those of control group while E-DT and E/e value were higher than those of control group (P<0.05; serum adiponectin (APN level was lower than that of control group while P-selectin, asymmetric dimethylarginine (ADMA, oxidized high-density lipoprotein (OX-HDL, MMP-2, MMP-9, lipoprotein-associated phospholipase A2 (Lp-PLA2 and Resistin levels were higher than those of control group (P<0.05; Hcy was negatively correlated with absolute GLPSS value, E/A value and APN level, and was positively correlated with E-DT value, E/e value as well as P-selectin, ADMA, OX-HDL, MMP-2, MMP-9, Lp- PLA2 and Resistin levels (P<0.05. Conclusions: There is direct correlation between serum Hcy levels and the severity of coronary heart disease in patients with H-type hypertension and coronary heart disease, it can be a reliable way to early screen for coronary heart disease and evaluate the illness, and it is also a new target of coronary heart disease intervention.

  7. The role of levosimendan in acute heart failure complicating acute coronary syndrome

    DEFF Research Database (Denmark)

    Nieminen, Markku S; Buerke, M.; Cohen-Solal, A.

    2016-01-01

    Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently bee...

  8. Myocardial scintigraphy with 201thallium for the diagnosis of coronary heart disease and heart muscle disease

    International Nuclear Information System (INIS)

    Keller, E.

    1986-01-01

    This work gives an overview of the presently used methods of diagnostic and therapy of coronary heart disease. With the use of 105 patients the viability of scintigraphical and radiological studies were compared to each other. The thallium scintigraphy thereby achieves excellent results with a sensitivity of 95% of coronary heart disease (with a pre-determined exclusion of myocardial diseases). In three cases small vessel disease was detected which could not be detected by a coronary angiogram. The correct localization of coronary stenosis with thallium scintigraphy was attained in the area of LAD at 77% and in the avea of RCA at 74% fairly reliable, whereas the determination of circumflex artery (sensitivity 29%) was rather poor. Also, the excact determination of the extent of coronary sclerosis shows that with multiple vessel diseases the sensitivity clearly decreases (1-vessel 78%, 2-vessel 38%, 3-vessel 13%), whereby the various coronary stenoses probably appear differently in scintigraphs. A better study method for the exact determination of the extent of myocardial ischemia is offered by the single photon emission computer tomography (SPECT) with the use of a rotating gamma camera. In view of the differential diagnostic for coronary diseases myocardial scintigraphy still plays a major role in myocardial diseases. In my own research pathological storage patterns could be shown in 14 such cases. (orig./MG) [de

  9. Exercise-based cardiac rehabilitation for coronary heart disease

    Science.gov (United States)

    Heran, Balraj S; Chen, Jenny MH; Ebrahim, Shah; Moxham, Tiffany; Oldridge, Neil; Rees, Karen; Thompson, David R; Taylor, Rod S

    2014-01-01

    Background The burden of coronary heart disease (CHD) worldwide is one of great concern to patients and healthcare agencies alike. Exercise-based cardiac rehabilitation aims to restore patients with heart disease to health. Objectives To determine the effectiveness of exercise-based cardiac rehabilitation (exercise training alone or in combination with psychosocial or educational interventions) on mortality, morbidity and health-related quality of life of patients with CHD. Search methods RCTs have been identified by searching CENTRAL, HTA, and DARE (using The Cochrane Library Issue 4, 2009), as well as MEDLINE (1950 to December 2009), EMBASE (1980 to December 2009), CINAHL (1982 to December 2009), and Science Citation Index Expanded (1900 to December 2009). Selection criteria Men and women of all ages who have had myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA), or who have angina pectoris or coronary artery disease defined by angiography. Data collection and analysis Studies were selected and data extracted independently by two reviewers. Authors were contacted where possible to obtain missing information. Main results This systematic review has allowed analysis of 47 studies randomising 10,794 patients to exercise-based cardiac rehabilitation or usual care. In medium to longer term (i.e. 12 or more months follow-up) exercise-based cardiac rehabilitation reduced overall and cardiovascular mortality [RR 0.87 (95% CI 0.75, 0.99) and 0.74 (95% CI 0.63, 0.87), respectively], and hospital admissions [RR 0.69 (95% CI 0.51, 0.93)] in the shorter term (< 12 months follow-up) with no evidence of heterogeneity of effect across trials. Cardiac rehabilitation did not reduce the risk of total MI, CABG or PTCA. Given both the heterogeneity in outcome measures and methods of reporting findings, a meta-analysis was not undertaken for health-related quality of life. In seven out of 10 trials reporting health

  10. cholesterol, coronary heart disease and oestrogens

    African Journals Online (AJOL)

    1971-04-03

    Apr 3, 1971 ... atheromatosis and coronalY heart disease in the human female are reviewed. Aspects ... For example, Barr' recorded mean levels of 197 in normal women aged 18 ..... Epstein, F. H. (1965): J. Chron. Dis.. 18. 735. 26. Kanne!

  11. What can we learn about treating heart failure from the heart's response to acute exercise? Focus on the coronary microcirculation.

    Science.gov (United States)

    Heinonen, Ilkka; Sorop, Oana; de Beer, Vincent J; Duncker, Dirk J; Merkus, Daphne

    2015-10-15

    Coronary microvascular function and cardiac function are closely related in that proper cardiac function requires adequate oxygen delivery through the coronary microvasculature. Because of the close proximity of cardiomyocytes and coronary microvascular endothelium, cardiomyocytes not only communicate their metabolic needs to the coronary microvasculature, but endothelium-derived factors also directly modulate cardiac function. This review summarizes evidence that the myocardial oxygen balance is disturbed in the failing heart because of increased extravascular compressive forces and coronary microvascular dysfunction. The perturbations in myocardial oxygen balance are exaggerated during exercise and are due to alterations in neurohumoral influences, endothelial function, and oxidative stress. Although there is some evidence from animal studies that the myocardial oxygen balance can partly be restored by exercise training, it is largely unknown to what extent the beneficial effects of exercise training include improvements in endothelial function and/or oxidative stress in the coronary microvasculature and how these improvements are impacted by risk factors such as diabetes, obesity, and hypercholesterolemia. Copyright © 2015 the American Physiological Society.

  12. The independent relationship between triglycerides and coronary heart disease

    OpenAIRE

    Alan Morrison, John E Hokanson

    2008-01-01

    Alan Morrison1, John E Hokanson21SCRIBCO, Blue Bell, PA, USA; 2Department of Epidemiology, Colorado School of Public Health, University of Colorado at Denver Denver, CO, USAAims: The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD).Methods and results: We systematically reviewed population-based cohort studies in which basel...

  13. Exercise-based cardiac rehabilitation for coronary heart disease

    OpenAIRE

    Anderson, Lindsey; Thompson, David R; Oldridge, Neil; Zwisler, Ann-Dorthe; Rees, Karen; Martin, Nicole; Taylor, Rod S

    2016-01-01

    BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health and outcomes of people with CHD. This is an update of a Cochrane systematic review previously published in 2011.OBJECTIVES: To assess the effectiveness and cost-effectiveness of exercise...

  14. Benefits of smoking cessation for coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Adi Hidayat

    2016-02-01

    Full Text Available Cardiovascular disease (CVD incidence increases with age and is frequently higher in the elderly.(1 Therefore prevention of CVD in the elderly through management of risk factors is important in order to reduce the risk of coronary heart disease (CHD. There are several risk factors of CVD that can be modified, such as smoking, physical activity, and unhealthy diet. Cessation of smoking is the most potent measure to prevent thousands of CVD events and death

  15. Impact of Experiencing Acute Coronary Syndrome Prior to Open Heart Surgery on Psychiatric Status

    Directory of Open Access Journals (Sweden)

    Volkan Yüksel

    Full Text Available Abstract Objective: The incidence of depression and anxiety is higher in patients with acute coronary syndrome. The aim of this study is to determine whether experiencing acute coronary syndrome prior to open heart surgery affects patients in terms of depression, hopelessness, anxiety, fear of death and quality of life. Methods: The study included 63 patients who underwent coronary bypass surgery between January 2015 and January 2016. The patients were divided into two groups: those diagnosed after acute coronary syndrome (Group 1 and those diagnosed without acute coronary syndrome (Group 2. Beck depression scale, Beck hopelessness scale, Templer death anxiety scale and death depression scale, State-Trait anxiety inventory and WHOQOL-Bref quality of life scale were applied. Results: There was no significant difference between the two groups in terms of the total score obtained from Beck depression scale, Beck hopelessness scale - future-related emotions, loss of motivation, future-related expectations subgroups, death anxiety scale, the death depression scale, State-Trait Anxiety Inventory - social and environmental subgroups. The mental quality of life sub-scores of group 2 were significantly higher. The patients in both groups were found to be depressed and hopeless about the future. Anxiety levels were found to be significantly higher in all of the patients in both groups. Conclusion: Acute coronary syndrome before coronary artery bypass surgery impairs more the quality of life in mental terms. But unexpectedly there are no differences in terms of depression, hopelessness, anxiety and fear of death.

  16. Impact of Experiencing Acute Coronary Syndrome Prior to Open Heart Surgery on Psychiatric Status.

    Science.gov (United States)

    Yüksel, Volkan; Gorgulu, Yasemin; Cinar, Rugul Kose; Huseyin, Serhat; Sonmez, Mehmet Bulent; Canbaz, Suat

    2016-01-01

    The incidence of depression and anxiety is higher in patients with acute coronary syndrome. The aim of this study is to determine whether experiencing acute coronary syndrome prior to open heart surgery affects patients in terms of depression, hopelessness, anxiety, fear of death and quality of life. The study included 63 patients who underwent coronary bypass surgery between January 2015 and January 2016. The patients were divided into two groups: those diagnosed after acute coronary syndrome (Group 1) and those diagnosed without acute coronary syndrome (Group 2). Beck depression scale, Beck hopelessness scale, Templer death anxiety scale and death depression scale, State-Trait anxiety inventory and WHOQOL-Bref quality of life scale were applied. There was no significant difference between the two groups in terms of the total score obtained from Beck depression scale, Beck hopelessness scale - future-related emotions, loss of motivation, future-related expectations subgroups, death anxiety scale, the death depression scale, State-Trait Anxiety Inventory - social and environmental subgroups. The mental quality of life sub-scores of group 2 were significantly higher. The patients in both groups were found to be depressed and hopeless about the future. Anxiety levels were found to be significantly higher in all of the patients in both groups. Acute coronary syndrome before coronary artery bypass surgery impairs more the quality of life in mental terms. But unexpectedly there are no differences in terms of depression, hopelessness, anxiety and fear of death.

  17. Ivabradine in acute coronary syndromes: Protection beyond heart rate lowering.

    Science.gov (United States)

    Niccoli, Giampaolo; Borovac, Josip Anđelo; Vetrugno, Vincenzo; Camici, Paolo G; Crea, Filippo

    2017-06-01

    Ivabradine is a heart rate reducing agent that exhibits anti-ischemic effects through the inhibition of funny electrical current in the sinus node resulting in heart rate reduction, thus enabling longer diastolic perfusion time, and reduced myocardial oxygen consumption without detrimental changes in arterial blood pressure, coronary vasomotion, and ventricular contractility. The current guideline-based clinical use of Ivabradine is reserved for patients with stable angina pectoris who cannot tolerate or whose symptoms are inadequately controlled with beta blockers. In patients with chronic heart failure and reduced ejection fraction, Ivabradine has demonstrated beneficial effects in improving clinical outcomes when added to conventional therapy. However, the role of Ivabradine in acute coronary syndromes has not been established. Based on the results from some relevant preclinical studies and a limited amount of clinical data that were reported recently, the role of Ivabradine in acute ischemic events warrants further investigation. The aim of this review is to provide an overview of the available literature on the potential role of Ivabradine in the clinical context of acute coronary syndromes. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. General Anesthesia in the Surgical Treatment of Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    N. A. Karpun

    2012-01-01

    Full Text Available The paper deals with the problem of anesthetic maintenance during surgical correction of coronary blood flow. The basis for this is the results of the investigations conducted at the V. A. Negovsky Research Institute of General Reanimatology, the objective of which was to improve the results of surgical treatment in patients with different forms of coronary heart disease (CHD, by optimizing the anesthetic maintenance of open heart surgery. Clinical and special examinations were made in 367 patients who had undergone surgical treatment (aortocoronary bypass surgery; formation of a mammary coronary anastomosis; resection and plastic repair of left ventricular aneurysms; thrombectomy from the heart chambers for CHD and its complications. The main methodological approach to this study is to personalize intensive therapy and general anesthesia, which are relied on both evidence-based medicine and an individual pathophysiological approach. The paper details how to choose the basic mode of general anesthesia depending on the form of CHD and myocardial contractile function. Furthermore, the authors propose methods for optimizing the perioperative period: postoperative analgesia; correction of the aggregate state of blood; operative hemodilution; prevention and correction of critically reduced blood oxygen capacity 

  19. C-reactive protein, inflammation and coronary heart disease

    Directory of Open Access Journals (Sweden)

    Amit Kumar Shrivastava

    2015-06-01

    Full Text Available Inflammation is widely considered to be an important contributing factor of the pathophysiology of coronary heart disease (CHD, and the inflammatory cascade is particularly important in the atherosclerotic process. In consideration of the important role that inflammatory processes play in CHD, recent work has been focused on whether biomarkers of inflammation may help to improve risk stratification and identify patient groups who might benefit from particular treatment strategies. Of these biomarkers, C-reactive protein (CRP has emerged as one of the most important novel inflammatory markers. CRP an acute phase protein is synthesized by hepatocytes in response to proinflammatory cytokines, in particular interleukin-6. Many large-scale prospective studies demonstrate that CRP strongly and independently predicts adverse cardiovascular events, including myocardial infarction, ischemic stroke, and sudden cardiac death in individuals both with and without overt CHD. CRP is believed to be both a marker and a mediator of atherosclerosis and CHD. CRP plays a pivotal role in many aspects of atherogenesis including, activation of complement pathway, lipids uptake by macrophage, release of proinflammatory cytokines, induces the expression of tissue factor in monocytes, promotes the endothelial dysfunction and inhibits nitric oxide production. The commercial availability of CRP high sensitive assays has made screening for this marker simple, reliable, and reproducible and can be used as a clinical guide to diagnosis, management, and prognosis of CHD.

  20. Intensive lifestyle changes for reversal of coronary heart disease.

    Science.gov (United States)

    Ornish, D; Scherwitz, L W; Billings, J H; Brown, S E; Gould, K L; Merritt, T A; Sparler, S; Armstrong, W T; Ports, T A; Kirkeeide, R L; Hogeboom, C; Brand, R J

    1998-12-16

    The Lifestyle Heart Trial demonstrated that intensive lifestyle changes may lead to regression of coronary atherosclerosis after 1 year. To determine the feasibility of patients to sustain intensive lifestyle changes for a total of 5 years and the effects of these lifestyle changes (without lipid-lowering drugs) on coronary heart disease. Randomized controlled trial conducted from 1986 to 1992 using a randomized invitational design. Forty-eight patients with moderate to severe coronary heart disease were randomized to an intensive lifestyle change group or to a usual-care control group, and 35 completed the 5-year follow-up quantitative coronary arteriography. Two tertiary care university medical centers. Intensive lifestyle changes (10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support) for 5 years. Adherence to intensive lifestyle changes, changes in coronary artery percent diameter stenosis, and cardiac events. Experimental group patients (20 [71%] of 28 patients completed 5-year follow-up) made and maintained comprehensive lifestyle changes for 5 years, whereas control group patients (15 [75%] of 20 patients completed 5-year follow-up) made more moderate changes. In the experimental group, the average percent diameter stenosis at baseline decreased 1.75 absolute percentage points after 1 year (a 4.5% relative improvement) and by 3.1 absolute percentage points after 5 years (a 7.9% relative improvement). In contrast, the average percent diameter stenosis in the control group increased by 2.3 percentage points after 1 year (a 5.4% relative worsening) and by 11.8 percentage points after 5 years (a 27.7% relative worsening) (P=.001 between groups. Twenty-five cardiac events occurred in 28 experimental group patients vs 45 events in 20 control group patients during the 5-year follow-up (risk ratio for any event for the control group, 2.47 [95% confidence interval, 1.48-4.20]). More regression

  1. Effects of Psychoeducation on Mental Health in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bashiri, Zahra; Aghajani, Mohammad; Masoudi Alavi, Negin

    2016-05-01

    Patients with coronary heart disease are at high risk for mental health disorders, such as depression and anxiety. Psychoeducation is a well-known intervention for psychiatric patients, but its use has been limited in other health conditions, such as coronary heart disease. The aim of this study was to evaluate the effect of psychoeducation on mental health in coronary heart disease patients. This randomized clinical trial included 70 patients with coronary heart disease at Shahid Beheshti hospital, in Kashan, Iran, in 2014. The patients were randomly assigned into two groups: the experimental group, which received eight sessions of psychoeducation, and the control group, which received routine care. Data were collected with the Goldberg mental health questionnaire (GHQ) and were analyzed using independent and paired t-tests performed with SPSS version 16. The means of overall GHQ scores were significantly decreased post-test in the intervention group, and the differences between the two groups were statistically significant in the overall GHQ scores (P = 0.0001). A significant difference was observed between the mean GHQ scores of the intervention group prior to and after the psychoeducational program (PEP) intervention (30 ± 4.66 vs. 20.50 ± 3.30) (P = 0.0001). No significant changes were observed in the control group pre- and post-test (P = 0.07). Psychoeducation resulted in improved mental health in patients with coronary heart disease. Therefore, it is recommended that this approach be performed as a complementary, effective, non-invasive, low-cost nursing intervention to reduce psychological problems in these patients.

  2. Epidemiology and prevention of coronary heart disease in families.

    Science.gov (United States)

    Higgins, M

    2000-04-01

    Although family histories are used primarily to aid in diagnosis and risk assessment, their value is enhanced when the family is considered as a unit for research and disease prevention. The value of a family history of coronary heart disease (CHD) is increased when the age, sex, number of relatives, and age at onset of disease are incorporated in a quantitative family risk score. Medical and lifestyle risk factors that aggregate in families include dyslipidemia, hypertension, obesity, hyperfibrinogenemia, diabetes mellitus, smoking habits, eating patterns, alcohol consumption, physical activity, and socioeconomic status. Advances in detecting and understanding interactions between genetic susceptibility and modifiable risk factors should lead to improvements in prevention and treatment. However, working with families can be difficult. In the United States, families are usually small, are often widely dispersed, and may not be intact. Family histories may be unknown, affected relatives may be dead, and secular trends mask similarities among generations. Many exposures occur outside the home, and families change over time. Ethical, legal, and social issues arise when dealing with families. Nevertheless, opportunities are missed when research, clinical practice, and prevention focus on individual patients. Greater emphasis on families is needed to reduce the burden of CHD.

  3. Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten Schou; Isaksen, Christin; Buhl, Jørgen Selmer

    2015-01-01

    : This is a cohort study that included patients examined between 2010 and 2013. Data were obtained from the Western Denmark Heart Registry. The follow-up ended 11 March 2014. RESULTS: A total of 3541 people (1621 men and 1920 women) were examined by CCTA. The rate of invasive coronary angiography during follow......-up was 28.5% in men versus 18.3% in women (pwomen (pwomen versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary...... revascularisation. Further adjustment for age and other risk factors did not change these estimates. CONCLUSIONS: Women had a lower CAC score than men and a corresponding lower rate of invasive coronary angiography. The risk of coronary revascularisation was modestly reduced in women, irrespective of CAC. This may...

  4. Modifiable Coronary Heart Disease Risk Factors in the Population Aged 20-49 Years

    Directory of Open Access Journals (Sweden)

    Francisco Carlos Valladares Mas

    2014-04-01

    Full Text Available Background: evidence provided by the Framingham Heart Study established the critical role of risk factors in the development of coronary heart disease. Over half a century later, current detection and control are still inadequate. Objective: to identify modifiable risk factors of coronary heart disease in individuals aged 20 to 49 years. Methods: a descriptive, cross-sectional study was conducted in 276 individuals from the doctor’s office No. 1 of the Fabio di Celmo Community Teaching Polyclinic in Cienfuegos. Patients were examined in the clinic visit and/or whole family visit. The studied variables included age, sex, skin color, risk factors (excess weight/obesity, physical inactivity, smoking, hypertension, diabetes, dyslipidemia and psychosocial factors, which were obtained from the medical interview, physical examination, laboratory tests (total cholesterol and triglycerides and review of individual medical records and family history. Results: risk factors most frequently identified were excess weight/obesity (42.4 %, physical inactivity (34.4 % and smoking (20.3 %. Presence of these risk factors increased with age, showing differences in the distribution by sex and was associated with psychosocial factors. Their coexistence and progress with age was significant. Conclusion: prevalence of modifiable risk factors for coronary heart disease in a young population was high, with frequent association, predominating factors related to unhealthy lifestyles.

  5. Drug-eluting stents vs. coronary artery bypass-grafting in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-12-01

    Full Text Available Background: Coronary artery bypass graft (CABG and percutaneous revascularisations with implantation of drug-eluting stents (DES are important treatment methods in coronary heart disease (CHD. Research questions: The evaluation addresses questions on medical efficacy, health economic parameters as well as ethic, social and legal implications in the use of DES vs. CABG in CHD patients. Methods: A systematic literature search was conducted in December 2006 in the most important electronic databases beginning from 2004. Register data and controlled clinical studies were included in the evaluation. Additionally, a health economic modelling was conducted. Results: Medical evaluation: The literature search yielded 2,312 hits. 14 publications about six controlled clinical studies and five publications about two registers were included into the evaluation. Register data showed low mortality (0.2% to 0.7% and low rates of myocardial infarction (0.5% to 1.4% during hospital stay. In patients with stenosis of the left anterior descending coronary artery one study showed in several analyses a significantly higher rate of reinterventions and a significantly higher rate of repeated angina pectoris for DES up to two years after the implantation (16.8% vs. 3.6% and 35% vs. 8%. In patients with left main coronary artery stenosis two studies revealed a significantly higher survival without myocardial infarction and stroke for DES up to one year (96% vs. 79% and 95% vs. 91% and two studies a significantly higher rate of revascularisations up to two years (20% vs. 4% and 25% vs. 5% after the primary intervention. In patients with multivessel disease, one study found a significantly higher mortality and myocardial infarction rate for CABG at one year (2.7% vs. 1.0% and 4.2% vs. 1.3%. The rate of revascularisations was significantly higher in two studies up to two years after DES implantation (8.5% vs. 4.2% and 14.2% vs. 5.3%. The rate at repeated angina pectoris was

  6. Relationship between serum thyroid hormones levels and heart failure in patients with coronary heart disease (CHD)

    International Nuclear Information System (INIS)

    Du Fuman; Liu Tongmei; Wang Weimin

    2006-01-01

    Objective: To investigate the relationship between serum thyroid hormones levels and severity of heart failure in patients with coronary heart disease (CHD). Methods: Serum thyroid hormones (FT 3 , FT 4 , TSH) levels were measured with RIA in 38 patients with CHD but no cardiac failure, 40 CHD patients with heat failure and 37 controls. Results: The serum FT 3 levels in patients with heart failure were significantly lower than those in the other two groups (P 4 and TSH in all these three groups of subjects. Moreover, the serum FT 3 levels in the patients with heart fail- ure were significantly positively correlated with the ejection fractions (EF) in these patients. Conclusion: Serum FT 3 levels dropped markedly in CHD patients with heart failure and the magnitude of decrease was positively correlated with the severity of the disease. (authors)

  7. Association Study of Gut Flora in Coronary Heart Disease through High-Throughput Sequencing

    OpenAIRE

    Cui, Li; Zhao, Tingting; Hu, Haibing; Zhang, Wen; Hua, Xiuguo

    2017-01-01

    Objectives. We aimed to explore the impact of gut microbiota in coronary heart disease (CHD) patients through high-throughput sequencing. Methods. A total of 29 CHD in-hospital patients and 35 healthy volunteers as controls were included. Nucleic acids were extracted from fecal samples, followed by ? diversity and principal coordinate analysis (PCoA). Based on unweighted UniFrac distance matrices, unweighted-pair group method with arithmetic mean (UPGMA) trees were created. Results. After dat...

  8. Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Shilane, David; Go, Alan S

    2014-01-01

    BACKGROUND: The effectiveness of beta-blockers for preventing cardiac events has been questioned for patients who have coronary heart disease (CHD) without a prior myocardial infarction (MI). OBJECTIVES: The purpose of this study was to assess the association of beta-blockers with outcomes among...... patients with new-onset CHD. METHODS: We studied consecutive patients discharged after the first CHD event (acute coronary syndrome or coronary revascularization) between 2000 and 2008 in an integrated healthcare delivery system who did not use beta-blockers in the year before entry. We used time......-varying Cox regression models to determine the hazard ratio (HR) associated with beta-blocker treatment and used treatment-by-covariate interaction tests (pint) to determine whether the association differed for patients with or without a recent MI. RESULTS: A total of 26,793 patients were included, 19...

  9. Heart team discussion in managing patients with coronary artery disease: outcome and reproducibility.

    Science.gov (United States)

    Long, Jenny; Luckraz, Heyman; Thekkudan, Joyce; Maher, Abdul; Norell, Michael

    2012-05-01

    Recent ESC/EACTS revascularization guidelines advocate a 'Heart Team' (HT) approach in the decision-making process when managing patients with coronary disease. We prospectively assessed HT decision-making in 150 patients analysing personnel attendance, data presented, the 'actioning' of the HT decision and, if not completed, then the reasons why. Additionally, 50 patients were specifically re-discussed after 1 year in order to assess consistency in decision-making. We have two HT meetings each week. At least one surgeon, interventional cardiologist and non-interventional cardiologist were present at all meetings. Data presented included patient demographics, symptoms, co-morbidities, coronary angiography, left ventricular function and other relevant investigations, e.g. echocardiograms. HT decisions included continued medical treatment (22%), percutaneous coronary intervention (PCI; 22%), coronary-artery bypass grafting (CABG; 34%) or further investigations such as pressure wire studies, dobutamine stress echo or cardiac magnetic resonance imaging (22%). These decisions were fully undertaken in 86% of patients. Reasons for aberration in the remaining 21 patients included patient refusal (CABG 29%, PCI 10%) and further co-morbidities (28%). On re-discussion of the same patient data (n = 50) a year later, 24% of decisions differed from the original HT recommendations reflecting the fact that, for certain coronary artery disease pattern, either CABG or PCI could be appropriate.

  10. Interventional cardiology and diabetes mellitus: age of effective coronary heart disease treatment

    Directory of Open Access Journals (Sweden)

    Victor Yur'evich Kalashnikov

    2011-03-01

    Full Text Available Introduction into clinical practice of coronary angioplasty has provided new possibilities for treatment of coronary heart disease (CHD in patientswith diabetes mellitus. The indications for endovascular interventions and principles of coronary stenting in such patients are described in this article.

  11. Randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease: systematic review.

    Science.gov (United States)

    Goulding, Lucy; Furze, Gill; Birks, Yvonne

    2010-05-01

    This paper is a report of a systematic review of randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease, and was conducted to determine whether such interventions were effective in changing maladaptive beliefs, and to assess any consequent change in coping and outcome. An increasing body of evidence suggests that faulty beliefs can lead to maladaptive behaviours and, in turn, to poor outcomes. However, the effectiveness of interventions to change such faulty illness beliefs in people with coronary heart disease is unknown. Multiple data bases were searched using a systematic search strategy. In addition, reference lists of included papers were checked and key authors in the field contacted. The systematic review included randomized controlled trials with adults of any age with a diagnosis of coronary heart disease and an intervention aimed at changing cardiac beliefs. The primary outcome measured was change in beliefs about coronary heart disease. Thirteen trials met the inclusion criteria. Owing to the heterogeneity of these studies, quantitative synthesis was not practicable. Descriptive synthesis of the results suggested that cognitive behavioural and counselling/education interventions can be effective in changing beliefs. The effects of changing beliefs on behavioural, functional and psychological outcomes remain unclear. While some interventions may be effective in changing beliefs in people with coronary heart disease, the effect of these changes on outcome is not clear. Further high quality research is required before firmer guidance can be given to clinicians on the most effective method to dispel cardiac misconceptions.

  12. Relationship of adiponectin level with lipid profile in type-2 diabetic men with coronary heart disease

    International Nuclear Information System (INIS)

    Durrani, S.; Jan, M.R.; Shah, J.; Khan, M.A.

    2015-01-01

    Cerebro-vascular disease is a commonest long term complication of type-2 diabetes mellitus. The study was done to determine concentration of serum adiponectin and lipid profile in type-2 diabetic men with coronary heart disease (CHD) in the region of Khyber Pakhtunkhwa (KPK), and to find possible relationship between them. Methods: This was a cross-sectional study comprising of randomly selected thirty six healthy adult males and thirty six type-2 diabetic males with coronary heart disease. Their fasting blood samples were analysed for serum adiponectin, fasting blood glucose, glycosylated haemoglobin and lipid profile which included total cholesterol (T-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). The relationship of adiponectin with other variables in type-2 diabetic men with coronary heart disease was determined with Pearson correlations coefficient (r). Results: Type-2 diabetic males with coronary heart disease when compared to healthy males showed significantly low levels of serum adiponectin (p=<0.001) and HDL-C (p=<0.001) and significantly high level of FBG (p=<0.001), HbA1c (p=<0.001), TC (p=<0.05), TG (p=<0.05) and LDL-C (p=<0.05). Serum adiponectin level showed a significant negative correlation with FBG (r = -0.332; p= 0.04), HbA1c (r = -0.818; p=<0.01) and TG (r = -0.640; p=<0.01) in type-2 diabetic men with coronary heart disease. Adiponectin showed a significant positive association with HDL-C in controls (r = 0.948; p=<0.01) and patients of type-2 diabetes with CHD (r = 0.650; p=<0.01). Conclusion: Serum adiponectin concentration is markedly decreased in patients of type-2 diabetes with coronary heart disease. Hypoadiponectinemia is related with deranged lipid profile, i.e., high TG and low HDL-C levels in type-2 diabetic men with CHD. Moreover, adiponectin is associated positively with HDL-C and negatively with HbA1c and TG levels in the studied population. (author)

  13. Effect of Heart Rate and Coronary Calcification on the Diagnostic Accuracy of the Dual-Source CT Coronary Angiography in Patients with Suspected Coronary Artery Disease

    International Nuclear Information System (INIS)

    Meng, Lingdong; Cui, Lianqun; Cheng, Yuntao; Wu, Xiaoyan; Tang, Yuansheng; Wang, Yong; Xu, Fayun

    2009-01-01

    To evaluate the diagnostic accuracy of a dual-source computed tomography (DSCT) coronary angiography, with a particular focus on the effect of heart rate and calcifications. One hundred and nine patients with suspected coronary disease were divided into 2 groups according to a mean heart rate ( 400). Next, the effect of heart rate and calcification on the accuracy of coronary artery stenosis detection was analyzed by using an invasive coronary angiography as a reference standard. Coronary segments of less than 1.5 mm in diameter in an American Heart Association (AHA) 15-segment model were independently assessed. The mean heart rate during the scan was 71.8 bpm, whereas the mean Agatston score was 226.5. Of the 1,588 segments examined, 1,533 (97%) were assessable. A total of 17 patients had calcium scores above 400 Agatston U, whereas 50 had heart rates ≥ 70 bpm. Overall the sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for significant stenoses were: 95%, 91%, 65%, and 99% (by segment), respectively and 97%, 90%, 81%, and 91% (by artery), respectively (n = 475). Heart rate showed no significant impact on lesion detection; however, vessel calcification did show a significant impact on accuracy of assessment for coronary segments. The specificity, PPV and accuracy were 96%, 80%, and 96% (by segment), respectively for an Agatston score less than 100% and 99%, 96% and 98% (by artery). For an Agatston score of greater to or equal to 400 the specificity, PPV and accuracy were reduced to 79%, 55%, and 83% (by segment), respectively and to 79%, 69%, and 85% (by artery), respectively. The DSCT provides a high rate of accuracy for the detection of significant coronary artery disease, even in patients with high heart rates and evidence of coronary calcification. However, patients with severe coronary calcification (> 400 U) remain a challenge to diagnose

  14. [Echocardiographic indices of the right heart in patients with coronary artery disease in different age groups].

    Science.gov (United States)

    Gajfulin, R A; Sumin, A N; Arhipov, O G

    2016-01-01

    The aim of study was to examine echocardiographic indices of right heart chambers in patients with coronary artery disease in different age groups. On 678 patients aged 38-85 years, who underwent echocardiography, are including with the use of spectral tissue Doppler. Obtained 2 age groups: 1st - patients up to 60 years (n=282) and group 2nd - patients 60 years and older (n=396). In the analysis the obtained results in patients with coronary heart disease in older age groups showed an increase in right ventricular wall thickness, systolic and average pressure in the pulmonary artery. These changes were accompanied by deterioration in left ventricular diastolic function, while the systolic function of the left and right ventricle were independent of age. Thus, the results can be recommended for assessment of right ventricular dysfunction in patients of older age groups.

  15. Executive function, but not memory, associates with incident coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Rostamian, Somayeh; van Buchem, Mark A; Westendorp, Rudi G J

    2015-01-01

    OBJECTIVE: To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia. METHODS: We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases...... from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to Z scores and averaged into a composite...... executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression...

  16. Role of NOD2/CARD15 in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Förster Matti

    2007-11-01

    Full Text Available Abstract Background: Bacterial DNA has been repeatedly detected in atheromatous lesions of coronary heart disease (CHD patients. Phylogenetic signatures in the atheroma lesions that are similar to those of bacterial biofilms on human barrier organs, including the respiratory or gastrointestinal tract, raise the question of a defective barrier function in CHD. NOD2 plays a major role in defense against bacterial invasion. Genetic variation in the CARD15 gene, which encodes NOD2, was previously shown to result in a barrier defect that causes chronic inflammatory disorders (e.g. Crohn disease. In the present study, we investigated the possible involvement of NOD2/CARD15 in the pathology of CHD by i analyzing the local expression of NOD2 in atherectomy versus healthy tissue (n = 5 each using histochemical immunofluorescence and ii by testing the three major functional CARD15 variants (R702W, G908R and 1007fs for association with early-onset CHD in 900 German patients and 632 healthy controls. Results: In atherectomy tissue of CHD patients, NOD2 was detected in inflammatory cells at the luminal sides of the lesions. However, the allele and genotype frequencies of the three major CARD15 polymorphisms did not differ between CHD patients and controls. Conclusion: The NOD2 up-regulation in atheroma lesions indicates an involvement of this protein in the pathology of CHD. Although NOD2 could be important in local immune response mechanisms, none of the analyzed CARD15 variants seem to play a significant role in the etiology of CHD.

  17. Depression risk in patients with coronary heart disease in Germany

    Institute of Scientific and Technical Information of China (English)

    Marcel Konrad; Louis Jacob; Michael A Rapp; Karel Kostev

    2016-01-01

    AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease(CHD) treated in German primary care practices.METHODS Longitudinal data from nationwide general practices in Germany(n = 1072) were analyzed.Individuals initially diagnosed with CHD(2009-2013) were identified,and 59992 patients were included and matched(1:1) to 59992 controls.The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD.Cox proportional hazards models were used to adjust for confounders.RESULTS Mean age was equal to 68.0 years(SD = 11.3).A total of 55.9% of patients were men.After a five-year follow-up,21.8% of the CHD group and 14.2% of the control group were diagnosed with depression(P < 0.001).In the multivariate regression model,CHD was a strong risk factor for developing depression(HR =1.54,95%CI:1.49-1.59,P < 0.001).Prior depressive episodes,dementia,and eight other chronic conditions were associated with a higher risk of developing depression.Interestingly,older patients and women were also more likely to be diagnosed with depression compared with younger patients and men,respectively.CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany.CHD patients should be routinely screened for depression to ensure improved treatment and management.

  18. Periodontal disease, tooth loss and coronary heart disease assessed by coronary angiography: a cross-sectional observational study.

    Science.gov (United States)

    Zanella, S M; Pereira, S S; Barbisan, J N; Vieira, L; Saba-Chujfi, E; Haas, A N; Rösing, C K

    2016-04-01

    To evaluate the association between periodontal disease, tooth loss and coronary heart disease (CHD). There is still controversy about the relationship between periodontal disease and tooth loss with vessel obstruction assessed using coronary angiography. This cross-sectional study included 195 patients that underwent coronary angiography and presented with at least six teeth. Patients were classified into three categories of coronary obstruction severity: absence; one or more vessels with ≤ 50% obstruction; and one or more vessels with ≥ 50% obstruction. The extent of coronary obstruction was dichotomized into 0 and ≥ 1 affected vessels. A periodontist blinded to patient CHD status conducted a full mouth examination to determine mean clinical attachment loss, mean periodontal probing depth and tooth loss. Multiple logistic regression models were applied adjusting for age, gender, hypertension, smoking, body mass index, low-density lipoprotein cholesterol and C-reactive protein. Most patients were males (62.1%) older than 60 years (50.8%), and 61% of them had CHD. Mean periodontal probing depth, clinical attachment loss and tooth loss were 2.64 ± 0.72 mm, 4.40 ± 1.31 mm and 12.50 ± 6.98 teeth respectively. In the multivariable models, tooth loss was significantly associated with a higher chance of having at least one obstructed vessel (odds ratio = 1.04; 95% confidence interval 1.01-1.09) and with vessel obstruction ≥ 50% (odds ratio = 1.06; 95% confidence interval 1.01-1.11). No significant associations were found between periodontal variables and vessel obstruction. Tooth loss was found to be a risk indicator for CHD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. [Population surveillance of coronary heart disease].

    Science.gov (United States)

    Ben Romdhane, Habiba; Bougatef, Souha; Skhiri, Hajer; Gharbi, Donia; Haouala, Habib; Achour, Noureddine

    2005-05-01

    A cross-sectional population survey was carried out in the Ariana region in 2000-01. The aim of this study is to report the prevalence of CHD as indicated by ECG Minnesota coding. A randomly selected sample included 1837 adults 40-70 years. Data on socio-economic status, demographic, medical history, health behaviour, clinical and biological investigations were recorded. Risk factors (hypertension, dyslipedemia, obesity, diabetes) are defined according to WHO criterias. Standard supine 12 lead ECGs were recorded. All ECGs are red and classified according to the Minnesota codes criteria on CHD probable, CHD possible and on Major abnormalities and minor abnormalities. CHD prevalence was higher on women. Major abnormalities are more common on women (20.6% vs 13%), while minor abnormalities prevalence was higher on men (15.5% vs 7.5%) (p<0.0001). The prevalence increased with age in both genders. This study tested how feasible is the population approach on CVDs surveillance. It highlighted the burden of cardiovascular diseases and support that women are at risk as men are. The value of ECG findings must be integrated in the cardiovascular diseases surveillance to identify high risk population.

  20. Continuous ECG Monitoring in Patients With Acute Coronary Syndrome or Heart Failure: EASI Versus Gold Standard.

    Science.gov (United States)

    Lancia, Loreto; Toccaceli, Andrea; Petrucci, Cristina; Romano, Silvio; Penco, Maria

    2018-05-01

    The purpose of the study was to compare the EASI system with the standard 12-lead surface electrocardiogram (ECG) for the accuracy in detecting the main electrocardiographic parameters (J point, PR, QT, and QRS) commonly monitored in patients with acute coronary syndromes or heart failure. In this observational comparative study, 253 patients who were consecutively admitted to the coronary care unit with acute coronary syndrome or heart failure were evaluated. In all patients, two complete 12-lead ECGs were acquired simultaneously. A total of 6,072 electrocardiographic leads were compared (3,036 standard and 3,036 EASI). No significant differences were found between the investigate parameters of the two measurement methods, either in patients with acute coronary syndrome or in those with heart failure. This study confirmed the accuracy of the EASI system in monitoring the main ECG parameters in patients admitted to the coronary care unit with acute coronary syndrome or heart failure.

  1. Nuclear Techniques for Coronary Heart Disease Therapy after Percutaneous Transluminal Coronary Angioplasty

    International Nuclear Information System (INIS)

    Nurlaila-Z

    2005-01-01

    Nuclear techniques studies of the heart represent one of the fastest growing areas of research. Several years ago, nuclear medicine cardiac studies were limited for the evaluation and diagnosis of myocardial infarction. Development in radiopharmaceutical-chemistry and instrumentation have made possible advances in nuclear medicine for restenosis cardiovascular therapy after percutaneous transluminal coronary angioplasty.The radionuclide as radiation source can be delivered to the target basically by two techniques, those are catheter-based systems and radioactive stents. For this purpose,it can be use the γ and β emitter radionuclides, in which the β emitter radionuclides is an ideal radionuclide for endovascular therapy. Restenosis after percutaneous transluminal coronary angioplasty can be prevented by using the radioactive stent. This review discusses several techniques which could be used for restenosis cardiovascular therapy. Furthermore, several types of radiopharmaceutical and kinds of radionuclides as well as doses of the compounds for this purpose are also reviewed. (author)

  2. Profile of coronary heart disease risk factors in first-year university ...

    African Journals Online (AJOL)

    There is substantial evidence that coronary heart disease risk factors are present in people of all ages. The extent to which the problem exists in university students in South Africa has not been confirmed in the literature and needs further investigation. The aim of the study was to profile the coronary heart disease risk factors ...

  3. 76 FR 9525 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2011-02-18

    ... coronary heart disease (CHD), in a manner that is consistent with FDA's February 14, 2003, letter of.... FDA-2000-P-0102, FDA-2000-P-0133, and FDA-2006-P-0033] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Extension of enforcement discretion...

  4. Coronary artery bypass grafting on the beating heart using the Octopus method

    NARCIS (Netherlands)

    Thijssens, K. M.; Rodrigus, I. E.; Amsel, B. J.; de Hert, S. G.; Moulijn, A. C.

    2000-01-01

    STUDY OBJECTIVE: To study the usefulness and effectiveness of off-pump coronary bypass grafting with the Octopus heart stabilizing device. METHOD: The files of thirty-one patients undergoing coronary artery bypass with the aid of the Octopus heart stabilizing device between April 1996 and October

  5. Exercise-based cardiac rehabilitation for coronary heart disease.

    Science.gov (United States)

    Anderson, Lindsey; Thompson, David R; Oldridge, Neil; Zwisler, Ann-Dorthe; Rees, Karen; Martin, Nicole; Taylor, Rod S

    2016-01-05

    Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health and outcomes of people with CHD. This is an update of a Cochrane systematic review previously published in 2011. To assess the effectiveness and cost-effectiveness of exercise-based CR (exercise training alone or in combination with psychosocial or educational interventions) compared with usual care on mortality, morbidity and HRQL in patients with CHD.To explore the potential study level predictors of the effectiveness of exercise-based CR in patients with CHD. We updated searches from the previous Cochrane review, by searching Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 6, 2014) from December 2009 to July 2014. We also searched MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Science Citation Index Expanded (December 2009 to July 2014). We included randomised controlled trials (RCTs) of exercise-based interventions with at least six months' follow-up, compared with a no exercise control. The study population comprised men and women of all ages who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris, or coronary artery disease. We included RCTs that reported at least one of the following outcomes: mortality, MI, revascularisations, hospitalisations, health-related quality of life (HRQL), or costs. Two review authors independently screened all identified references for inclusion based on the above inclusion and exclusion criteria. One author extracted data from the included trials and assessed their risk of bias; a second review author checked data. We stratified meta-analysis by the duration of follow up of trials, i.e. short-term: 6

  6. Viral Heart Disease and Acute Coronary Syndromes - Often or Rare Coexistence?

    Science.gov (United States)

    Pawlak, Agnieszka; Wiligorska, Natalia; Wiligorska, Diana; Frontczak-Baniewicz, Malgorzata; Przybylski, Maciej; Krzyzewski, Rafal; Ziemba, Andrzej; Gil, Robert J

    2018-01-01

    Clinical presentation of viral myocarditis can mimic acute coronary syndrome and making diagnosis of viral heart disease (VHD) may be challenging. The presence of coronary artery disease (CAD) does not always exclude VHD and these entities can coexist. However, the incidence of co-occurrence of CAD and VHD is not precisely known. Moreover, inflammatory process caused by viruses may result in atherosclerotic plaque destabilization. The goal of this work is to summarize the current knowledge about co-occurrence of VHD and CAD. This article presents the importance of inflammatory process in both diseases and helps to understand pathophysiological mechanisms underlying their coexistence. It provides information about making differential diagnosis between these entities, including clinical presentation, noninvasive imaging features and findings in endomyocardial biopsy. Although currently there are no standard therapy strategies in coexistence of VHD and CAD, we present some remarkable aspects of treatment of patients, in whom VHD co-occurs with CAD. Viral heart disease may occur both in patients without and with atherosclerotic plaques in coronary arteries. Destabilization of atherosclerotic plaques in coronary arteries can be facilitated by inflammatory process. Increased inflammatory infiltrates in the coronary lesions of patients with VHD can lead to plaques' instability and consequently trigger acute coronary syndrome. In this article we attempted to present that co-occurrence of VHD and CAD may have therapeutic implications and as specific antiviral treatment is currently available, proper diagnosis and treatment can improve patient's condition and prognosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  7. Long working hours may increase risk of coronary heart disease.

    Science.gov (United States)

    Kang, Mo-Yeol; Cho, Soo-Hun; Yoo, Min-Sang; Kim, Taeshik; Hong, Yun-Chul

    2014-11-01

    To evaluate the association between long working hours and risk of coronary heart disease (CHD) estimated by Framingham risk score (FRS) in Korean adults. This study evaluated adult participants in Korean National Health and Nutrition Examination Survey IV (2007-2009). After inclusion and exclusion criteria were applied, the final sample size for this study model was 8,350. Subjects were asked about working hours and health status. Participants also completed physical examinations and biochemical measurement necessary for estimation of FRS. Multiple logistic regression was conducted to investigate the association between working hours and 10-year risk for CHD estimated by FRS. Compared to those who work 31-40 hr, significantly higher 10-year risk was estimated among subjects working longer hours. As working hours increased, odds ratio (OR) for upper 10 percent of estimated 10-year risk for CHD was increased up to 1.94. Long working hours are significantly related to risk of coronary heart disease. © 2014 Wiley Periodicals, Inc.

  8. Implementation and consistency of Heart Team decision-making in complex coronary revascularisation.

    Science.gov (United States)

    Pavlidis, Antonis N; Perera, Divaka; Karamasis, Grigoris V; Bapat, Vinayak; Young, Chris; Clapp, Brian R; Blauth, Chris; Roxburgh, James; Thomas, Martyn R; Redwood, Simon R

    2016-03-01

    A multidisciplinary team (MDT) approach for decision-making in patients with complex coronary artery disease (CAD) is now a class IC recommendation in the European and American guidelines for myocardial revascularisation. The aim of this study was to evaluate the implementation and consistency of Heart Team HT decision-making in complex coronary revascularisation. We prospectively evaluated the data of 399 patients derived from 51 consecutive MDT meetings held in a tertiary cardiac centre. A subset of cases was randomly selected and re-presented with the same clinical data to a panel blinded to the initial outcome, at least 6 months after the initial discussion, in order to evaluate the reproducibility of decision-making. The most common decisions included continued medical management (30%), coronary artery bypass grafting (CABG) (26%) and percutaneous coronary intervention (PCI) (17%). Other decisions, such as further assessment of symptoms or evaluation with further invasive or non-invasive tests were made in 25% of the cases. Decisions were implemented in 93% of the cases. On re-discussion of the same data (n=40) within a median period of 9 months 80% of the initial HT recommendations were successfully reproduced. The Heart Team is a robust process in the management of patient with complex CAD and decisions are largely reproducible. Although outcomes are successfully implemented in the majority of the cases, it is important that all clinical information is available during discussion and patient preference is taken into account. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. The role of Homocysteine as a predictor for coronary heart disease

    Directory of Open Access Journals (Sweden)

    Schramm, Susanne

    2007-11-01

    Full Text Available Background and objective: There is an ongoing debate on the role of the cytotoxic aminoacid homocysteine as a causal risk factor for the development of coronary heart disease. Results from multiple case control-studies demonstrate, that there is a strong association between high plasma levels of homoysteine and prevalent coronary heart disease, independent of other classic risk factors. Furthermore, results from interventional studies point out that elevated plasma levels of homocysteine may effectively be lowered by the intake of folic acid and B vitamins. In order to use this information for the construction of a new preventive strategy against coronary heart disease, more information is needed: first, whether homocysteine actually is a causal risk factor with relevant predictive properties and, second, whether by lowering elevated homocysteine plasma concentrations cardiac morbidity can be reduced. Currently in Germany the determination of homocysteine plasma levels is reimbursed for by statutory health insurance in patients with manifest coronary heart disease and in patients at high risk for coronary heart disease but not for screening purposes in asymptomatic low risk populations.Against this background the following assessment sets out to answer four questions: 1. Is an elevated homocysteine plasma concentration a strong, consistent and independent (of other classic risk factors predictor for coronary heart disease? 2. Does a therapeutic lowering of elevated homoysteine plasma levels reduce the risk of developing coronary events? 3. What is the cost-effectiveness relationship of homocysteine testing for preventive purposes? 4. Are there morally, socially or legally relevant aspects that should be considered when implementing a preventive strategy as outlined above? Methods: In order to answer the first question, a systematic overview of prospective studies and metaanalyses of prospective studies is undertaken. Studies are included that

  10. Cardiovascular metabolic syndrome: mediators involved in the pathophysiology from obesity to coronary heart disease.

    Science.gov (United States)

    Roos, Cornelis J; Quax, Paul H A; Jukema, J Wouter

    2012-02-01

    Patients with obesity and diabetes mellitus are at increased risk for cardiovascular events and have a higher cardiovascular morbidity and mortality. This worse prognosis is partly explained by the late recognition of coronary heart disease in these patients, due to the absence of symptoms. Early identification of coronary heart disease is vital, to initiate preventive medical therapy and improve prognosis. At present, with the use of cardiovascular risk models, the identification of coronary heart disease in these patients remains inadequate. To this end, biomarkers should improve the early identification of patients at increased cardiovascular risk. The first part of this review describes the pathophysiologic pathway from obesity to coronary heart disease. The second part evaluates several mediators from this pathophysiologic pathway for their applicability as biomarkers for the identification of coronary heart disease.

  11. Primary prevention in patients with a strong family history of coronary heart disease.

    Science.gov (United States)

    Burke, Lora A

    2003-01-01

    The interplay of genetic and environmental factors places first-degree relatives of individuals with premature coronary heart disease at greater risk of developing the disease than the general population. Disease processes, such as dyslipidemia, hypertension, and glucose and insulin metabolism, and lifestyle habits, such as eating and exercise patterns, as well as socioeconomic status aggregate in families with coronary heart disease. The degree of risk associated with a family history varies with the degree of relationship and the age at onset of disease. All individuals with a family history of premature heart disease should have a thorough coronary risk assessment performed, which can be initiated in an office visit. Absolute risk for coronary heart disease determination will predict the intensity of preventive interventions. This article reviews the components of risk determination and primary prevention in individuals with a strong family history of coronary heart disease.

  12. Coronary heart disease after radiotherapy for peptic ulcer disease

    International Nuclear Information System (INIS)

    Carr, Zhanat A.; Land, Charles E.; Kleinerman, Ruth A.; Weinstock, Robert W.; Stovall, Marilyn; Griem, Melvin L.; Mabuchi, Kiyohiko

    2005-01-01

    Purpose: To evaluate the risk of coronary heart disease (CHD) and cerebrovascular disease after radiotherapy (RT) for peptic ulcer disease. Methods and materials: Peptic ulcer disease patients treated with RT (n = 1859) or by other means (n = 1860) at the University of Chicago Medical Center between 1936 and 1965, were followed through 1997. The observed numbers of cause-specific deaths were compared with the expected numbers from the general population rates. During RT, 5% of the heart was in the treatment field and the remainder of the heart mostly received scattered radiation. A volume-weighted cardiac dose was computed to describe the average tissue dose to the entire organ. We used Cox proportional hazards regression analysis to analyze the CHD and cerebrovascular disease risk associated with RT, adjusting for confounding factors. Results: Greater than expected CHD mortality was observed among the irradiated patients. The irradiated patients received volume-weighted cardiac doses ranging from 1.6 to 3.9 Gy and the portion of the heart directly in the field received doses of 7.6-18.4 Gy. The CHD risk increased with the cardiac dose (p trend = 0.01). The cerebrovascular disease risk was not associated with the surrogate carotid dose. Conclusion: The excess CHD risk in patients undergoing RT for peptic ulcer disease decades previously indicates the need for long-term follow-up for cardiovascular disease after chest RT

  13. 76 FR 49707 - Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease; Reopening of the...

    Science.gov (United States)

    2011-08-11

    ... Risk of Coronary Heart Disease; Reopening of the Comment Period AGENCY: Food and Drug Administration... reconsider its proposed amendments to the phytosterols and risk of coronary heart disease health [[Page 49708... December 8, 2010, proposing to amend regulations on plant sterol/ stanol esters and risk of coronary heart...

  14. Ultrasound assessment of mitral annular displacement in patients with coronary heart disease and its correlation with left heart function and serum indexes

    Directory of Open Access Journals (Sweden)

    Bing-Yan Lai

    2016-10-01

    Full Text Available Objective: To analyze the ultrasound assessment of mitral annular displacement in patients with coronary heart disease and its correlation with left heart function and serum indexes. Methods: A total of 89 patients with coronary heart disease were divided into angina pectoris group 42 cases and myocardial infarction group 47 cases according to the illness, and 58 cases of healthy subjects were included in control group. Values of mitral annular displacement (MAD parameters, left heart function indexes and serum illness-related indexes of three groups were detected, and the correlation between values of MAD parameters and values of cardiac function indexes and serum illness-related indexes were further analyzed. Results: MAD parameters TMAD1, TMAD2 and TMADmid values, heart function LVEF values and serum CysC level of myocardial infarction group and angina pectoris group were lower than those of control group, and cardiac function LVEDD, LVESD and A/E values as well as serum H-FABP, ICTP, Hcy and vWF levels were higher than those of control group (P<0.05; MAD parameters TMAD1, TMAD2 and TMADmid values of patients with coronary heart disease were negatively correlated with LVEDD, LVESD and A/E values as well as H-FABP, ICTP, Hcy and vWF levels, and were positively correlated with LVEF value and CysC level (P<0.05. Conclusions: Ultrasound assessment of mitral annular displacement in patients with coronary heart disease can early diagnose coronary heart disease and judge the disease severity, and it plays a positive role in optimizing disease prognosis.

  15. Perceived social support following percutaneous coronary intervention is a crucial factor in patients with coronary heart disease.

    Science.gov (United States)

    Kähkönen, Outi; Kankkunen, Päivi; Miettinen, Heikki; Lamidi, Marja-Leena; Saaranen, Terhi

    2017-05-01

    To describe perceived social support among patients with coronary heart disease following percutaneous coronary intervention. A low level of social support is considered a risk factor for coronary heart disease in healthy individuals and reduces the likelihood that people diagnosed with coronary heart disease will have a good prognosis. A descriptive cross-sectional study. A survey of 416 patients was conducted in 2013. A self-report instrument, Social Support of People with Coronary Heart Disease, was used. The instrument comprises three dimensions of social support: informational, emotional, functional supports and 16 background variables. Data were analysed using descriptive statistics, factor analysis, mean sum variables and multivariate logistic regression. Perceived informational support was primarily high, but respondents' risk factors were not at the target level. The weakest items of informational support were advice on physical activity, continuum of care and rehabilitation. Regarding the items of emotional support, support from other cardiac patients was the weakest. The weakest item of functional support was respondents' sense of the healthcare professionals' care of patients coping with their disease. Background variables associated with perceived social support were gender, marital status, level of formal education, profession, physical activity, duration of coronary heart disease and previous myocardial infarction. Healthcare professionals should pay extra attention to women, single patients, physically inactive patients, those demonstrating a lower level of education, those with a longer duration of CHD, and respondents without previous acute myocardial infarction. Continuum of care and counselling are important to ensure especially among them. This study provides evidence that healthcare professionals should be more aware of the individual needs for social support among patients with coronary heart disease after percutaneous coronary intervention

  16. Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients.

    Science.gov (United States)

    Mosleh, Sultan M; Almalik, Mona Ma

    2016-06-01

    Patients diagnosed with coronary heart disease are strongly recommended to adopt healthier behaviours and adhere to prescribed medication. Previous research on patients with a wide range of health conditions has explored the role of patients' illness perceptions in explaining coping and health outcomes. However, among coronary heart disease patients, this has not been well examined. The purpose of this study was to explore coronary heart disease patients' illness perception beliefs and investigate whether these beliefs could predict adherence to healthy behaviours. A multi-centre cross-sectional study was conducted at four tertiary hospitals in Jordan. A convenience sample of 254 patients (73% response rate), who visited the cardiac clinic for routine review, participated in the study. Participants completed a self-reported questionnaire, which included the Brief Illness Perception Questionnaire, the Godin Leisure Time Activity questionnaire and the Morisky Medication Adherence Scale. Patients reported high levels of disease understanding (coherence) and they were convinced that they were able to control their condition by themselves and/or with appropriate treatment. Male patients perceived lower consequences (pbehaviours. © The European Society of Cardiology 2014.

  17. Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

    International Nuclear Information System (INIS)

    Habets, Jesse; Mali, Willem P.T.M.; Budde, Ricardo P.J.; Brink, Renee B.A. van den; Uijlings, Ruben; Spijkerboer, Anje M.; Chamuleau, Steven A.J.

    2012-01-01

    Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of prosthetic heart valves. The best systolic and diastolic axial reconstructions were selected for coronary assessment. Each present coronary segment was scored for the presence of valve-related artefacts prohibiting coronary artery assessment. Scoring was performed in consensus by two observers. Eighty-two CT angiograms were performed on a 64-slice (n = 27) or 256-slice (n = 55) multidetector CT. Eighty-nine valves and five annuloplasty rings were present. Forty-three out of 1160 (3.7%) present coronary artery segments were non-diagnostic due to valve artefacts (14/82 patients). Valve artefacts were located in right coronary artery (15/43; 35%), left anterior descending artery (2/43; 5%), circumflex artery (14/43; 32%) and marginal obtuse (12/43; 28%) segments. All cobalt-chrome containing valves caused artefacts prohibiting coronary assessment. Biological and titanium-containing valves did not cause artefacts except for three specific valve types. Most commonly implanted prosthetic heart valves do not hamper coronary assessment on multidetector CT. Cobalt-chrome containing prosthetic heart valves preclude complete coronary artery assessment because of severe valve artefacts. circle Most commonly implanted prosthetic heart valves do not hamper coronary artery assessment circle Prosthetic heart valve composition determines the occurrence of prosthetic heart valve-related artefacts circle Bjoerk-Shiley and Sorin tilting disc valves preclude diagnostic coronary artery segment assessment. (orig.)

  18. [CARDIOREABILITATION PECULIARITIES AND CORRECTION OF VIOLATIONS OF SISTOLIC, DIASOLIC FUNCTION AND HEART RATE VARIABILITY IN PATIENTS WITH ACUTE CORONARY SYNDROME AND CORONARY ARTERY REVASCULARIZATION].

    Science.gov (United States)

    Shved, M; Tsuglevych, L; Kyrychok, I; Levytska, L; Boiko, T; Kitsak, Ya

    2017-04-01

    In patients with acute coronary syndrome (ACS) who underwent coronary arteries revascularization, violations of hemodynamics, metabolism and heart rate variability often develop in the postoperative period, therefore, the goal of the study was to establish the features of disturbances and the effectiveness of correction of left ventricular systolic and diastolic dysfunction and heart rate variability in stages of cardiorehabilitation in patients with acute coronary syndrome who underwent coronary arteries revascularization. The experimental group included 40 patients with ACS in the postoperative period who underwent balloon angioplasty and stenting of the coronary arteries (25 patients with ST-segment elevation ACS and 15 patients without ST-segment elevation ACS). The age of examined patients was 37 to 74 years, an average of 52.6±6.7 years. The control group consisted of 20 patients, comparable in age and clinico-laboratory manifestations of ACS, who underwent drug treatment with direct anticoagulants, double antiplatelet therapy, β-blockers, ACE inhibitors and statins. Clinical efficacy of cardiorespiratory process in patients of both groups was assessed by the dynamics of general clinical symptoms and parameters of natriuretic propeptide, systolic and diastolic function of the left ventricle and heart rate variability. In the initial state, clinical and laboratory-instrumental signs of myocardial ischemia disappear in patients with ACS undergoing surgical revascularization of the coronary arteries, but clinical and subclinical manifestations of heart failure were diagnosed. The use of the accelerated program of cardiac rehabilitation already during the first month of studies leads to a decreasement of the signs of systolic and diastolic dysfunction, the level of NT-proBNP and improve in the variability of the heart rhythm wich significantly improves the life quality of patients with ACS. To monitor the effectiveness and safety of cardiac rehabilitation in

  19. Serum homocysteine as a risk factor for coronary heart disease

    International Nuclear Information System (INIS)

    Naureen, A.; Fatima, F.; Munazza, B.; Shaheen, R.

    2012-01-01

    Background: Homocysteine (Hcy) is an intermediate formed during the catabolism of sulphur containing essential amino acid, methionine and Less than one percent of tHcy is found as the free form. Development of atherosclerotic changes and thrombo-embolism are common features in patients with homocysteinuria. This study was conducted to assess the relationship of Hcy and coronary heart disease (CHD) in our population. Methods: The cross-sectional analytical study was carried out at the Department of Biochemistry, Hazara University Mansehra and Ayub Medical College, Abbottabad. A total of 80 subjects were included in this study and were divided into 2 groups. Cases Group consisted of 40 patients who had confirmed Myocardial Infarction (MI) coming for routine follow-up (first re-visit) after the acute attack. Control Group consisted of 40 matching healthy individuals. Demographic data including age, gender, dietary habits, height and weight as documented in preformed proforma. Blood pressure was taken in sitting posture. Serum total Hcy were measured. Data was entered into computer using SPSS 16.0 for analysis. Results: The mean age of the cases was 59.68+-8.06 (30-70) years and that of the controls was 58.93+-6.93 (48-76) years. The average BMI of cases was 27.70+-3.61 Kg/m2 and of the controls was 25.66+-2.98 Kg/m2. This increase of BMI from controls to cases was statistically significant (p<0.050). The mean systolic BP of the cases was 153.88+-11.90 mmHg in comparison with 142.62+-11.65 mmHg for the controls. This difference was statistically significant (p<0.001). Mean tHcy level of the cases was 17.15+-4.45 micro mol/l while that of controls was 12.20+-2.53 micro mol/l. There is a statistically significant difference between cases and controls with respect to Hcy levels (p<0.001). Conclusion: Plasma tHcy level has a powerful predictor value of CHD and routine screening for elevated Hcy concentrations is advisable especially for individuals who manifest

  20. Assessment of waist/hip ratio and its relationship with coronary heart disease in community hospital of district swat

    International Nuclear Information System (INIS)

    Ahmad, R.; Ahmad, A.; Jan, S.; Rehman, I.U.

    2007-01-01

    To evaluate the relationship between central obesity (Abdominal adiposity), measured by Waist/Hip ratio and the development of Coronary Heart Disease in adult population of district Swat. The study comprised of 100 subjects, 34 Control, 33 Hypertensive subjects and 33 subjects with Coronary Heart Disease. Weight, Height, Waist/Hip ratio and Blood Pressure of subjects with Coronary Heart Disease (CHD) were compared with Hypertensive subjects and Control subjects. Patients with Coronary Heart Disease had higher Waist/Hip ratio and Blood Pressure than Hypertensive subjects, which in turn had higher values than control subjects. Waist/hip ratio is the dominant risk factor predicting Coronary Heart Disease. (author)

  1. 201Tl-redistribution analysis in early and delayed myocordial scintigrams of patients with coronary heart disease (CHD)

    International Nuclear Information System (INIS)

    Hoer, G.; Sebening, H.; Sauer, E.; Dressler, J.; Lutilsky, L.; Wagner-Manslau, C.; Bofilias, I.; Technische Univ. Muenchen

    1979-01-01

    Scans were performed on 8 healthy subjects and 25 with coronary heart disease proven by angiography and ventriculography including 6 with previous myocardial infarction at rest, exercise, and 1 and 2 h after exercise. Data were collected by a gamma camera interfaced to a data collection system. In healthy subjects 201 Tl distribution was homogeneous at rest and after exercise, the count rate ranging between 100% - as set in the region of maximum - and 80% over other regions of myocardium. In 19 patients with coronary heart disease it was uniform only at rest; 6 patients with previous myocardial infarction had locally diminished 201 Tl uptake even at rest. In patients with coronary heart disease without previous myocardial infarction, scans made immediately after exercise showed significant 201 Tl hypofixation in region of minimum, the count rate of which was less than 80% of the count rate as determined over region of maximum, 201 Tl uptake. Scans made 1 and 2 h after exercise had filling-in of 201 Tl within the region of minimum the count rate of which returned to the normal range of at least 80% of the count rate measured over region of maximum uptake. This return to resting distribution was called 201 Tl redistribution. Six patients with coronary heart disease and previous myocardial infarction had 201 Tl defects larger after exercise than at rest, without redistribution being observed. Redistribution in late postexercise scans is a sign of reversible ischemia in coronary heart disease. Scans at rest may be omitted in coronary heart disease, because transient ischemia is undetectable, unless spontaneous angina occurs during scan procedure. (orig.) [de

  2. Psychosocial antecedents of hostility in persons with coronary heart disease.

    Science.gov (United States)

    Sofhauser, Cynthia D

    2003-09-01

    Although it is known that hostility precedes coronary heart disease (CHD), little is known about factors that influence the development and progression of hostile characteristics. The relations among hostility, self-esteem, self-concept, and psychosocial residual were conceptualized within the modeling and role-modeling theoretical framework and examined in a sample of 85 persons with CHD. There were significant associations between all variables. Regression analyses revealed that self-esteem, mistrust residual, isolation residual, and self-concept contributed significantly, accounting for 31% of the variation in hostility scores. These findings provide support for the belief that the development of hostility in persons with CHD is related to beliefs and attitudes about the self and others. Persons with self-esteem need deficits, and a subsequent build up of negative psychosocial residual, have poor self-concepts. This poor self-concept is hostile in nature and reflects a mistrust of others and a deep sense of isolation.

  3. Myocardial images in nonacute coronary and noncoronary heart diseases

    International Nuclear Information System (INIS)

    Poe, N.D.; Eber, L.M.; Norman, A.S.; Selin, C.E.; Terao, E.N.

    1977-01-01

    To determine the variables that might affect interpretability of myocardial perfusion images in patients with acute myocardial infarctions, images obtained following intravenous administration of potassium-43 or cesium-129 were evaluated in 68 patients with nonacute coronary or noncoronary heart diseases, who were undergoing cardiac catheterization. Severe coronary arterial disease usually produces no distinctive perfusion defects in the resting state. Remote infarcts likewise tend to remain undetectable unless accompanied by wall-motion disturbances that can be detected by ventriculography. Left ventricular hypertrophy or cardiac dilatation can produce perfusion patterns indistinguishable from the ischemic defects of infarction. Right ventricular hypertrophy can cause image alterations that mimic infarcts in the left ventricle. In patients with acute myocardial infarction, sequential imaging studies with perfusion indicators should be of value in determining the effects of various therapeutic maneuvers on regional myocardial perfusion, but variations caused by conditions other than acute vascular occlusion limit the usefulness of perfusion imaging for diagnosing acute infarction. In suspected acute infarction, perfusion imaging will be used most effectively in conjunction with other imaging or nonimaging procedures that show the presence of damaged or necrotic myocardium. The information derived from this study should be generally applicable to the interpretation of imaging results obtained with the newer indicators of myocardial perfusion now in use or under development

  4. Regulation of Coronary Blood Flow in Health and Ischemic Heart Disease

    Science.gov (United States)

    Duncker, Dirk J.; Koller, Akos; Merkus, Daphne; Canty, John M.

    2018-01-01

    The major factors determining myocardial perfusion and oxygen delivery have been elucidated over the past several decades, and this knowledge has been incorporated into the management of patients with ischemic heart disease (IHD). The basic understanding of the fluid mechanical behavior of coronary stenoses has also been translated to the cardiac catheterization laboratory where measurements of coronary pressure distal to a stenosis and coronary flow are routinely obtained. However, the role of perturbations in coronary microvascular structure and function, due to myocardial hypertrophy or coronary microvascular dysfunction, in IHD is becoming increasingly recognized. Future studies should therefore be aimed at further improving our understanding of the integrated coronary microvascular mechanisms that control coronary blood flow, and of the underlying causes and mechanisms of coronary microvascular dysfunction. This knowledge will be essential to further improve the treatment of patients with IHD. PMID:25475073

  5. SheppHeartCABG trial-comprehensive early rehabilitation after coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Hojskov, Ida Elisabeth; Moons, Philip; Hansen, Niels Viggo

    2017-01-01

    rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial. METHODS/ANALYSIS: SheppHeartCABG is an investigator-initiated randomised...... clinical superiority trial with blinded outcome assessment, employing 1:1 central randomisation to rehabilitation plus usual care versus usual care alone. On the basis of a sample size calculation, 326 patients undergoing coronary artery bypass grafting will be included from two clinical sites. All...... patients receive usual care and patients allocated to the experimental intervention follow 4 weeks rehabilitation consisting of an exercise programme, psycho-educative consultations and a compact mindfulness programme. The primary outcome is physical function measured by the 6-min walk test. The secondary...

  6. Association of changes in health-related quality of life in coronary heart disease with coronary procedures and sociodemographic characteristics

    Directory of Open Access Journals (Sweden)

    Rollag Arnfinn

    2004-10-01

    Full Text Available Abstract Background Few studies have focused on the association between the sociodemographic characteristics of a patient with the change in health-related quality of life (HRQOL following invasive coronary procedures, and the results remain inconclusive. The objective of the present study was to measure the temporal changes in HRQOL of patients with coronary heart disease, and assess how these changes are associated with invasive coronary procedures and sociodemographic characteristics. Methods This was a prospective study of 254 patients with angina pectoris and 90 patients with acute coronary syndrome. HRQOL was assessed with the multi-item scales and summary components of the SF-36, both 6 weeks and 2 years after baseline hospitalization in 1998. Paired t-tests and multiple regression analyses were used to assess temporal changes in HRQOL and to identify the associated factors. Results Physical components of HRQOL had improved most during the 2 years following invasive coronary procedures. Our findings indicated that patients with angina pectoris who were younger, male, and more educated were most likely to increase their HRQOL following invasive coronary procedures. When adjusting for baseline HRQOL scores, invasive coronary procedures and sociodemographic characteristics did not explain temporal changes in patients with acute coronary syndrome, possibly due to higher comorbidity. Conclusion Sociodemographic characteristics should be taken into account when comparing and interpreting changes in HRQOL scores in patients with and without invasive coronary procedures.

  7. A coronary heart disease risk model for predicting the effect of potent antiretroviral therapy in HIV-1 infected men

    DEFF Research Database (Denmark)

    May, Margaret; Sterne, Jonathan A C; Shipley, Martin

    2007-01-01

    Many HIV-infected patients on highly active antiretroviral therapy (HAART) experience metabolic complications including dyslipidaemia and insulin resistance, which may increase their coronary heart disease (CHD) risk. We developed a prognostic model for CHD tailored to the changes in risk factors...

  8. ROLE OF GLYCAEMIA LEVEL IN THE DEVELOPMENT OF INTERSTITIAL COLLAGEN IN PATIENTS WITH CORONARY HEART DISEASE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    T. Rudenko

    2015-12-01

    Full Text Available A role of blood glucose levels in the development of interstitial collagen has been studied in 84 patients (53 women and 31 men, average age 60 ± 2.4 years with coronary heart disease (CHD. All patients were divided into twocomparable groups: a study group including patients with coronary heart disease andtype 2 diabetes mellitus (DM and a control group consisting of patients with coronary heart disease without DM. All patients received standard medical therapy as recommended by the European Society of Cardiology. The level of blood glucose in both groups was assessed by the standard technique, a degree of interstitial collagen volume fraction (ICVF was measured using the formula of J. Shirani et al. The data were processed by parametric and nonparametric statistical methods. It has been proved that hyperglycemia in type 2 diabetes contributes to the development of ICVF, the degree of which increases with the rise of blood glucose level. A high level ofICVF in patients with coronary heart disease and diabetes type 2 can be a predictor of myocardial dyssynchrony development and heart failure progression, therefore, a close monitoring and timely correction of changes of blood glucose levelsare recommended to prevent the complication development. ICVF evaluation should become a routine diagnostic method in all patients with type 2 diabetes.

  9. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial.

    Science.gov (United States)

    2015-06-13

    The benefit of CT coronary angiography (CTCA) in patients presenting with stable chest pain has not been systematically studied. We aimed to assess the effect of CTCA on the diagnosis, management, and outcome of patients referred to the cardiology clinic with suspected angina due to coronary heart disease. In this prospective open-label, parallel-group, multicentre trial, we recruited patients aged 18-75 years referred for the assessment of suspected angina due to coronary heart disease from 12 cardiology chest pain clinics across Scotland. We randomly assigned (1:1) participants to standard care plus CTCA or standard care alone. Randomisation was done with a web-based service to ensure allocation concealment. The primary endpoint was certainty of the diagnosis of angina secondary to coronary heart disease at 6 weeks. All analyses were intention to treat, and patients were analysed in the group they were allocated to, irrespective of compliance with scanning. This study is registered with ClinicalTrials.gov, number NCT01149590. Between Nov 18, 2010, and Sept 24, 2014, we randomly assigned 4146 (42%) of 9849 patients who had been referred for assessment of suspected angina due to coronary heart disease. 47% of participants had a baseline clinic diagnosis of coronary heart disease and 36% had angina due to coronary heart disease. At 6 weeks, CTCA reclassified the diagnosis of coronary heart disease in 558 (27%) patients and the diagnosis of angina due to coronary heart disease in 481 (23%) patients (standard care 22 [1%] and 23 [1%]; pheart disease increased (1·09, 1·02-1·17; p=0·0172), the certainty increased (1·79, 1·62-1·96; pheart disease. This changed planned investigations (15% vs 1%; pheart disease, CTCA clarifies the diagnosis, enables targeting of interventions, and might reduce the future risk of myocardial infarction. The Chief Scientist Office of the Scottish Government Health and Social Care Directorates funded the trial with supplementary awards

  10. Concurrent Coronary Artery and Valvular Heart Disease - Hybrid Treatment Strategies in 2013.

    Science.gov (United States)

    Grubb, Kendra J; Nazif, Tamim; Williams, Mathew R; George, Isaac

    2013-08-01

    Concomitant coronary artery disease (CAD) and valvular heart disease is an increasingly common problem in the ageing population. Hybrid procedures combine surgical and transcatheter approaches to facilitate minimally invasive surgery or to transform a single high-risk open surgery into two less risky procedures. In ideal circumstances, this strategy may decrease the surgical risk in elderly, high-risk and reoperative surgical candidates, while improving patient comfort, convenience and cost-effectiveness. Hybrid procedures can be performed in a staged fashion or as a 'one-stop' procedure in a hybrid operating suite. Increasing evidence supports the safety and short-term efficacy of hybrid valve repair or replacement and coronary revascularisation procedures. Nevertheless, important questions remain, including the optimal timing of the individual procedures and the optimal antiplatelet therapy after percutaneous coronary intervention. With ongoing advances in procedural techniques and anticoagulation strategies, as well as the accumulation of long-term outcomes data, hybrid approaches to concomitant CAD and valvular heart disease will likely become increasingly common.

  11. Milk and other dietary influences on coronary heart disease

    Science.gov (United States)

    Grant, W. B.

    1998-01-01

    While dietary links to ischemic heart disease (IHD) and coronary heart disease (CHD) mortality have been studied for many years, the correlation has not clearly been resolved, especially for older populations. In this paper, a multi-country statistical approach involving 32 countries is used to find dietary links to IHD and CHD for various age groups aged 35+. For IHD, milk carbohydrates were found to have the highest statistical association for males aged 35+ and females aged 65+, while for females aged 35-64, sugar was found to have the highest association. In the case of CHD, non-fat milk was found to have the highest association for males aged 45+ and females aged 75+, while for females 65-74, milk carbohydrates and sugar had the highest associations, and for females aged 45-64, sugar had the highest association. A number of mechanisms have been proposed in the literature that might explain the milk carbohydrate or non-fat milk association. One of the most prominent theories is that animal proteins contribute to homocysteine (Hcy) production; however, milk more than meat lacks adequate B vitamins to convert Hcy to useful products. Lactose and calcium in conjunction with Hcy from consumption of non-fat milk may also contribute to calcification of the arteries.

  12. Selective estrogen receptor modulators and risk for coronary heart disease.

    Science.gov (United States)

    Cano, A; Hermenegildo, C; Oviedo, P; Tarín, J J

    2007-04-01

    Coronary heart disease (CHD) is the leading cause of death in women in most countries. Atherosclerosis is the main biological process determining CHD. Clinical data support the notion that CHD is sensitive to estrogens, but debate exists concerning the effects of the hormone on atherosclerosis and its complications. Selective estrogen receptor modulators (SERMs) are compounds capable of binding the estrogen receptor to induce a functional profile distinct from estrogens. The possibility that SERMs may shift the estrogenic balance on cardiovascular risk towards a more beneficial profile has generated interest in recent years. There is considerable information on the effects of SERMs on distinct areas that are crucial in atherogenesis. The complexity derived from the diversity of variables affecting their mechanism of action plus the differences between compounds make it difficult to delineate one uniform trend for SERMs. The present picture, nonetheless, is one where SERMs seem less powerful than estrogens in atherosclerosis protection, but more gentle with advanced forms of the disease. The recent publication of the Raloxifene Use for The Heart (RUTH) study has confirmed a neutral effect for raloxifene. Prothrombotic states may favor occlusive thrombi at sites occupied by atheromatous plaques. Platelet activation has received attention as an important determinant of arterial thrombogenesis. Although still sparse, available evidence globally suggests neutral or beneficial effects for SERMs.

  13. Coronary Heart Disease: Pandemic in a True Sense

    Directory of Open Access Journals (Sweden)

    Saurabh RamBihariLal Shrivastava

    2013-09-01

    Full Text Available Cardiovascular diseases are caused because of abnormalities in the heart and blood vessels. Recent trends reveal that the incidence of coronary heart disease (CHD has gradually decreased in many developed countries, but the situation remains quite challenging in developing nations that account for more than 60% of the global burden. Multiple socio-demographic, personal, physician related and healthcare delivery system related factors have been identified which act in variable combinations to either influence the incidence of CHD or affect the short/long-term outcome of the disease. Of all CHD cases who succumb within 28 days of onset of symptoms, almost 67% fail to reach even a hospital. This clearly signifies the importance of primary prevention and early recognition of the warning signs in averting cause-specific mortality. The main priority is to develop cost-effective equitable health care innovations in CHD prevention and to monitor the trend of CHD so that evidence-based interventions can be formulated. To conclude, inculcating health-promoting behaviors in school children and the general population by means of community-based health screening and education interventions could avert many more deaths attributed to CHDs.

  14. Coronary heart disease: pandemic in a true sense.

    Science.gov (United States)

    Rambiharilal Shrivastava, Saurabh; Saurabh Shrivastava, Prateek; Ramasamy, Jegadeesh

    2013-01-01

    Cardiovascular diseases are caused because of abnormalities in the heart and blood vessels. Recent trends reveal that the incidence of coronary heart disease (CHD) has gradually decreased in many developed countries, but the situation remains quite challenging in developing nations that account for more than 60% of the global burden. Multiple socio-demographic, personal, physician related and healthcare delivery system related factors have been identified which act in variable combinations to either influence the incidence of CHD or affect the short/long-term outcome of the disease. Of all CHD cases who succumb within 28 days of onset of symptoms, almost 67% fail to reach even a hospital. This clearly signifies the importance of primary prevention and early recognition of the warning signs in averting cause-specific mortality. The main priority is to develop cost-effective equitable health care innovations in CHD prevention and to monitor the trend of CHD so that evidence-based interventions can be formulated. To conclude, inculcating health-promoting behaviors in school children and the general population by means of community-based health screening and education interventions could avert many more deaths attributed to CHDs.

  15. Diagnostic value of electrocardiography, dynamic isotope studies and angiography in coronary heart disease

    International Nuclear Information System (INIS)

    Haas, J.

    1986-01-01

    The goal of this work is on the basis of the case histories of 36 patients with heart anamneses (27 with electrocardiographically and/or enzymatically detected heart infarcts, 9 with various cardial diseases) to test the diagnostic value of stress electrocardiograms, dynamic isotope examinations of the heart and coronary angiographies in the cases of myocardial infarcts, heart wall aneurysms, coronary heart disease and in the determination of the global discharge fraction, specifically broad scanning (heart front, side and back walls) as well as fine scanning (individual coronary vessel branches). In the case of myocardial infarct the stress EKG and the heart scintigraphy agree with one another to a large degree, whereby scintigraphy (with 99mTc-DPTA) in addition detects infarcted myocardial regions. In the diagnosis of heart wall aneurysms scintigraphy and ventriculography had the same results in 91.6% of the cases. Coronary heart disease results agreed for all three methods in 91.7% of the cases and with scintigraphy and angiography in 94.4%. The degree of agreement between scintigraphy and coronary angiography is confirmed in the literature. One-, two- and 3-vessel diseases can be determined with these two methods in 90 to 75% agreement. The result lies thereby above the values of 201Tl-myocardial scintigraphy given in the literature. Also the global discharge fraction shows scintigraphic as well as angiographic agreement of almost 90%. (TRV) [de

  16. Anomalous aortic origin of a coronary artery: a report from the Congenital Heart Surgeons Society Registry.

    Science.gov (United States)

    Poynter, Jeffrey A; Williams, William G; McIntyre, Susan; Brothers, Julie A; Jacobs, Marshall L

    2014-01-01

    Anomalous aortic origin of a coronary artery (AAOCA) is a common congenital heart lesion that may be rarely associated with myocardial ischemia and sudden death in the young. Evidence-based criteria for managing young patients with AAOCA are lacking. The Congenital Heart Surgeons Society (CHSS) established a multicenter registry of patients with AAOCA aged ≤30 years to develop these criteria. All institutional members of the CHSS are eligible to enroll patients. Patients were enrolled retrospectively if diagnosis of AAOCA occurred between January 1, 1998, and January 20, 2009, and prospectively from January 20, 2009 forward. The first phase of analysis explored possible associations between demographics, symptoms, coronary anatomy, and management using correlation analysis and logistic regression. As of June 2012, 198 patients were enrolled from CHSS member institutions (median age at diagnosis = 10.2 years; 64% male). Data were extracted from clinical records. Fifty-four percent were symptomatic at presentation (most commonly chest pain, N = 78). The AAOCA was diagnosed at autopsy in two patients who presented with sudden death (one with anomalous aortic origin of the left coronary artery [AAOLCA]; one with a single ostium above a commissure giving rise to both left and right coronary arteries). Imaging reports documented anomalous aortic origin of the right coronary artery (AAORCA) in 144 patients, AAOLCA in 51 patients, and AAOLCA/AAORCA in 1 patient. Surgery or autopsy without surgery was performed in 106 patients (71 AAORCA [67%]; 31 AAOLCA [29%]; and 4 AAORCA/AAOLCA [4%]) at a median age of 12.6 years. Overall, 52% of patients with AAORCA versus 67% with AAOLCA had surgery. Most surgical operative reports described an intramural segment of the coronary artery with anomalous origin. Surgery correlated with symptoms, older age, and presence of an intramural segment in the setting of AAOLCA. Management decisions, including surgical referral, are associated

  17. The advisory brought to practice; routine screening on depression (and anxiety) in coronary heart disease; Consequences and implications

    NARCIS (Netherlands)

    Luttik, M.L.; Jaarsma, T.; Sanderman, R.; Fleer, J.

    2011-01-01

    INTRODUCTION: Following the evidence, the American Heart Association recently published a Science Advisory with the recommendation that patients with Coronary Heart Disease (CHD) should be screened for depressive symptoms and depression. Also the Heart Failure Guidelines recommend routine screening

  18. The advisory brought to practice Routine screening on depression (and anxiety) in coronary heart disease; consequences and implications

    NARCIS (Netherlands)

    Luttik, M. L. A.; Jaarsma, T.; Sanderman, R.; Fleer, J.

    2011-01-01

    Introduction: Following the evidence, the American Heart Association recently published a Science Advisory with the recommendation that patients with Coronary Heart Disease (CHD) should be screened for depressive symptoms and depression. Also the Heart Failure Guidelines recommend routine screening

  19. 5-Fluorouracil-induced acute reversible heart failure not explained by coronary spasms, myocarditis or takotsubo

    DEFF Research Database (Denmark)

    Fakhri, Yama; Dalsgaard, Morten; Nielsen, Dorte

    2016-01-01

    A 69-year-old woman presented with arterial hypotension, pulmonary oedema and a severely depressed left ventricular ejection fraction (LVEF) of 25% only 3 days after having received her first treatment for colorectal cancer with 5-fluorouracil (5-FU)-based therapy. The ECG demonstrated widespread......, cardiac MRI scan 9 days later showed a normal LVEF with signs of neither myocardial oedema nor necrosis. Despite the high therapeutic efficacy of 5-FU in treatment of colorectal cancer, it is associated with undesired cardiac toxicities including coronary spasms, toxic inflammation and takotsubo...... ST-segment depression and echocardiography showed uniform hypokinesia of all left ventricular (LV) myocardial segments without signs of regional LV ballooning. Coronary angiography was normal and the patient gained full recovery after receiving treatment with heart failure medication. Interestingly...

  20. Psychophysical rehabilitation aspects of patient with coronary heart disease and Angina.

    Directory of Open Access Journals (Sweden)

    Mohammed Ali Khaleel.

    2012-03-01

    Full Text Available It is analyzed scientific and methodological literature, considered the views of scientists on the link of stress and cardiovascular diseases. It is determined causes of stress, with recommendations for combating stress and its prevention. A program of rehabilitation for patients with coronary artery disease after hospital discharge is shown. The experiment involved 88 patients of coronary heart disease and angina, II and III functional class at the age of 40-65 years. Participants were divided into two groups the main and control. The control group performed a program of physical rehabilitation, including breathing and physical exercises, in the program we have added to the main group autogenic exercises. At the end the experiment revealed that the health indicators of main group better than the control group in 23%.

  1. THE EFFECT OF WAIST CIRCUMFERENCES MORE THAN NORMAL ON THE INCIDENT OF CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Pria Wahyu

    2017-07-01

    Full Text Available Introduction: Coronary heart disease is known as the most common disease that causes mortality in the world, one of the examination to identify the risks of coronary heart disease is measuring waist circumference. The purpose of this study was to identify correlation between large waist circumferences and the incident of coroner heart disease. Method: Design used in this study was analytic observational (retrospective with cross sectional approach. There were 63 respondents which sampling by simple random sampling. The independent variable was waist circumferences and the dependent variable was coronary heart disease. Data were collected by direct observation then analyzed by spearman correlation statistic test with significance level α≤0.05. Result: The result showed that waist circumferences more than normal had significant correlation with the incident of coronary heart disease (p=0.02. Analysis: It can be concluded that there was correlation between waist circumferences more than normal and the incident of coronary heart disease to the clients with coroner cardiac disease. Discussion: Earlier screening and detection is needed to prevent coronary heart disease.

  2. Role of depression in secondary prevention of Chinese coronary heart disease patients receiving percutaneous coronary intervention.

    Directory of Open Access Journals (Sweden)

    Can Feng

    Full Text Available Coronary heart disease (CHD patients who have undergone percutaneous coronary intervention (PCI have higher rates of depression than the general population. However, few researchers have assessed the impact of depression on the secondary prevention of CHD in China.The main purpose of this investigation was to explore the relationship between depression and secondary prevention of CHD in Chinese patients after PCI.This descriptive, cross-sectional one-site study recruited both elective and emergency PCI patients one year after discharge. Data from 1934 patients were collected in the clinic using questionnaires and medical history records between August 2013 and September 2015. Depression was evaluated by the 9-item Patient Health Questionnaire. Secondary prevention of CHD was compared between depression and non-depression groups.We found that depression affected secondary prevention of CHD in the following aspects: lipid levels, blood glucose levels, smoking status, physical activity, BMI, and rates of medication use.Depressive patients with CHD are at increased risk of not achieving the lifestyle and risk factor control goals recommended in the 2006 AHA guidelines. Screening should focus on patients after PCI because treating depression can improve outcomes by improving secondary prevention of CHD.

  3. [Effect of intensive pretreatment with atorvastatin calcium on outcomes of percutaneous coronary intervention in elderly patients with coronary heart disease].

    Science.gov (United States)

    Guo, Xiaoyan; Huang, Xuecheng; Wang, Qiwu

    2015-02-01

    To observe the effects of different loading doses of atorvastatin calcium on the outcomes of percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease (CHD). A total of 120 CHD patients aged over 80 years were randomly assigned into 3 equal groups to receive intensive pretreatment with statin at the doses of 20, 40, or 60 mg prior to PCI performed within 48 to 72 h after admission. The changes of postoperative cardiac biochemical markers including creatine kinase isoenzyme (CKMB), troponin I (cTNI) and high-sensitivity c-reactive protein (hs-CRP) were observed and the incidence of major adverse cardiac events (MACE, including cardiac death, myocardial infarction, and target vessel revascularization) were recorded within 30 days after PCI. Thirty-four patients in 20 mg statin group, 40 in 40 mg statin group, and 38 in 60 mg statin group completed this study. In all the 3 groups, hs-CRP level significantly increased at 12 and 24 h after PCI compared with the preoperative levels (P0.05). Intensive pretreatment with 60 mg/day atorvastatin calcium can significantly reduce myocardial infarction related to PCI with good safety in elderly patients with CHD.

  4. Efficacy of trimetazidine combining with metoprolol on plasma BNP in coronary heart disease patients with heart failure

    Directory of Open Access Journals (Sweden)

    Ping Li

    2016-01-01

    Full Text Available Objective: To explore the effect of combined application of trimetazidine and metoprolol on plasma BNP in coronary heart disease patients with heart failure and the clinical efficacy. Methods: A total of 140 cases of coronary heart disease patients with heart failure treated in Cardiology Department of our hospital from May 2012 to January 2015 were selected and divided into study group and control group by random number table method. The control group received digitalis, diuretics, ACEI (angiotensin-converting enzyme inhibitor and other conventional drugs for treatment, the study group received combined use of trimetazidine and metoprolol on the basis of routine treatment of the control group, and treatment duration was 12 weeks. Then plasma BNP, systolic blood pressure, heart rate, left ventricular end diastolic diameter (LVEDD, left ventricular end systolic end (LVESD and left ventricular ejection fraction (LVEF of two groups before and after treatment were statistically analyzed, and the overall effect was evaluated. Results: Before treatment, there were no significant differences in plasma BNP, blood pressure, heart rate, LVEDD, LVESD and LVEF between the two groups; after treatment, plasma BNP, blood pressure, heart rate, LVEDD and LVESD of both groups decreased and LVEF increased, but the changes in study group were better than those in control group. Conclusion: Trimetazidine combined with metoprolol has better application effect in plasma BNP decrease and heart function improvement in coronary heart disease patients with heart failure.

  5. Plasma cystathionine and risk of acute myocardial infarction among patients with coronary heart disease: Results from two independent cohorts.

    Science.gov (United States)

    Dhar, Indu; Svingen, Gard F T; Pedersen, Eva R; DeRatt, Barbara; Ulvik, Arve; Strand, Elin; Ueland, Per M; Bønaa, Kaare H; Gregory, Jesse F; Nygård, Ottar K

    2018-04-21

    Cystathionine is a thio-ether and a metabolite formed from homocysteine during transsulfuration. Elevated plasma cystathionine levels are reported in patients with cardiovascular disease; however prospective relationships with acute myocardial infarction (AMI) are unknown. We investigated associations between plasma cystathionine and AMI among patients with suspected and/or verified coronary heart disease (CHD). Subjects from two independent cohort studies, the Western Norway Coronary Angiography Cohort (WECAC) (3033 patients with stable angina pectoris; 263 events within 4.8 years of median follow-up) and the Norwegian Vitamin Trial (NORVIT) (3670 patients with AMI; 683 events within 3.2 years of median follow-up) were included. In both cohorts, plasma cystathionine was associated with several traditional CHD risk factors (P coronary heart disease, and is possibly related to altered redox homeostasis. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Effort-Reward Imbalance at Work and Incident Coronary Heart Disease

    DEFF Research Database (Denmark)

    Dragano, Nico; Siegrist, Johannes; Nyberg, Solja T.

    2017-01-01

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance...... between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease...... have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress....

  7. Organization-and-technological model of medical care delivered to patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Popova Y.V.

    2014-09-01

    Full Text Available Organization-and-technological model of medical care delivered to patients with coronary heart disease based on IDEF0 methodology and corresponded with clinical guidelines is presented.

  8. Patient education in the management of coronary heart disease.

    Science.gov (United States)

    Brown, James Pr; Clark, Alexander M; Dalal, Hayes; Welch, Karen; Taylor, Rod S

    2011-12-07

    Cardiac rehabilitation (CR) is a complex multifaceted intervention consisting of three core modalities: education, exercise training and psychological support. Whilst exercise and psychological interventions for patients with coronary heart disease (CHD) have been the subject of Cochrane systematic reviews, the specific impact of the educational component of CR has not previously been investigated. 1. Assess effects of patient education on mortality, morbidity, health-related quality of life (HRQofL) and healthcare costs in patients with CHD.2. Explore study level predictors of the effects of patient education (e.g. individual versus group intervention, timing with respect to index cardiac event). The following databases were searched: The Cochrane Library, (CENTRAL, CDSR, DARE, HTA, NHSEED), MEDLINE (OVID), EMBASE (OVID), PsycINFO (EBSCOhost) and CINAHL (EBSCOhost). Previous systematic reviews and reference lists of included studies were also searched. No language restrictions were applied. 1. Randomised controlled trials (RCTs) where the primary interventional intent was education.2. Studies with a minimum of six-months follow-up and published in 1990 or later.3. Adults with diagnosis of CHD. Two review authors selected studies and extracted data. Attempts were made to contact all study authors to obtain relevant information not available in the published manuscript. For dichotomous variables, risk ratios and 95% confidence intervals (CI) were derived for each outcome. For continuous variables, mean differences and 95% CI were calculated for each outcome. Thirteen RCTs involving 68,556 subjects with CHD and follow-up from six to 60 months were found. Overall, methodological quality of included studies was moderate to good. Educational 'dose' ranged from a total of two clinic visits to a four-week residential stay with 11 months of follow-up sessions. Control groups typically received usual medical care. There was no strong evidence of an effect of education on

  9. Coronary risk stratification of patients undergoing surgery for valvular heart disease

    DEFF Research Database (Denmark)

    Hasselbalch, Rasmus Bo; Engstrøm, Thomas; Pries-Heje, Mia

    2017-01-01

    BACKGROUND: Multislice computed tomography (MSCT) is a non-invasive, less expensive, low-radiation alternative to coronary angiography (CAG) prior to valvular heart surgery. MSCT has a high negative predictive value for coronary artery disease (CAD) but previous studies of patients with valvular ...

  10. Coronary Physiology During Exercise and Vasodilation in the Healthy Heart and in Severe Aortic Stenosis

    NARCIS (Netherlands)

    Lumley, Matthew; Williams, Rupert; Asrress, Kaleab N.; Arri, Satpal; Briceno, Natalia; Ellis, Howard; Rajani, Ronak; Siebes, Maria; Piek, Jan J.; Clapp, Brian; Redwood, Simon R.; Marber, Michael S.; Chambers, John B.; Perera, Divaka

    2016-01-01

    Severe aortic stenosis (AS) can manifest as exertional angina even in the presence of unobstructed coronary arteries. The authors describe coronary physiological changes during exercise and hyperemia in the healthy heart and in patients with severe AS. Simultaneous intracoronary pressure and flow

  11. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

  12. Depressive Symptoms, Health Behaviors, and Subsequent Inflammation in Patients With Coronary Heart Disease : Prospective Findings From the Heart and Soul Study

    NARCIS (Netherlands)

    Duivis, Hester E.; de Jonge, Peter; Penninx, Brenda W.; Na, Bee Ya; Cohen, Beth E.; Whooley, Mary A.

    Objective: Depression has been associated with inflammation in patients with coronary heart disease. However, it is uncertain whether depressive symptoms lead to inflammation or vice versa. Method: The authors evaluated 667 outpatients with established coronary heart disease from the Heart and Soul

  13. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial.

    Science.gov (United States)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren

    2013-10-09

    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, pacute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. © 2013.

  14. Coated stents to prevent restenosis in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2005-11-01

    Full Text Available Background: In-stent-restenosis (ISR is considered to be an essential limiting factor of stenting in coronary heart disease (CHD. The development of coated stents has raised expectations on substantial lowering restenosis after stenting with decreasing the rate of restenosis and a reduction in the rate of clinical events. Objectives: The present analysis addresses the questions on medical effectiveness and cost-effectiveness of the use of various coated stent types in CHD. Methods: The literature was searched in December 2004 in the most relevant medical and economic databases. The medical evaluation was conducted on the basis of published RCT. The data from the studies regarding various angiographic, sonographic and clinical endpoints were checked for methodical quality and summarised in meta-analyses. Within the scope of economic evaluation the primary studies were analysed and modelling was performed, applying clinical effect estimates from the meta-analyses of the medical evaluation and current estimates of German costs. Results: Medical evaluation: Ten different stenttypes were used in the included 26 RCT. The results for heparin, silicon-carbide, carbon and PTFE coated stenttypes could not reveal any significant differences between the medical effectiveness of coated and uncoated stents. The application of sirolimus, paclitaxel, everolimus and 7-hexanoyltaxol eluting stents showed a significant lower restenosis at 6-9 months with decrease in the rate of restenosis for polymer-based sirolimus, paclitaxel and 7-hexanoyltaxol eluting stents. In contrast, the use of gold-coated and actinomycin-D eluting stents was associated with a significantly higher restenosis. The polymer-based sirolimus and paclitaxel eluting stents also showed a significant and considerable reduction in the rate of repeated percutaneous revascularisations at 6-12 months (3.5% vs. 19.7%; p<0.0001, RR=0.19 [95%CI: 0.11; 0.33] and 3.5% vs. 12.2%; p<0.0001, RR=0.30 [95%CI: 0

  15. Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

    Science.gov (United States)

    Schwandt, Hilary M.; Coresh, Josef; Hindin, Michelle J.

    2010-01-01

    Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine…

  16. Disclosing Genetic Risk for Coronary Heart Disease: Attitudes Toward Personal Information in Health Records.

    Science.gov (United States)

    Brown, Sherry-Ann; Jouni, Hayan; Marroush, Tariq S; Kullo, Iftikhar J

    2017-04-01

    Incorporating genetic risk information in electronic health records (EHRs) will facilitate implementation of genomic medicine in clinical practice. However, little is known about patients' attitudes toward incorporation of genetic risk information as a component of personal health information in EHRs. This study investigated whether disclosure of a genetic risk score (GRS) for coronary heart disease influences attitudes toward incorporation of personal health information including genetic risk in EHRs. Participants aged 45-65 years with intermediate 10-year coronary heart disease risk were randomized to receive a conventional risk score (CRS) alone or with a GRS from a genetic counselor, followed by shared decision making with a physician using the same standard presentation and information templates for all study participants. The CRS and GRS were then incorporated into the EHR and made accessible to both patients and physicians. Baseline and post-disclosure surveys were completed to assess whether attitudes differed by GRS disclosure. Data were collected from 2013 to 2015 and analyzed in 2015-2016. GRS and CRS participants reported similar positive attitudes toward incorporation of genetic risk information in the EHR. Compared with CRS participants, participants with high GRS were more concerned about the confidentiality of genetic risk information (OR=3.67, 95% CI=1.29, 12.32, p=0.01). Post-disclosure, frequency of patient portal access was associated with positive attitudes. Participants in this study of coronary heart disease risk disclosure overall had positive attitudes toward incorporation of genetic risk information in EHRs, although those who received genetic risk information had concerns about confidentiality. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Coronary blood flow and thallium 201 uptake in rejecting rat heart transplantations

    International Nuclear Information System (INIS)

    Bergsland, J.; Hwang, K.; Driscoll, R.; Carr, E.A.; Wright, J.R.; Curran-Everett, D.C.; Carroll, M.; Krasney, E.; Krasney, J.A.

    1989-01-01

    The effects of rejection on coronary flow (CAF) in heart allografts are unclear, although previous evidence with cardiac imaging agents indicates impaired flow during advanced rejection. The purpose of this study was to measure CAF in heterotopically placed heart grafts. Lewis rats (LEW) received grafts from either syngeneic Lewis rats (LEW/LEW group) or allogeneic ACI rats (ACI/LEW group). CAF was measured in both the transplanted and native hearts with radiolabeled microspheres. Rejection was measured histologically (grades 0 [absent] to 4+ [severe]). In addition systemic blood pressure and cardiac outputs of the native hearts were determined with microspheres. Different animals were studied during relatively early (4 days) and late (6 days) rejection. Among the 4-day animals a cyclosporine-treated group was included (ACI/LEW CyA). In 6-day rats CAF in allografts was lower (0.56 +/- .06 ml/gm/min) compared with syngeneic grafts (1.72 +/- 0.4 ml/gm/min) (p less than 0.05). The CAF in the native hearts did not differ significantly but was higher than in the grafts in both groups. Heart rates were reduced in allografts (p less than 0.05). It is interesting that arterial pressure and cardiac output were significantly lower in animals bearing allogeneic than syngeneic grafts. In rats studied at 4 days graft CAF was lower than in the native heart in both the LEW/LEW and ACI/LEW groups, but there was no significant difference in behavior between groups. The same was true for a cyclosporine-treated group. Graft heart rates were similar in all 4-day rats

  18. Coronary Artery Dissection: Not Just a Heart Attack

    Science.gov (United States)

    ... for Heart.org CPR & ECC for Heart.org Shop for Heart.org Causes for Heart.org Advocate ... chest pain or pressure, shortness of breath, profuse sweating and dizziness. “Around 80 percent of the time, ...

  19. Inherited dyslipidaemic disorders contributing to coronary heart disease

    International Nuclear Information System (INIS)

    Attaullah, S.; Ahmed, Z.; Rehman, J.

    2008-01-01

    Lipoprotein (a) [Lp (a)] is an established independent risk factor for premature myocardial infarction (MI)/coronary artery disease (CAD). The study was conducted to determine the value of Lp (a) in prediction of CAD or MI in the offspring at risk. A total of 160 subjects were investigated. Serum Lp (a) was measured by ELISA, serum total cholesterol, triglycerides (TG) and HDL-Cholesterol by enzymatic colorimetric methods using standard kits. Differences in levels of total Lp (a) and cholesterol were observed between patients and controls. Both Lp (a) (16.23+-1.95 mg/dL) and cholesterol (175.00+-7.60 mg/dL) of group A (patients) were higher than the corresponding controls. However an opposite trend in results was noted for serum HDL-Cholesterol in patients vs. controls.: Persons found to have elevated levels of Lp (a) should focus on controlling the known modifiable risk factor for heart disease, especially smoking, hypercholesterolemia, obesity, hypertension and sedentary life style. (author)

  20. Depression and coronary artery disease -real heart attack

    International Nuclear Information System (INIS)

    Farooqi, S.; Ahmed, B.

    2001-01-01

    Both depression and ischaemic heart disease are said to become the leading causes of morbidity and mortality in developing countries during the next two decades. The relationship between these two disorders has long been speculated but only recently addressed scientifically. A Medline search was conducted to obtain the articles that address the association between depressive disorders and coronary artery disease (CAD). Most studies following large cohorts over a period ranging from 4.5 to 27 years have shown that depression is associated with a significantly high risk of developing CAD. These studies also show that patients who have depression following myocardial infarction hat poorer prognosis on major cardiac end points like reoccurrence of myocardial infarction and death as compared to the non-depressed group. The psychosocial variables associated with depression like social isolation, acute and chronic stressful life events are also associated with increased risk of developing CAD. The mechanisms underlying this association between depression and CAD are unknown at present. The effectiveness of psychosocial interventions in reducing this increased risks have been demonstrated while the trials assessing the efficacy and safety of anti depressed drugs are underway. The implications of these finding are discussed in the context of developing countries. (author)

  1. Relationship between regional severity of emphysema and coronary heart disease

    International Nuclear Information System (INIS)

    Nagao, Michinobu; Sakai, Shinya; Yasuhara, Yoshifumi; Ikezoe, Junpei; Murase, Kenya; Ichiki, Taku

    2000-01-01

    We analyzed the relationship between regional severity of emphysema, which was evaluated by three-dimensional fractal analysis (3D-FA) of Technegas SPECT images, and coronary heart disease (CHD). For 22 patients with emphysema who underwent Technegas SPECT, we followed up CHD events. The follow-up period was 5.4±0.5 (mean ±SD) years. We defined the upper-lung fractal dimension (U-FD) and lower-lung fractal dimension (L-FD) obtained with 3D-FA of Technegas SPECT images as the regional severity of emphysema. FD became greater with the progression of emphysematous change. During the follow-up period, CHD events occurred in 6 (27%) of the 22 patients. The ratio of U-FD to L-FD for patients with CHD events (0.87±0.22) was significantly smaller than for patients without CHD events (1.52±0.38) (p=0.0015). These findings suggest that severer emphysema in the lower lung indicates a higher risk of CHD than that in the upper lung. (author)

  2. Patient education in the management of coronary heart disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Brown, James Pr; Clark, Alexander M

    2017-01-01

    BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is a complex multifaceted....... To explore the potential study level predictors of the effects of patient education in patients with CHD (e.g. individual versus group intervention, timing with respect to index cardiac event). SEARCH METHODS: We updated searches from the previous Cochrane review, by searching the Cochrane Central Register.......5%) versus 12/102 (11.8%); random effects RR 0.63, 95% CI 0.26 to 1.48; very low quality of evidence). However, there was some evidence of a reduction with education in fatal and/or non-fatal cardiovascular events (2 studies, 310 studies; 21/152 (13.8%) versus 61/158 (38.6%); random effects RR 0.36, 95% CI 0...

  3. Meta-analyses of HFE variants in coronary heart disease.

    Science.gov (United States)

    Lian, Jiangfang; Xu, Limin; Huang, Yi; Le, Yanping; Jiang, Danjie; Yang, Xi; Xu, Weifeng; Huang, Xiaoyan; Dong, Changzheng; Ye, Meng; Zhou, Jianqing; Duan, Shiwei

    2013-09-15

    HFE gene variants can cause hereditary hemochromatosis (HH) that often comes along with an increased risk of coronary heart disease (CHD). The goal of our study is to assess the contribution of four HFE gene variants to the risk of CHD. We conducted four meta-analyses of the studies examining the association between four HFE gene variants and the risk of CHD. A systematic search was conducted using MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI), Wanfang Chinese Periodical. Meta-analyses showed that HFE rs1799945-G allele was associated with a 6% increased risk of CHD (P=0.02, odds ratio (OR)=1.06, 95% confidence interval (CI)=1.01-1.11). However, no association between the other three HFE gene variants (rs1800562, rs1800730, and rs9366637) and CHD risk was observed by the meta-analyses (all P values>0.05). In addition, the results of our case-control study indicated that rs1800562 and rs1800730 were monomorphic, and that rs1799945 and rs9366637 were not associated with CHD in Han Chinese. Our meta-analysis suggested that a significant association existed between rs1799945 mutation and CHD, although this mutation was rare in Han Chinese. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Overview of Coronary Heart Disease Risk Initiatives in South Asia.

    Science.gov (United States)

    Kalra, Ankur; Bhatt, Deepak L; Rajagopalan, Sanjay; Suri, Kunal; Mishra, Sundeep; Iqbal, Romaina; Virani, Salim S

    2017-06-01

    Cardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking. Several multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD and their risk factors. The PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP), the Kerala Acute Coronary Syndrome (ACS), and Trivandrum Heart Failure registries have focused on secondary prevention of CVD and performance measurement in both outpatient and inpatient settings, respectively. The Prospective Urban and Rural Epidemiology (PURE), Centre for Cardiometabolic Risk Reduction in South Asia (CARRS), and other epidemiologic and genetic studies have focused on primary prevention of CVD and evaluated variables such as environment, smoking, physical activity, health systems, food and nutrition policy, dietary consumption patterns, socioeconomic factors, and healthy neighborhoods. The international cardiovascular community has been responsive to a burgeoning cardiovascular disease burden in South Asia. Several collaborations have formed between the West (North America in particular) and South Asia to catalyze evidence-based and data-driven changes in the federal health policy in this part of the world to promote cardiovascular health and mitigate cardiovascular risk.

  5. Myocardial perfusion imaging for the detection of coronary heart disease

    International Nuclear Information System (INIS)

    Strauss, H.W.; Cook, D.J.; Bailey, I.; Rouleau, J.; Pitt, B.

    1976-01-01

    A method of myocardial perfusion imaging using 201 Tl is described. Thallium is able to substitute for potassium in biological systems including transport by the sodium--potassium ATP-ase system. The high extraction efficiency of the heart for 201 Tl offers a method whereby a tracer may be administered intravenously and is concentrated to a significant degree by the heart. However, only about 3 to 4 percent of the dose administered lodges in the myocardium. Experiments with dogs indicated that the regional distribution of Tl in the heart reflects the regional distribution of blood flow. The goal is to develop a procedure that can detect those patients with significant disease prior to the onset of a catastrophic event and studies are being undertaken to improve the sensitivity of the method for the detection of smaller lesions in the myocardium

  6. Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease.

    Science.gov (United States)

    Sanchez-Garcia, M Esther; Ramirez-Lara, Irene; Gomez-Delgado, Francisco; Yubero-Serrano, Elena M; Leon-Acuña, Ana; Marin, Carmen; Alcala-Diaz, Juan F; Camargo, Antonio; Lopez-Moreno, Javier; Perez-Martinez, Pablo; Tinahones, Francisco José; Ordovas, Jose M; Caballero, Javier; Blanco-Molina, Angeles; Lopez-Miranda, Jose; Delgado-Lista, Javier

    2018-02-23

    Microcirculation disturbances have been associated to most of the cardiovascular risk factors as well as to multiple inflammatory diseases. However, whether these abnormalities are specifically augmented in patients with coronary heart disease is still unknown. We aimed to evaluate if there is a relationship between the presence of coronary heart disease and the existence of functional and structural capillary abnormalities evaluated in the cutaneous microcirculation by videocapillaroscopy. Two matched samples of 30 participants with and without coronary heart disease but with similar clinical and anthropometric characteristics were evaluated by videocapillaroscopy at the dorsal skin of the third finger of the non-dominant hand. We calculated basal capillary density as well as capillary density after a period of arterial and venous occlusion in order to evaluate functionality and maximum capillary density. We also measured capillary recruitment. Microvascular capillary density at rest was significantly lower in patients suffering from coronary heart disease than in controls. This fact was also found after dynamic tests (arterial and venous occlusion), suggesting functional impairments. Capillary recruitment of the samples was not different in our sample. In our study, patients with coronary heart disease exhibit functional and structural microvascular disturbances. Although this is a very preliminary study, these findings open the door for further studying the microvascular functionality in coronary patients and how it relates to the response to treatment and/or the prognosis of the disease. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  7. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    Science.gov (United States)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  8. Incidental finding of single coronary artery in a patient with alcoholic cardiomyopathy presenting as acute heart failure.

    Science.gov (United States)

    McNair, Patrick; Jones, Erica; Truong, Quynh; Singh, Harsimran

    Single coronary artery is a rare clinical finding. Diagnosis is typically made incidentally after the patient presents with symptoms and undergoes coronary angiography, coronary computed tomography angiography (CTA), or post-mortem during autopsy. Several high-risk features of anomalous coronary arteries have been described in the literature. Our paper describes a case of dilated alcoholic cardiomyopathy presenting as heart failure with diagnostic workup incidentally revealing single coronary artery. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Post-traumatic stress disorder and incidence of coronary heart disease: a twin study.

    Science.gov (United States)

    Vaccarino, Viola; Goldberg, Jack; Rooks, Cherie; Shah, Amit J; Veledar, Emir; Faber, Tracy L; Votaw, John R; Forsberg, Christopher W; Bremner, J Douglas

    2013-09-10

    The aim of this study was to determine whether post-traumatic stress disorder (PTSD) is associated with coronary heart disease (CHD) using a prospective twin study design and objective measures of CHD. It has long been hypothesized that PTSD increases the risk of CHD, but empirical evidence using objective measures is limited. We conducted a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Among twin pairs without self-reported CHD at baseline, we selected pairs discordant for a lifetime history of PTSD, pairs discordant for a lifetime history of major depression, and pairs without either condition. All underwent a clinic visit after a median follow-up of 13 years. Outcomes included clinical events (myocardial infarction, other hospitalizations for CHD and coronary revascularization) and quantitative measures of myocardial perfusion by [(13)N] ammonia positron emission tomography, including a stress total severity score and coronary flow reserve. A total of 562 twins (281 pairs) with a mean age of 42.6 years at baseline were included in this study. The incidence of CHD was more than double in twins with PTSD (22.6%) than in those without PTSD (8.9%; p Stress total severity score was significantly higher (+95%, p = 0.001) and coronary flow reserve was lower (-0.21, p = 0.02) in twins with PTSD than in those without PTSD, denoting worse myocardial perfusion. Associations were only mildly attenuated in 117 twin pairs discordant for PTSD. Among Vietnam-era veterans, PTSD is a risk factor for CHD. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Physiological importance of the coronary arterial blood supply to the rattlesnake heart

    DEFF Research Database (Denmark)

    Hagensen, Mette; Abe, Augusto S.; Falk, Erling

    2008-01-01

    Pa and 58.2±2.2 beats min-1, respectively, during activity and the ECG was not affected. This was not different from sham-operated snakes. Thus, while the outer compact layer of the rattlesnake heart clearly has an extensive coronary supply, rattlesnakes sustain a high blood pressure and heart rate during...

  11. Nutrition in the prevention of Coronary Heart Disease and the management of lipoprotein disorders

    Science.gov (United States)

    Cardiovascular disease (CVD) is comprised of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD). CVD is caused by progressive narrowing and blockage of arteries supplying the heart, brain, and other tissues and organs. CVD is the leading cause of death and disability in our ...

  12. Recent trends in coronary heart disease epidemiology in India.

    Science.gov (United States)

    Gupta, Rajeev

    2008-01-01

    Coronary heart disease (CHD) is epidemic in India and one of the major causes of disease-burden and deaths. Mortality data from the Registrar General of India shows that cardiovascular diseases are a major cause of death in India now. Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases cause about 40% of the deaths in urban areas and 30% in rural areas. Analysis of cross-sectional CHD epidemiological studies performed over the past 50 years reveals that this condition is increasing in both urban and rural areas. The adult prevalence has increased in urban areas from about 2% in 1960 to 6.5% in 1970, 7.0% in 1980, 9.7% in 1990 and 10.5% in 2000; while in rural areas, it increased from 2% in 1970, to 2.5% in 1980, 4% in 1990, and 4.5% in 2000. In terms of absolute numbers this translates into 30 million CHD patients in the country. The disease occurs at a much younger age in Indians as compared to those in North America and Western Europe. Rural-urban differences reveal that risk factors like obesity, truncal obesity, hypertension, high cholesterol, low HDL cholesterol and diabetes are more in urban areas. Case-control studies also confirm the importance of these risk factors. The INTERHEART-South Asia study identified that eight established coronary risk factors--abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, and lack of physical activity--accounted for 89% of the cases of acute myocardial infarction in Indians. There is epidemiological evidence that all these risk factors are increasing. Over the past fifty years prevalence of obesity, hypertension, hypercholesterolemia, and diabetes have increased significantly in urban (R2 0.45-0.74) and slowly in rural areas (R2 0.19-0.29). There is an urgent need for development and implementation of suitable primordial, primary, and secondary prevention

  13. Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease.

    Science.gov (United States)

    Page, Tamara; Lockwood, Craig; Conroy-Hiller, Tiffany

    2005-02-01

    Background  Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives  The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria  This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results  Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that

  14. Levels of pregnancy-associated plasma protein-A in patients with coronary heart diseases and clinic significance

    International Nuclear Information System (INIS)

    Wang Lingyan; Cai Gaojun; Zhang Wenwei; Wang Wenzhi; Sun Wenwei; Yan Weiqun

    2006-01-01

    Objective: To explore the relationship between pregnancy-associated plasma protein-A (PAPP-A) and occurance, development of cardiovascular diseases, and lipids. Methods: 75 patients with coronary disease were divided into acute myocardial infarction (n=32), unstable angina pectoris (n=22) and stable angina pectoris (n=21) groups, and 60 subjects without coronary diseases were used as controls. The serum PAPP-A, IL-6, IL-10, lipids were measured in all patients and controls by different methods of enzymatically amplified two-step sandwith- type immunoassay, double antibody radio-immunoassay, ABC-HRP, auto biochemistic analytist. Results: (1) The level of PAPP-A in acute coronary syndrome (ACS, including acute myocardial infarction and unstable angina pectoris) patients was significantly higher than that in stable angina pectoris patients and controls (P<0.05). (2) There were significantly associations between PAPP-A and serum totle cholesterol, ApoA1/ApoB (r=0.348, 0.420, P<0.05). (3) The levels of IL-6 and IL-10 in coronary heart disease patients were significantly higher than those in controls (P<0.05), and the variations among acute myocardial infarction, unstable angina pectoris, stable angina pectoris patients were significantly (P<0.05). There were significantly associations between PAPP-A, IL-6 and IL-10 (Spearman r 0.446, 0.523, P<0.05). Conclusion: PAPP-A is significantly associated with occurance and development of coronary heart disease, probablely as a marker of unstable plaque in coronary heart disease. (authors)

  15. Risk factors of coronary heart disease among medical diagnostic X-ray workers

    International Nuclear Information System (INIS)

    Zhang Wei; Wang Jixian; Zhao Yongcheng; Li Benxiao; Fan Tiqiang; Zhao Zhigang; Lin Zhidong

    2002-01-01

    Objective: To investigate risk factors of coronary heart disease (CHD) in medical diagnostic X-ray workers in China, especially the relationship of CHD with occupational irradiation. Methods: A 1:2 matched case-control study was carried out. The study subjects consisted of 112 pair-matched cases and controls coming from different hospitals in China. Information about occupational and non-occupational risk factors obtained by interviewing every subjects personally. Individual doses were estimated by normalized work load method. SAS 6.12 software conditional Logistic regression method was applied to data analysis. Results: Variables such as family history of CHD (OR=17.298, P = 0.0001), history of hypertension (OR = 6.172, P = 0.0003), overweight (OR = 2.679, P = 0.0150), physical exercises (OR = 0.421, P0.0333), diabetes (OR = 7.823, P = 0.0200), radiation protection condition (OR = 3.992, P 0.0027), and accumulated radiation dose (OR = 1.612, P 0.0454) were included in the last model. Conclusions: For the medical diagnostic X-ray workers, family history of coronary heart disease, history of hypertension, diabetes, etc. are the main risk factors of CHD, and occupational exposure may be a potential risk factor. As for the mechanism, further studies are needed

  16. Population assessment of future trajectories in coronary heart disease mortality.

    Directory of Open Access Journals (Sweden)

    Rosa Björk Thorolfsdottir

    Full Text Available BACKGROUND: Coronary heart disease (CHD mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. METHODS AND FINDINGS: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25-74. Calculations were based on combining: i data on population numbers and projections (Statistics Iceland, ii population risk factor levels and projections (Refine Reykjavik study, and iii effectiveness of specific risk factor reductions (published meta-analyses. Projections for three contrasting scenarios were compared: (1 If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. (2 If recent trends in risk factors (past 5 years continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3 Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. CONCLUSIONS: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future.

  17. Gender differences in risk factors for coronary heart disease.

    Science.gov (United States)

    Tan, Yen Y; Gast, Gerrie-Cor M; van der Schouw, Yvonne T

    2010-02-01

    Coronary heart disease (CHD), traditionally considered a male disease, is also a major threat to women. This review article addresses independent risk factors for CHD that are specific for women as well as non-gender-specific risk factors and how their effects differ between men and women. Although polycystic ovary syndrome (PCOS) in women is associated with an adverse metabolic risk profile, current evidence regarding future risk of CHD is conflicting. Preeclampsia is consistently associated with higher risk of CHD later in life. Menopause is associated with an increased risk of CHD, and the earlier the onset of menopause, the larger the risk. Existing data on postmenopausal hormone therapy (HT) was inconclusive with regard to possible protection when HT is initiated close to menopause in young peri- or postmenopausal women. Evidence on use of low-dose oral contraceptives strongly suggests no increased risk of CHD. Although levels of physical inactivity are similar for men and women, the higher prevalences of hypertension, diabetes, and obesity in older women portends a greater risk in women than in men. Additionally, risk factors like smoking, hypertriglyceridemia and low high-density lipoprotein cholesterol levels have greater impact in women than in men. This review indicates that acknowledgement of non-gender-specific risk factors in addition to those that are unique to women would help optimize diagnosis, treatment and earlier prevention of CHD in women. Further research is needed to ascertain if incorporating these gender-specific risks into a clinically used risk stratification model would change outcome in women. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  18. 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.

  19. Clinical value of 201Tl lung/heart ratio during exercise in hypertensive patients with coronary artery disease

    International Nuclear Information System (INIS)

    Ouyang Wei; He Guorong; Liu Jinhua; Huang Yuying

    2002-01-01

    Objective: The purpose of the study was to evaluate the relationship between 201 Tl lung/heart ratio during exercise and left ventricular diastolic function and its diagnostic value on severity of coronary artery disease. Methods: One hundred and two patients with documented coronary artery disease were divided into three groups, including no hypertension, hypertension without or with left ventricular hypertrophy groups. Exercise/delay 201 Tl myocardial perfusion tomography was performed on all patients included. Lung/heart ratio was defined on the anterior planar image obtained during exercise tomography. Results: The lung/heart ratios during exercise in no hypertension (0.43 +- 0.09, P 0.05). The lung/heart ratios of multi-vessel disease subgroup in no hypertension (0.46 +- 0.10 vs 0.40 +- 0.09, P 0.05). When lung/heart ratio was≥0.45, the sensitivities for predicting the presence of multi-vessel disease were 82%, 90%, 40% and specificities were 75%, 75%, 45%, respectively, in no hypertension, hypertension without and with hypertrophy groups. In no hypertension (r=0.402, P 0.05). In no hypertension (r=-0.413, P<0.01), hypertension without (r=-0.662, P<0.01) and with hypertrophy groups (r=-0.408, P<0.05), lung/heart ratios all showed a significant reverse correlation with correspondent E/A ratios. Conclusions: The exercise lung/heart ratios has a better diagnostic value for multi-vessel disease and left ventricular diastolic function abnormalities of coronary artery disease with or without hypertension, but not for multi-vessel disease in hypertension patients complicated with myocardial hypertrophy

  20. Heart rate modulation in stable coronary artery disease without clinical heart failure: What we have already learned from SIGNIFY?

    Directory of Open Access Journals (Sweden)

    Gian Piero Perna

    2016-12-01

    In conclusion, heart rate is a marker of risk but is not a risk factor and/or a target of therapy in patients with stable coronary artery disease and preserved ventricular systolic function. Standard doses of ivabradine are indicated for treatment of angina as an alternative or in addition to beta-blockers, but should not be administered in association with CYP3A4 inhibitors or heart rate-lowering calcium-channel blockers.

  1. Differences Characteristics Patients Diabetes Mellitus Type 2 with and without Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Nindara Citra Aquarista

    2017-04-01

    Full Text Available Diabetes mellitus is the third highest Non-Communicable Diseases (NCDs, which causes death in Indonesia.The incidence of coronary heart disease in diabetes mellitus is high, 65% of people with diabetes mellitus die due to coronary heart disease and stroke. The purpose of this study is to analyze the differences in the characteristics of Diabetes mellitus type 2 in patients with and without coronary heart disease in Haji General Hospital Surabaya year 2016. This research uses observational analysis with cross sectional study design. The subject of the study is the incidence of diabetes Mellitus type 2 with and without coronary heart disease with undergoing outpatient treatment at Haji General Hospital Surabaya year 2016. The Samples were taken by fixed-disease sampling method with 42 people as the samples. The data analysis uses Chi Square test. The results show for the independent variables that have the most significant difference inHaji General Hospital Surabaya year 2016 is smoking behavior (p = 0.00; PR = 7.85; 95% CI = 2.09 to 29.50 and hypertension (p = 0,002; PR = 3.51; 95% CI = 1.42 to 8.67. In conclusion, the smoking behavior and hypertension can lead to complications of coronary heart disease for patients with type in Diabetes Mellitus type 2 in Haji General Hospital year 2016. It needs awareness to check blood pressure regularly and eliminate the smoking habit as the prevention of complications of coronary heart disease for patients with diabetes mellitus type 2. Keywords: diabetes mellitus type 2, coronary hearth disease.

  2. Risk factors for coronary heart disease and actual diagnostic criteria for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mitrović-Perišić Nataša

    2009-01-01

    Full Text Available Background/Aim. Recent studies indicate that the prevalence of diabetes mellitus (DM type 2 is increasing in the world. Chronic hyperglycemia in DM is associated with a long term damage, dysfunction and failure of various organs, especially retina, kidney, nerves and, in addition, with an increased risk of cardiovasclar disease. For a long time the illness has been unknown. Early diagnosis of diabetes could suspend the development of diabetic complications. The aim of the study was to establish risk for the development of coronary disease in the patients evaluated by the use of new diagnostic criteria for DM. Methods. The study included 930 participants without diagnosis of DM, hypertension, dyslipidemia, nor coronary heart disease two years before the study. The patients went through measuring of fasting plasma glycemia, erythrocytes, hematocrit, cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase. In the group with hyperglycemia the 2-hour oral glucose tolerance test was performed. We analyzed ECG and made blood pressure monitoring, and also measured body mass, height, waist and hip circumference. We analyzed life style, especially smoking, and exercise and family history. Results. Diabetes prevalence was 2.68%, and prevalences of impaired fasting glucose, impaired glucose tolerance and DM were 12.15%. Average age of males and females was 38 and 45 years, respectively. In the healthy population there was higher frequency of smokers (55% vs 42%, but in the population with hyperglycemia there were more obesity (23% vs 10.5%, hypertension (39% vs 9%, hypercholesterolemia (76% vs 44.1%, lower HDL-C (52.2% vs 25.7%. Cummulative risk factor in healthy subjects, and those with hyperglycemia were 5.6% and 14%, respectively. Conclusion. Subjects with hyperglicemia without diagnosis of DM have higher risk factors for coronary heart disease.

  3. Patient education in the management of coronary heart disease.

    Science.gov (United States)

    Anderson, Lindsey; Brown, James Pr; Clark, Alexander M; Dalal, Hasnain; Rossau, Henriette K; Bridges, Charlene; Taylor, Rod S

    2017-06-28

    Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is a complex multifaceted intervention which aims to improve the health outcomes of people with CHD. Cardiac rehabilitation consists of three core modalities: education, exercise training and psychological support. This is an update of a Cochrane systematic review previously published in 2011, which aims to investigate the specific impact of the educational component of cardiac rehabilitation. 1. To assess the effects of patient education delivered as part of cardiac rehabilitation, compared with usual care on mortality, morbidity, health-related quality of life (HRQoL) and healthcare costs in patients with CHD.2. To explore the potential study level predictors of the effects of patient education in patients with CHD (e.g. individual versus group intervention, timing with respect to index cardiac event). We updated searches from the previous Cochrane review, by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library, Issue 6, 2016), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) in June 2016. Three trials registries, previous systematic reviews and reference lists of included studies were also searched. No language restrictions were applied. 1. Randomised controlled trials (RCTs) where the primary interventional intent was education delivered as part of cardiac rehabilitation.2. Studies with a minimum of six-months follow-up and published in 1990 or later.3. Adults with a diagnosis of CHD. Two review authors independently screened all identified references for inclusion based on the above inclusion criteria. One author extracted study characteristics from the included trials and assessed their risk of bias; a second review author checked data. Two independent

  4. f antihypertensive of coronary heart disease Hypertension in a rural

    African Journals Online (AJOL)

    1990-07-21

    Jul 21, 1990 ... a high body mass index, a high uric acid level, a high prevalence of coronary ... Little information exists on the prevalence of hypertension in white South ... selective ,B-blockers have adverse effects on lipid metabolism. Research ..... importance of attention to other coronary risk factors before and during ...

  5. Is Chronic Low Back Pain Associated with the Prevalence of Coronary Heart Disease when Genetic Susceptibility Is Considered?

    DEFF Research Database (Denmark)

    Fernandez, Matt; Ordoñana, Juan R; Hartvigsen, Jan

    2016-01-01

    OBJECTIVE: To investigate the chronic low back pain and coronary heart disease relationship, after adjusting for relevant confounders, including genetics. METHODS: In a cross-sectional design, 2148 twins were recruited from the Murcia Twin Registry, Spain. The exposure was chronic LBP...... twin pairs discordant for chronic LBP utilised, separated for zygosity-dizygotic (DZ) and monozygotic (MZ) pairs, which adjusted for shared familial factors, including genetics. RESULTS: Chronic LBP pain is associated with lifetime myocardial infarction [odds ratio (OR) = 2.69, 95% confidence interval...... of the association remained or increased in the co-twin control analyses, none reached statistical significance. CONCLUSION: Chronic LBP is associated with a higher prevalence of myocardial infarction and coronary heart disease. It is possible that this association remains even when controlling for genetics...

  6. Coronary blood flow and coronary stenosis correlations in ischemic heart patients

    International Nuclear Information System (INIS)

    Manukov, I.

    2003-01-01

    The aim of the study is the assessment of the methodology for the C-TIMI frame count by Gibson for easy and fast determination of the coronary blood flow during a selective coronary angiography. 75 patient have been studied with one-branch affection of the coronary arteries. The criteria for exclusion are: myocardial hypertrophy, valve lesions, myocardial infarction and dyslipidemia. Depending of the characteristics of the coronary stenotic changes, the patients have been divided into two groups: 1) Patients with 'ordinary' stenosis of the coronary artery and 2) Patients with 'complex' stenosis. The severity of the stenotic changes in percents is the same for the two groups - 78%±13% vs 81±12%, respectively. In the first group a pronounced correlation is observed between the severity of the coronary stenosis and the slowing of the coronary blood flow. The 'threshold' stenotic level is 89%. In the second group the lowest value of the coronary stenosis is 73% (p>0.01 vs group 1). No correlation is observed between the severity of the coronary stenosis and the slowing of the coronary blood flow. A conclusion is made that the Gibson method for the assessment of the blood flow is convenient for the daily practice not only for the assessment of the significance of the coronary changes, but also for fast analysis of the achieved reconstruction of the coronary arteries after angioplasty. Additional studies of the significance of the different signs of 'complexity' of the coronary stenosis for the slowing of the blood flow are necessary

  7. The use of simple indicators for detecting potential coronary heart disease susceptibility in the third-class airman population.

    Science.gov (United States)

    1972-07-01

    An analysis was made of an eight-year interval change in several Framingham Heart Study (FHS) indicators of coronary heart disease (CHD) susceptibility as measured on 475 male air traffic control (ATC) personnel. The initial measurements were obtaine...

  8. Discriminative Power of the HEART Score for Obstructive Coronary Artery Disease in Acute Chest Pain Patients Referred for CCTA.

    Science.gov (United States)

    Kolff, Adriana Q; Bom, Michiel J; Knol, Remco J J; van de Zant, Friso M; van der Zee, Petrus M; Cornel, Jan H

    2016-03-01

    To investigate the ability of the HEART score to predict the presence of obstructive coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA) and its ability to predict the occurrence of major adverse cardiac events (MACE) in patients referred for CCTA after emergency department (ED) presentation. From December 2011 to August 2014, 710 ED patients with chest pain who underwent CCTA within 30 days were included. The HEART score was retrospectively calculated and patients were followed for MACE, comprised of death, myocardial infarction, and revascularization. Association of CAD at CCTA in the different categories of the HEART score was analyzed using χ test. The performance of the HEART score in discriminating between those with and without obstructive CAD was evaluated by receiver operating characteristics. Kaplan-Meier analysis was used to assess MACE-free survival stratified by HEART-score categories. During median follow-up of 826 days (interquartile range: 563-1056), MACE occurred in 46 (6.5%) patients; 3 (0.4%) myocardial infarction, 8 (1.1%) death, and 36 (5.1%) revascularizations. A low HEART score was a significant predictor for MACE-free survival (P = 0.010). CCTA revealed obstructive CAD in 11.7% of patients, with no significant difference between patients with a low and intermediate/high HEART score, respectively 10.7% and 13.2% (P = 0.29). The ability of the HEART score to identify obstructive CAD was poor with an AUC of the receiver operating characteristics curve of 0.53. The HEART score does not adequately identify patients with obstructive CAD at CCTA. It does however predict occurrence of MACE in medium-term follow-up. Excluding patients from additional testing based solely on a low HEART score may lead to suboptimal patient management. CCTA had important implications on patient management and may be a more appropriate tool to further stratify risk in ED chest pain patients.

  9. Positive Affect and Survival in Patients With Stable Coronary Heart Disease : Findings From the Heart and Soul Study

    NARCIS (Netherlands)

    Hoen, Petra W.; Denollet, Johan; de Jonge, Peter; Whooley, Mary A.

    Objective: Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might

  10. Positive affect and survival in patients with stable coronary heart disease : Findings from the Heart and Soul Study

    NARCIS (Netherlands)

    Hoen, P.W.; Denollet, J.; de Jonge, P.; Whooley, M.A.

    2013-01-01

    Objective: Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might

  11. Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.

    Science.gov (United States)

    Djoussé, Luc; Hopkins, Paul N; North, Kari E; Pankow, James S; Arnett, Donna K; Ellison, R Curtis

    2011-04-01

    Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. We studied in a cross-sectional design 4970 participants aged 25-93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]. These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population. Published by Elsevier Ltd.

  12. [Relationship between epicardial adipose tissue and clinical prognosis of patients with coronary heart disease after percutaneous coronary intervention].

    Science.gov (United States)

    Zhang, Y Y; Li, X; Lin, W H; Liu, J J; Jing, R; Lu, Y J; Di, C Y; Shi, H Y; Gao, P

    2018-01-16

    Objective: To further evaluate the clinical value of epicardial adipose tissue volume (EATV) in predicting the prognosis of coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods: From July 2013 to July 2016 in TEDA International Cardiovascular Disease Hospital, a total of 474 patients diagnosed with CHD were included in this study.According to the result of EATV, patients were divided into three groups, group A (EATV≤75 ml), group B (75 mlEATVEATV≥150 ml). Then the level of body mass index (BMI), hypersensitive c-reactive protein (hs-CRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-α were tested for all the three groups.All the patients were followed up for 1 year for major adverse cardiovascular events (MACE). The clinical value of EATV in predicting the occurrence of MACE events was evaluated. Results: The BMI, level of hs-CRP, TNF-α in group B were higher than group A, group C were significantly higher than group B, with statistically significant difference across all the comparisons ( P EATV was positively correlated with hs-CRP, IL-6, TNF-α ( r =0.675-0.700, P EATV level was 120.39 ml to predict MACE (area under cure: 0.751, 95% CI : 0.634-0.868, P EATV>120.39 ml can be used as an independent risk factor for predicting the occurrence of MACE. Conclusion: The level of EATV is closely related to the occurrence of MACE events, and EATV>120.39 ml is an independent risk factor for MACE in patients with CHD after PCI.

  13. Ranking of psychosocial and traditional risk factors by importance for coronary heart disease

    DEFF Research Database (Denmark)

    Schnohr, Peter; Marott, Jacob L; Kristensen, Tage S.

    2015-01-01

    .001] and systolic blood pressure (≥160 mmHg or blood pressure medication vs. never smoker; HR 1.74; 95% CI, 1.43-2.11; P ...-statistics and net reclassification improvement. During the follow-up, 1731 non-fatal and fatal coronary events were registered. In men, the highest ranking risk factors for coronary heart disease were vital exhaustion [high vs. low; hazard ratio (HR) 2.36; 95% confidence interval (CI), 1.70-3.26; P

  14. Compartment analysis of 125I-labelled albumin washout from coronary vessels of isolated perfused hearts

    International Nuclear Information System (INIS)

    Cheng Eap Ng; Seh-Hoon Song

    1978-01-01

    Albumin labelled with 125 I was used as a tracer to investigate the washout kinetics of plasma from the coronary circulation of isolated perfused feline hearts. Compartmentalization with experimental results showed at least two compartments. The model was compared with a three-compartment model found previously for red blood cells. The results indicate that there is a separation of plasma and RBC in the coronary microcirculation. (author)

  15. Noninvasive imaging in the assessment and prevention of coronary heart disease

    International Nuclear Information System (INIS)

    Llerena Rojas, Luis Roberto; Peix Gonzalez, Amalia; Valiente Mustelier, Juan

    2011-01-01

    Echocardiography, multidetector computed tomography, magnetic resonance imaging, and nuclear cardiology can all help prevent coronary heart disease. Echocardiography can identify asymptomatic individuals who are at risk of coronary disease and who should receive aggressive preventative therapy by providing data on the carotid intima-media thickness, arterial stiffness and flow-mediated dilatation of the brachial artery. The calcium score is an independent predictor of cardiac events that influences clinical risk scores such as the Framingham risk score. By using multidetector computed tomography or magnetic resonance imaging for coronary angiography, it is possible to visualize both the lumen and vessel walls of coronary arteries and to discriminate between calcified and noncalcified atherosclerotic plaque before invasive coronary angiography is performed. With nuclear cardiology, the functional effects of atherosclerotic lesions can be evaluated by assessing perfusion and ventricular function simultaneously

  16. Effort–Reward Imbalance at Work and Incident Coronary Heart Disease

    Science.gov (United States)

    Siegrist, Johannes; Nyberg, Solja T.; Lunau, Thorsten; Fransson, Eleonor I.; Alfredsson, Lars; Bjorner, Jakob B.; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E. H.; Nielsen, Martin L.; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H.; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J. M.; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G. David; Kivimäki, Mika

    2017-01-01

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain. Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress. PMID:28570388

  17. Incident solar radiation and coronary heart disease mortality rates in Europe

    International Nuclear Information System (INIS)

    Wong, Alfred

    2008-01-01

    The reported low mortality rate from coronary heart disease in Portugal, Spain, Italy, Greece, and France, to a lesser extent, has been attributed in numerous nutritional studies to the consumption of a Mediterranean-type diet. There are still many unresolved issues about the direct causal effect of the Mediterranean dietary regime on low incidence of coronary heart disease. An analysis of coronary heart disease mortality rates in Europe from a latitudinal gradient perspective has shown to have a close correlation to incident solar radiation. It is surmised that the resulting increased in situ biosynthesis of Vitamin D 3 could be the critical missing confounder in the analysis of the beneficial health outcome of the Mediterranean diet

  18. Heart Failure with Transient Left Bundle Branch Block in the Setting of Left Coronary Fistula

    Directory of Open Access Journals (Sweden)

    Stephen P. Juraschek

    2011-01-01

    Full Text Available Coronary arterial fistulas are rare communications between vessels or chambers of the heart. Although cardiac symptoms associated with fistulas are well described, fistulas are seldom considered in the differential diagnosis of acute myocardial ischemia. We describe the case of a 64-year-old man who presented with left shoulder pain, signs of heart failure, and a new left bundle branch block (LBBB. Cardiac catheterization revealed a small left anterior descending (LAD-to-pulmonary artery (PA fistula. Diuresis led to subjective improvement of the patient's symptoms and within several days the LBBB resolved. We hypothesize that the coronary fistula in this patient contributed to transient ischemia of the LAD territory through a coronary steal mechanism. We elected to observe rather than repair the fistula, as his symptoms and ECG changes resolved with treatment of his heart failure.

  19. [Expression of proBNP and NT-proBNP in Sudden Death of Coronary Heart Disease].

    Science.gov (United States)

    Zeng, Q; Sun, R F; Li, Z; Zhai, L Q; Liu, M Z; Guo, X J; Gao, C R

    2017-10-01

    To study the expression change of pro-brain natriuretic peptide (proBNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in sudden death of coronary atherosclerotic heart disease, and to explore its application in forensic diagnosis. Myocardial and blood samples were collected from normal control group, sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group (20 cases in each group). The expression of proBNP in myocardial samples were detected by immunohistochemical staining and Western blotting, and that of BNP mRNA were detected by reverse transcription PCR (RT-PCR). The content of NT-proBNP in plasma were detected by ELISA. Immunohistochemical staining showed positive expression of proBNP in both sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group. There was no positive expression in normal control group. For sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group, the relative expression of proBNP protein and BNP mRNA in myocardial tissue and the NT-proBNP content in plasma were higher than that of normal control group ( P heart disease group was higher than that of single coronary stenosis group ( P heart disease and determine whether the sudden death due to coronary atherosclerotic heart disease. Copyright© by the Editorial Department of Journal of Forensic Medicine

  20. Racial and geographic variation in coronary heart disease mortality trends

    Directory of Open Access Journals (Sweden)

    Gillum Richard F

    2012-06-01

    Full Text Available Abstract Background Magnitudes, geographic and racial variation in trends in coronary heart disease (CHD mortality within the US require updating for health services and health disparities research. Therefore the aim of this study is to present data on these trends through 2007. Methods Data for CHD were analyzed using the US mortality files for 1999–2007 obtained from the US Centers for Disease Control and Prevention. Age-adjusted annual death rates were computed for non-Hispanic African Americans (AA and European Americans (EA aged 35–84 years. The direct method was used to standardize rates by age, using the 2000 US standard population. Joinpoint regression models were used to evaluate trends, expressed as annual percent change (APC. Results For both AA men and women the magnitude in CHD mortality is higher compared to EA men and women, respectively. Between 1999 and 2007 the rate declined both in AA and in EA of both sexes in every geographic division; however, relative declines varied. For example, among men, relative average annual declines ranged from 3.2% to 4.7% in AA and from 4.4% to 5.5% in EA among geographic divisions. In women, rates declined more in later years of the decade and in women over 54 years. In 2007, age-adjusted death rate per 100,000 for CHD ranged from 93 in EA women in New England to 345 in AA men in the East North Central division. In EA, areas near the Ohio and lower Mississippi Rivers had above average rates. Disparities in trends by urbanization level were also found. For AA in the East North Central division, the APC was similar in large central metro (−4.2, large fringe metro (−4.3, medium metro urbanization strata (−4.4, and small metro (−3.9. APC was somewhat higher in the micropolitan/non-metro (−5.3, and especially the non-core/non-metro (−6.5. For EA in the East South Central division, the APC was higher in large central metro (−5.3, large fringe metro (−4.3 and medium metro

  1. Myocardial scintigraphy with 201Tl in combination with pharmacological tests in the diagnosis of coronary heart diseases

    International Nuclear Information System (INIS)

    Tokareva, E.A.; Sergienko, V.B.; Sidorenko, B.A.

    1989-01-01

    The paper presents the results from examination of 67 patients with coronary heart disease verified by a bicycle ergometric tests, 48 underwent 201 Tl myocardial scintigraphy along with a dipyridamole test, 19, the scintigraphy in combination with an isoproterenol test. The feasibilities of employing the procedures in the diagnosis of coronary heart disease were compared by statistic analysis

  2. Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data

    DEFF Research Database (Denmark)

    Wensley, Frances; Gao, Pei; Burgess, Stephen

    2011-01-01

    To use genetic variants as unconfounded proxies of C reactive protein concentration to study its causal role in coronary heart disease.......To use genetic variants as unconfounded proxies of C reactive protein concentration to study its causal role in coronary heart disease....

  3. The joint impact of family history of myocardial infarction and other risk factors on 12-year coronary heart disease mortality

    NARCIS (Netherlands)

    Boer, J M; Feskens, E.J.; Verschuren, W M Monique; Seidell, J C; Kromhout, D.

    1999-01-01

    We investigated the impact of family history of myocardial infarction on 12-year coronary heart disease mortality. Men and women with a family history had an increased risk for coronary heart disease death, irrespective of other risk factors (RR = 1.58; 95% CI = 1.17-2.13 and RR = 2.12; 95% CI =

  4. Coronary heart disease risk assessment and characterization of coronary artery disease using coronary CT angiography: comparison of asymptomatic and symptomatic groups

    International Nuclear Information System (INIS)

    Hwang, Y.; Kim, Y.; Chung, I.-M.; Ryu, J.; Park, H.

    2010-01-01

    Aim: To evaluate the prevalence of coronary artery disease (CAD) in relation to risk of coronary heart disease (CHD) and assess plaque characteristics from coronary computed tomography (CT) angiography in asymptomatic and symptomatic patients. Materials and methods: Three hundred and ninety consecutive patients [asymptomatic group, n = 138; symptomatic group (atypical or non-anginal chest pain), n = 252] were retrospectively enrolled. They were subsequently classified into three CHD risk categories, based on the National Cholesterol Education Program guidelines, and 10 year risks of coronary events were calculated using Framingham risk score. CT was evaluated for stenosis, plaque composition, and coronary calcium scores. Results: CAD was observed in 42% of the asymptomatic group and 62% of the symptomatic group. In the former, the prevalence of CAD in low-, moderate- and high-risk subgroups was 21.4, 47.4 and 65%, respectively, and was 33.3, 74.4, and 72.4% in the symptomatic group. Framingham 10-year risks of coronary events were significantly higher in patients with CAD than in normal participants, and receiver operating characteristics curves showed that discriminatory power was poor in the asymptomatic group and symptomatic men, and good in symptomatic women. Of the participants in the asymptomatic group, 12% exhibited only non-calcified plaques and of the symptomatic group, 7% exhibited only non-calcified plaques. The coronary calcium score was significantly higher for significant stenosis than for non-significant stenosis in both groups. Conclusions: The prevalence of CAD was not negligible even in subgroups with low-to-moderate CHD risk. Additionally, the Framingham risk score was effective for predicting CAD only in symptomatic women. Coronary calcium scores correlated with significant stenosis; however, a sizeable percentage of both groups had only non-calcified plaques.

  5. Comparison of the safety and efficacy for application of (cypher)TM and (taxus)TM coronary stent in patients with coronary heart disease and concurrent diabetic

    International Nuclear Information System (INIS)

    Zhang Junjie; Chen Shaoliang; Chen Huaixin; Li Zhiheng; Lin Yanting

    2005-01-01

    Objective: To compare the relative safety and efficacy of Cypher and Taxus stent in coronary heart disease complicated with diabetes. Methods: A retrospective study of our hospital's Cardiology database containing one hundred and twenty-two CHD complicated with diabetes undergone selective or urgent implantation of DES stent between June 2002 and February 2004 were divided into Cypher stent group (n=31) and Taxus stent group (n=91). The endpoints included cardiac death ,myocardial infarction (MI) and TLR at 6-month. Results: 122 patients with majority of males (80%) and mean age of 56 ± 11 years. The baseline characteristics were similar in both groups. Majority lesions treated were consisted of AHA/ACC Type B2/C (75%). Compared to the Taxus group, the Cypher group had a smaller mean reference diameter (2.4±0.6 mm versus 2.6±0.7 mm, P TM and (Taxus) TM coronary stents are proved to be equally safe and effective with low rate of clinical restenosis, TLR and MACE at 6-month in coronary heart disease complicated with diabetes patients. (authors)

  6. Low Birth Weight as The Risk factor of Coronary Heart Diseases

    Directory of Open Access Journals (Sweden)

    Joko Wahyu Wibowo

    2011-12-01

    Full Text Available Low birth weight, a nutritional deficiency is related to the increased in the coronary heart disease insidence. Low birth weight is correlated with the hipotalamus-pituitary-adrenal responsible for the the concentration of cortisol in sirculation, increased in homosistein, insuline resistence and increased C reactive protein playing role on the aterosclerosis process predispose the corronary disease. This paper will discuss the relationship between the low birth weight and the ateroclesoris process leading to coronary heart disesase (Sains Medika, 3(2:185-200.

  7. Evaluation of proinflammatory cytokines and brain natriuretic peptide in patients with rheumatic heart diseases and coronary heart disease complicated by chronic heart insufficiency

    Directory of Open Access Journals (Sweden)

    N A Shoslak

    2005-01-01

    Full Text Available Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP in patients with rheumatic heart diseases (RHD and coronary heart disease (CHD complicated by chronic heart insufficiency (CHI. Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \\frsilenko classification and 30 healthy persons of control group were examined. Besides clinical evaluation common laboratory and instrumental methods were used. Thorough echocardiography analysis, quantitative evaluation of serum TNF a, IL6 and BNP by immuno-enzyme assay was performed. Results. Direct correlation between cytokines and BNP levels and pts with CHI clinical state severity was revealed. These indiccs significantly differed in coronary and non-coronary (RHD CHI. TNF a concentration was minimal in mitral stenosis. Maximal concentrations of IL6 and TNF a were revealed in tricuspid regurgitation. TNF a concentration elevated with increase of heart linear dimensions. BNP showed similar but less prominent tendencies. Conclusion. Significant difference of studied indices in coronary and non-coronary (RHD CHI was shown. Despite of similarity of CHI clinical features levels of inflammation biological indices in RHD was significantly lower than in CHD that requires further discussion.

  8. Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease.

    Science.gov (United States)

    Vale, Margarite J; Jelinek, Michael V; Best, James D; Dart, Anthony M; Grigg, Leeanne E; Hare, David L; Ho, Betty P; Newman, Robert W; McNeil, John J

    Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease. However, those disease management programs in which drugs are not prescribed by allied health professionals have not improved coronary risk factor status. The objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary heart disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors. Multicenter randomized controlled trial in which 792 patients from 6 university teaching hospitals underwent a stratified randomization by cardiac diagnosis within each hospital: 398 were assigned to usual care plus The COACH Program and 394 to usual care alone. Patients in The COACH Program group received regular personal coaching via telephone and mailings to achieve the target levels for their particular coronary risk factors. There was one coach per hospital. The primary outcome was the change in TC (DeltaTC) from baseline (in hospital) to 6 months after randomization. Secondary outcomes included measurement of a wide range of physical, nutritional, and psychological factors. The analysis was performed by intention to treat. The COACH Program achieved a significantly greater DeltaTC than usual care alone: the mean DeltaTC was 21 mg/dL (0.54 mmol/L) (95% confidence interval [CI], 16-25 mg/dL [0.42-0.65 mmol/L]) in The COACH Program vs 7 mg/dL (0.18 mmol/L) (95% CI, 3-11 mg/dL [0.07-0.29 mmol/L]) in the usual care group (PCOACH Program group than in the usual care group. Coaching produced substantial improvements in most of the other coronary risk factors and in patient quality of life. Coaching, delivered as The COACH Program, is a highly effective strategy in reducing TC and many other coronary risk

  9. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  10. Usefulness of Beta blockade in contemporary management of patients with stable coronary heart disease.

    Science.gov (United States)

    Winchester, David E; Pepine, Carl J

    2014-11-15

    Considerable progress has been made over the last few decades in the management of clinically stable coronary heart disease (SCHD), including improvements in interventions (e.g., percutaneous revascularization), pharmacological management, and risk factor control (e.g., smoking, diet, activity level, hypercholesterolemia, hypertension). Although β blockers have long been used for the treatment of SCHD, their efficacy was established in the era before widespread use of reperfusion interventions, modern medical therapy (e.g., angiotensin-converting enzyme inhibitors, angiotensin receptor blockers), or preventive treatments (e.g., aspirin, statins). On the basis of these older data, β blockers are assumed beneficial, and their use has been extrapolated beyond patients with heart failure and previous myocardial infarction, which provided the best evidence for efficacy. However, there are no randomized clinical trials demonstrating that β blockers decrease clinical events in patients with SCHD in the modern era. Furthermore, these agents are associated with weight gain, problems with glycemic control, fatigue, and bronchospasm, underscoring the fact that their use is not without risk. In conclusion, data are currently lacking to support the widespread use of β blockers for all SCHD patients, but contemporary data suggest that they be reserved for a well-defined high-risk group of patients with evidence of ongoing ischemia, left ventricular dysfunction, heart failure, and perhaps some arrhythmias. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Clinical performance of dual-source computerized tomography (DSCT) in primary diagnostics of coronary heart diseases

    International Nuclear Information System (INIS)

    Brunner, H.; Froehner, S.; Wagner, M.; Schmitt, R.; Brunn, J.; Gietzen, F.H.; Kerber, S.

    2008-01-01

    Dual-source-CT-technology (DSCT) improves temporal resolution of cardiac computed tomography to 83 ms per heart-phase. In this study, the clinical performance of this new method is evaluated. Materials and Methods: In fifty patients (33 male, 17 female; age 50±13 years) with suspected coronary heart disease, CT angiography (slice thickness 0,75 mm, contrast-agent 60-80 ml iomeprol) was performed with a Somatom Definition scanner. Based on the coronary 15-segment-model of the AHA, scores for image quality and lumen reduction were established to enable the observer, to give recommendations for further therapy. Results: Out of 750 possible AHA-segments, 655 were depicted (87,3%). 591 segments (90,2%) were assessed without any limitation of quality, 49 (7,5%) segments showed moderate, and 15 (2,3%) segments severe limitation in image quality. 508 (77,6%) segments were without pathological findings, 92 (14,0%) segments had minimal atherosclerotic lesions, 42 (6,4%) segments suffered from stenoses with lumen reduction less than 70%, and 13 (2,0%) showed significant stenoses of more than 70%. In 31 patients (62%), coronary heart disease was ruled out by CT angiography without any need for further non-invasive or invasive diagnostics. 8 patients (16%) underwent stress-testing for ischemia. In 11 (22%) patients coronary angiography was recommended, and DSCT findings were confirmed in 10 cases. Only one LCx stenosis was overestimated in DSCT. Conclusion: Contrast-enhanced DSCT is a powerful tool in diagnosis of coronary heart disease. 98% of coronary segments could be assessed in diagnostic quality, and at least 90% of haemodynamically significant coronary stenoses were detected. (orig.)

  12. Reduction in Heart Rate Variability with Traffic and Air Pollution in Patients with Coronary Artery Disease

    Science.gov (United States)

    Zanobetti, Antonella; Gold, Diane R.; Stone, Peter H.; Suh, Helen H.; Schwartz, Joel; Coull, Brent A.; Speizer, Frank E.

    2010-01-01

    Introduction Ambient particulate pollution and traffic have been linked to myocardial infarction and cardiac death risk. Possible mechanisms include autonomic cardiac dysfunction. Methods In a repeated-measures study of 46 patients 43–75 years of age, we investigated associations of central-site ambient particulate pollution, including black carbon (BC) (a marker for regional and local traffic), and report of traffic exposure with changes in half-hourly averaged heart rate variability (HRV), a marker of autonomic function measured by 24-hr Holter electrocardiogram monitoring. Each patient was observed up to four times within 1 year after a percutaneous intervention for myocardial infarction, acute coronary syndrome without infarction, or stable coronary artery disease (4,955 half-hour observations). For each half-hour period, diary data defined whether the patient was home or not home, or in traffic. Results A decrease in high frequency (HF; an HRV marker of vagal tone) of −16.4% [95% confidence interval (CI), −20.7 to −11.8%] was associated with an interquartile range of 0.3-μg/m3 increase in prior 5-day averaged ambient BC. Decreases in HF were independently associated both with the previous 2-hr averaged BC (−10.4%; 95% CI, −15.4 to −5.2%) and with being in traffic in the previous 2 hr (−38.5%; 95% CI, −57.4 to −11.1%). We also observed independent responses for particulate air matter with aerodynamic diameter ≤ 2.5 μm and for gases (ozone or nitrogen dioxide). Conclusion After hospitalization for coronary artery disease, both particulate pollution and being in traffic, a marker of stress and pollution, were associated with decreased HRV. PMID:20064780

  13. THE EFFECT OF PHYSICAL ACTIVITY ON INFLAMMATORY MARKERS.THE RISK OF NEW CORONARY EVENT IN CORONARY HEART DISEASE PATIENTS

    Directory of Open Access Journals (Sweden)

    Todorka Savic

    2007-12-01

    Full Text Available Inflammation is an important factor in the pathogenesis of atherosclerosis, and several markers of inflammation have been associated with an increased risk of cardiovascular events. Physical activity may lower the risk of coronary heart disease(CHD by mitigating inflammation. The aim of the study was to investigate the effects of aerobic exercise training on systemic inflammatory response in patients with stabile coronary artery disease participating in a cardiovascular rehabilitation exercise program. Male (n=29 and female (n=23 patients with stable coronary heart disease were recruited for this study. All patients were divided into two groups: group with regular aerobic physical training during cardiovascular rehabilitation program phase II along 3 weeks in rehabilitation center and 3 weeks after that in home of patients and sedentary lifestyle group. There were no significant differences in gender distribution among analyzed groups. Student’s t test showed no significant difference in mean age, waist circumference (OS and waist/hip ratio (WHR. Degree of obesity was measured by BMI, and there was a significant improvement in BMI in patients who underwent the six-week physical training compared to control group (p<0.05.Physical training during 6 weeks did not show any effects on leukocyte count and ICAM-1 levels compared to control group. The exercise training induced reduction in plasma CRP levels by 23.72%, p<0.001, and reduction in plasma VCAM-1 levels by Moderate aerobic exercise training resulted in a significant reduction of inflammatory state by decreasing CRP and VCAM-1 levels without significant body mass and visceral obesity reduction. The obtained results indicate that regular physical activity is clinically attractive in primary and secondary prevention of coronary heart diseases.

  14. HeartCare+: A Smart Heart Care Mobile Application for Framingham-Based Early Risk Prediction of Hard Coronary Heart Diseases in Middle East

    Directory of Open Access Journals (Sweden)

    Hoda Ahmed Galal Elsayed

    2017-01-01

    Full Text Available Background. Healthcare is a challenging, yet so demanding sector that developing countries are paying more attention to recently. Statistics show that rural areas are expected to develop a high rate of heart diseases, which is a leading cause of sudden mortality, in the future. Thus, providing solutions that can assist rural people in detecting the cardiac risks early will be vital for uncovering and even preventing the long-term complications of cardiac diseases. Methodology. Mobile technology can be effectively utilized to limit the cardiac diseases’ prevalence in rural Middle East. This paper proposes a smart mobile solution for early risk detection of hard coronary heart diseases that uses the Framingham scoring model. Results. Smart HeartCare+ mobile app estimates accurately coronary heart diseases’ risk over 10 years based on clinical and nonclinical data and classifies the patient risk to low, moderate, or high. HeartCare+ also directs the patients to further treatment recommendations. Conclusion. This work attempts to investigate the effectiveness of the mobile technology in the early risk detection of coronary heart diseases. HeartCare+ app intensifies the communication channel between the lab workers and patients residing in rural areas and cardiologists and specialist residing in urban places.

  15. The relationship between urban sprawl and coronary heart disease in women.

    Science.gov (United States)

    Griffin, Beth Ann; Eibner, Christine; Bird, Chloe E; Jewell, Adria; Margolis, Karen; Shih, Regina; Ellen Slaughter, Mary; Whitsel, Eric A; Allison, Matthew; Escarce, Jose J

    2013-03-01

    Studies have reported relationships between urban sprawl, physical activity, and obesity, but - to date - no studies have considered the relationship between sprawl and coronary heart disease (CHD) endpoints. In this analysis, we use longitudinal data on post-menopausal women from the Women's Health Initiative (WHI) Clinical Trial to analyze the relationship between metropolitan statistical area (MSA)-level urban compactness (the opposite of sprawl) and CHD endpoints including death, any CHD event, and myocardial infarction. Models control for individual and neighborhood socio-demographic characteristics. Women who lived in more compact communities at baseline had a lower probability of experiencing a CHD event and CHD death or MI during the study follow-up period. One component of compactness, high residential density, had a particularly noteworthy effect on outcomes. Finally, exploratory analyses showed evidence that the effects of compactness were moderated by race and region. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality

    DEFF Research Database (Denmark)

    Collaboration, Emerging Risk Factors; Erqou, Sebhat; Kaptoge, Stephen

    2009-01-01

    were recorded, including 9336 CHD outcomes, 1903 ischemic strokes, 338 hemorrhagic strokes, 751 unclassified strokes, 1091 other vascular deaths, 8114 nonvascular deaths, and 242 deaths of unknown cause. Within-study regression analyses were adjusted for within-person variation and combined using meta.......02-1.18) for ischemic stroke, 1.01 (95% CI, 0.98-1.05) for the aggregate of nonvascular mortality, 1.00 (95% CI, 0.97-1.04) for cancer deaths, and 1.00 (95% CI, 0.95-1.06) for nonvascular deaths other than cancer. CONCLUSION: Under a wide range of circumstances, there are continuous, independent, and modest......CONTEXT: Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationship of Lp(a) concentration with risk of major vascular...

  17. The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion.

    Science.gov (United States)

    Nieminen, Markku S; Buerke, Michael; Cohen-Solál, Alain; Costa, Susana; Édes, István; Erlikh, Alexey; Franco, Fatima; Gibson, Charles; Gorjup, Vojka; Guarracino, Fabio; Gustafsson, Finn; Harjola, Veli-Pekka; Husebye, Trygve; Karason, Kristjan; Katsytadze, Igor; Kaul, Sundeep; Kivikko, Matti; Marenzi, Giancarlo; Masip, Josep; Matskeplishvili, Simon; Mebazaa, Alexandre; Møller, Jacob E; Nessler, Jadwiga; Nessler, Bohdan; Ntalianis, Argyrios; Oliva, Fabrizio; Pichler-Cetin, Emel; Põder, Pentti; Recio-Mayoral, Alejandro; Rex, Steffen; Rokyta, Richard; Strasser, Ruth H; Zima, Endre; Pollesello, Piero

    2016-09-01

    Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease. In acute heart failure, and especially in cardiogenic shock related to ischemic conditions, vasopressors and inotropes are used. However, both pathophysiological considerations and available clinical data suggest that these treatments may have disadvantageous effects. The inodilator levosimendan offers potential benefits due to a range of distinct effects including positive inotropy, restoration of ventriculo-arterial coupling, increases in tissue perfusion, and anti-stunning and anti-inflammatory effects. In clinical trials levosimendan improves symptoms, cardiac function, hemodynamics, and end-organ function. Adverse effects are generally less common than with other inotropic and vasoactive therapies, with the notable exception of hypotension. The decision to use levosimendan, in terms of timing and dosing, is influenced by the presence of pulmonary congestion, and blood pressure measurements. Levosimendan should be preferred over adrenergic inotropes as a first line therapy for all ACS-AHF patients who are under beta-blockade and/or when urinary output is insufficient after diuretics. Levosimendan can be used alone or in combination with other inotropic or vasopressor agents, but requires monitoring due to the risk of hypotension. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Association of plasma phytosterol concentrations with incident coronary heart disease Data from the CORA study, a case-control study of coronary artery disease in women

    NARCIS (Netherlands)

    Windler, Eberhard; Zyriax, Birgit-Christiane; Kuipers, Folkert; Linseisen, Jakob; Boeing, Heiner

    Aims: Phytosterols have been proposed to be atherogenic. This research investigates whether plasma concentrations of phytosterols correlate with the manifestation of coronary heart disease. Methods and results: The CORA study compares clinical, biochemical, and lifestyle factors in consecutive pre-

  19. The next generation: poor compliance with risk factor guidelines in the children of parents with premature coronary heart disease.

    Science.gov (United States)

    Langner, N R; Rowe, P C; Davies, R

    1994-01-01

    The offspring of individuals with premature coronary heart disease are themselves at increased risk for myocardial infarction before the age of 55. Consensus panels have recommended that all such offspring undergo an evaluation of cardiovascular risk, including cholesterol testing. To examine self-reported rates of cardiovascular risk factor assessment in this population, we conducted a telephone survey of 318 Canadian adults with premature coronary heart disease and of one offspring from 298 (94%) of the 318 families. The median age of the offspring was 20 years (range 2 to 39 y). Among the 219 late adolescent and young adult offspring, only 97 (44%) reported having had a blood cholesterol measurement during the preceding 3 years. Thirty-seven percent reported being current smokers, 31% were overweight, and 30% exercised fewer than three times per week. Men were less likely than women to report having had their blood pressure measured in the preceding year (57% vs 80%). These low rates of cardiac risk factor assessment families of patients with premature coronary heart disease represent missed opportunities for primary prevention. More effective strategies to prevent atherosclerosis in this population are needed.

  20. Integrated genetic and epigenetic prediction of coronary heart disease in the Framingham Heart Study.

    Directory of Open Access Journals (Sweden)

    Meeshanthini V Dogan

    Full Text Available An improved method for detecting coronary heart disease (CHD could have substantial clinical impact. Building on the idea that systemic effects of CHD risk factors are a conglomeration of genetic and environmental factors, we use machine learning techniques and integrate genetic, epigenetic and phenotype data from the Framingham Heart Study to build and test a Random Forest classification model for symptomatic CHD. Our classifier was trained on n = 1,545 individuals and consisted of four DNA methylation sites, two SNPs, age and gender. The methylation sites and SNPs were selected during the training phase. The final trained model was then tested on n = 142 individuals. The test data comprised of individuals removed based on relatedness to those in the training dataset. This integrated classifier was capable of classifying symptomatic CHD status of those in the test set with an accuracy, sensitivity and specificity of 78%, 0.75 and 0.80, respectively. In contrast, a model using only conventional CHD risk factors as predictors had an accuracy and sensitivity of only 65% and 0.42, respectively, but with a specificity of 0.89 in the test set. Regression analyses of the methylation signatures illustrate our ability to map these signatures to known risk factors in CHD pathogenesis. These results demonstrate the capability of an integrated approach to effectively model symptomatic CHD status. These results also suggest that future studies of biomaterial collected from longitudinally informative cohorts that are specifically characterized for cardiac disease at follow-up could lead to the introduction of sensitive, readily employable integrated genetic-epigenetic algorithms for predicting onset of future symptomatic CHD.

  1. Effect of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    De-Mao Yi

    2017-05-01

    Full Text Available Objective: To investigate the effects of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease, Methods: 110 patients with coronary heart disease from June 2015 to June 2016 in our hospital were selected as the research objects, randomly divided into observation group 55 cases and control group 55 cases, The patients in both groups received conventional treatment of coronary heart disease, and the control group was given orally atorvastatin calcium capsules at the same time. The observation group was added with trimetazidine hydrochloride tablets on the basis of the control group. The left ventricular ejection fraction (LVEF, left ventricular end diastolic diameter (LVEDD, left ventricular end-diastolic diameter (LVESD, C reactive protein (CRP, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6, superoxide dismutase (SOD and MDA levels of two groups were compared respectively before and after treatment. Results: Before treatment, the LVESD, LVEDD and LVEF levels between observation group and the control group had no significant difference (P>0.05; Compared with before treatment, LVESD and LVEDD levels in the observation group and control group after treatment were significantly decreased, LVEF increased significantly, and there were significant differences (P0.05; After treatment, SOD in the observation group and the control group were significantly increased, MDA decreased significantly, and the differences were statistically significant (P0.05; compared with before treatment, the CRP, TNF-α, and IL-6 of observation group and control group after treatment were significantly decreased, and the differences were statistically significant (P<0.05; After treatment, CRP, TNF-α, and IL-6 of the observation group were lower than the control group, and the difference was statistically significant (P<0.05. Conclusions: Atorvastatin combined with trimetazidine can

  2. Role of coronary endothelium in cyclic AMP formation by the heart

    International Nuclear Information System (INIS)

    Kroll, K.; Schrader, J.

    1986-01-01

    In order to quantify the activation of adenylate cyclase of the coronary endothelium in vivo, endothelial adenine nucleotides of isolated guinea pig hearts were selectively pre-labeled by intracoronary infusion of tritiated (H3)-adenosine, and the coronary efflux of H3-cAMP was measured. The adenosine receptor agonist, NECA (12 μM), increased total cAMP release 4 fold, and raised H3-cAMP release 22 fold. Several classes of coronary vasodilators (adenosine, L-PIA, D-PIA, the beta 2-adrenergic agonist procaterol, and PGE1) caused dose-dependent increases in endothelial-derived H3-cAMP release. These increases were accompanied by decreases in vascular resistance, at agonist doses without positive intropic effects. Hypoxic perfusion also raised H3-cAMP release, and this was antagonized by theophylline. It is concluded: (1) cyclic AMP formation by coronary endothelium can dominate total cAMP production by the heart; (2) coronary endothelial adenylate cyclase-coupled receptors for adenosine (A2), catecholamines (beta2) and prostaglandins are activated in parallel with coronary vasodilation; (3) endothelial adenylate cyclase can be activated by endogenous adenosine

  3. Clinical aspects of coronary heart diseases without myocardial infarction and in the chronic infarction phase

    International Nuclear Information System (INIS)

    Kober, G.

    1984-01-01

    Reductions in coronary vessel diameters of more than 50% are usually caused by atherosclerosis, seldom by predominant spasme. They can lead via an inadequate myocardial perfusion to angina pectoris. Whereas in patients with organic coronary stenoses exertional angina is typical, patients with coronary spasms usually tend to angina at rest. Depending on the symptoms, a stable or unstable angina can be distinguished from the status anginosus and a variant form of angina. During anginal attacks signs of myocardial ischemia can often be seen in the electrocardiogram. This applies to patients with and without earlier myocardial infarctions. When pathologic ECG-changes can already be seen in the ECG at rest, difficulties often arise during evaluation of the exercise-ECG. In those cases, diagnosis can be improved by additional investigations, especially with radionuclear techniques. For a conclusive diagnosis, left heart catheterization and a functional coronary angiography is necessary. Coronary heart disease can be treated either by drug therapy, coronary angioplasty or bypass surgery. The same diagnostic procedures are suitable for the evaluation of a therapeutical success and for primary diagnosis. (orig.) [de

  4. 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.

  5. [Association between ABO blood groups and coronary heart disease in Chinese Guangxi Zhuang population].

    Science.gov (United States)

    Shi, Ying; Lin, Yingzhong; Liu, Hairun; Ji, Qingwei; Lu, Zhihong; Lu, Zhengde; Xu, Nengwen; Yuan, Jun; Liu, Ling

    2015-09-01

    To investigate this association between ABO blood groups and coronary heart disease (CHD) in the Chinese Guangxi Zhuang population. From August 2010 to April 2013, we performed a case-control study in a Chinese Zhuang population, which included 1 024 CHD cases and 1 024 age and gender-matched non-CHD controls. The ABO blood groups and biological variables were measured by standard laboratory procedures. The Gensini score was used to evaluate the severity of coronary artery stenosis. Compared to non-CHD control group, CHD group had higher levels of fasting blood glucose ((6.71 ± 6.72) mmol/L vs. (4.98 ± 1.55) mmol/L, P blood groups were associated with CHD risk in the Chinese Zhuang population. Compared with group O, the group B individuals had a higher risk of CHD (OR = 2.33, 95% CI 1.88-2.90, P group O subjects in the CHD group, and MACE at 1-year follow-up was similar between ABO blood groups of CHD individuals. ABO blood groups are associated with CHD risk in the Chinese Zhuang population.

  6. The Statins in Prevention of Coronary Heart Diseases in Type 2 Diabetics

    Directory of Open Access Journals (Sweden)

    Bećir Heljić

    2009-02-01

    Full Text Available We aimed to determine whether the administration of statins to type 2 diabetics without pre-existing CHD reduced the incidence of CHD and their effects on cholesterol and CRP levels. All the participants were carefully interviewed, clinically examined, and laboratory tested to exclude conditions likely to provoke an inflammatory response that was an exclusion criterion. Exclusion criteria: Serious heart, liver or kidney problems, history of renal transplant, recent history of drug or alcohol abuse, HbA1c>10%, blood pressure >140/90mmHg, BMI >35 kg/m2, triglycerides >3,0mmol/dm3. 95 obese diabetics (mean age 60,9 years and BMI=31,59 kg/m2, diabetes duration more than 10 years without pre-existing CHD, were included in the analysis and were randomized to simvastatin (25 female and 20 male used 40 mg simvastatin daily or placebo (30 female and 20 male group. After six months, simvastatin significantly lowered CRP levels by 19%, (p<0,01, cholesterol levels by 18%, TG levels by 8%, LDL levels by 20% and VLDL levels by 17%, whereas there was no change with placebo. After one year the difference sustained between groups. Coronary events were rarely in the simvastatin group (6,6% than in the placebo group (14%. Coronary revascularizations were 4 in the placebo group and 1 in the simvastatin group. Rate of stroke was more often in the placebo group (18% than in the simvastatin group (8,8%. So, reduction of acute CHD events is for 7,4% in the simvastatin group. Positive correlation was between CRP and CVD (r=0,29. Statin therapy reduced the risk of coronary hearth disease in diabetics without CHD.

  7. The risk of coronary heart disease of seafarers on vessels sailing under a German flag.

    Science.gov (United States)

    Oldenburg, Marcus; Jensen, Hans-Joachim; Latza, Ute; Baur, Xaver

    2010-01-01

    This study aimed to predict the risk of coronary heart disease (CHD) among seafarers on German-flagged vessels and to assess the association of shipboard job duration at sea with the risk of CHD. During the legally required medical fitness test for nautical service, 161 seafarers in Hamburg participated in a cross-sectional study which included an interview, blood sampling, and blood pressure measurements (response 84.9%). The predicted 10-year risk of an acute coronary event of the examined German seafarers aged 35 to 64 years (n = 46) was assessed in comparison with a sample of male German employees of the same age working ashore (PROCAM study). The number of independent CHD risk factors (according to the PROCAM study) was compared in the groups with 'shorter' and 'longer' median shipboard job duration at sea (15.0 years). The examined German seafarers had a similar age-standardized predicted 10-year CHD risk as the German reference population. Nearly all independent CHD risk factors were significantly more frequent in seamen with job duration at sea of ≥ 15 years than in those with 〈 15 years. After adjusting for age, the number of CHD risk factors was associated with job duration (OR 1.08 [95% CI 1.02-1.14] per year). Seafarers on German-flagged ships have to attend a medical fitness test for nautical service every 2 years. Thus, it can be assumed that seafarers present a healthier population than employees ashore. In this study, however, CHD risk of seafarers was similar to that of the reference population. This may indicate that working onboard implies a high coronary risk. Furthermore, the study results suggest a tendency of increased risk of CHD among seafarers with longer job duration at sea.

  8. Multi-slice spiral CT coronary angiography: influence of heart rate and reconstruction window on image quality

    International Nuclear Information System (INIS)

    Mao Dingbiao; Hua Yanqing; Wang Mingpeng; Zhang Guozhen; Wu Weilan; Hu Fei; Ge Xiaojun; Ding Qiyong

    2004-01-01

    Objective: To evaluate the influence of heart rate and reconstruction window on image quality of multi-slice spiral CT coronary angiography. Methods: Retrospectively ECG-gated MSCT coronary angiography were performed in 80 healthy cases. Results: Four coronary (RCA, LM, LAD, LCX) segments were analyzed in each patient with regard to image quality. 82.1% (46/56) of the coronary segments were sufficient for analysis in patients with heart rate ≤60 bpm, 63.4% (104/164) with 61-70 bpm, 41.2%(28/68) with 71-80 bpm, and 31.2%(10/32) with>80 bpm, respectively. The left anterior descending artery, left circumflex artery, and the right coronary artery were best visualized when the reconstruction window was 60%-70%, 50%-60%, and 50%-70%, respectively. Conclusion: Image quality of MSCT coronary angiography is highly dependent on heart rate and reconstruction window

  9. Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease.

    Science.gov (United States)

    Roche, S Lucy; Silversides, Candice K

    2013-07-01

    Obesity, hypertension, and coronary artery disease are prevalent in the general population and well recognized as contributors to cardiac morbidity and mortality. With surgical and medical advances, there is a growing and aging population with congenital heart disease who are also at risk of developing these comorbidities. In addition, some congenital cardiac lesions predispose patients to conditions such as hypertension or coronary artery disease. The effect of these comorbidities on the structurally abnormal heart is not well understood, but might be very important, especially in those with residual abnormalities. Thus, in addition to surveillance for and treatment of late complications it is important for the congenital cardiologist to consider and aggressively manage acquired comorbidities. In this review we explore the prevalence of hypertension, obesity, and coronary artery disease, discuss congenital lesions that predispose to these conditions and review management strategies for this unique population. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  10. Association of coronary heart disease with age-adjusted aortocoronary calcification in patients with familial hypercholesterolaemia

    DEFF Research Database (Denmark)

    Jensen, J M; Gerdes, Lars Ulrik; Jensen, H K

    2000-01-01

    OBJECTIVES: Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD: traditio......OBJECTIVES: Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD......: traditional risk factors of CHD (age, sex, cholesterol, hypertension, smoking and body mass index), cholesterol year score, and aortic as well as coronary calcium measured by spiral computed tomography (CT). SUBJECTS: We invited 88 individuals with molecularly defined FH of whom 80 (91%) decided...

  11. Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Ricci, Cristian; Wood, Angela; Muller, David

    2018-01-01

    OBJECTIVE: To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke. DESIGN: Multicentre case-cohort study. SETTING: A study of cardiovascular disease (CVD) determinants within the European Prospecti...

  12. A new beating-heart off-pump coronary artery bypass grafting training model

    NARCIS (Netherlands)

    Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E.; Koene, Bart M.; Erasmus, Michiel E.; Natour, Ehsan; Mariani, Massimo A.

    OBJECTIVES: Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. METHODS: Human cadavers were embalmed according to the

  13. Omega-3 fatty acids and coronary heart disease. The final verdict?

    NARCIS (Netherlands)

    Kromhout, D.

    2012-01-01

    Purpose of review: The fish fatty acids eicosapentenoic acid (EPA) and docosahexenoic acid (DHA) may be protective against fatal coronary heart disease (CHD) and sudden cardiac death. This review summarizes the recent findings of prospective cohort studies and randomized controlled trials. Recent

  14. Periodontitis in coronary heart disease patients: strong association between bleeding on probing and systemic biomarkers.

    Science.gov (United States)

    Bokhari, Syed Akhtar H; Khan, Ayyaz A; Butt, Arshad K; Hanif, Mohammad; Izhar, Mateen; Tatakis, Dimitris N; Ashfaq, Mohammad

    2014-11-01

    Few studies have examined the relationship of individual periodontal parameters with individual systemic biomarkers. This study assessed the possible association between specific clinical parameters of periodontitis and systemic biomarkers of coronary heart disease risk in coronary heart disease patients with periodontitis. Angiographically proven coronary heart disease patients with periodontitis (n = 317), aged >30 years and without other systemic illness were examined. Periodontal clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) and systemic levels of high-sensitivity C-reactive protein (CRP), fibrinogen (FIB) and white blood cells (WBC) were noted and analyzed to identify associations through linear and stepwise multiple regression analyses. Unadjusted linear regression showed significant associations between periodontal and systemic parameters; the strongest association (r = 0.629; p periodontal and systemic inflammation marker, respectively. Stepwise regression analysis models revealed that BOP was a predictor of systemic CRP levels (p periodontal parameter significantly associated with each systemic parameter (CRP, FIB, and WBC). In coronary heart disease patients with periodontitis, BOP is strongly associated with systemic CRP levels; this association possibly reflects the potential significance of the local periodontal inflammatory burden for systemic inflammation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients

    NARCIS (Netherlands)

    Ginting, H.; Näring, G.W.B.; Veld, W.M. van der; Srisayekti, W.; Becker, E.S.

    2013-01-01

    This study assesses the validity and determines the cut-off point for the Beck Depression Inventory-II (the BDI-II) among Indonesians. The Indonesian version of the BDI-II (the Indo BDI-II) was administered to 720 healthy individuals from the general population, 215 Coronary Heart Disease (CHD)

  16. Overweight Status, Obesity, and Risk Factors for Coronary Heart Disease in Adults with Intellectual Disability

    Science.gov (United States)

    Henderson, C. Michael; Robinson, Laura M.; Davidson, Philip W.; Haveman, Meindert; Janicki, Matthew P.; Albertini, Giorgio

    2008-01-01

    Research indicates that adults with intellectual disabilities (ID) have high rates of overweight status/obesity (OSO). OSO is associated with several important risk factors for coronary heart disease (CHD). This study focused on assessing whether such risk factors are being identified in adults with ID who are receiving their healthcare in…

  17. Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease

    NARCIS (Netherlands)

    Brouwer, Beate G.; Visseren, Frank L. J.; Stolk, Ronald P.; van der Graaf, Yolanda

    Objective: We investigated whether the presence of concomitant coronary heart disease (CHD) in patients with peripheral arterial disease (PAD) can be explained by intra-abdominal fat accumulation and compared different measures of adiposity as predictors of CHD in patients with PAD. Research Methods

  18. A metabolic profile is associated with the risk of incident coronary heart disease

    NARCIS (Netherlands)

    Vaarhorst, A.; Verhoeven, A.; Weller, C.M.; Bohringer, S.; Brandt, van den P.A.; Greevenbroek, M.M.; Merry, A.H.; Verschuren, W.M.M.; Boer, J.M.A.; Feskens, E.J.M.; Heijmans, B.T.; Slagboom, P.E.

    2014-01-01

    Background Metabolomics, defined as the comprehensive identification and quantification of low-molecular-weight metabolites to be found in a biological sample, has been put forward as a potential tool for classifying individuals according to their risk of coronary heart disease (CHD). Here, we

  19. Causal effect of plasminogen activator inhibitor type 1 on coronary heart disease

    NARCIS (Netherlands)

    Song, Ci; Burgess, Stephen; Eicher, John D.; O'Donnell, Christopher J.; Johnson, Andrew D.; Huang, Jie; Sabater-Lleal, Maria; Asselbergs, Folkert W.; Tregouet, David-Alexandre; Shin, So Youn; Ding, Jingzhong; Baumert, Jens; Oudot-Mellakh, Tiphaine; Folkersen, Lasse; Smith, Nicholas L.; Williams, Scott M; Ikram, Mohammad Arfan; Kleber, Marcus E.; Becker, Diane M.; Truong, Vinh; Mychaleckyj, Josyf C.; Tang, Weihong; Yang, Qiong; Sennblad, Bengt; Moore, Jason H; Williams, Frances M.K.; Dehghan, Abbas; Silbernagel, Günther; Schrijvers, Elisabeth M.C.; Smith, Shelly; Karakas, Mahir; Tofler, Geoffrey H.; Silveira, Angela; Navis, Gerjan J.; Lohman, Kurt; Chen, Ming Huei; Peters, Annette; Goel, Anuj; Hopewell, Jemma C.; Chambers, John C.; Saleheen, Danish; Lundmark, Per; Psaty, Bruce M.; Strawbridge, Rona J.; Boehm, Bernhard O.; Carter, Angela M.; Meisinger, Christa; Peden, John F.; Bis, Joshua C.; McKnight, Barbara; Öhrvik, John; Taylor, Kent D.; Franzosi, Maria Grazia; Seedorf, Udo; Collins, Rory; Franco-Cereceda, Anders; Syvänen, Ann-Christine; Goodall, Alison H.; Yanek, Lisa R.; Cushman, Mary; Müller-Nurasyid, Martina; Folsom, Aaron R.; Basu, Saonli; Matijevic, Nena; van Gilst, Wiek H.; Kooner, Jaspal S.; Danesh, John; Clarke, Robert; Meigs, James B; Kathiresan, Sekar; Reilly, Muredach P; Klopp, Norman; Harris, Tamara B.; Winkelmann, Bernhard R.; Grant, Peter J.; Hillege, Hans L.; Watkins, Hugh; Spector, Timothy D; Becker, Lewis C; Tracy, Russell P.; März, Winfried; Uitterlinden, Andre G; Eriksson, Per; Cambien, Francois; Morange, Pierre Emmanuel; Koenig, Wolfgang; Soranzo, Nicole; van der Harst, Pim; Liu, Yongmei; Hamsten, Anders; Ehret, Georg B.; Munroe, Patricia B.; Rice, Kenneth M.; Bochud, Murielle; Chasman, Daniel I.; Smith, Albert V.; Tobin, Martin D; Verwoert, Germaine C; Hwang, Shih-Jen; Pihur, Vasyl; Vollenweider, Peter; O'Reilly, Paul F.; Amin, Najaf; Bragg-Gresham, Jennifer L.; Teumer, Alexander; Glazer, Nicole L.; Launer, Lenore J.; Zhao, Jing Hua; Aulchenko, Yurii S.; Heath, Simon; Sõber, Siim; Parsa, Afshin; Luan, Jian'an; Arora, Pankaj; Zhang, Feng; Lucas, Gavin; Hicks, Andrew A.; Jackson, Anne U.; Tanaka, Toshiko; Wild, Sarah H.; Rudan, Igor; Igl, Wilmar; Milaneschi, Yuri; Parker, Alex N.; Fava, Cristiano; Fox, Ervin R.; Kumari, Meena; Go, Min Jin; Linda Kao, Wen Hong; Sjögren, Marketa; Vinay, D. G.; Alexander, Myriam; Tabara, Yasuharu; Shaw-Hawkins, Sue; Whincup, Peter H.; Shi, Gang; Kuusisto, Johanna; Tayo, Bamidele O.; Seielstad, Mark; Sim, Xueling; Nguyen, Khanh Dung Hoang; Lehtimäki, Terho; Matullo, Giuseppe; Wu, Ying; Gaunt, Tom R.; Onland-Moret, N. Charlotte; Cooper, Matthew N.; Platou, Carl G P; Org, Elin; Hardy, Rebecca; Dahgam, Santosh; Palmen, Jutta; Vitart, Veronique; Braund, Peter S; Kuznetsova, Tatiana; Uiterwaal, Cuno S.P.M.; Adeyemo, Adebowale; Palmas, Walter R.; Campbell, Harry; Ludwig, Barbara; Tomaszewski, Maciej; Tzoulaki, Ioanna; Palmer, Nicholette D.; Aspelund, Thor; Garcia, Melissa; Chang, Yen Pei C.; O'Connell, Jeffrey R.; Steinle, Nanette I.; Grobbee, Diederick E.; Arking, Dan E.; Kardia, Sharon L. R.; Morrison, Alanna C.; Hernandez, Dena G.; Najjar, Samer; McArdle, Wendy L.; Hadley, David; Brown, Morris J; Connell, John M; Hingorani, Aroon D.; Day, Ian N M; Lawlor, Debbie A.; Beilby, John P.; Lawrence, Robert W.; Ongen, Halit; Dreisbach, Albert W; Li, Yali; Young, J. Hunter; Kähönen, Mika; Viikari, Jorma S.; Adair, Linda S.; Lee, Nanette R.; Olden, Matthias; Pattaro, Cristian; Hoffman Bolton, Judith A.; Köttgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grässler, Jürgen; Groop, Leif C.; Voight, Benjamin F; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Inês; Khaw, Kay Tee; Weder, Alan B.; Hunt, Steven C.; Sun, Yan V.; Bergman, Richard N.; Collins, Francis S.; Bonnycastle, Lori L.; Scott, Laura J; Stringham, Heather M.; Peltonen, Leena; Perola, Markus; Vartiainen, Erkki; Brand, Stefan Martin; Staessen, Jan A.; Wang, Thomas J.; Burton, Paul R.; Artigas, Maria Soler; Dong, Yanbin; Snieder, Harold; Wang, Xiaoling; Zhu, Haidong; Lohman, Kurt; Rudock, Megan E.; Heckbert, Susan R; Wiggins, Kerri L.; Doumatey, Ayo; Shriner, Daniel; Veldre, Gudrun; Viigimaa, Margus; Kinra, Sanjay; Prabhakaran, Dorairaj; Tripathy, Vikal; Langefeld, Carl D.; Rosengren, Annika; Thelle, Dag S.; Corsi, Anna Maria; Singleton, Andrew; Forrester, Terrence; Hilton, Gina; McKenzie, Colin A.; Salako, Tunde; Iwai, Naoharu; Kita, Yoshikuni; Ogihara, Toshio; Ohkubo, Takayoshi; Okamura, Tomonori; Ueshima, Hirotsugu; Umemura, Satoshi; Eyheramendy, Susana; Meitinger, Thomas; Wichmann, H-Erich; Cho, Yoon Shin; Kim, Hyung Lae; Lee, Jong-Young; Scott, James; Sehmi, Joban S.; Zhang, Weihua; Hedblad, Bo; Nilsson, Peter M.; Smith, George Davey; Wong, Andrew; Narisu, Narisu; Stančáková, Alena; Raffel, Leslie J.; Yao, Jie; Schwartz, Stephen M.; Arfan Ikram, M.; Longstreth, W.T. jr.; Mosley, Thomas H; Seshadri, Sudha; Shrine, Nick R.G.; Wain, Louise V.; Morken, Mario A.; Swift, Amy J.; Laitinen, Jaana; Prokopenko, Inga; Zitting, Paavo; Cooper, Jackie A.; Humphries, Steve E.; Rasheed, Asif; Bakker, Stephan J. L.; Janipalli, Charles S.; Mani, K. Radha; Yajnik, Chittaranjan S.; Mattace-Raso, Francesco U.S.; Oostra, Ben A.; Demirkan, Ayse; Isaacs, Aaron; Rivadeneira, Fernando; Lakatta, Edward G; Orru, Marco; Scuteri, Angelo; Ala-Korpela, Mika; Kangas, Antti J.; Lyytikäinen, Leo-Pekka; Soininen, Pasi; Tukiainen, Taru; Würtz, Peter; Ong, Rick Twee Hee; Dörr, Marcus; Kroemer, Heyo K; Völker, Uwe; Völzke, Henry; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Zelenika, Diana; Deloukas, Panos; Mangino, Massimo; Zhai, Guangju; Meschia, James F.; Nalls, Michael A.; Sharma, Pankaj; Terzic, Janos; Kumar, M. V.Kranthi; Denniff, Matthew; Zukowska-Szczechowska, Ewa; Wagenknecht, Lynne E.; Fowkes, F. Gerald R.; Charchar, Fadi J; Schwarz, Peter E. H.; Hayward, Caroline; Guo, Xiuqing; Rotimi, Charles N.; Bots, Michiel L.; Brand, Eva; Samani, Nilesh J.; Polasek, Ozren; Talmud, Philippa J.; Nyberg, Fredrik; Kuh, Diana; Laan, Maris; Hveem, Kristian; Palmer, Lyle J.; van der Schouw, Yvonne T.; Casas, Juan P.; Mohlke, Karen L.; Vineis, Paolo; Raitakari, Olli T.; Ganesh, Santhi K.; Wong, Tien-Yin; Shyong Tai, E.; Cooper, Richard S.; Laakso, Markku; Rao, Dabeeru C.; Morris, Richard W.; Dominiczak, Anna F.; Kivimaki, Mika; Marmot, Michael G.; Miki, Tetsuro; Chandak, Giriraj R.; Coresh, Josef; Navis, Gerjan J.; Salomaa, Veikko; Han, Bok-Ghee; Zhu, Xiaofeng; Melander, Olle; Ridker, Paul M.; Bandinelli, Stefania; Gyllensten, Ulf B.; Wright, Alan F.; Wilson, James F.; Ferrucci, Luigi; Farrall, Martin; Tuomilehto, Jaakko; Pramstaller, Peter P.; Elosua, Roberto; Sijbrands, Eric J. G.; Altshuler, David; Loos, Ruth J. F.; Gieger, Christian; Meneton, Pierre; Wareham, Nicholas J.; Gudnason, Vilmundur; Rotter, Jerome I.; Rettig, Rainer; Uda, Manuela; Strachan, David P.; Witteman, Jacqueline C M; Hartikainen, Anna-Liisa; Beckmann, Jacques S.; Boerwinkle, Eric; Vasan, Ramachandran S; Boehnke, Michael; Larson, Martin G.; Järvelin, Marjo-Riitta; Abecasis, Gonçalo R.; Chakravarti, Aravinda; Elliott, Paul; Van Duijn, Cornelia M.; Newton-Cheh, Christopher; Levy, Daniel; Caulfield, Mark J.; Johnson, Toby; van der Lugt, Aad; Shuldiner, Alan R.; Hofman, Albert; Kraja, Aldi T.; Uitterlinden, Andre G; Ziegler, Andreas; Newman, Anne B; Schillert, Arne; Oostra, Ben A.; Thorsson, Bolli; Mitchell, Braxton D.; Fox, Caroline S.; White, Charles C.; Ballantyne, Christie; Van Duijn, Cornelia M.; Herrington, David M.; O'Leary, Daniel H.; Siscovick, David S.; Couper, David J; Halperin, Eran; Stoegerer, Eva Maria; Ernst, Florian; Krestin, Gabriel P.; Homuth, Georg; Heiss, Gerardo; Usala, Gianluca; Eiriksdottir, Gudny; Shen, Haiqing; Erich Wichmann, H.; Schmidt, Helena; Borecki, Ingrid B.; Markus, Hugh S.; Witteman, Jacqueline C.; Lüdemann, Jan; Huffman, Jennifer E.; Murabito, Joanne M.; Thiery, Joachim; Seissler, Jochen; Massaro, Joseph M.; Polak, Joseph F.; Cunningham, Julie; North, Kari E.; Petrovic, Katja E; Rice, Kenneth M.; Adrienne Cupples, L.; Bielak, Lawrence F.; Launer, Lenore J.; de Andrade, Mariza; Feitosa, Mary F.; Kavousi, Maryam; Sitzer, Matthias; Oudkerk, Matthijs; Province, Michael A.; Nalls, Michael A.; Franceschini, Nora; Peyser, Patricia A.; Wolf, Philip A.; Zhang, Qunyuan; Wild, Philipp S; Schnabel, Renate B.; D'Agostino, Ralph B.; Chilukoti, Ravi Kumar; Schmidt, Reinhold; Sanna, Serena; Demissie, Serkalem; Sigurdsson, Sigurdur; Blankenberg, Stefan; Bevan, Steve; Elias-Smale, Suzette E.; Zeller, Tanja; Illig, Thomas; Münzel, Thomas; Howard, Timothy D.; Hoffmann, Udo; Schminke, Ulf; Nambi, Vijay; Post, Wendy S.; Rathmann, Wolfgang; Li, Xia; Cheng, Yu Ching

    2017-01-01

    Background--Plasminogen activator inhibitor type 1 (PAI-1) plays an essential role in the fibrinolysis system and thrombosis. Population studies have reported that blood PAI-1 levels are associated with increased risk of coronary heart disease (CHD). However, it is unclear whether the association

  20. Homocysteine determinants and the evidence to what extent homocysteine determines the risk of coronary heart disease.

    NARCIS (Netherlands)

    Bree, A. de; Verschuren, W.M.M.; Kromhout, D.; Kluijtmans, L.A.J.; Blom, H.J.

    2002-01-01

    Cardiovascular diseases (CVD), especially coronary heart disease (CHD), are the most important causes of death in industrialized countries. Increased concentrations of total plasma homocysteine (tHcy) have been associated with an increased risk of CHD. Assuming that this relation is causal, a lower

  1. Association of coronary heart disease with age-adjusted aortocoronary calcification in patients with familial hypercholesterolaemia

    DEFF Research Database (Denmark)

    Jensen, J M; Gerdes, Lars Ulrik; Jensen, H K

    2000-01-01

    OBJECTIVES: Existing algorithms of risk of coronary heart disease (CHD) do not pertain to patients with familial hypercholesterolaemia (FH), whose arteries have been exposed to hypercholesterolaemia since birth. We studied a cohort of FH patients to compare four diagnostic models of CHD: traditio...

  2. Physical inactivity, abdominal obesity and risk of coronary heart disease in apparently healthy men and women

    NARCIS (Netherlands)

    Arsenault, B. J.; Rana, J. S.; Lemieux, I.; Després, J.-P.; Kastelein, J. J. P.; Boekholdt, S. M.; Wareham, N. J.; Khaw, K.-T.

    2010-01-01

    Objective: To test the hypothesis that for any given body mass index (BMI) category, active individuals would have a smaller waist circumference than inactive individuals. Our second objective was to examine the respective contribution of waist circumference and physical inactivity on coronary heart

  3. Intake of ruminant trans fatty acids and risk of coronary heart disease - An overview

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; Bysted, Anette; Andersen, Niels Lyhne

    2006-01-01

    Epidemiological studies have shown a strong direct (positive) association between the intake of trans fatty acids (TRA) and the risk of coronary heart disease (CHD), primarily accounted for by industrially produced TFA (IP-TFA). However, comparisons, between ruminant TEA (R-TFA) and IP-TFA and risk...

  4. Nuclear medical determination of left ventricular diastolic function in coronary heart disease

    International Nuclear Information System (INIS)

    Brugger, P.; Laesser, W.K.; Kullich, W.; Stoiberer, I.; Klein, G.

    1985-01-01

    In 64 patients with coronary heart disease, the left ventricular diastolic function was determined by means of a new nuclear medical method (nuclear stethoscope). The investigations revealed an abnormal diastolic filling in 85.9% of the cases on the basis of the parameters peak filling rate and time to peak filling rate as manifestation of a disturbed ventricular function

  5. Explaining the Decline in Coronary Heart Disease Mortality in the Netherlands between 1997 and 2007

    NARCIS (Netherlands)

    Koopman, Carla; Vaartjes, Ilonca; van Dis, Ineke; Verschuren, W M Monique; Engelfriet, Peter; Heintjes, Edith M; Blokstra, Anneke; Deeg, Dorly J H; Visser, Marjolein; Bots, Michiel L; O'Flaherty, Martin; Capewell, Simon

    2016-01-01

    OBJECTIVE: We set out to determine what proportion of the mortality decline from 1997 to 2007 in coronary heart disease (CHD) in the Netherlands could be attributed to advances in medical treatment and to improvements in population-wide cardiovascular risk factors. METHODS: We used the IMPACT-SEC

  6. Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury

    NARCIS (Netherlands)

    de Groot, S.; Post, M. W.; Snoek, G. J.; Schuitemaker, M.; van der Woude, L. H.

    Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related

  7. Trends in risk factors for coronary heart disease in the Netherlands

    NARCIS (Netherlands)

    Koopman, C.; Vaartjes, I.; Blokstra, A.; Verschuren, W. M M; Visser, M.; Deeg, D. J H; Bots, M. L.; Van Dis, I.

    2016-01-01

    Background: Favourable trends in risk factor levels in the general population may partly explain the decline in coronary heart disease (CHD) morbidity and mortality. Our aim was to present long-term national trends in established risk factors for CHD.  Methods: Data were obtained from five data

  8. Trends in risk factors for coronary heart disease in the Netherlands

    NARCIS (Netherlands)

    Koopman, C; Vaartjes, I; Blokstra, A; Verschuren, W M M; Visser, M; Deeg, D J H; Bots, M L; van Dis, I

    2016-01-01

    BACKGROUND: Favourable trends in risk factor levels in the general population may partly explain the decline in coronary heart disease (CHD) morbidity and mortality. Our aim was to present long-term national trends in established risk factors for CHD. METHODS: Data were obtained from five data

  9. Prolonged ischemic heart disease and coronary artery bypass - relation to contractile reserve

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Bangsgaard, Regitze; Carstensen, Steen

    2002-01-01

    OBJECTIVE: A major effect of coronary artery bypass grafting (CABG) in patients with ischemic heart disease and impaired left ventricular (LV) contractile function is believed to be an improvement in LV function due to recovery of dysfunctional, but viable myocardium. However, recent studies have...

  10. Omega-3 polyunsaturated fatty acid biomarkers and coronary heart disease: Pooling project of 19 cohort studies

    Science.gov (United States)

    The role of omega-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers. This study sought to evaluate biomarkers of seafood-derived eicosapentaenoic acid ...

  11. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality

    DEFF Research Database (Denmark)

    (Tybjaerg-Hansen, A.) The Fibrinogen Studies Collaboration.The Copenhagen City Heart Study; Tybjærg-Hansen, Anne

    2009-01-01

    CONTEXT: Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationship of Lp(a) concentration with risk of major vascular...

  12. Exercise-based cardiac rehabilitation in patients with coronary heart disease: a practice guideline

    NARCIS (Netherlands)

    Achttien, R. J.; Staal, J. B.; van der Voort, S.; Kemps, H. M. C.; Koers, H.; Jongert, M. W. A.; Hendriks, E. J. M.

    2013-01-01

    To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR

  13. Exercise-based cardiac rehabilitation in patients with coronary heart disease: a practice guideline

    NARCIS (Netherlands)

    Achttien, R.J.; Staal, J.B.; Voort, S. van der; Kemps, H.M.; Koers, H.; Jongert, M.W.; Hendriks, E.J.; Development, G. Practice Recomm

    2013-01-01

    BACKGROUND: To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary

  14. A metabolomic profile is associated with the risk of incident coronary heart disease

    NARCIS (Netherlands)

    Vaarhorst, A.A.M.; Verhoeven, A.; Weller, C.M.; Böhringer, S.; Göraler, S.; Meissner, A.; Deelder, A.M.; Henneman, P.; Gorgels, A.P.M.; van den Brandt, P.A.; Schouten, L.J.; van Greevenbroek, M.M.; Merry, A.H.H.; Verschuren, W.M.M.; van den Maagdenberg, A.M.J.M.; Willems van Dijk, K.; Isaacs, A.; Boomsma, D.I.; Oostra, B.A.; van Duijn, C.M.; Jukema, J.W.; Boer, J.M.A.; Feskens, E.; Heijmans, B.T.; Slagboom, P.E.

    2014-01-01

    Background Metabolomics, defined as the comprehensive identification and quantification of low-molecular-weight metabolites to be found in a biological sample, has been put forward as a potential tool for classifying individuals according to their risk of coronary heart disease (CHD). Here, we

  15. IL-1β level in Sudanese patients with atherosclerotic coronary heart ...

    African Journals Online (AJOL)

    McRoy

    studies investigating inflammatory cytokines in atherosclerotic patients with coronary heart disease (CHD).[2,5-7]. However, systemic level of IL-1β may still be unreliable marker for atherosclerosis. This is because systemic level of IL-1β could not faithfully reflect the local inflammatory process near the atheromatous lesions.

  16. Involvement of interleukin-1 genotypes in the association of coronary heart disease with periodontitis

    DEFF Research Database (Denmark)

    Geismar, Karen; Enevold, Christian; Sørensen, Lars Korsbæk

    2008-01-01

    Epidemiologic studies demonstrated an association between periodontitis (PE) and coronary heart disease (CHD). The coexistence of the two disease entities could be dependent on mutual risk factors, and polymorphism of the interleukin (IL)-1 gene cluster associated with the severity of PE might also...

  17. Validating the Type D personality construct in Chinese patients with coronary heart disease

    DEFF Research Database (Denmark)

    Yu, Doris S F; Thompson, David R; Yu, Cheuk Man

    2010-01-01

    Type D personality predicts poor prognosis in coronary heart disease (CHD) but little is known about Type D in non-Western cultures. We examined the (a) validity of the Type D construct and its assessment with the DS14 scale in the Chinese culture, (b) prevalence of Type D, and (c) gender vs. Typ...

  18. Prospective study of alcohol drinking patterns and coronary heart disease in women and men

    DEFF Research Database (Denmark)

    Tolstrup, Janne; Jensen, Majken K; Tjønneland, Anne

    2006-01-01

    OBJECTIVE: To determine the association between alcohol drinking patterns and risk of coronary heart disease in women and men. DESIGN: Population based cohort study. SETTING: Denmark, 1993-2002. PARTICIPANTS: 28 448 women and 25 052 men aged 50-65 years, who were free of cardiovascular disease...... at entry to the study. MAIN OUTCOME MEASURES: Incidence of coronary heart disease occurring during a median follow-up period of 5.7 years. RESULTS: 749 and 1283 coronary heart disease events occurred among women and men. Women who drank alcohol on at least one day a week had a lower risk of coronary heart...... disease than women who drank alcohol on less than one day a week. Little difference was found, however, between drinking frequency: one day a week (hazard ratio 0.64, 95% confidence interval 0.51 to 0.81), 2-4 days a week (0.63, 0.52 to 0.77), five or six days a week (0.79, 0.61 to 1.03), and seven days...

  19. Cognition and Incident Coronary Heart Disease in Late Midlife: The Whitehall II Study

    Science.gov (United States)

    Singh-Manoux, Archana; Sabia, Severine; Kivimaki, Mika; Shipley, Martin J.; Ferrie, Jane E.; Marmot, Michael G.

    2009-01-01

    The purpose of this study was to investigate whether cognitive function in midlife predicts incident coronary heart disease (CHD), followed up over 6 years. Data on 5292 (28% women, mean age 55) individuals free from CHD at baseline were drawn from the British Whitehall II study. We used Cox regression to model the association between cognition…

  20. Risk Factors for Coronary Heart Disease Among Inpatients Who Have Mild Intellectual Disability and Mental Illness

    Science.gov (United States)

    Merriman, S.; Haw, C.; Kirk, J.; Stubbs, J.

    2005-01-01

    Coronary heart disease (CHD) is a major cause of morbidity and mortality in the UK. The aim of this study was to screen inpatients with mild or borderline intellectual disability, many of whom also have mental illness, for risk factors for CHD. Participants were interviewed, measured and had blood samples taken. Of the 53 participants, 20 (37.7%)…

  1. Education and Coronary Heart Disease Risk: Potential Mechanisms Such as Literacy, Perceived Constraints, and Depressive Symptoms

    Science.gov (United States)

    Loucks, Eric B.; Gilman, Stephen E.; Howe, Chanelle J.; Kawachi, Ichiro; Kubzansky, Laura D.; Rudd, Rima E.; Martin, Laurie T.; Nandi, Arijit; Wilhelm, Aude; Buka, Stephen L.

    2015-01-01

    Objective: Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in…

  2. Elders' Knowledge about Risk Factors of Coronary Heart Disease, Their Perceived Risk, and Adopted Preventive Behaviors

    Science.gov (United States)

    Al Khayyal, Hatem; El Geneidy, Moshera; El Shazly, Somaya Abdel Moneim

    2016-01-01

    Coronary heart disease is the most frequent single cause of death among persons over 65 years of age and it seems to continue to be a significant threat to the health and wellbeing of the elderly population all over the world, yet the condition is largely preventable. The aims of this study to assess and determine the relations among elder's…

  3. Hospitalization Cost Offset of a Hostility Intervention for Coronary Heart Disease Patients

    Science.gov (United States)

    Davidson, Karina W.; Gidron, Yori; Mostofsky, Elizabeth; Trudeau, Kimberlee J.

    2007-01-01

    The authors evaluated hospitalization cost offset of hostility management group therapy for patients with coronary heart disease (CHD) from a previously published randomized controlled trial (Y. Gidron, K. Davidson, & I. Bata, 1999). Twenty-six male patients with myocardial infarction or unstable angina were randomized to either 2 months of…

  4. Coronary Heart Disease Knowledge and Risk Factors among Tri-Ethnic College Students

    Science.gov (United States)

    Koutoubi, Samer; Huffman, Fatma G.; Ciccazzo, Michele W.; Himburg, Susan P.; Johnson, Paulette

    2005-01-01

    Objectives: Coronary heart disease (CHD) is the leading cause of death in the United States and Europe. This study identified and compared nutritional knowledge associated with CHD risk factors among tri-ethnic college students. Design: A quantitative, cross-sectional, observational study using questionnaires. Setting: University laboratory.…

  5. Adult height, coronary heart disease and stroke : A multi-locus Mendelian randomization meta-analysis

    NARCIS (Netherlands)

    Nüesch, Eveline; Dale, Caroline; Palmer, Tom M.; White, Jon; Keating, Brendan J.; van Iperen, Erik P A; Goel, Anuj; Padmanabhan, Sandosh; Asselbergs, F. W.; Verschuren, W. M.; Wijmenga, C.; Van der Schouw, Y. T.; Onland-Moret, N. C.; Lange, Leslie A.; Hovingh, G. K.; Sivapalaratnam, Suthesh; Morris, Richard W.; Whincup, Peter H.; Wannamethe, Goya S.; Gaunt, Tom R.; Ebrahim, Shah; Steel, Laura; Nair, Nikhil; Reiner, Alexander P.; Kooperberg, Charles; Wilson, James F.; Bolton, Jennifer L.; McLachlan, Stela; Price, Jacqueline F.; Strachan, Mark W J; Robertson, Christine M.; Kleber, Marcus E.; Delgado, Graciela; März, Winfried; Melander, Olle; Dominiczak, Anna F.; Farrall, Martin; Watkins, Hugh; Leusink, Maarten; Maitland-van der Zee, Anke H.; de Groot, Mark C H; Dudbridge, Frank; Hingorani, Aroon; Ben-Shlomo, Yoav; Lawlor, Debbie A.; Amuzu, A.; Caufield, M.; Cavadino, A.; Cooper, J.; Davies, T. L.; Day, I. N.; Drenos, F.; Engmann, J.; Finan, C.; Giambartolomei, C.; Hardy, R.; Humphries, S. E.; Hypponen, E.; Kivimaki, M.; Kuh, D.; Kumari, M.; Ong, K.; Plagnol, V.; Power, C.; Richards, M.; Shah, S.; Shah, T.; Sofat, R.; Talmud, P. J.; Wareham, N.; Warren, H.; Whittaker, J. C.; Wong, A.; Zabaneh, D.; Smith, George Davey; Wells, Jonathan C.; Leon, David A.; Holmes, Michael V.; Casas, Juan P.

    2016-01-01

    Background: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. Methods: We developed an allele score based on 69 single nucleotide

  6. Dietary fatty acids and risk factors for coronary heart disease : controlled studies in healthy volunteers

    NARCIS (Netherlands)

    Zock, P.L.

    1995-01-01

    High levels of LDL cholesterol, blood pressure and Lp(a), and low levels of HDL cholesterol increase the risk for coronary heart disease (CHD). This thesis describes the effects of dietary fatty acids on these risk factors. In each of three trials we fed diets with tailored fatty acid

  7. Risk factors for coronary heart disease in the Indians of Durban

    African Journals Online (AJOL)

    Summary. Coronary heart disease (CHD) is a major problem in migrant ... Indians in the metropolitan area of Durban to determine the prevalence and ... and judging by the high MRs for all three cardiovascular diseases ... circumstances than the indigent rural populations in Iridia, had very ..... Left ventricular hypertrophy.

  8. Risk factors for coronary heart disease in middle-aged men in Crete in 1982.

    NARCIS (Netherlands)

    Aravanis, C.; Mensink, R.P.; Corcondilas, A.; Ioanidis, P.; Feskens, E.J.M.; Katan, M.B.

    1988-01-01

    Risk factors for coronary heart disease were studied in healthy middle- aged Cretan men in order to compare them with the middle-aged men of a previous generation studied in 1960 as the Cretan cohort of the Seven Countries Study (1960). In the present cohort mean values for total cholesterol were

  9. Erectile dysfunction and pcsychoemotional state in ischemic heart disease patients undergone coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Ye. V. Pomeshkin

    2012-01-01

    Full Text Available The impact of erectile dysfunction on psychoemotional state of patients undergone coronary artery bypass graft surgery was evaluated. The International Index of Erectile Function, postcompression cavernous artery dilation test, nocturnal penile tumescence recording and psychophysiological exam were used. It was found that ischemic heart disease patients have higher incidence of associated psychoemotional and erectile dysfunctions.

  10. Interleukin-6 receptor pathways in coronary heart disease: a collaborative meta-analysis of 82 studies

    NARCIS (Netherlands)

    Sarwar, Nadeem; Butterworth, Adam S.; Freitag, Daniel F.; Gregson, John; Willeit, Peter; Gorman, Donal N.; Gao, Pei; Saleheen, Danish; Rendon, Augusto; Nelson, Christopher P.; Braund, Peter S.; Hall, Alistair S.; Chasman, Daniel I.; Tybjærg-Hansen, Anne; Chambers, John C.; Benjamin, Emelia J.; Franks, Paul W.; Clarke, Robert; Wilde, Arthur A. M.; Trip, Mieke D.; Steri, Maristella; Witteman, Jacqueline C. M.; Qi, Lu; van der Schoot, C. Ellen; de Faire, Ulf; Erdmann, Jeanette; Stringham, Heather M.; Koenig, Wolfgang; Rader, Daniel J.; Melzer, David; Reich, David; Psaty, Bruce M.; Kleber, Marcus E.; Panagiotakos, Demosthenes B.; Willeit, Johann; Wennberg, Patrik; Woodward, Mark; Adamovic, Svetlana; Rimm, Eric B.; Meade, Tom W.; Gillum, Richard F.; Shaffer, Jonathan A.; Hofman, Albert; Onat, Altan; Sundström, Johan; Wassertheil-Smoller, Sylvia; Mellström, Dan; Gallacher, John; Cushman, Mary; Tracy, Russell P.; Kauhanen, Jussi; Karlsson, Magnus; Salonen, Jukka T.; Wilhelmsen, Lars; Amouyel, Philippe; Cantin, Bernard; Best, Lyle G.; Ben-Shlomo, Yoav; Manson, JoAnn E.; Davey-Smith, George; de Bakker, Paul I. W.; O'Donnell, Christopher J.; Wilson, James F.; Wilson, Anthony G.; Assimes, Themistocles L.; Jansson, John-Olov; Ohlsson, Claes; Tivesten, Åsa; Ljunggren, Östen; Reilly, Muredach P.; Hamsten, Anders; Ingelsson, Erik; Cambien, Francois; Hung, Joseph; Thomas, G. Neil; Boehnke, Michael; Schunkert, Heribert; Asselbergs, Folkert W.; Kastelein, John J. P.; Gudnason, Vilmundur; Salomaa, Veikko; Harris, Tamara B.; Kooner, Jaspal S.; Allin, Kristine H.; Nordestgaard, Børge G.; Hopewell, Jemma C.; Goodall, Alison H.; Ridker, Paul M.; Hólm, Hilma; Watkins, Hugh; Ouwehand, Willem H.; Samani, Nilesh J.; Kaptoge, Stephen; Di Angelantonio, Emanuele; Harari, Olivier; Danesh, John; Quertermous, Thomas; Go, Alan S.; Hlatky, Mark A.; Knowles, Joshua W.; Smith, Albert V.; Chrysohoou, Christina; Pitsavos, Christos; Stefanadis, Christodoulos; Balmforth, Anthony J.; Thompson, John R.; Sivapalaratnam, Suthesh; Maiwald, Stephani; Basart, Hanneke; Motazacker, Mahdi; de Jong, Jonas S. S. G.; Dekker, Lucas R. C.; Tanck, Michael; Bezzina, Connie R.; Whincup, Peter H.; Morris, Richard W.; Wannamethee, S. Goya; Kiechl, Stefan; Yarnell, John W. G.; Lowe, Gordon; Rumley, Ann; Mukamal, Kenneth J.; Havulinna, Aki S.; Lokki, Marja-Liisa; Nieminen, Markku S.; Ripatti, Samuli; Sinisalo, Juha; McQuillan, Brendan M.; Beilby, John P.; Thompson, Peter L.; Thorleifsson, Guðmar; Thorgeirsson, Guðmundur; Thorsteinsdóttir, Unnur; Stefansson, Kari; Jula, Antti; Männistö, Satu; Perola, Markus; Tikkanen, Emmi; Boer, Jolanda M. A.; Onland-Moret, N. Charlott; van der Schouw, Yvonne T.; Verschuren, W. M. Monique; Jansson, Jan-Håkan; Dupuis, Josée; Fontes, João D.; Yin, Xiaoyan; Tuomilehto, Jaakko; Koenig, Inke R.; Nahrstaedt, Janja; Loley, Christina; Stark, Klaus; Willenborg, Christina; Hengstenberg, Christian; Schreiber, Stefan; Preuss, Michael; Barroso, Inês; Hallmans, Göran; Shungin, Dmitry; Cheng, Kar Keung; Lam, Tai Hing; Jiang, Chao Chiang; Pai, Jennifer; Collins, Rory; Parish, Sarah; Armitage, Jane; Jackson, Anne; Hveem, Kristian; Wiggins, Kerri L.; Heckbert, Susan R.; Smith, Nicholas L.; Bis, Joshua C.; Ferrucci, Luigi; Guralnik, Jack M.; Bandinelli, Stefania; Singleton, Andrew B.; Tuomainen, Tomi-Pekka; Kurl, Sudhir; Zhang, Weihua; Kooner, Angad S.; Das, Debashis; März, Winfried; Scharnagl, Hubert; Böhm, Bernhard O.; Winkelmann, Bernhard R.; Folsom, Aaron R.; Shea, Steven J.; Laakso, Markku; Kuusisto, Johanna; Baumert, Jens; Thorand, Barbara; Illig, Thomas; Meisinger, Christa; Rosengren, Annika; Karlsson, Magnus K.; Hu, Frank B.; Hankinson, Susan E.; Davidson, Karina W.; Fraser, Ross; Wild, Sarah; Campbell, Harry; Qasim, Atif; Qu, Liming; Li, Mingyao; Lind, Lars; Syvänen, Ann-Christine; Arveiler, Dominique; Farrall, Martin; Peden, John F.; Deloukas, Panos; Sheikh, Nasir; Rasheed, Asif; Dagenais, Gilles R.; Dehghan, Abbas; van Duijn, Cornelia M.; Uitterlinden, Andre G.; Abecasis, Goncalo R.; Cucca, Francesco; Sanna, Serena; Uda, Manuela; Schlessinger, David; Sabater-Lleal, Maria; Silveira, Angela; Gigante, Bruna; Howard, Barbara V.; Basu, Samar; Rose, Lynda M.; Buring, Julie

    2012-01-01

    Background Persistent inflammation has been proposed to contribute to various stages in the pathogenesis of cardiovascular disease. Interleukin-6 receptor (IL6R) signalling propagates downstream inflammation cascades. To assess whether this pathway is causally relevant to coronary heart disease, we

  11. Depression as a non-causal variable risk marker in coronary heart disease

    NARCIS (Netherlands)

    Meijer, Anna; Zuidersma, Marij; de Jonge, Peter

    2013-01-01

    Background: After decades of investigations, explanations for the prospective association between depression and coronary heart disease (CHD) are still incomplete. Discussion: Depression is often suggested to be causally related to CHD. Based on the available literature, we would rather argue that

  12. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease

    Science.gov (United States)

    Scavenger receptor BI (SR-BI) is the major receptor for high-density lipoprotein (HDL) cholesterol (HDL-C). In humans, high amounts of HDL-C in plasma are associated with a lower risk of coronary heart disease (CHD). Mice that have depleted Scarb1 (SR-BI knockout mice) have markedly elevated HDL-C l...

  13. Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

    Science.gov (United States)

    Holly, Deirdre; Sharp, John

    2014-01-01

    People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

  14. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease

    DEFF Research Database (Denmark)

    Zanoni, Paolo; Khetarpal, Sumeet A; Larach, Daniel B

    2016-01-01

    Scavenger receptor BI (SR-BI) is the major receptor for high-density lipoprotein (HDL) cholesterol (HDL-C). In humans, high amounts of HDL-C in plasma are associated with a lower risk of coronary heart disease (CHD). Mice that have depleted Scarb1 (SR-BI knockout mice) have markedly elevated HDL-...

  15. The Framingham Risk Function Underestimated Absolute Coronary Heart Disease Risk in Czech Men

    Czech Academy of Sciences Publication Activity Database

    Reissigová, Jindra; Zvárová, Jana

    2007-01-01

    Roč. 46, č. 1 (2007), s. 43-49 ISSN 0026-1270 Institutional research plan: CEZ:AV0Z10300504 Keywords : external validation * Framingham risk function * coronary heart disease Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.451, year: 2007

  16. Male pattern baldness and its association with coronary heart disease: a meta-analysis

    Science.gov (United States)

    Yamada, Tomohide; Hara, Kazuo; Umematsu, Hitomi; Kadowaki, Takashi

    2013-01-01

    Objective To confirm the association between male pattern baldness and coronary heart disease (CHD). Design Meta-analysis of observational studies. Data sources Medline and the Cochrane Library were searched for articles published up to November 2012 using keywords that included both ‘baldness’ and ‘coronary heart disease’ and the reference lists of those studies identified were also searched. Study selection Observational studies were identified that reported risk estimates for CHD related to baldness. Two observers independently assessed eligibility, extracted data and assessed the possibility of bias. Data synthesis The adjusted relative risk (RR) and 95% CI were estimated using the DerSimonian-Laird random-effect model. Results 850 possible studies, 3 cohort studies and 3 case–control studies were selected (36 990 participants). In the cohort studies, the adjusted RR of men with severe baldness for CHD was 1.32 (95% CI 1.08 to 1.63, p=0.008, I2=25%) compared to those without baldness. Analysis of younger men (baldness (RR 1.44, 95% CI 1.11 to 1.86, p=0.006, I2=0%). In three studies employing the modified Hamilton scale, vertex baldness was associated with CHD and the relation depended on the severity of baldness (severe vertex: RR 1.48 (1.04 to 2.11, p=0.03); moderate vertex: RR 1.36 (1.16 to 1.58, pbaldness was not associated with CHD (RR 1.11 (0.92 to 1.32, p=0.28)). Conclusions Vertex baldness, but not frontal baldness, is associated with an increased risk of CHD. The association with CHD depends on the severity of vertex baldness and also exists among younger men. Thus, vertex baldness might be more closely related to atherosclerosis than frontal baldness, but the association between male pattern baldness and CHD deserves further investigation. PMID:23554099

  17. Association of Anxiety and Depression With All‐Cause Mortality in Individuals With Coronary Heart Disease

    Science.gov (United States)

    Watkins, Lana L.; Koch, Gary G.; Sherwood, Andrew; Blumenthal, James A.; Davidson, Jonathan R.T.; O'Connor, Christopher; Sketch, Michael H.

    2013-01-01

    Background Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co‐occurrence of depression and anxiety. We examined whether anxiety is associated with increased risk of mortality after accounting for depression in individuals with established CHD. Methods and Results The cohort was composed of 934 men and women with confirmed CHD (mean age, 62±11 years) who completed the Hospital Anxiety and Depression scale (HADS) during hospitalization for coronary angiography. Over the 3‐year follow‐up period, there were 133 deaths. Elevated scores on the HADS anxiety subscale (HADS‐A≥8) were associated with increased risk of mortality after accounting for established risk factors including age, congestive heart failure, left ventricular ejection fraction, 3‐vessel disease, and renal disease (hazard ratio [HR], 2.27; 95% CI, 1.55 to 3.33; Pdepression subscale (HADS‐D≥8) were also associated with increased risk of mortality (HR, 2.18; 95% CI, 1.47 to 3.22; Panxiety, HR, 1.83; 95% CI, 1.18 to 2.83; P=0.006; depression, HR, 1.66; 95% CI, 1.06 to 2.58; P=0.025). Estimation of the HR for patients with both anxiety and depression versus those with neither revealed a larger HR than for patients with either factor alone (HR, 3.10; 95% CI, 1.95 to 4.94; PAnxiety is associated with increased risk of mortality in CHD patients, particularly when comorbid with depression. Future studies should focus on the co‐occurrence of these psychosocial factors as markers of increased mortality risk. PMID:23537805

  18. Functional distribution of coronary vascular volume in beating goat hearts

    NARCIS (Netherlands)

    van der Ploeg, C. P.; Dankelman, J.; Spaan, J. A.

    1993-01-01

    With use of hemoglobin-bound O2 as an endogenous tracer, intramyocardial blood volume distribution between vessels involved in O2 exchange and more distal vessels was estimated. In nine anesthetized open-chest goats, the left main coronary artery was cannulated and perfused at a constant flow.

  19. Darapladib for preventing ischemic events in stable coronary heart disease

    NARCIS (Netherlands)

    White, Harvey D.; Held, Claes; Stewart, Ralph; Tarka, Elizabeth; Brown, Rebekkah; Davies, Richard Y.; Budaj, Andrzej; Harrington, Robert A.; Steg, P. Gabriel; Ardissino, Diego; Armstrong, Paul W.; Avezum, Alvaro; Aylward, Philip E.; Bryce, Alfonso; Chen, Hong; Chen, Ming-Fong; Corbalan, Ramon; Dalby, Anthony J.; Danchin, Nicolas; de Winter, Robbert J.; Denchev, Stefan; Diaz, Rafael; Elisaf, Moses; Flather, Marcus D.; Goudev, Assen R.; Granger, Christopher B.; Grinfeld, Liliana; Hochman, Judith S.; Husted, Steen; Kim, Hyo-Soo; Koenig, Wolfgang; Linhart, Ales; Lonn, Eva; López-Sendón, José; Manolis, Athanasios J.; Mohler, Emile R.; Nicolau, José C.; Pais, Prem; Parkhomenko, Alexander; Pedersen, Terje R.; Pella, Daniel; Ramos-Corrales, Marco A.; Ruda, Mikhail; Sereg, Mátyás; Siddique, Saulat; Sinnaeve, Peter; Smith, Peter; Sritara, Piyamitr; Swart, Henk P.; Westendorp, Iris C. D.

    2014-01-01

    Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated

  20. Diabetes, Glycemic Control, and New-Onset Heart Failure in Patients With Stable Coronary Artery Disease Data from the Heart and Soul Study

    NARCIS (Netherlands)

    van Melle, Joost P.; Bot, Marisica; De Jonge, Peter; De Boer, Rudolf A.; van Veldhuisen, Dirk J.; Whooley, Mary A.

    OBJECTIVE- Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS- We evaluated the association of diabetes and

  1. Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis.

    Science.gov (United States)

    Trieu, Nelson; Eslick, Guy D

    2014-10-20

    Alopecia has been associated with an increased risk of coronary heart disease as well as the following risk factors for cardiovascular disease: hyperinsulinaemia, insulin resistance, metabolic syndrome, dyslipidaemia, and hypertension. We performed a meta-analysis to quantitatively determine the level of risk of coronary heart disease and risk factors in individuals with alopecia. A systematic literature search was conducted using several databases. We calculated pooled odds ratios and 95% confidence intervals using a random effects model. In total, 31 studies comprising 29,254 participants with alopecia were eligible for the meta-analysis and showed that alopecia is associated with an increased risk of coronary heart disease (OR 1.22, 95% CI: 1.07-1.39), hyperinsulinaemia (OR 1.97, 95% CI: 1.20-3.21), insulin resistance (OR 4.88, 95% CI: 2.05-11.64), and metabolic syndrome (OR 4.49, 95% CI: 2.36-8.53). Individuals with alopecia were also shown to be more likely compared to those without alopecia to have higher serum cholesterol levels (OR 1.60, 95% CI: 1.17-2.21), higher serum triglyceride levels (OR 2.07, 95% CI: 1.32-3.25), higher systolic blood pressures (OR 1.73, 95% CI: 1.29-2.33), and higher diastolic blood pressures (OR 1.59, 95% CI: 1.16-2.18). Alopecia is associated with an increased risk of coronary heart disease, and there appears to be a dose-response relationship with degree of baldness whereby the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinaemia, insulin resistance, metabolic syndrome, and having elevated serum total cholesterol and triglyceride levels. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Relation of Perceived Health Competence to Physical Activity in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bachmann, Justin M; Mayberry, Lindsay S; Wallston, Kenneth A; Huang, Shi; Roumie, Christianne L; Muñoz, Daniel; Patel, Niral J; Kripalani, Sunil

    2018-05-01

    Physical inactivity is highly associated with mortality, especially in patients with coronary heart disease. We evaluated the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on cumulative physical activity levels in the Mid-South Coronary Heart Disease Cohort Study. The Mid-South Coronary Heart Disease Cohort Study consists of 2,587 outpatients (32% were female) with coronary heart disease at an academic medical center network in the United States. Cumulative physical activity was quantified in metabolic equivalent (MET)-minutes per week with the International Physical Activity Questionnaire. We investigated associations between the 2-item Perceived Health Competence Scale (PHCS-2) and MET-minutes/week after adjusting for co-morbidities and psychosocial factors with linear regression. Nearly half of participants (47%) exhibited low physical activity levels (Perceived health competence was highly associated with physical activity after multivariable adjustment. A nonlinear relation was observed, with the strongest effect on physical activity occurring at lower levels of perceived health competence. There was effect modification by gender (p = 0.03 for interaction). The relation between perceived health competence and physical activity was stronger in women compared with men; an increase in the PHCS-2 from 3 to 4 was associated with a 73% increase in MET-minutes/week in women (95% confidence interval 43% to 109%, p perceived health competence was strongly associated with less physical activity in patients with coronary heart disease and may represent a potential target for behavioral interventions. Published by Elsevier Inc.

  3. Clarithromycin for 2 Weeks for Stable Coronary Heart Disease: 6-Year Follow-Up of the CLARICOR Randomized Trial and Updated Meta-Analysis of Antibiotics for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Gluud, Christian; Als-Nielsen, Bodil; Damgaard, Morten

    2008-01-01

    Objectives: We have reported increased 2.6-year mortality in clarithromycin- versus placebo-exposed stable coronary heart disease patients, but meta-analysis of randomized trials in coronary heart disease patients showed no significant effect of antibiotics on mortality. Here we report the 6-year...... disease versus placebo/no intervention (17 trials, 25,271 patients, 1,877 deaths) showed a significantly increased relative risk of death from antibiotics of 1.10 (1.01-1.20) without heterogeneity. Conclusions: Our results stress the necessity to consider carefully the strength of the indication before...... administering antibiotics to patients with coronary heart disease....

  4. Motivation is a crucial factor for adherence to a healthy lifestyle among people with coronary heart disease after percutaneous coronary intervention.

    Science.gov (United States)

    Kähkönen, Outi; Kankkunen, Päivi; Saaranen, Terhi; Miettinen, Heikki; Kyngäs, Helvi; Lamidi, Marja-Leena

    2015-10-01

    To test the Theory of Adherence of People with Chronic Disease with regard to adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention. Increased knowledge of the concept of adherence is needed for the development of nursing interventions and nursing guidelines for patients with coronary heart disease. A cross-sectional, multi-centre study. This study was conducted from February-December 2013 with 416 patients with coronary heart disease 4 months after undergoing a percutaneous coronary intervention. A self-reported questionnaire was used to assess their adherence to treatment. Data were analysed using structural equation modelling. The theory explained 45% of the adherence to a healthy lifestyle and 7% of the adherence to medication. Structural equation modelling confirmed that motivation and results of care had the highest association with adherence to a healthy lifestyle. Responsibility was associated with adherence to medication. Support from next of kin, support from nurses and physicians, and motivation, co-operation, fear of complications and a sense of normality were associated with adherence. Patients who are motivated to perform self-care and consider the results of care to be important were more likely to adhere to a healthy lifestyle. Responsible patients were more likely to adhere to their medication. It is important to account for these elements as a part of secondary prevention strategies among patients with coronary heart disease after a percutaneous coronary intervention. © 2015 John Wiley & Sons Ltd.

  5. Copeptin in acute coronary syndromes and heart failure management: State of the art and future directions.

    Science.gov (United States)

    Schurtz, Guillaume; Lamblin, Nicolas; Bauters, Christophe; Goldstein, Patrick; Lemesle, Gilles

    2015-01-01

    Over the past two decades, the use of multiple biomarkers has changed cardiovascular disease management. Recently, several trials have assessed the diagnostic and prognostic performances of copeptin, especially in patients with heart failure or acute coronary syndromes. Primary results are interesting, with copeptin looking promising for: the management of patients who present at emergency departments early after chest pain onset and the risk stratification of patients with heart failure. The purpose of this article is to review the data on the place of copeptin in the management of patients with chest pain or heart failure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Coronary heart disease risk in patients with stroke or transient ischemic attack and no known coronary heart disease: findings from the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Amarenco, Pierre; Goldstein, Larry B; Sillesen, Henrik

    2010-01-01

    Noncoronary forms of atherosclerosis (including transient ischemic attacks or stroke of carotid origin or >50% stenosis of the carotid artery) are associated with a 10-year vascular risk of >20% and are considered as a coronary heart disease (CHD) -risk equivalent from the standpoint of lipid...... management. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial included patients with stroke or transient ischemic attack and no known CHD regardless of the presence of carotid atherosclerosis. We evaluated the risk of developing clinically recognized CHD in SPARCL patients....

  7. hs-CRP is strongly associated with coronary heart disease (CHD): A data mining approach using decision tree algorithm.

    Science.gov (United States)

    Tayefi, Maryam; Tajfard, Mohammad; Saffar, Sara; Hanachi, Parichehr; Amirabadizadeh, Ali Reza; Esmaeily, Habibollah; Taghipour, Ali; Ferns, Gordon A; Moohebati, Mohsen; Ghayour-Mobarhan, Majid

    2017-04-01

    Coronary heart disease (CHD) is an important public health problem globally. Algorithms incorporating the assessment of clinical biomarkers together with several established traditional risk factors can help clinicians to predict CHD and support clinical decision making with respect to interventions. Decision tree (DT) is a data mining model for extracting hidden knowledge from large databases. We aimed to establish a predictive model for coronary heart disease using a decision tree algorithm. Here we used a dataset of 2346 individuals including 1159 healthy participants and 1187 participant who had undergone coronary angiography (405 participants with negative angiography and 782 participants with positive angiography). We entered 10 variables of a total 12 variables into the DT algorithm (including age, sex, FBG, TG, hs-CRP, TC, HDL, LDL, SBP and DBP). Our model could identify the associated risk factors of CHD with sensitivity, specificity, accuracy of 96%, 87%, 94% and respectively. Serum hs-CRP levels was at top of the tree in our model, following by FBG, gender and age. Our model appears to be an accurate, specific and sensitive model for identifying the presence of CHD, but will require validation in prospective studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The UPBEAT Nurse-Delivered Personalized Care Intervention for People with Coronary Heart Disease Who Report Current Chest Pain and Depression: A Randomised Controlled Pilot Study

    NARCIS (Netherlands)

    Barley, E.A.; Walters, P.; Haddad, M.; Phillips, R.; Achilla, E.; McCrone, P.; van Marwijk, H.W.J.; Mann, A.; Tylee, A.

    2014-01-01

    Background: Depression is common in people with coronary heart disease (CHD) and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial

  9. Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease

    International Nuclear Information System (INIS)

    Goo, Hyun Woo; Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee; Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun

    2005-01-01

    There is little information on the ability of non-ECG-gated cardiac CT to demonstrate the coronary arteries of children. To evaluate the visibility of the origin and proximal course of coronary arteries on non-ECG-gated cardiac CT, in which the coronary artery was not of primary diagnostic concern, in children with congenital heart disease. From December 2002 to March 2004, 126 cardiac CT examinations from 104 children (median age 11 months; age range 1 day to 15 years) were evaluated. All patients had ventriculo-arterial concordance and no malformations of the great arteries; those with coronary artery anomalies were excluded. Contrast-enhanced 16-slice spiral CT was performed without ECG-gating and multiplanar images for coronary arteries were obtained. The visibility of coronary artery origins was graded on a three-point scale, while nine segments of the arteries were graded on a four-point scale. CT images in which it was possible to trace the coronary arteries were considered diagnostic. The visibility of each whole coronary artery and the origins and proximal four segments of coronary arteries were calculated. The visibility of coronary arteries was also correlated with patient age. The percentage of CT images of diagnostic quality was 49.3% for the whole coronary artery and 81.7% for the origins and proximal four segments. There was a significant positive correlation between the visibility of coronary arteries and age. Non-ECG-gated cardiac CT, in which the coronary artery is not of primary diagnostic concern, is frequently able to visualize the origin and proximal course of coronary arteries and may be helpful in detecting coronary artery anomalies in children with congenital heart disease. (orig.)

  10. Clinical evaluation of domestic biodegradable drug-eluting stents in the treatment of coronary heart disease

    International Nuclear Information System (INIS)

    Yu Hongying; Suo Chuantao; Shang Ruiping

    2009-01-01

    Objective: To evaluate the safety and efficacy of domestic biodegradable drug-eluting stent, EXCEL, in clinical treatment of coronary heart disease. Methods: During the period of Jan. 2008-Oct. 2008, 100 patients with coronary heart disease who consented to PCI and postoperative coronary angiography were selected and enrolled in the study. The patients were divided into EXCEL group (n = 58) and Cypher group (n = 42). The immediate successful rate of interventional therapy and the complications occurred during hospitalization were observed. Postoperative follow-up and checkup coronary angiography were conducted. Results: No significant difference in the relevant clinical data, in the number and type of diseased coronary branch and in the mean length of implanted stents existed between two groups. Also, no statistically significant difference in the occurrence of major adverse cardiac event (MACE), in-stent restenosis and thrombosis was present between two groups. Conclusion: Compared with Cypher stenting, EXCEL stenting carries similar, i.e. rather low, occurrence of MACE and in-stent restenosis. (authors)

  11. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials.

    Science.gov (United States)

    Mega, J L; Stitziel, N O; Smith, J G; Chasman, D I; Caulfield, M; Devlin, J J; Nordio, F; Hyde, C; Cannon, C P; Sacks, F; Poulter, N; Sever, P; Ridker, P M; Braunwald, E; Melander, O; Kathiresan, S; Sabatine, M S

    2015-06-06

    Genetic variants have been associated with the risk of coronary heart disease. In this study, we tested whether or not a composite of these variants could ascertain the risk of both incident and recurrent coronary heart disease events and identify those individuals who derive greater clinical benefit from statin therapy. A community-based cohort study (the Malmo Diet and Cancer Study) and four randomised controlled trials of both primary prevention (JUPITER and ASCOT) and secondary prevention (CARE and PROVE IT-TIMI 22) with statin therapy, comprising a total of 48,421 individuals and 3477 events, were included in these analyses. We studied the association of a genetic risk score based on 27 genetic variants with incident or recurrent coronary heart disease, adjusting for traditional clinical risk factors. We then investigated the relative and absolute risk reductions in coronary heart disease events with statin therapy stratified by genetic risk. We combined data from the different studies using a meta-analysis. When individuals were divided into low (quintile 1), intermediate (quintiles 2-4), and high (quintile 5) genetic risk categories, a significant gradient in risk for incident or recurrent coronary heart disease was shown. Compared with the low genetic risk category, the multivariable-adjusted hazard ratio for coronary heart disease for the intermediate genetic risk category was 1·34 (95% CI 1·22-1·47, pgenetic risk category was 1·72 (1·55-1·92, pgenetic risk categories. Similarly, we noted greater absolute risk reductions in those individuals in higher genetic risk categories (p=0·0101), resulting in a roughly threefold decrease in the number needed to treat to prevent one coronary heart disease event in the primary prevention trials. Specifically, in the primary prevention trials, the number needed to treat to prevent one such event in 10 years was 66 in people at low genetic risk, 42 in those at intermediate genetic risk, and 25 in those at high

  12. Social Integration and Reduced Risk of Coronary Heart Disease in Women: The Role of Lifestyle Behaviors.

    Science.gov (United States)

    Chang, Shun-Chiao; Glymour, Maria; Cornelis, Marilyn; Walter, Stefan; Rimm, Eric B; Tchetgen Tchetgen, Eric; Kawachi, Ichiro; Kubzansky, Laura D

    2017-06-09

    Higher social integration is associated with lower cardiovascular mortality; however, whether it is associated with incident coronary heart disease (CHD), especially in women, and whether associations differ by case fatality are unclear. This study sought to examine the associations between social integration and risk of incident CHD in a large female prospective cohort. Seventy-six thousand three hundred and sixty-two women in the Nurses' Health Study, free of CHD and stroke at baseline (1992), were followed until 2014. Social integration was assessed by a simplified Berkman-Syme Social Network Index every 4 years. End points included nonfatal myocardial infarction and fatal CHD. Two thousand three hundred and seventy-two incident CHD events occurred throughout follow-up. Adjusting for demographic, health/medical risk factors, and depressive symptoms, being socially integrated was significantly associated with lower CHD risk, particularly fatal CHD. The most socially integrated women had a hazard ratio of 0.55 (95% confidence interval, 0.41-0.73) of developing fatal CHD compared with those least socially integrated ( P for trend social integration and nonfatal myocardial infarction risk were largely explained by health-promoting behaviors, particularly through differences in cigarette smoking; however, the association with fatal CHD risk remained after accounting for these behaviors and, thus, may involve more direct biological mechanisms. Social integration is inversely associated with CHD incidence in women, but is largely explained by lifestyle/behavioral pathways. © 2017 American Heart Association, Inc.

  13. Undertreatment of hyperlipidemia in patients with coronary artery disease and heart failure.

    Science.gov (United States)

    Sueta, Carla A; Massing, Mark W; Chowdhury, Mridul; Biggs, David P; Simpson, Ross J

    2003-02-01

    Coronary artery disease patients with heart failure (CAD+HF) are at high risk for cardiovascular events. We examined the frequency of lipid assessment and prescription of lipid-lowering agents in outpatients with combined CAD+HF compared with patients with CAD alone. We analyzed an administrative data set from the Quality Assurance Program II, a Merck & Co., Inc., sponsored national retrospective chart audit of 41,487 CAD patients seen at 296 ambulatory medical practices. About 34% of these patients had CAD+HF. Documentation of low-density lipoprotein (LDL) cholesterol was significantly lower in patients with CAD+HF (53%) compared with those with CAD alone (69%). Lipid-lowering drugs were prescribed in only 36% of patients with CAD+HF, compared with 52% of patients with CAD alone. Lipid levels alone did not justify this disparity. Patients with documented LDL cholesterol values were 4 times more likely to receive a prescription for a lipid-lowering medication than those without recorded values. Other predictors of lipid-lowering prescription included: younger age, history of myocardial infarction, revascularization, care by a cardiologist, and geographic region. Patients with CAD, HF, and advanced age simultaneously experience among the highest risk and the lowest lipid-lowering treatment rates. Strategies to increase LDL testing and aggressively treat patients with heart failure and CAD are warranted.

  14. Left ventricular volume during supine exercise: importance of myocardial scar in patients with coronary heart disease

    International Nuclear Information System (INIS)

    Mann, D.L.; Scharf, J.; Ahnve, S.; Gilpin, E.

    1987-01-01

    Existing studies suggest that exercise-induced ischemia produces an increase in left ventricular end-diastolic volume; however, all of these studies have included patients with previous myocardial infarction. To test whether the end-diastolic volume response to exercise is related to the extent of myocardial scar, the results of gated radionuclide supine exercise tests performed on 130 subjects were reviewed. The patient group comprised 130 subjects were reviewed. The patient group comprised 130 men aged 35 to 65 years (mean +/- SD 52 +/- 5) with documented coronary heart disease. The extent of myocardial ischemia and scar formation was assessed by stress electrocardiography and thallium-201 scintigraphy. Patients were classified into three groups on the basis of left ventricular end-diastolic volume response at peak exercise: group 1 (n = 72) had an increase of end-diastolic volume greater than 10%, group 2 (n = 41) had a change in end-diastolic volume less than 10% and group 3 (n = 17) had a decrease in end-diastolic volume greater than 10% (n = 17). At rest there was no significant difference among groups in heart rate, systolic blood pressure, end-diastolic (EDVrest) or end-systolic volumes or ejection fraction (p greater than 0.05); however, at peak exercise the end-systolic volume response was significantly greater for group 1 (p less than 0.002)

  15. Association between blood cholesterol level with periodontal status of coronary heart disease patients

    Science.gov (United States)

    Valensia, Rosy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is an abnormal narrowing of heart arteries associated with local accumulation of lipids, in the form of cholesterol and triglycerides. Periodontal disease is a chronic inflammatory that suggests link to the development of CHD. In periodontitis have been reported changes in lipid profile, include increased of cholesterol levels of blood. Objective: to analyse correlation between blood cholesterol level with periodontal status of CHD and non CHD subjects. Methods: Periodontal status and blood cholesterol level of 60 CHD and 40 non CHD subjects was measured. Result: Blood cholesterol level in CHD subjects differs from non CHD subjects (p=0.032). Blood cholesterol level correlates with pocket depth (p=0.003) and clinical attachment loss (CAL) (p=0.000) in CHD subjects. Blood cholesterol level correlates with pocket depth (p=0.010) in non CHD subjects. There is no significant correlation between blood cholesterol level and bleeding on probing (BOP) in CHD subjects. There is no significant correlation between blood cholesterol level with BOP and CAL in non CHD subjects. Conclusion: Blood cholesterol level in control group is higher than CHD patients. Blood cholesterol level positively associated with pocket depth (r=0.375) and CAL (r=0.450) in CHD patients. Blood cholesterol level is positively associated with pocket depth (r=0.404) in control group.

  16. Job stress and behavioral characteristics in relation to coronary heart disease risk among Japanese police officers.

    Science.gov (United States)

    Shiozaki, Maki; Miyai, Nobuyuki; Morioka, Ikuharu; Utsumi, Miyoko; Hattori, Sonomi; Koike, Hiroaki; Arita, Mikio; Miyashita, Kazuhisa

    2017-08-08

    This study examined the association between job-related behavioral characteristics and the risk of coronary heart diseases (CHD) in Japanese male police officers. Compared to office clerks, police officers exhibited greater age-related increases of the prevalence of CHD risk factors, and a clustering number of CHD risk factors was significantly higher in the group of those over 45 yr of age. Among the police officers, coronary-prone behavior was more frequent than that seen in office clerks. The police officers with coronary-prone behavior tended to engage in shift work and to work overtime more; yet they were less likely to perceive job stress and to express the relevant physical and psychological symptoms than those without coronary-prone behavior. The subjects with such behavioral characteristics had a significantly greater number of CHD risk factors. In a multiple regression analysis, coronary-prone behavior together with age, social support, walking hours per day, and amount of alcohol consumption were selected as significant determinants of a cluster of CHD risk factors. These results suggest that coronary-prone behavior may contribute to the higher prevalence of CHD risk factors in police officers via leading the long working hours and the work-related unfavorable lifestyles, such as alcohol drinking and physical inactivity.

  17. Value of heart-lung ratio of 99Tcm N-NOET in detection of coronary artery disease

    International Nuclear Information System (INIS)

    Zhang Wanchun; Li Sijin; Liu Jianzhong; Hu Guang; Wang Jin; Lv Jiyuan

    2005-01-01

    To investigate the relationship between the heart-lung ratio (HLR) assessed with exercise 99 Tc m N-NOET myocardial perfusion imaging and coronary artery disease (CAD), 10 normal volunteers (7 male and 3 female, aged 40.0 ± 5.8 years), and 40 suspected CAD patients (21 male and 19 female, aged 55.2 ± 8.5 years) underwent exercise (30 min)-delayed (2 and 4 h postinjection) 99 Tc m -NOET gated myocardial perfusion imaging, and the HLR at different time was calculated. 13 patients among them took the coronary angiography in two months. According to the exercise heart-lung ratio (EXHLR), 50 subjects were divided into two groups. G1(n=36, EXHLR≥2) included 10 normal volunteers, 5 patients with normal coronary arteries, and the rest 21 patients had no relevant symptom and cardiac event in the follow-up period of 4 to 12 months. The image was normal in all of the subjects in G1. In G2 (n=14, EXHLR 99 Tc m N-NOET may be useful as a diagnostic index in CAD because it is more sensitive than myocardial perfusion imaging. (authors)

  18. Positive Affect and Health Behaviors Across 5 Years in Patients With Coronary Heart Disease: The Heart and Soul Study.

    Science.gov (United States)

    Sin, Nancy L; Moskowitz, Judith Tedlie; Whooley, Mary A

    2015-01-01

    Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD). Outpatients with CHD reported positive affect, physical activity, sleep quality, medication adherence, cigarette smoking, and alcohol use at baseline (n = 1022) and 5 years later (n = 662). Covariates in regression analyses included demographics, cardiac disease severity, and depressive symptoms. At baseline, higher positive affect (per 1 standard deviation) was associated with better health behaviors: physical activity (odds ratio [OR] = 1.52, 95% 95% confidence interval [CI] = 1.30-1.77, p positive affect did not predict health behaviors at follow-up, accounting for baseline behaviors. However, increases in positive affect across 5 years co-occurred with improvements in physical activity (B = 0.023, standard error [SE] = 0.008, p = .002), sleep quality (B = 0.011, SE = 0.005, p = .039), and medication adherence (B = 0.014, SE = 0.004, p Positive affect was associated with health behaviors among patients with CHD. Efforts to sustain or enhance positive affect may be promising for promoting better health behaviors.

  19. Magnetic Resonance Imaging Measurement of Left Ventricular Blood Flow and Coronary Flow Reserve in Patients with Chronic Heart Failure due to Coronary Artery Disease

    Energy Technology Data Exchange (ETDEWEB)

    Aras, A.; Anik, Y.; Demirci, A.; Balci, N.C.; Kozdag, G.; Ural, D.; Komsuoglu, B. (Radiology Dept. and Cardiology Dept., Kocaeli Univ. School of Medicine, Kocaeli (Turkey))

    2007-11-15

    Background: Coronary sinus flow reflects global cardiac perfusion and has been used for the assessment of myocardial flow reserve, which is reduced in chronic heart failure (CHF). Coronary flow reserve (CFR) can be measured by using phase-contrast (PC) velocity-encoded cine (VEC) magnetic resonance imaging (MRI). Purpose: To quantify and compare global left ventricular (LV) perfusion and CFR in patients with CHF and in a healthy control group by measuring coronary sinus flow with PC VEC MRI, and to correlate this with global LV perfusion, segmental first-pass perfusion, and viability in the same patients. Material and Methods: Cardiac MRI was performed in 20 patients with CHF of ischemic origin and in a control group of healthy subjects (n 11) at rest and after pharmacological stress induced by i.v. dipyridamole. The MRI protocol included cine MRI, VEC MRI, first-pass perfusion, and delayed contrast-enhanced MRI for viability. Global LV perfusion was quantified by measuring coronary sinus flow on VEC MRI at rest in all subjects. CFR was determined as the ratio of global LV perfusion before and after pharmacologic stress. Results: At rest, global LV perfusion was not significantly different in patients with CHF and the control group. After administration of dipyridamole, global LV perfusion and CFR were significantly lower in patients with CHF compared to the control group (P<0.001). An inverse correlation was observed between CFR and the number of infarcted and/or ischemic segments (P = 0.083, P = 0.037). Conclusion: A combined cardiac MRI protocol including function and perfusion techniques together with VEC MRI can be used to evaluate global LV perfusion and CFR in patients with CHF. Global LV perfusion and CFR measurements may have potential in the monitoring of CHF. Impaired CFR may contribute to progressive decline in LV function in patients with CHF

  20. Magnetic Resonance Imaging Measurement of Left Ventricular Blood Flow and Coronary Flow Reserve in Patients with Chronic Heart Failure due to Coronary Artery Disease

    International Nuclear Information System (INIS)

    Aras, A.; Anik, Y.; Demirci, A.; Balci, N.C.; Kozdag, G.; Ural, D.; Komsuogl u, B.

    2007-01-01

    Background: Coronary sinus flow reflects global cardiac perfusion and has been used for the assessment of myocardial flow reserve, which is reduced in chronic heart failure (CHF). Coronary flow reserve (CFR) can be measured by using phase-contrast (PC) velocity-encoded cine (VEC) magnetic resonance imaging (MRI). Purpose: To quantify and compare global left ventricular (LV) perfusion and CFR in patients with CHF and in a healthy control group by measuring coronary sinus flow with PC VEC MRI, and to correlate this with global LV perfusion, segmental first-pass perfusion, and viability in the same patients. Material and Methods: Cardiac MRI was performed in 20 patients with CHF of ischemic origin and in a control group of healthy subjects (n 11) at rest and after pharmacological stress induced by i.v. dipyridamole. The MRI protocol included cine MRI, VEC MRI, first-pass perfusion, and delayed contrast-enhanced MRI for viability. Global LV perfusion was quantified by measuring coronary sinus flow on VEC MRI at rest in all subjects. CFR was determined as the ratio of global LV perfusion before and after pharmacologic stress. Results: At rest, global LV perfusion was not significantly different in patients with CHF and the control group. After administration of dipyridamole, global LV perfusion and CFR were significantly lower in patients with CHF compared to the control group (P<0.001). An inverse correlation was observed between CFR and the number of infarcted and/or ischemic segments (P = 0.083, P 0.037). Conclusion: A combined cardiac MRI protocol including function and perfusion techniques together with VEC MRI can be used to evaluate global LV perfusion and CFR in patients with CHF. Global LV perfusion and CFR measurements may have potential in the monitoring of CHF. Impaired CFR may contribute to progressive decline in LV function in patients with CHF

  1. Use of corrosion casting techniques to evaluate coronary collateral vessels and anastomoses in hearts of canine cadavers.

    Science.gov (United States)

    Noestelthaller, Arne; Probst, Alexander; Koenig, Horst E

    2005-10-01

    To study and investigate branching patterns of the canine coronary arteries and collateral circulation by use of corrosion casting techniques. 31 hearts obtained from cadavers of clinically normal dogs of various ages and breeds and of either sex. 3-dimensional reproduction of coronary arteries was achieved by postmortem injection and perfusion with casting materials into the aortic sinus via the ascending aorta. Perfused hearts were macerated and carefully irrigated; the air-dried specimens were examined macroscopically and with a magnifying headset. Collateral arteries and inter- and intra-arterial anastomoses were successfully detected in 8 corrosion cast specimens. In total, 9 coronary collateral arteries and 3 interarterial anastomoses were found. Our finding of coronary collateral arteries in canine hearts is in agreement with recent findings in coronary flow study. On the basis of our results, vasodilation treatment to improve collateral vessel remodeling in dogs with myocardial dysfunction may be warranted.

  2. Magnesium and trace metals: risk factors for coronary heart disease - associations between blood levels and angiographic findings

    International Nuclear Information System (INIS)

    Manthey, J.; Stoeppler, M.; Morgenstern, W.; Nussel, E.; Opherk, D.; Weintraut, A.; Wesch, H.; Kubler, W.

    1981-01-01

    A deficiency or an excessive intake of metals with cardiovascular effects is suspected to be involved in the pathogenesis of coronary heart disease (CHD) and sudden death. Therefore, in 106 patients undergoing coronary arteriography, serum levels of six essential metals (magnesium, chromium, copper, manganese, selenium and zinc) and whole blood concentrations of two elements without known essential function (cadmium and lead) were measured using atomic absorption spectrophotometry, including the flameless technique, or neutron activation analysis. Our results suggest that a deficiency of magnesium but not of the other metals studied may be present in patients with severe CHD; elevated serum copper and manganese levels do not play a role in the development of CHD in the sample of patients studied; and cigarette smoking may be associated with increased serum cadmium levels, which may explain in part the contribution of smoking to the risk of sudden death in patients with CHD

  3. Correlates of lung/heart ratio of thallium-201 in coronary artery disease

    International Nuclear Information System (INIS)

    Homma, S.; Kaul, S.; Boucher, C.A.

    1987-01-01

    We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain

  4. Depression in primary care patients with coronary heart disease: baseline findings from the UPBEAT UK study.

    Directory of Open Access Journals (Sweden)

    Paul Walters

    Full Text Available An association between depression and coronary heart disease is now accepted but there has been little primary care research on this topic. The UPBEAT-UK studies are centred on a cohort of primary patients with coronary heart disease assessed every six months for up to four years. The aim of this research was to determine the prevalence and associations of depression in this cohort at baseline.Participants with coronary heart disease were recruited from general practice registers and assessed for cardiac symptoms, depression, quality of life and social problems.803 people participated. 42% had a documented history of myocardial infarction, 54% a diagnosis of ischaemic heart disease or angina. 44% still experienced chest pain. 7% had an ICD-10 defined depressive disorder. Factors independently associated with this diagnosis were problems living alone (OR 5.49, 95% CI 2.11-13.30, problems carrying out usual activities (OR 3.71, 95% CI 1.93-7.14, experiencing chest pain (OR 3.27, 95% CI 1.58-6.76, other pains or discomfort (OR 3.39, 95% CI 1.42-8.10, younger age (OR 0.95 per year 95% CI 0.92-0.98.Problems living alone, chest pain and disability are important predictors of depression in this population.

  5. Safety and efficacy of a drug regimen to control heart rate during 64-slice ECG-gated coronary CTA in children

    International Nuclear Information System (INIS)

    Rigsby, Cynthia K.; Nicholas, Angela C.; deFreitas, R.A.; Leidecker, Christianne; Johanek, Andrew J.; Anley, Peter; Wang, Deli; Uejima, Tetsu

    2010-01-01

    The adult practice for ECG-gated single-source 64-slice coronary CTA (CCTA) includes administering beta-blockers to reduce heart rate. There are limited data on this process in children. To evaluate the safety and efficacy of a drug regimen to decrease heart rate before performing CCTA in children. IV remifentanil and esmolol infusion were chosen to decrease heart rate in 41 children (mean age 6.5 years) while they were under general anesthesia (GA) for CCTA. Drug doses, changes in heart rate and procedural complications were recorded. CCTA image quality was graded on a scale of 1 to 5. The relationships between image quality and heart rate and image quality and age were evaluated. Patient effective radiation doses were calculated. Heart rates were lowered utilizing esmolol (4 children), remifentanil (2 children) or both (35 children); 26 children received nitroglycerin for coronary vasodilation. The mean decrease in heart rate was 26%. There were no major complications. The average image-quality score was 4.4. Higher heart rates were associated with worse image quality (r = 0.67, P < 0.0001). Older age was associated with better image quality (r = 0.66, P < 0.0001). Effective radiation doses were 0.7 to 7.0 mSv. Heart rate reduction for pediatric CCTA can be safely and effectively achieved while yielding high-quality images. (orig.)

  6. Dual-source CT coronary angiography in patients with premature heart-beats: initial experience

    International Nuclear Information System (INIS)

    Wang Yining; Zhang Zhuhua; Kong Lingyan; Song Lan; Mu Wenbin; Wang Yun; Jin Zhengyu

    2008-01-01

    Objective: To evaluate the feasibility of dual-source computed tomography (DSCT) coronary angiography in a population with premature heart-beats. Methods: Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner (Somatom Definition, Siemens AG, Germany). The images were reconstmcted before and after ECG editing. Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent (1) to non-assessable (4). The results of the two groups were compared with a paired t-test, and a P value of less than 0.05 was considered significant. Results: The mean heart rate during examination ranged from 49 to 111 bpm[ mean(70.7±12.4) bpm]. Twenty-eight of 70 patients with relatively small variability of the heart rate [(41.0±18.4) bpm] got diagnostic image quality without ECG editing. In other 42 patients with larger variability of the heart rate [(71.4±28.7) bpm], the mean image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing, there was a significant difference (t= 13.764, P 2 =121.846, P<0.01). Finally, the diagnostic image accounted 98.0% (1014/1035) in all segments of 70 patients. Conclusion: DSCT can provide diagnostic images for patients with premature heart-beats. The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing. (authors)

  7. Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease.

    Science.gov (United States)

    Rosenson, Robert S; Kent, Shia T; Brown, Todd M; Farkouh, Michael E; Levitan, Emily B; Yun, Huifeng; Sharma, Pradeep; Safford, Monika M; Kilgore, Meredith; Muntner, Paul; Bittner, Vera

    2015-01-27

    National guidelines recommend use of high-intensity statins after hospitalization for coronary heart disease (CHD) events. This study sought to estimate the proportion of Medicare beneficiaries filling prescriptions for high-intensity statins after hospital discharge for a CHD event and to analyze whether statin intensity before hospitalization is associated with statin intensity after discharge. We conducted a retrospective cohort study using a 5% random sample of Medicare beneficiaries between 65 and 74 years old. Beneficiaries were included in the analysis if they filled a statin prescription after a CHD event (myocardial infarction or coronary revascularization) in 2007, 2008, or 2009. High-intensity statins included atorvastatin 40 to 80 mg, rosuvastatin 20 to 40 mg, and simvastatin 80 mg. Among 8,762 Medicare beneficiaries filling a statin prescription after a CHD event, 27% of first post-discharge fills were for a high-intensity statin. The percent filling a high-intensity statin post-discharge was 23.1%, 9.4%, and 80.7%, for beneficiaries not taking statins pre-hospitalization, taking low/moderate-intensity statins, and taking high-intensity statins before their CHD event, respectively. Compared with beneficiaries not on statin therapy pre-hospitalization, multivariable adjusted risk ratios for filling a high-intensity statin were 4.01 (3.58-4.49) and 0.45 (0.40-0.52) for participants taking high-intensity and low/moderate-intensity statins before their CHD event, respectively. Only 11.5% of beneficiaries whose first post-discharge statin fill was for a low/moderate-intensity statin filled a high-intensity statin within 365 days of discharge. The majority of Medicare beneficiaries do not fill high-intensity statins after hospitalization for CHD. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Diagnostic value of placental growth factor in patients with coronary heart disease

    Directory of Open Access Journals (Sweden)

    M. V. Tulikov

    2014-07-01

    Full Text Available Objective: to study the diagnostic value of placental growth factor (PlGF in patients with coronary heart disease (CHD. Subjects and methods. 151 patients (75 men and 76 women; mean age 58.9 ± 12.3 years, including 66 patients with exercise-induced stable angina, 32 with unstable angina, 32 with myocardial infarction, and 21 with no clinical signs of CHD, were followed up. Blood PlGF levels were measured in all the examinees; C-reactive protein (CRP concentrations were also determined using a high-sensitivity method in the patients with CHD.Results. In the patients with acute coronary syndrome (ACS, the levels of PlGF were significantly higher than in those with exercise-induced stable angina and in healthy individuals (17.3 ± 11.4 versus 11.2 ± 7.3 and 8.8 ± 6.7 pg/ml; p < 0.001. Estimation of the diagnostic value of the determination of PlGF levels in the diagnosis of ACS in troponin-negative examinees revealed that the area under the ROC curve (AUC was 0.76. The quality of a diagnostic model using CRP was inferior to that with PlGF (n = 45; AUC for PlGF = 0.79; that for CRP = 0.65.Conclusion. The elevated level of PlGF may be considered as a diagnostic marker for ACS, including in the absence of the higher levels of cardiac troponins.

  9. Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up

    OpenAIRE

    Holmberg, Sara; Thelin, Anders; Stiernstr?m, Eva-Lena

    2009-01-01

    Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752) participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12...

  10. Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Janssen, V.; Gucht, V. de; Dusseldorp, E.; Maes, S.

    2012-01-01

    Background: Lifestyle modification programmes for coronary heart disease patients have been shown to effectively improve risk factors and related health behaviours, quality of life, reincidence, and mortality. However, improvements in routine cardiac care over the recent years may offset the

  11. The use of simple indicators for detecting potential coronary heart disease susceptibility in the air traffic controller population.

    Science.gov (United States)

    1972-05-01

    An analysis was made of an eight-year interval change in several indicators of coronary heart disease (CHD) susceptibility as measured on 475 male air traffic control (ATC) personnel. The initial measurements were obtained from these personnel as ATC...

  12. Quantifying the contributions of behavioral and biological risk factors to socioeconomic disparities in coronary heart disease incidence: the MORGEN study

    NARCIS (Netherlands)

    Kershaw, Kiarri N.; Droomers, Mariël; Robinson, Whitney R.; Carnethon, Mercedes R.; Daviglus, Martha L.; Verschuren, W. M. Monique

    2013-01-01

    Quantifying the impact of different modifiable behavioral and biological risk factors on socioeconomic disparities in coronary heart disease (CHD) may help inform targeted, population-specific strategies to reduce the unequal distribution of the disease. Previous studies have used analytic

  13. Genetics and genomics of cholesterol and polyunsaturated fatty acid metabolism in relation to coronary heart disease risk

    NARCIS (Netherlands)

    Lu Yingchang (Kevin), Y.

    2011-01-01

    Background

    Coronary heart disease (CHD) continues to be a leading cause of morbidity and mortality among adults worldwide. Deregulated lipid metabolism (dyslipidemia) that manifests as hypercholesterolemia, hypertriglyceridemia, low high-density-lipoprotein (HDL)

  14. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Uhre; O'Reilly, Eilis J; Heitmann, Berit Lilienthal

    2009-01-01

    BACKGROUND: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. OBJECTIVE: ...

  15. Application of 99mTc-MIBI myocardial tomography imaging for the diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    Wu Kegui; Chen Daguang; Chen Jinshui

    1992-01-01

    99m Tc-MIBI myocardial tomography imaging was obtained from 119 cases with Sopha Medical SPECT system. 38 cases of coronary heart diseases, 33 cases of coronary heart diseases combined with hypertension and 48 cases of myocardial infarction were diagnosed according to clinical symptoms and signs, ECG, exercise ECG (treadmill test) and other laboratory studies. The results showed that positive rate of myocardial thermography imaging for detecting coronary heart disease was 70.21% at rest, and the positivity can be further increased by myocardial tomography imaging with exercise test. On the contrary the positivity of exercise ECG was only 63.8%. It was concluded that radionuclide myocardial tomography imaging was noninvasive and more sensitive and specific than the exercise ECG in detecting coronary heart disease

  16. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS

    NARCIS (Netherlands)

    Minneboo, Madelon; Peters, Ron J. G.; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J. J.

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were

  17. CURRENT APPROACHES TO EVALUATION OF THE MULTIVESSEL CORONARY ATHEROSCLEROSIS IN PATIENTS WITH CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    D. N. Perutsky

    2011-01-01

    Full Text Available Aim. To determine the validity of stress echocardiography by fractional reserve blood flow (FFR as the reference method in detection of coronary arteries requiring revascularization, as well as to optimize the determination of the functional significance of coronary artery lesions in patients with multivessel coronary atherosclerosis. Material and methods. Patients (n=36 with stable angina class 2-3 with multivessel coronary atherosclerosis were included into the study. Stress echocardiography with dobutamine or exercise test (treadmill was performed in all patients. Selective coronary angiography with subsequent evaluation of FFR was carried out in patients with a positive result of stress echocardiography. Totally 108 arteries (87 with stenosing atherosclerosis were assessed.  Results. According to coronary angiography bi-vessel and three-vessel damages were revealed in 21 (58% and 15 (42% patients, respectively. Method of stress echocardiography as compared with FFR shown sensitivity — 58%, specificity — 95%, positive predictive value — 87%, positive predictive value of a negative result — 17%. Method of coronary angiography (as a method to detect significant stenosis by visual assessment of coronary artery as compared with FFR demonstrated sensitivity 100%, specificity — 30%, positive predictive value — 42%. Conclusion. Stress echocardiography for noninvasive patient examination improves the accuracy of determination for the need and extent of revascularization.

  18. Brief report: Coronary Heart Disease: an Unknown Association to Pathological Gambling

    Directory of Open Access Journals (Sweden)

    Candice eGermain

    2011-03-01

    Full Text Available Pathological gamblers, because of their high level of stress, depression and alcohol or nicotine consumption may be overexposed to coronary heart disease (CHD. To test this association, we assessed pathological gambling (DSM-IV-TR criteria and SOGS scale among 73 patients hospitalized in cardiology for CHD and 61 in-patients from the same department hospitalized for a non coronary disorder. We found six cases of PG (8.2% and one case of problem gambling in the CHD group versus no case in the non-coronary group (p=0.01. Pathological gambling was not associated to a higher level of alcohol or nicotine consumption neither to a higher level of sensation-seeking.

  19. Studies Bearing on Coronary Heart Disease in South Mrican ...

    African Journals Online (AJOL)

    1973-01-20

    Jan 20, 1973 ... heart disease (CHD); it is very common in Whites, some- what less ... In seeking to avoid the ill-effects of CHD risk factors, it is .... population in Soweto, Johannesburg, and calculating how .... Among Bantu adults living in remote country areas, .... spent in energy expenditure, greater than that of walking.

  20. Cholesterol, coronary heart disease and oestrogens | Utian | South ...

    African Journals Online (AJOL)

    Present concepts of the interrelationship between oestrogens, endogenous and exogenous, and the development of atheromatosis and coronalY heart disease in the human female are reviewed. Aspects of research conducted by me at Groote Schuur Hospital, Cape Town, are incorporated in the discussion. The current ...

  1. The role of percutaneous transluminal coronary angioplasty in heart transplant recipients.

    Science.gov (United States)

    Schnetzler, B; Drobinski, G; Dorent, R; Camproux, A C; Ghossoub, J; Thomas, D; Gandjbakhch, I

    2000-06-01

    Review the acute and late results of percutaneous transluminal coronary angioplasty (PTCA) in heart transplant recipients and examine the factors predictive of restenosis. Coronary graft disease (CGD) is the main factor responsible for late graft loss. Medical treatment, surgical revascularization, or retransplantation gives only suboptimal results in this regard. Therefore, PTCA has been attempted in this situation. More than 332 heart transplantations in our institution have been performed since 1992, the date of the first PTCA in our patients. We are currently in charge of 450 patients. All the characteristics, procedure-related information, and clinical outcome of patients needing PTCA were assessed by review of each patient's clinical records. All coronary angiograms were reviewed by an independent cardiologist. Since 1992, 53 coronary sites have been dilated in the course of 39 procedures in 29 patients. Indication for PTCA was asymptomatic angiographic coronary graft disease in 35 sites (64.8%), angina in 9 (16.6%), silent ischemia in 2 (3.7%), acute myocardial infarction in 1 (1.8%), and CHF in 7 (12.9%). Primary success ( 50%) was 32.5% (14/43). Mean follow-up was 1.27 year +/- 1.2 (SD). Five deaths (17. 2%) occurred in follow-up and were all in relation to coronary graft disease. Mean time separating PTCA from death was 0.9 year +/- 1.3 (SD). We also sought to look at factors predictive of restenosis. By multivariate analysis, a positive recipient's serology for cytomegalovirus (CMV) before the graft was the only factor found protective against restenosis (odds ratio 22.4; confidence interval 1.1 to 443.4). PTCA in heart transplant recipients allows a high level of primary success with a low periprocedural-complication rate. Restenosis rate seems equivalent to restenosis rate in native coronary arteries. Mortality during follow-up is increased in this population and is the consequence of a high level of coronary events. Recipient positivity for CMV before

  2. [Study of serum levels of homocystein, lipids and their peroxidation products in patients with coronary heart disease].

    Science.gov (United States)

    Belaia, O L; Fedorova, N V

    2005-01-01

    The subjects of the study were 30 patients with coronary heart disease (19--with stable, and 11--with instable angina), and 15 practically healthy individuals. The study included measurement of the levels of homocysteine (HC), total cholesterol, cholesterol of low-density lipoproteins, cholesterol of high-density lipoproteins, and lipidperoxidation (LP) products (TBA-reactive products), as well as coagulo-fibrinolytic parameters. The study revealed that patients with instable angina had significantly higher levels of HC and TBA-reactive products compared to those with stable angina and healthy controls. HC level correlated with LP processes in CHD patients (r = 0.55). Methionine loading allowed revealing latent hyperhomocysteinemia.

  3. Coronary Physiology During Exercise and Vasodilation in the Healthy Heart and in Severe Aortic Stenosis.

    Science.gov (United States)

    Lumley, Matthew; Williams, Rupert; Asrress, Kaleab N; Arri, Satpal; Briceno, Natalia; Ellis, Howard; Rajani, Ronak; Siebes, Maria; Piek, Jan J; Clapp, Brian; Redwood, Simon R; Marber, Michael S; Chambers, John B; Perera, Divaka

    2016-08-16

    Severe aortic stenosis (AS) can manifest as exertional angina even in the presence of unobstructed coronary arteries. The authors describe coronary physiological changes during exercise and hyperemia in the healthy heart and in patients with severe AS. Simultaneous intracoronary pressure and flow velocity recordings were made in unobstructed coronary arteries of 22 patients with severe AS (mean effective orifice area 0.7 cm(2)) and 38 controls, at rest, during supine bicycle exercise, and during hyperemia. Stress echocardiography was performed to estimate myocardial work. Wave intensity analysis was used to quantify waves that accelerate and decelerate coronary blood flow (CBF). Despite a greater myocardial workload in AS patients compared with controls at rest (12,721 vs. 9,707 mm Hg/min(-1); p = 0.003) and during exercise (27,467 vs. 20,841 mm Hg/min(-1); p = 0.02), CBF was similar in both groups. Hyperemic CBF was less in AS compared with controls (2,170 vs. 2,716 cm/min(-1); p = 0.05). Diastolic time fraction was greater in AS compared with controls, but minimum microvascular resistance was similar. With exercise and hyperemia, efficiency of perfusion improved in the healthy heart, demonstrated by an increase in the relative contribution of accelerating waves. By contrast, in AS, perfusion efficiency decreased due to augmentation of early systolic deceleration and an attenuated rise in systolic acceleration waves. Invasive coronary physiological evaluation can be safely performed during exercise and hyperemia in patients with severe aortic stenosis. Ischemia in AS is not related to microvascular disease; rather, it is driven by abnormal cardiac-coronary coupling. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010

    OpenAIRE

    arsin, A. Arsunan

    2011-01-01

    Dipresentasikan pada kegiatan " The 43rd APACPH Conference" di Graduate School of Public Health, Yonsei University, Korea. pada tanggal 20-22 Oktober 2011 RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010 A. Arsunan Arsin, Wiwik, Ridwan Amiruddin Hasanuddin University, Indonesia Coronary heart disease is the first cause of death in the world and the fifth cause of death in all hospitals in Indonesi...

  5. Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation.

    Science.gov (United States)

    Logue, Jennifer; Murray, Heather M; Welsh, Paul; Shepherd, James; Packard, Chris; Macfarlane, Peter; Cobbe, Stuart; Ford, Ian; Sattar, Naveed

    2011-04-01

    The effect of body mass index (BMI) on coronary heart disease (CHD) risk is attenuated when mediators of this risk (such as diabetes, hypertension and hyperlipidaemia) are accounted for. However, there is now evidence of a differential effect of risk factors on fatal and non-fatal CHD events, with markers of inflammation more strongly associated with fatal than non-fatal events. To describe the association with BMI separately for both fatal and non-fatal CHD risk after accounting for classical risk factors and to assess any independent effects of obesity on CHD risk. In the West of Scotland Coronary Prevention Study BMI in 6082 men (mean age 55 years) with hypercholesterolaemia, but no history of diabetes or CVD, was related to the risk of fatal and non-fatal CHD events. After excluding participants with any event in the first 2 years, 1027 non-fatal and 214 fatal CHD events occurred during 14.7 years of follow-up. A minimally adjusted model (age, sex, statin treatment) and a maximally adjusted model (including known CVD risk factors and deprivation) were compared, with BMI 25-27.4 kg/m² as referent. The risk of non-fatal events was similar across all BMI categories in both models. The risk of fatal CHD events was increased in men with BMI 30.0-39.9 kg/m² in both the minimally adjusted model (HR = 1.75 (95% CI 1.12 to 2.74)) and the maximally adjusted model (HR = 1.60 (95% CI 1.02 to 2.53)). These hypothesis generating data suggest that obesity is associated with fatal, but not non-fatal, CHD after accounting for known cardiovascular risk factors and deprivation. Clinical trial registration WOSCOPS was carried out and completed before the requirement for clinical trial registration.

  6. Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Ph Gabriel Steg

    Full Text Available BACKGROUND: Heart rate (HR is an emerging risk factor in coronary artery disease (CAD. However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta-blockers, among patients with stable CAD in routine clinical practice. The goal of the present analysis was to describe HR in such patients, overall and in relation to beta-blocker use, and to describe the determinants of HR. METHODS AND FINDINGS: CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis of >50%, or chest pain associated with proven myocardial ischemia. A total of 33,438 patients from 45 countries in Europe, the Americas, Africa, Middle East, and Asia/Pacific were enrolled between November 2009 and July 2010. Most of the 33,177 patients included in this analysis were men (77.5%. Mean (SD age was 64.2 (10.5 years, HR by pulse was 68.3 (10.6 bpm, and by electrocardiogram was 67.2 (11.4 bpm. Overall, 44.0% had HR ≥ 70 bpm. Beta-blockers were used in 75.1% of patients and another 14.4% had intolerance or contraindications to beta-blocker therapy. Among 24,910 patients on beta-blockers, 41.1% had HR ≥ 70 bpm. HR ≥ 70 bpm was independently associated with higher prevalence and severity of angina, more frequent evidence of myocardial ischemia, and lack of use of HR-lowering agents. CONCLUSIONS: Despite a high rate of use of beta-blockers, stable CAD patients often have resting HR ≥ 70 bpm, which was associated with an overall worse health status, more frequent angina and ischemia. Further HR lowering is possible in many patients with CAD. Whether it will improve symptoms and outcomes is being tested.

  7. Relationship between coping ways with stress and levels of IL-1β and cortisol in coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Alireza Agha Yousefi

    2012-08-01

    Full Text Available Background and Aim: Coping ways with stress in coronary heart disease patients can lead to significant changes in the levels of biomarkers IL- 1 β and cortisol. Thus, the aim of the present study was to examine the relationship between coping ways with stress and level of IL- 1 β and cortisol in coronary heart disease patients.   Materials and Methods: The statistical population covered all patients with CHD who referred to Tehran Shahid Rajaie Heart Hospital. 44 patients with CHD admitted to different wards of the hospital were selected as eligible cases.In the present, Lazarus and Folkman questionnaires and Human IL- 1 β kits manufactured by Austrian Bender Med System Manufacturing Co and cortisol kits ( made by IBL Manufacturing Co., Germany,employing ELISA method of measurement ,were used.   Results: It was found that there was a significant positive correlation between emotional focused coping ways with biomarkers IL - 1 β and cortisol .But, a significant negative correlation was observed between problem focused coping ways and biomarkers IL-1 β and cortisol .Moreover, between 8 ways of coping with stress only predictive positive re-evaluation had a significant relationship with IL-1 β and Cortisol.   Conclusion: An increase in the use of problem focused coping ways including positive re-evaluation way can reduce levels of IL- 1 β and cortisol.

  8. Perceived job insecurity as a risk factor for incident coronary heart disease

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Nyberg, Solja T; Batty, George David

    2013-01-01

    OBJECTIVE: To determine the association between self reported job insecurity and incident coronary heart disease. DESIGN: A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. DATA SOURCES: We obtained individual....... REVIEW METHODS: Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models...... versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (

  9. Smoking and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults

    DEFF Research Database (Denmark)

    Tolstrup, Janne S; Hvidtfeldt, Ulla Arthur; Flachs, Esben Meulengracht

    2014-01-01

    Objectives. We investigated associations of smoking and coronary heart disease (CHD) by age. Methods. Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192 067 women and 74 720 men, aged 40-89 years). Results. During follow-up, 4326 cases...... years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81......% (50-59 years), 71% for (60-69 years), and 68% (70+ years) among women who smoked. Conclusions. Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age. (Am J Public Health. Published online ahead of print June 13...

  10. Long working hours and risk of coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    , Economic and Social Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working......BACKGROUND: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. METHODS: We...... identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative...

  11. Coronary heart disease in women: a challenge for the 21st century

    Directory of Open Access Journals (Sweden)

    Maria Cecília Solimene

    2010-01-01

    Full Text Available Heart disease is the first killer of women in the modern era, regardless of age, race and of ethnicity, although its prevalence rises after menopause. Modern women have professional and housewife responsibilities, consume excess of fat and carbohydrates, smoke, do not exercise regularly and do not have enough time to rest. This situation leads to overweight, dyslipidemia, arterial hypertension, impaired glucose tolerance and diabetes. Women do not often participate in preventive studies and still undergo less intensive and invasive evaluation and treatment for chest pain when compared to men. However, the rate of coronary death is twice higher in women than in men after myocardial infarction and revascularization procedures. The objective of this review is to analyze the main gender differences regarding symptoms, diagnosis, management and prognosis of coronary heart disease and to discuss the influence of hormonal replacement therapy in the prevention of cardiovascular disease in postmenopausal women.

  12. Determination of serum insulinlike growth factor II levels in coronary heart disease patient and its significance

    International Nuclear Information System (INIS)

    Fan Bifu; Ji Naijun; Mei Yibin; Wang Chengyao; Zhao Junfei; Guan Lihua; Gao Meiying; Li Jiangao

    2002-01-01

    Objective: To explore the changes and clinical significance of serum insulinlike growth factor II (IGF II) levels in coronary heart disease (CHD) patients. Methods: The serum IGF II levels were determined by radioimmunoassay in 68 patients with coronary heart disease (CHD) and 30 controls with only mild non-cardiac diseases. Results: Compared with the controls, the serum IGF II level in CHD patients were increased significantly (0.66 ± 0.13 μg/L vs 0.51 ± 0.11 μg/L; t = 5.506, p 0.05). Level in patients dies in hospital (n = 9) were much higher than those in patients recovered (n = 59) (t = 2.402, p < 0.05). Conclusion: Serum IGF II levels seems to be related to the seriousness of CHD; the actual mechanism remains to be defined

  13. Alkaline phosphatase levels in patients with coronary heart disease saliva and its relation with periodontal status

    Science.gov (United States)

    Yunita, Dina Suci; Masulili, Sri Lelyati C.; Tadjoedin, Fatimah M.; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is a disease that causes narrowing of the coronary arteries. Currently, there is a hypothesis regarding periodontal infection that increases risk for heart disease. Alkaline phosphatase (ALP) as a marker of inflammation will increase in atherosclerosis and periodontal disease. The objective of this research is analyzing the relationship between the levels of alkaline phosphatase in saliva with periodontal status in patients with CHD and non CHD. Here, saliva of 104 subjects were taken, each 1 ml, and levels of Alkaline Phosphatase was analyzed using Abbott ci4100 architect. We found that no significant difference of Alkaline Phosphatase levels in saliva between CHD patients and non CHD. Therefore, it can be concluded that Alkaline Phosphatase levels in patients with CHD saliva was higher than non CHD and no association between ALP levels with periodontal status.

  14. Mental Health and Stressful Life Events in Coronary Heart Disease Patients and Non- Patients

    Directory of Open Access Journals (Sweden)

    Samaneh Nateghian

    2008-07-01

    Full Text Available "nObjective: "n The main goal of this study is to compare stressful life events and mental health in coronary heart disease (CHD patients and non-patients. "nMethod: In this research, 120 participants (n=68 male, n= 52 female were divided into two groups of patients (n=60 and non-patients (n=60. They were selected from Vali Asr Hospital of Meshginshahr (Iran and completed the  General Health Questionnaire (GHQ and Stressful Life Events Inventory . "nResults: Data was analyzed using independent t-test. The results showed significant differences between CHD patients and non-patients in mental health and stressful life events. CHD patients showed high rates of physical symptoms and anxiety of GHQ . "nConclusion: CHD patients reported more stressful life events. Therefore, it can be inferred that psychological factors are important in coronary heart disease.

  15. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease.

    Science.gov (United States)

    Langrish, Jeremy P; Li, Xi; Wang, Shengfeng; Lee, Matthew M Y; Barnes, Gareth D; Miller, Mark R; Cassee, Flemming R; Boon, Nicholas A; Donaldson, Ken; Li, Jing; Li, Liming; Mills, Nicholas L; Newby, David E; Jiang, Lixin

    2012-03-01

    Air pollution exposure increases cardiovascular morbidity and mortality and is a major global public health concern. We investigated the benefits of reducing personal exposure to urban air pollution in patients with coronary heart disease. In an open randomized crossover trial, 98 patients with coronary heart disease walked on a predefined route in central Beijing, China, under different conditions: once while using a highly efficient face mask, and once while not using the mask. Symptoms, exercise, personal air pollution exposure, blood pressure, heart rate, and 12-lead electrocardiography were monitored throughout the 24-hr study period. Ambient air pollutants were dominated by fine and ultrafine particulate matter (PM) that was present at high levels [74 μg/m³ for PM(2.5) (PM with aerodynamic diamater reduced maximal ST segment depression (-142 vs. -156 μV, p = 0.046) over the 24-hr period. When the face mask was used during the prescribed walk, mean arterial pressure was lower (93 ± 10 vs. 96 ± 10 mmHg, p = 0.025) and heart rate variability increased (high-frequency power: 54 vs. 40 msec², p = 0.005; high-frequency normalized power: 23.5 vs. 20.5 msec, p = 0.001; root mean square successive differences: 16.7 vs. 14.8 msec, p = 0.007). However, mask use did not appear to influence heart rate or energy expenditure. Reducing personal exposure to air pollution using a highly efficient face mask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to PM air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population.

  16. Comparison of efficacy and safety of atorvastatin (80 mg) to simvastatin (20 to 40 mg) in patients aged <65 versus >or=65 years with coronary heart disease (from the Incremental DEcrease through Aggressive Lipid Lowering [IDEAL] study)

    DEFF Research Database (Denmark)

    Tikkanen, Matti J; Holme, Ingar; Cater, Nilo B

    2009-01-01

    -label study. Several cardiovascular end points were evaluated, including the occurrence of a first major coronary event (MCE; nonfatal myocardial infarction, coronary heart disease death, or resuscitated cardiac arrest), the primary end point of the trial, and occurrence of any cardiovascular event (MCE......, stroke, revascularization, unstable angina, congestive heart failure, and peripheral artery disease). Although there were no significant interactions between age and treatment, the magnitude of effect in favor of atorvastatin was higher in younger versus older patients (occurrence of first MCE, hazard...... in primary and secondary end points were observed only in patients 65 years with stable coronary disease....

  17. Correlation between the GP78 Gene Polymorphism and Coronary Atherosclerotic Heart Disease

    Directory of Open Access Journals (Sweden)

    Long Wang

    2018-01-01

    Full Text Available Objective: To study the correlation between the GP78 gene polymorphism and blood fat, blood glucose, blood pressure and coronary atherosclerotic heart disease. Methods: A total of 72 patients with coronary atherosclerotic heart disease were selected as the observation group, and 68 healthy participants were selected as the control group. The gp78 gene polymorphism of both groups was studied via polymerase chain reaction-restriction fragment length polymorphism (RFLP. At the same time, the multiple expression quantities of the GP78 gene in the tissues of both groups were tested via fluorogenic quantitative PCR, enzyme-linked immunosorbent assay (ELISA and Western-blotting assay. Furthermore, the blood fat, blood glucose and blood pressure of subjects in both groups were tested. Results: The percentages of the gp78 gene polymorphisms of Arg/Arg, Arg/Gly and Gly/Gly at the 145 locus of the study subjects in the observation group were 12.3%, 43.2% and 44.5%, respectively, while those in the control group were 74.3%, 11.2% and 14.5%, respectively, and there were significant differences between both groups. Based on the test results of the blood fat, blood glucose and blood pressure of the objects in the observation group and control group, significant differences were found between the two groups (P<0.05. Conclusion: There was a significant correlation between the 145 locus of the gp89 gene and coronary atherosclerotic heart disease, indexes of blood fat, blood glucose and blood pressure. Keywords: blood fat, blood glucose, blood pressure, coronary sclerosis, heart disease

  18. Aldosterone Does Not Predict Cardiovascular Events Following Acute Coronary Syndrome in Patients Initially Without Heart Failure.

    Science.gov (United States)

    Pitts, Reynaria; Gunzburger, Elise; Ballantyne, Christie M; Barter, Philip J; Kallend, David; Leiter, Lawrence A; Leitersdorf, Eran; Nicholls, Stephen J; Shah, Prediman K; Tardif, Jean-Claude; Olsson, Anders G; McMurray, John J V; Kittelson, John; Schwartz, Gregory G

    2017-01-10

    Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome. Patients with New York Heart Association class II (with LVEF coronary heart disease death, nonfatal myocardial infarction, stroke, hospitalization for unstable angina, or resuscitated cardiac arrest. Hospitalization for HF was a secondary endpoint. Over a median follow-up of 37 months, the primary outcome occurred in 366 patients (9.0%), and hospitalization for HF occurred in 72 patients (1.8%). There was no association between aldosterone and either the time to first occurrence of a primary outcome (hazard ratio for doubling of aldosterone 0.92, 95% confidence interval 0.78-1.09, P=0.34) or hospitalization for HF (hazard ratio 1.38, 95% CI 0.96-1.99, P=0.08) in Cox regression models adjusted for covariates. In patients with recent acute coronary syndrome but without advanced HF, aldosterone does not predict major cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00658515. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Physical activity in patients with stable coronary heart disease: an international perspective

    OpenAIRE

    Stewart, Ralph; Held, Claes; Brown, Rebekkah; Vedin, Ola; Hagstrom, Emil; Lonn, Eva; Armstrong, Paul; Granger, Christopher B.; Hochman, Judith; Davies, Richard; Soffer, Joseph; Wallentin, Lars; White, Harvey

    2013-01-01

    Aims Despite the known benefits of regular exercise, the reasons why many coronary heart disease (CHD) patients engage in little physical activity are not well understood. This study identifies factors associated with low activity levels in individuals with chronic CHD participating in the STABILITY study, a global clinical outcomes trial evaluating the lipoprotein phospholipaseA2 inhibitor darapladib. Methods and results Prior to randomization, 15 486 (97.8%) participants from 39 countries c...

  20. Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI

    Energy Technology Data Exchange (ETDEWEB)

    Manzke, Robert [University Hospital of Ulm, Department of Internal Medicine II, Ulm (Germany); Philips Research Europe, Clinical Sites Research, Hamburg (Germany); Binner, Ludwig; Bornstedt, Axel; Merkle, Nico; Lutz, Anja; Gradinger, Robert [University Hospital of Ulm, Department of Internal Medicine II, Ulm (Germany); Rasche, Volker [University Hospital of Ulm, Department of Internal Medicine II, Ulm (Germany); Experimental Cardiovascular Imaging, Internal Medicine II, Ulm (Germany)

    2011-04-15

    To investigate the feasibility of MRI for non-invasive assessment of the coronary sinus (CS) and the number and course of its major tributaries in heart failure patients. Fourteen non-ischaemic heart failure patients scheduled for cardiac resynchronisation therapy (CRT) underwent additional whole-heart coronary venography. MRI was performed 1 day before device implantation. The visibility, location and dimensions of the CS and its major tributaries were assessed and the number of potential implantation sites identified. The MRI results were validated by X-ray venography conventionally acquired during the device implantation procedure. The right atrium (RA), CS and mid-cardiac vein (MCV) could be visualised in all patients. 36% of the identified candidate branches were located posterolaterally, 48% laterally and 16% anterolaterally. The average diameter of the CS was quantified as 9.8 mm, the posterior interventricular vein (PIV) 4.6 mm, posterolateral segments 3.3 mm, lateral 2.9 mm and anterolateral 2.9 mm. Concordance with X-ray in terms of number and location of candidate branches was given in most cases. Contrast-enhanced MRI venography appears feasible for non-invasive pre-interventional assessment of the course of the CS and its major tributaries. (orig.)

  1. Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI

    International Nuclear Information System (INIS)

    Manzke, Robert; Binner, Ludwig; Bornstedt, Axel; Merkle, Nico; Lutz, Anja; Gradinger, Robert; Rasche, Volker

    2011-01-01

    To investigate the feasibility of MRI for non-invasive assessment of the coronary sinus (CS) and the number and course of its major tributaries in heart failure patients. Fourteen non-ischaemic heart failure patients scheduled for cardiac resynchronisation therapy (CRT) underwent additional whole-heart coronary venography. MRI was performed 1 day before device implantation. The visibility, location and dimensions of the CS and its major tributaries were assessed and the number of potential implantation sites identified. The MRI results were validated by X-ray venography conventionally acquired during the device implantation procedure. The right atrium (RA), CS and mid-cardiac vein (MCV) could be visualised in all patients. 36% of the identified candidate branches were located posterolaterally, 48% laterally and 16% anterolaterally. The average diameter of the CS was quantified as 9.8 mm, the posterior interventricular vein (PIV) 4.6 mm, posterolateral segments 3.3 mm, lateral 2.9 mm and anterolateral 2.9 mm. Concordance with X-ray in terms of number and location of candidate branches was given in most cases. Contrast-enhanced MRI venography appears feasible for non-invasive pre-interventional assessment of the course of the CS and its major tributaries. (orig.)

  2. Diagnostic accuracy of dual-source CT coronary angiography in a population unselected for degree of coronary artery calcification and without heart rate modification

    International Nuclear Information System (INIS)

    Lin, C.-J.; Hsu, J.-C.; Lai, Y.-J.; Wang, K.-L.; Lee, J.-Y.; Li, A.-H.; Chu, S.-H.

    2010-01-01

    Aim: To assess the ability of coronary angiography performed using dual-source computed tomography (DSCT) to evaluate coronary artery disease (CAD) in a population with unselected heart rates and extensive coronary calcification. Materials and methods: Forty-four patients at intermediate to high risk for CAD underwent both DSCT coronary angiography and invasive coronary angiography (ICA) within 30 days. No beta blockers were administered prior to imaging. Image quality and quantitatively stenosis of all coronary segments with a diameter ≥1.5 mm were accessed. Patients were stratified according to mean heart rate (<70 versus ≥70 bpm) and heart rate variability (<10 versus ≥10 bpm). DSCT detection of coronary stenosis by segment, vessel, and patient characteristics were compared to the reference standard of ICA. Results: Diagnostic accuracy for all patients was high regarding sensitivity (97%), positive predictive value (PPV, 84.2%), and negative predictive value (NPV, 83.3%) but low regarding specificity (45.5%) with a moderate interobserver agreement (Kappa = 0.50). The accuracy for vessel-based diagnosis was high regarding sensitivity (96.6%), specificity (80.8%), PPV (80.3%), and NPV (96.7%). The segment-based diagnostic results revealed a moderate interobserver agreement for image quality and sensitivity, specificity, PPV and NPV for all segments of 66.9, 97.8, 90.8, and 89.9%, respectively. Conclusion: DSCT coronary angiography has high diagnostic accuracy in assessing CAD among patients at intermediate to high risk without using heart rate-modulating premedication. DSCT is not superior to ICA for diagnosis of calcified segments.

  3. EFFECT OF POSITIONING ON BLEEDING COMPLICATION AND LOW BACK PAIN AFTER DIAGNOSTIC CORONARY ANGIOGRAPHY IN PATIENTS WITH CORONARY HEART DISEASE IN AN INTEGRATED HEART CARE CENTER IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Theresia Febriana Christi Tyas Utami

    2018-05-01

    Full Text Available Background: Coronary angiography can cause complications of arterial and subcutaneous bleeding (hematoma and back pain. Changing the position of the patient (positioning in bed can reduce the pain post-diagnostic catheterization complications. Objective: This study was to examine the effect of positioning on bleeding complication and low back pain after diagnostic coronary angiography in patients with coronary heart disease patient in the Integrated Heart Care Center in Indonesia. Methods: This study was a true-experimental study with randomized posttest-only control group design. Thirty respondents were randomly selected using simple random sampling, which 15 respondents were randomly assigned in the experiment group and control group. The experiment group was given a positioning with 150, 300, 450 head-of-bed elevation in left and right lateral position. An arc tool was used to measure the height of head of bed elevation, a measuring cup to measure arterial bleeding using, a perforated transparent plastic with 5 cm diameter to measure subcutaneous bleeding (hematoma, and Numeric Pain Rating Scale to measure low back pain. Data were analyzed using Kolmogorov- Smirnov and Repeated Measured ANOVA. Results: Findings showed that positioning had no effect on arterial hemorrhage (ρ=1.000 and subcutaneous bleeding (hematoma (ρ=0.999. Repeated ANOVA test results revealed that positioning had a significant effect on low back pain (ρ=0.017. Conclusion: There was no significant effect of positioning on the occurrence of arterial and subcutaneous bleeding (hematoma, but there was a significant effect in reducing low back pain.

  4. [The role of epicardial fat and obesity parameters in the prediction of coronary heart disease].

    Science.gov (United States)

    Prídavková, Dana; Kantárová, Daniela; Lišková, Renáta; Červeň, Peter; Kovář, František; Mokáň, Marián

    2016-04-01

    To assess the relationship of parameters of obesity in relationship to coronary angiography findings with correlation of epicardial fat (EF) thickness in uppermentioned context. There were 80 patients examined (43 males, 37 postmenopausal females) undergoing elective coronary angiography. We examined the regular obesity parameters - BMI, waist circumference (WC), neck circumference (NC), total body fat (TBF), and visceral fat (VF) using bioimpedance. We assessed the echocardiographically measured EF thickness. We added examination of lipidogram, glycaemia, HOMA-IR (insulin resistance index) and AIP (aterogenic index of plasma). The set was divided into group with coronarographically proved stenosis or stenoses (withCS), and a group without finding of quantifiable stenosis or stenoses (withoutCS). The average thickness of EF in withCS group was 6.3 vs 5.6 mm in group withoutCS (p obesity parameters in assessment of pre-clinical stages of coronary atherosclerosis and prediction of risk of coronary heart disease. In adipose parameters, EF thickness was correlated the most by WC. Risk stratification of coronary artery disease is supplemented by increased HOMA-IR and AIP.

  5. NMR-based lipidomic analysis of blood lipoproteins differentiates the progression of coronary heart disease.

    Science.gov (United States)

    Kostara, Christina E; Papathanasiou, Athanasios; Psychogios, Nikolaos; Cung, Manh Thong; Elisaf, Moses S; Goudevenos, John; Bairaktari, Eleni T

    2014-05-02

    Abnormal lipid composition and metabolism of plasma lipoproteins play a crucial role in the pathogenesis of coronary heart disease (CHD). A (1)H NMR-based lipidomic approach was used to investigate the correlation of coronary artery stenosis with the atherogenic (non-HDL) and atheroprotective (HDL) lipid profiles in 99 patients with CHD of various stages of disease and compared with 60 patients with normal coronary arteries (NCA), all documented in coronary angiography. The pattern recognition models created from lipid profiles predicted the presence of CHD with a sensitivity of 87% and a specificity of 88% in the HDL model and with 90% and 89% in the non-HDL model, respectively. Patients with mild, moderate, and severe coronary artery stenosis were progressively differentiated from those with NCA in the non-HDL model with a statistically significant separation of severe stage from both mild and moderate. In the HDL model, the progressive differentiation of the disease stages was statistically significant only between patients with mild and severe coronary artery stenosis. The lipid constituents of lipoproteins that mainly characterized the initial stages and then the progression of the disease were the high levels of saturated fatty acids in lipids in both HDL and non-HDL particles, the low levels of HDL-phosphatidylcholine, HDL-sphingomyelin, and omega-3 fatty acids and linoleic acid in lipids in non-HDL particles. The conventional lipid marker, total cholesterol, found in low levels in HDL and in high levels in non-HDL, also contributed to the onset of the disease but with a much lower coefficient of significance. (1)H NMR-based lipidomic analysis of atherogenic and atheroprotective lipoproteins could contribute to the early evaluation of the onset of coronary artery disease and possibly to the establishment of an appropriate therapeutic option.

  6. C Reactive protein levels as a marker of coronary heart disease in middle aged individuals

    International Nuclear Information System (INIS)

    Haleem, N.; Marwat, Z.I.; Abbasi, S.; Tauqeer, S.

    2016-01-01

    Background: coronary heart disease is multifactorial inflammatory process which involves the accumulation of lipid macrophages and intimal plaques in smooth muscle cell in large and medium sized arteries. C reactive protein (CRP) which is an inflammatory marker is considered as global risk assessment for coronary heart disease. The objective of study is to determine the CRP level as risk marker in coronary heart disease in middle aged individuals. Methods: This cross sectional study was conducted in Hayatabad medical complex Peshawar and Rehman Medical Institute Peshawar. On the basis of predesigned questionnaire, 100 middle aged individuals of age 40-60 years and 50 normal subjects of same age were questioned by taking consent. Data was collected and analysed by SPSS-15. Results: It was founded that 74 percentage of patients have higher values of CRP and 4 percentage have high values of CRP in controls. The t-test applied at 95 percentage confidence interval with mean difference of 22.096+2.36 of CHD individuals and 1.288±1.70 of control group. P-value was 0.001 which is found to be significant. Conclusion: It was observed that CRP has higher association with CHD. (author)

  7. Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

    2012-10-01

    Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if self-reported early menopause (menopause at an age menopause (either natural menopause or surgical removal of ovaries at an age menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank P = 0.008 and P = 0.0158). In models adjusted for age, race/ethnicity, Multi-ethnic Study Atherosclerosis site, and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (hazard ratio, 2.08; 95% CI, 1.17-3.70; and hazard ratio, 2.19; 95% CI, 1.11-4.32, respectively). Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors.

  8. Management and outcomes following an acute coronary event in patients with chronic heart failure 1999-2007.

    Science.gov (United States)

    Ranasinghe, Isuru; Naoum, Chris; Aliprandi-Costa, Bernadette; Sindone, Andrew P; Steg, P Gabriel; Elliott, John; McGarity, Bruce; Lefkovits, Jeffrey; Brieger, David

    2012-05-01

    The outcome of patients with chronic heart failure (CHF) following an ischaemic event is poorly understood. We evaluated the management and outcomes of CHF patients presenting with an acute coronary syndrome (ACS) and explored changes in outcomes over time. A total of 5556 patients enrolled in the Australia-New Zealand population of the Global Registry of Acute Coronary Events (GRACE) between 1999 and 2007 were included. Patients with CHF (n = 609) were compared with those without CHF (n = 4947). Patients with CHF were on average 10 years older, were more likely to be female, had more co-morbidities and cardiac risk factors, and were more likely to have a prior history of angina, myocardial infarction, and revascularization by coronary artery bypass graft (CABG) when compared with those without CHF. CHF was associated with a substantial increase in in-hospital renal failure [odds ratio (OR) 1.76, 95% confidence interval (CI) 1.15-2.71], readmission post-discharge (OR 1.47, 95% CI 1.17-1.90), and 6-month mortality (OR 2.25, 95% CI 1.55-3.27). Over the 9 year study period, in-hospital and 6 month mortality in those with CHF declined by absolute rates of 7.5% and 14%, respectively. This was temporally associated with an increase in prescription of thienopyridines, beta-blockers, statins, and angiotensin II receptor blockers, increased rates of coronary angiography, and 31.8% absolute increase in referral rates for cardiac rehabilitation. Acute coronary syndrome patients with pre-existing CHF are a very high risk group and carry a disproportionate mortality burden. Encouragingly, there was a marked temporal improvement in outcomes over a 9 year period with an increase in evidence-based treatments and secondary preventative measures.

  9. [The interdependence of coronary pain control and level of anxiety in women with ischiaemic heart disease].

    Science.gov (United States)

    Gleba, Elzbieta; Nasiłowska-Barud, Alicja; Wysokiński, Andrzej; Jedrych, Marian

    2012-01-01

    Interdependences between pain and anxiety in cardiac ischaemia are multidimensional and complex. Both of these phenomena share a lot of traits and they tend to reinforce each other at physiological level. Apart from arduousness of pain, cognitive understanding of its nature becomes an important mediating factor. One of important characteristics of the patient's attitude towards their illness is localization of pain control. The aim of the study was to analyze an interdependence between an anxiety as a state and as a trait and the localization of pain control in women with coronary heart decease. The study included 52 female patients hospitalised at The Department of Cardiology of The Medical University of Lublin who underwent coronarography. The used methods included an interview, State - Trait Anxiety Inventory of Spielberger (STAI) and The Beliefs about Pain Control Questionnaire (BPCQ). The results did not confirm an often suggested opinion that internal localization of pain control reduces anxiety and activates the patient. The intensity of the internal localization of pain control correlates significantly with the intensity of the dependence of pain of activity of the doctors as well as on the anxiety as trait. It is higher in women with lower education. Perhaps better educated patients, not so ready to react with anxiety, can treat pain more realistically as a sign of a pathological process which can be understood and evaluated not so much as a catastrophe. They do not feel personally responsible for the pain, either, and are able to accept the limits of the doctor's assistance, having no unrealistic expectations with regard to the pain treatment. The results of the research indicate that in women with ischiaemic heart decease better adjustment to the illness and a lower level of anxiety as a trait are connected with the understanding and acceptance of their situation by the patient, rather than with too big extent of expectations towards the control of pain

  10. Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study.

    Science.gov (United States)

    Cole, Judith A; Smith, Susan M; Hart, Nigel; Cupples, Margaret E

    2013-08-28

    Healthy lifestyles help to prevent coronary heart disease (CHD) but outcomes from secondary prevention interventions which support lifestyle change have been disappointing. This study is a novel, in-depth exploration of patient factors affecting lifestyle behaviour change within an intervention designed to improve secondary prevention for patients with CHD in primary care using personalised tailored support. We aimed to explore patients' perceptions of factors affecting lifestyle change within a trial of this intervention (the SPHERE Study), using semi-structured, one-to-one interviews, with patients in general practice. Interviews (45) were conducted in purposively selected general practices (15) which had participated in the SPHERE Study. Individuals, with CHD, were selected to include those who succeeded in improving physical activity levels and dietary fibre intake and those who did not. We explored motivations, barriers to lifestyle change and information utilised by patients. Data collection and analysis, using a thematic framework and the constant comparative method, were iterative, continuing until data saturation was achieved. We identified novel barriers to lifestyle change: such disincentives included strong negative influences of social networks, linked to cultural norms which encouraged consumption of 'delicious' but unhealthy food and discouraged engagement in physical activity. Findings illustrated how personalised support within an ongoing trusted patient-professional relationship was valued. Previously known barriers and facilitators relating to support, beliefs and information were confirmed. Intervention development in supporting lifestyle change in secondary prevention needs to more effectively address patients' difficulties in overcoming negative social influences and maintaining interest in living healthily.

  11. Systematic review of zinc biochemical indicators and risk of coronary heart ‎disease

    Directory of Open Access Journals (Sweden)

    Maryam Hashemian

    2015-11-01

    Full Text Available BACKGROUND: Poor zinc nutritional status is suspected as a risk factor for coronary heart disease (CHD. Since zinc absorption may be influenced by some nutritional and physiologic factors, it would be better to investigate zinc status through biochemical measurements. The objective of the present study was to review recent studies investigating the association of zinc biomarkers with CHD, systematically. METHODS: The MEDLINE database was used for relevant studies published from January 2009 to December 2013 with appropriate keywords. Articles were included in this study if they were human studies, original articles, and published in English. RESULTS: Six case-control studies and two prospective cohort studies that measured zinc biomarkers were included in the study. Almost all case-control studies suggest that decreased plasma zinc was associated with increased CHD risk. Cohort studies did not support this relationship. CONCLUSION: The majority of the evidence for this theory is extracted from case-control studies, which might have bias. Prospective studies and randomized clinical trials are needed to investigate whether poor zinc status is associated with increased CHD risk. Consequently, a protective role of zinc in CHD could not be still established. 

  12. Management of patients with coronary heart disease in family medicine: correlates of quality of care.

    Science.gov (United States)

    Tušek-Bunc, Ksenija; Petek, Davorina

    2018-04-10

    Family medicine plays an important role in quality of care (QoC) of coronary heart disease (CHD) patients. This study's aim was to determine the quality of secondary cardiovascular disease prevention in the everyday practice of family physicians. This study was observational cross-sectional. About 36 randomly selected family medicine practices stratified by size and location in Slovenia. CHD patients randomly selected from a patient register available in family medicine practices. The instrument for assessment of quality included a form for collecting data from medical records, a general practice assessment questionnaire and a patient questionnaire. QoC was defined by two composite variables, namely risk factor registration and CHD patient process of care, as the two care outcomes. In multivariate analysis, we performed multilevel regression analysis to identify the associations between QoC, the patient and the practice characteristics. The final sample included 423 CHD patients from 36 family medicine practices. Risk factor registration was associated with the practice organisation score (P = 0.004), practice size (P = 0.042), presence of comorbid atherosclerotic diseases (P = 0.043) and a lower age of CHD patients (P = 0.001). CHD patient process of care was associated with the practice organisation score (0.045) and a lower age of CHD patients (P = 0.035). The most important factors affecting the quality of CHD patient care were linked to the organisational characteristics of the family medicine practices.

  13. Particulate Air Pollution, Ambulatory Heart Rate Variability, and Cardiac Arrhythmia in Retirement Community Residents with Coronary Artery Disease

    Science.gov (United States)

    Longhurst, John; Tjoa, Thomas; Sioutas, Constantinos; Delfino, Ralph J.

    2013-01-01

    Background: Decreased heart rate variability (HRV) has been associated with future cardiac morbidity and mortality and is often used as a marker of altered cardiac autonomic balance in studies of health effects of airborne particulate matter. Fewer studies have evaluated associations between air pollutants and cardiac arrhythmia. Objectives: We examined relationships between cardiac arrhythmias, HRV, and exposures to airborne particulate matter. Methods: We measured HRV and arrhythmia with ambulatory electrocardiograms in a cohort panel study for up to 235 hr per participant among 50 nonsmokers with coronary artery disease who were ≥ 71 years of age and living in four retirement communities in the Los Angeles, California, Air Basin. Exposures included hourly outdoor gases, hourly traffic-related and secondary organic aerosol markers, and daily size-fractionated particle mass. We used repeated measures analyses, adjusting for actigraph-derived physical activity and heart rate, temperature, day of week, season, and community location. Results: Ventricular tachycardia was significantly increased in association with increases in markers of traffic-related particles, secondary organic carbon, and ozone. Few consistent associations were observed for supraventricular tachycardia. Particulates were significantly associated with decreased ambulatory HRV only in the 20 participants using ACE (angiotensin I–converting enzyme) inhibitors. Conclusions: Although these data support the hypothesis that particulate exposures may increase the risk of ventricular tachycardia for elderly people with coronary artery disease, HRV was not associated with exposure in most of our participants. These results are consistent with previous findings in this cohort for systemic inflammation, blood pressure, and ST segment depression. Citation: Bartell SM, Longhurst J, Tjoa T, Sioutas C, Delfino RJ. 2013. Particulate air pollution, ambulatory heart rate variability, and cardiac arrhythmia in

  14. Improving coronary heart disease self-management using mobile technologies (Text4Heart): a randomised controlled trial protocol.

    Science.gov (United States)

    Dale, Leila Pfaeffli; Whittaker, Robyn; Jiang, Yannan; Stewart, Ralph; Rolleston, Anna; Maddison, Ralph

    2014-03-04

    Cardiac rehabilitation (CR) is a secondary prevention program that offers education and support to assist patients with coronary heart disease (CHD) make lifestyle changes. Despite the benefits of CR, attendance at centre-based sessions remains low. Mobile technology (mHealth) has potential to reach more patients by delivering CR directly to mobile phones, thus providing an alternative to centre-based CR. The aim of this trial is to evaluate if a mHealth comprehensive CR program can improve adherence to healthy lifestyle behaviours (for example, physically active, fruit and vegetable intake, not smoking, low alcohol consumption) over and above usual CR services in New Zealand adults diagnosed with CHD. A two-arm, parallel, randomised controlled trial will be conducted at two Auckland hospitals in New Zealand. One hundred twenty participants will be randomised to receive a 24-week evidence- and theory-based personalised text message program and access to a supporting website in addition to usual CR care or usual CR care alone (control). The primary outcome is the proportion of participants adhering to healthy behaviours at 6 months, measured using a composite health behaviour score. Secondary outcomes include overall cardiovascular disease risk, body composition, illness perceptions, self-efficacy, hospital anxiety/depression and medication adherence. This study is one of the first to examine an mHealth-delivered comprehensive CR program. Strengths of the trial include quality research design and in-depth description of the intervention to aid replication. If effective, the trial has potential to augment standard CR practices and to be used as a model for other disease prevention or self-management programs. Australian New Zealand Clinical Trials Registry: ACTRN12613000901707.

  15. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan

    Directory of Open Access Journals (Sweden)

    Eman Alsaleh

    2016-07-01

    Full Text Available Abstract Background Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Methods Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71 with usual care (n = 85 was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Results Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD of frequency: 0.23 (0.87 days/week versus -.06 (0.40; duration: 15.53 (90.15 minutes/week versus −3.67 (22.60 minutes/week; intensity: 31.05 (105.98 Metabolic equivalents (METs versus 14.68 (90.40 METs. Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD of frequency: 3.15 (2.75 days/week versus 0.37 (1.83 days/week; duration: 150.90 (124.47 minutes/week versus 24.05 (195.93 minutes/week; intensity: 495.12 (413.74 METs versus14.62 (265.06 METs. Effect size was 0.36 for walking

  16. Subclinical Hyperthyroidism and the Risk of Coronary Heart Disease and Mortality

    Science.gov (United States)

    Collet, Tinh-Hai; Gussekloo, Jacobijn; Bauer, Douglas C.; den Elzen, Wendy P. J.; Cappola, Anne R.; Balmer, Philippe; Iervasi, Giorgio; Åsvold, Bjørn O.; Sgarbi, José A.; Völzke, Henry; Gencer, Bariş; Maciel, Rui M. B.; Molinaro, Sabrina; Bremner, Alexandra; Luben, Robert N.; Maisonneuve, Patrick; Cornuz, Jacques; Newman, Anne B.; Khaw, Kay-Tee; Westendorp, Rudi G. J.; Franklyn, Jayne A.; Vittinghoff, Eric; Walsh, John P.; Rodondi, Nicolas

    2013-01-01

    Background Data from prospective cohort studies regarding the association between subclinical hyperthyroidism and cardiovascular outcomes are conflicting. We aimed to assess the risks of total and coronary heart disease (CHD) mortality, CHD events, and atrial fibrillation (AF) associated with endogenous subclinical hyperthyroidism among all available large prospective cohorts. Methods Individual data on 52 674 participants were pooled from 10 cohorts. Coronary heart disease events were analyzed in 22 437 participants from 6 cohorts with available data, and incident AF was analyzed in 8711 participants from 5 cohorts. Euthyroidism was defined as thyrotropin level between 0.45 and 4.49 mIU/L and endogenous subclinical hyperthyroidism as thyrotropin level lower than 0.45 mIU/L with normal free thyroxine levels, after excluding those receiving thyroid-altering medications. Results Of 52 674 participants, 2188 (4.2%) had subclinical hyperthyroidism. During follow-up, 8527 participants died (including 1896 from CHD), 3653 of 22 437 had CHD events, and 785 of 8711 developed AF. In age-and sex-adjusted analyses, subclinical hyperthyroidism was associated with increased total mortality (hazard ratio [HR], 1.24, 95% CI, 1.06–1.46), CHD mortality (HR, 1.29; 95% CI, 1.02–1.62), CHD events (HR, 1.21; 95% CI, 0.99–1.46), and AF (HR, 1.68; 95% CI, 1.16–2.43). Risks did not differ significantly by age, sex, or preexisting cardiovascular disease and were similar after further adjustment for cardiovascular risk factors, with attributable risk of 14.5% for total mortality to 41.5% for AF in those with subclinical hyperthyroidism. Risks for CHD mortality and AF (but not other outcomes) were higher for thyrotropin level lower than 0.10 mIU/L compared with thyrotropin level between 0.10 and 0.44 mIU/L (for both, P value for trend, ≤.03). Conclusion Endogenous subclinical hyperthyroidism is associated with increased risks of total, CHD mortality, and incident AF, with highest

  17. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan.

    Science.gov (United States)

    Alsaleh, Eman; Windle, Richard; Blake, Holly

    2016-07-26

    Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71) with usual care (n = 85) was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring) and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 0.23 (0.87) days/week versus -.06 (0.40); duration: 15.53 (90.15) minutes/week versus -3.67 (22.60) minutes/week; intensity: 31.05 (105.98) Metabolic equivalents (METs) versus 14.68 (90.40) METs). Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 3.15 (2.75) days/week versus 0.37 (1.83) days/week; duration: 150.90 (124.47) minutes/week versus 24.05 (195.93) minutes/week; intensity: 495.12 (413.74) METs versus14.62 (265.06) METs). Effect size was 0.36 for walking frequency, 0.05 for walking duration, 0

  18. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  19. Association Between Lipoprotein(A) and Small Apo(A) Phenotypes and Coronary Heart Disease in Sudanese Diabetic Patients

    International Nuclear Information System (INIS)

    Ahmed, A.M.; Elabid, B.E.H.; Addalla, M.A.

    2013-01-01

    Background:Recent studies indicate an independent association of apolipoprotein(a) small phenotypes with the diabetes and the onset of coronary heart disease.Apolipoprotein(a)small phenotypes when used together with Lipoprotein(a) levels make powerful markers in assessing the actual risk of developing coronary heart disease in diabetic patients. Objectives: Evaluation of clinical and diagnostic significant of Lipoprotein(a) levels and apolipoprotein(a) small phenotypes and its relation to coronary heart disease in Sudanese diabetic patients. Setting and duration of study: Diabetic patients attending hospitals and medical centers from May 2011-December 2012, in Khartoum, Sudan. Patients and Methods: This was a case control, hospital based study done on 138 Sudanese diabetic patients attending hospitals and medical centers in Khartoum. Patients were divided into 2 groups. One group had diabetic cases with coronary heart disease and the other were diabetic patients without coronary heart disease. Controls were age and gender matched. Blood samples were collected from both groups(patients and controls) and were run for apolipoproteins, lipoproteins and apolipoprotein(a) small phenotype,low-density lipoprotein,high-density lipoprotein and trigeminal ganglia. Results: The levels of Lipoprotein(a) of patients were significantly higher than controls (p<0.05). Apolipoprotein(a)small phenotype distribution showed a significant difference when compared between patients of both groups (diabetics with and without coronary heart disease) and controls (p<0.05). Both low-density lipoprotein and high-density lipoprotein cholesterol showed significant difference in both patient groups and controls (p<0.05). Total cholesterol and triglyceride levels showed no significant difference between patients and controls. Apolipoprotein(a) small phenotypes showed significant distribution in diabetic patients when compared with coronary heart disease patients (more than one low molecular weight

  20. Morphologic expression of the left coronary artery in pigs. An approach in relation to human heart

    Directory of Open Access Journals (Sweden)

    Fabian Alejandro Gómez

    2014-04-01

    Full Text Available Introduction: In spite of its importance as an experimental model, the information on the left coronary artery in pigs is sparse. Objective: To determine the morphologic features of the left coronary artery in pigs. Methods: We evaluated 158 pig hearts. The left coronary artery was perfused with synthetic resin after their ostia had been catheterized. Diameters and courses of the vascular beds were measured with an electronic caliper (Mitutoyo(r. Results: The diameter of left coronary artery was 6.98 ± 1.56 mm and its length was 3.51±0.99 mm. It was found to end up by bifurcating itself into the anterior interventricular artery and the circumflex artery in 79% of the cases, and by trifurcating in 21% of the cases, with the presence of the diagonal artery. The anterior interventricular artery ended up at the apex in 79.7% of the cases, and the circumflex artery at the posterior aspect of the left ventricle in 64% of the case, this artery never reached the posterior interventricular sulcus. An anastomosis between the terminal branches of the anterior interventricular artery and the posterior interventricular artery was found in 7.6% of the specimens. The antero-superior branch of the anterior interventricular artery occurred in 89.9% of the hearts. A left marginal branch was observed in 87.9% of the cases with a diameter of 2.25±0.55 mm. Conclusion: Compared with humans, pigs have shorter left coronary artery trunks and branches; even the circumflex artery never reaches the posterior interventricular sulcus. Our findings are useful for the design of experimental hemodynamic and procedural models.

  1. Better prognosis in overweight/obese coronary heart disease patients with high plasma levels of leptin.

    Science.gov (United States)

    Simiti, Luminita Animarie Vida; Todor, Irina; Stoia, Mirela Anca; Goidescu, Cerasela Mihaela; Anton, Florin Petru; Farcas, Anca Daniela

    2016-01-01

    The involvement of leptin in atherosclerosis is very complex, including inflammation, the oxidative stress and thrombosis. Leptin has atherogenic and also antiatherogenic actions. In obesity elevated leptin levels are not sufficient to prevent disturbances of energy balance, suggesting that obese people are leptin resistant. The aim of the study was to investigate the relationship between baseline plasma levels of leptin and the incidence of new ischemic events in patients with CHD. Plasma levels of leptin in fifty nine consecutive patients (29 men and 30 women) with CHD hospitalized in the County Emergency Clinical Hospital of Cluj-Napoca were measured using commercially available ELISA at admission. Patients with active infectious disease, neoplasia, acute coronary syndrome, stroke, hepatic or renal failure and severe heart failure were excluded The relationship between leptin levels and incident cardiovascular events (angina, nonfatal myocardial infarction or heart failure) over two years follow-up was studied using MEDCALC version 9.6. 73.6% patients with CHD were overweight or suffered of obesity. There were no significant differences between women and men regarding the plasma levels of leptin, the body mass index (BMI), the number of rehospitalizations, rehospitalizations/patient, diabetes mellitus, hypertension or dyslipidemia. Only in women plasma levels of leptin are correlated with BMI. As compared with men with overweight and obesity (BMI≥25kg/m(2)), plasma levels of leptin were significantly higher in women with overweight and obesity (3905.97±463.91 pg/ml vs 1835.17±533.9 pg/ml) (p2000 pg/ml and BMI >28kg/m(2) had a better prognosis, suggesting a protective role of leptin in overweight/mild obesity.

  2. Heparin monotherapy or bivalirudin during percutaneous coronary intervention in patients with non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease: results from the Evaluation of Drug-Eluting Stents and Ischemic Events registry.

    Science.gov (United States)

    Bangalore, Sripal; Pencina, Michael J; Kleiman, Neal S; Cohen, David J

    2014-06-01

    The use of bivalirudin versus unfractionated heparin monotherapy in patients without ST-segment-elevation myocardial infarction is not well defined. The study population consisted of patients enrolled in the Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) registry with either non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease, who underwent percutaneous coronary intervention with either unfractionated heparin or bivalirudin monotherapy. Propensity score matching was used to adjust for baseline characteristics. The primary bleeding (in-hospital composite bleeding-access site bleeding, thrombolysis in myocardial infarction major/minor bleeding, or transfusion) and primary (in-hospital death/myocardial infarction) and secondary ischemic outcomes (death/myocardial infarction/unplanned repeat revascularization at 12 months) were evaluated. Propensity score matching yielded 1036 patients with non-ST-segment-elevation acute coronary syndromes and 2062 patients with stable ischemic heart disease. For the non-ST-segment-elevation acute coronary syndrome cohort, bivalirudin use was associated with lower bleeding (difference, -3.3% [-0.8% to -5.8%]; P=0.01; number need to treat=30) without increase in either primary (difference, 1.2% [4.1% to -1.8%]; P=0.45) or secondary ischemic outcomes, including stent thrombosis (difference, 0.0% [1.3% to -1.3%]; P=1.00). Similarly, in the stable ischemic heart disease cohort, bivalirudin use was associated with lower bleeding (difference, -1.8% [-0.4% to -3.3%]; P=0.01; number need to treat=53) without increase in either primary (difference, 0.4% [2.3% to -1.5%]; P=0.70) or secondary ischemic outcomes, including stent thrombosis (difference, 0.0% [0.7% to -0.7%]; P=1.00) when compared with unfractionated heparin monotherapy. Among patients with non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease undergoing percutaneous coronary intervention, bivalirudin use

  3. Predictors of exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure

    DEFF Research Database (Denmark)

    Uddin, Jamal; Zwisler, Ann-Dorthe; Lewinter, Christian

    2016-01-01

    .76-1.41) standard deviation units higher, and in trials reporting maximum oxygen uptake (VO2max) was 3.3 ml/kg.min(-1) (95% CI: 2.6-4.0) higher. There was evidence of a high level of statistical heterogeneity across trials (I(2) statistic > 50%). In multivariable meta-regression analysis, only exercise intervention......BACKGROUND: The aim of this study was to undertake a comprehensive assessment of the patient, intervention and trial-level factors that may predict exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure. DESIGN: Meta-analysis and meta-regression...... analysis. METHODS: Randomized controlled trials of exercise-based rehabilitation were identified from three published systematic reviews. Exercise capacity was pooled across trials using random effects meta-analysis, and meta-regression used to examine the association between exercise capacity and a range...

  4. Radiation doses to Norwegian heart-transplanted patients undergoing annual coronary angiography

    International Nuclear Information System (INIS)

    Seierstad, T.; Friberg, E. G.; Lervag, C.; Widmark, A.; Wilhelmsen, N.; Stranden, E.

    2012-01-01

    Heart-transplanted patients in Norway undergo annual coronary angiography (CA). The aims of this study were to establish a conversion factor between dose-area product and effective dose for these examinations and to use this to evaluate the accumulated radiation dose and risks associated with annual CA. An experienced cardiac interventionist performed a simulated examination on an Alderson phantom loaded with thermoluminescence dosemeters. The simulated CA examination yielded a dose-area product of 17 Gy cm 2 and an effective dose of 3.4 mSv: the conversion factor between dose-area product and effective dose was 0.20 mSv Gy cm -2 . Dose-area product values from 200 heart-transplanted patients that had undergone 906 CA examinations between 2001 and 2008 were retrieved from the institutional database. Mean dose-area product from annual CA was 25 Gy cm 2 , ranging from 2 to 140 Gy cm 2 . Mean number of CA procedure was 8 (range, 1-23). Mean accumulated effective dose for Norwegian heart-transplanted patients between 2001 and 2008 was 34 mSv (range, 5-113 mSv). Doses and radiation risks for heart-transplanted patients are generally low, because most heart transplantations are performed on middle-aged patients with limited life expectancy. Special concern should however be taken to reduce doses for young heart-transplanted patients who are committed to lifelong follow-up of their transplanted heart. (authors)

  5. Positive affect and survival in patients with stable coronary heart disease: findings from the Heart and Soul Study.

    Science.gov (United States)

    Hoen, Petra W; Denollet, Johan; de Jonge, Peter; Whooley, Mary A

    2013-07-01

    Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might explain this association. The Heart and Soul Study is a prospective cohort study of 1,018 outpatients with stable coronary heart disease. Participants were recruited between September 11, 2000, and December 20, 2002, and were followed up to June 2011. Baseline positive affect was assessed by using the 10-item positive affect subscale of the Positive and Negative Affect Schedule. Cox proportional hazards regression was used to estimate the risk of mortality (primary outcome measure) and cardiovascular events (heart failure, myocardial infarction, stroke, transient ischemic attack) associated with positive affect, adjusting for baseline cardiac disease severity and depression. We also evaluated the extent to which these associations were explained by potential biological and behavioral mediators. A total of 369 patients (36%) died during a mean ± SD follow-up period of 7.1 ± 2.5 years. Positive affect was not significantly associated with cardiovascular events (hazard ratio [HR]: 0.89; 95% CI, 0.79-1.00; P = .06). However, each standard deviation (8.8-point) increase in positive affect score was associated with a 16% decreased risk of all-cause mortality (HR: 0.84; 95% CI, 0.76-0.92; P = .001). After adjustment for cardiac disease severity and depressive symptoms, positive affect remained significantly associated with improved survival (HR: 0.87; 95% CI, 0.78-0.97; P = .01). The association was no longer significant after adjustment for behavioral factors, and particularly physical activity (HR: 0.92; 95% CI, 0.82-1.03; P = .16). Further adjustment for C-reactive protein and omega-3 fatty acids did not result in any meaningful changes (HR: 0.94; 95% CI, 0.84-1.06; P = .31). In this

  6. Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

    Directory of Open Access Journals (Sweden)

    Kono Y

    2014-08-01

    Full Text Available Yasushi Kono,1 Shota Fukuda,1 Akihisa Hanatani,2 Koki Nakanishi,2 Kenichiro Otsuka,2 Haruyuki Taguchi,1 Kenei Shimada2 1Department of Medicine, Osaka Ekisaikai Hospital, Osaka, Japan; 2Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, Osaka, Japan Background: Remote ischemic conditioning (RIC is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF with reduced left ventricular ejection fraction. Coronary flow reserve (CFR is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE. This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE. Methods: Ten patients with HF with left ventricular ejection fraction of less than 40%, and ten healthy volunteers were enrolled in this study. RIC treatment was performed twice a day for 1 week. Our custom-made RIC device was programmed to automatically conduct 4 cycles of 5 minutes inflation and 5 minutes deflation of a blood pressure cuff to create intermittent arm ischemia. CFR measurements and laboratory tests were examined before, and after 1 week of RIC treatment. Results: One week of RIC treatment was well tolerated in both groups. RIC treatment increased CFR from 4.0±0.9 to 4.6±1.3 (mean ± standard deviation in healthy subjects (P=0.02, and from 1.9±0.4 to 2.3±0.7 in patients with HF (P=0.03, respectively. Systolic blood pressure in healthy subjects, and heart rate in HF patients decreased after RIC treatment (both P<0.01. Conclusion: This study demonstrated that a 1 week course of RIC treatment improved coronary microcirculation in healthy subjects and patients with HF associated with reduced left ventricular ejection fraction. Keyword: echocardiography, coronary flow reserve, heart failure, preconditioning

  7. Association Study of Gut Flora in Coronary Heart Disease through High-Throughput Sequencing

    Directory of Open Access Journals (Sweden)

    Li Cui

    2017-01-01

    Full Text Available Objectives. We aimed to explore the impact of gut microbiota in coronary heart disease (CHD patients through high-throughput sequencing. Methods. A total of 29 CHD in-hospital patients and 35 healthy volunteers as controls were included. Nucleic acids were extracted from fecal samples, followed by α diversity and principal coordinate analysis (PCoA. Based on unweighted UniFrac distance matrices, unweighted-pair group method with arithmetic mean (UPGMA trees were created. Results. After data optimization, an average of 121312±19293 reads in CHD patients and 234372±108725 reads in controls was obtained. Reads corresponding to 38 phyla, 90 classes, and 584 genera were detected in CHD patients, whereas 40 phyla, 99 classes, and 775 genera were detected in controls. The proportion of phylum Bacteroidetes (56.12% was lower and that of phylum Firmicutes was higher (37.06% in CHD patients than those in the controls (60.92% and 32.06%, P<0.05. PCoA and UPGMA tree analysis showed that there were significant differences of gut microbial compositions between the two groups. Conclusion. The diversity and compositions of gut flora were different between CHD patients and healthy controls. The incidence of CHD might be associated with the alteration of gut microbiota.

  8. Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006

    Directory of Open Access Journals (Sweden)

    Rastam Samer

    2012-09-01

    Full Text Available Abstract Background Despite advances made in treating coronary heart disease (CHD, mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. Methods The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Results Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81% of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Conclusion Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD.

  9. Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006.

    Science.gov (United States)

    Rastam, Samer; Al Ali, Radwan; Maziak, Wasim; Mzayek, Fawaz; Fouad, Fouad M; O'Flaherty, Martin; Capewell, Simon

    2012-09-09

    Despite advances made in treating coronary heart disease (CHD), mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81%) of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD.

  10. Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses.

    Science.gov (United States)

    Gayda, Mathieu; Gremeaux, Vincent; Bherer, Louis; Juneau, Martin; Drigny, Joffrey; Dupuy, Olivier; Lapierre, Gabriel; Labelle, Véronique; Fortier, Annik; Nigam, Anil

    2017-01-01

    Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD) sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and [Formula: see text] peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC), 20 age-matched old healthy controls (OHC) and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamic (impedance cardiography) and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy) were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher [Formula: see text] peak, maximal cardiac index (CI max), cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery) and cognitive function (for all items) (Pcognitive inhibition and flexibility and long-term verbal memory (Pcognitive function (Pcognitive function (Pcognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with [Formula: see text] peak, CI max and cerebral oxygenation-perfusion.

  11. [metabonomics research on coronary heart disease patients of phlegm turbidity syndrome and qi deficiency syndrome].

    Science.gov (United States)

    Cheng, Peng; Chen, Ze-qi; Wang, Dong-sheng

    2015-02-01

    To study the correlation between Chinese medical types of coronary heart disease (CHD) [i.e., phlegm turbidity syndrome (PTS) and qi deficiency syndrome (QDS)] and their metabolites. Recruited were 65 CHD patients including 37 cases of PTS and 28 cases of QDS. Serum endogenous metabolites in the two syndrome types were determined by gas chromatograph-mass spectrometer-computer (GC/MS), and their differences between their metabolic profiles analyzed. More than 100 chromatographic peaks were totally scanned. Chromatograms obtained was matched with mass spectrum bank, and finally we got the category contribution value of 46 kinds of substances. Results of MCTree analysis showed patients of PTS and patients of QDS could be effectively distinguished. Compounds contributing to identify the two syndromes were sequenced as serine, valine, 2 hydroxy propionic acid. Comparison of metabolites showed contents of serine and 2 hydroxy propionic acid were higher in patients of PTS than in patients of QDS (Pmetabonomics of CHD TCM syndrome types could provide material bases for TCM syndrome differentiation of CHD, indicating that metabonomics technologies might become a new research method for TCM syndrome typing.

  12. Research on Zheng Classification Fusing Pulse Parameters in Coronary Heart Disease

    Science.gov (United States)

    Guo, Rui; Wang, Yi-Qin; Xu, Jin; Yan, Hai-Xia; Yan, Jian-Jun; Li, Fu-Feng; Xu, Zhao-Xia; Xu, Wen-Jie

    2013-01-01

    This study was conducted to illustrate that nonlinear dynamic variables of Traditional Chinese Medicine (TCM) pulse can improve the performances of TCM Zheng classification models. Pulse recordings of 334 coronary heart disease (CHD) patients and 117 normal subjects were collected in this study. Recurrence quantification analysis (RQA) was employed to acquire nonlinear dynamic variables of pulse. TCM Zheng models in CHD were constructed, and predictions using a novel multilabel learning algorithm based on different datasets were carried out. Datasets were designed as follows: dataset1, TCM inquiry information including inspection information; dataset2, time-domain variables of pulse and dataset1; dataset3, RQA variables of pulse and dataset1; and dataset4, major principal components of RQA variables and dataset1. The performances of the different models for Zheng differentiation were compared. The model for Zheng differentiation based on RQA variables integrated with inquiry information had the best performance, whereas that based only on inquiry had the worst performance. Meanwhile, the model based on time-domain variables of pulse integrated with inquiry fell between the above two. This result showed that RQA variables of pulse can be used to construct models of TCM Zheng and improve the performance of Zheng differentiation models. PMID:23737839

  13. Research on Zheng Classification Fusing Pulse Parameters in Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Rui Guo

    2013-01-01

    Full Text Available This study was conducted to illustrate that nonlinear dynamic variables of Traditional Chinese Medicine (TCM pulse can improve the performances of TCM Zheng classification models. Pulse recordings of 334 coronary heart disease (CHD patients and 117 normal subjects were collected in this study. Recurrence quantification analysis (RQA was employed to acquire nonlinear dynamic variables of pulse. TCM Zheng models in CHD were constructed, and predictions using a novel multilabel learning algorithm based on different datasets were carried out. Datasets were designed as follows: dataset1, TCM inquiry information including inspection information; dataset2, time-domain variables of pulse and dataset1; dataset3, RQA variables of pulse and dataset1; and dataset4, major principal components of RQA variables and dataset1. The performances of the different models for Zheng differentiation were compared. The model for Zheng differentiation based on RQA variables integrated with inquiry information had the best performance, whereas that based only on inquiry had the worst performance. Meanwhile, the model based on time-domain variables of pulse integrated with inquiry fell between the above two. This result showed that RQA variables of pulse can be used to construct models of TCM Zheng and improve the performance of Zheng differentiation models.

  14. Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents.

    Science.gov (United States)

    Kearns, Cristin E; Schmidt, Laura A; Glantz, Stanton A

    2016-11-01

    Early warning signals of the coronary heart disease (CHD) risk of sugar (sucrose) emerged in the 1950s. We examined Sugar Research Foundation (SRF) internal documents, historical reports, and statements relevant to early debates about the dietary causes of CHD and assembled findings chronologically into a narrative case study. The SRF sponsored its first CHD research project in 1965, a literature review published in the New England Journal of Medicine, which singled out fat and cholesterol as the dietary causes of CHD and downplayed evidence that sucrose consumption was also a risk factor. The SRF set the review's objective, contributed articles for inclusion, and received drafts. The SRF's funding and role was not disclosed. Together with other recent analyses of sugar industry documents, our findings suggest the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD. Policymaking committees should consider giving less weight to food industry-funded studies and include mechanistic and animal studies as well as studies appraising the effect of added sugars on multiple CHD biomarkers and disease development.

  15. Shexiang Baoxin Pills for Coronary Heart Disease in Animal Models: Preclinical Evidence and Promoting Angiogenesis Mechanism

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    Ke-Jian Zhang

    2017-06-01

    Full Text Available Shexiang Baoxin Pill (SBP originated from a classical TCM Fufang Suhexiang Pill for chest pain with dyspnea in the Southern Song Dynasty (1107–110 AD. Here, we aimed to evaluate preclinical evidence and possible mechanism of SBP for experimental coronary heart disease (CHD. Studies of SBP in animal models with CHD were identified from 6 databases until April 2016. Study quality for each included article was evaluated according to the CAMARADES 10-item checklist. Outcome measures were myocardial infarction area, vascular endothelial growth factor (VEGF and microvessel count (MVC. All the data were analyzed by using RevMan 5.1 software. As a consequence, 25 studies with 439 animals were identified. The quality score of studies ranged from 2 to 5, with the median of 3.6. Meta-analysis of seven studies showed more significant effects of SBP on the reduction of the myocardial infarction area than the control (P < 0.01. Meta-analysis of eight studies showed significant effects of SBP for increasing VEGF expression compared with the control (P < 0.01. Meta-analysis of 10 studies indicated that SBP significantly improved MVC compared with the control (P < 0.01. In conclusion, these findings preliminarily demonstrated that SBP can reduce myocardial infarction area, exerting cardioprotective function largely through promoting angiogenesis.

  16. Association between Toll-like receptor 4 Asp299Gly polymorphism and coronary heart disease susceptibility.

    Science.gov (United States)

    Wu, B W; Zhu, J; Shi, H M; Jin, B; Wen, Z C

    2017-08-07

    Published data on the association between Toll-like receptor 4 (TLR4) Asp299Gly polymorphism and coronary heart disease (CHD) susceptibility are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. English-language studies were identified by searching PubMed and Embase databases (up to November 2016). All epidemiological studies were regarding Caucasians because no TLR4 Asp/Gly and Gly/Gly genotypes have been detected in Asians. A total of 20 case-control studies involving 14,416 cases and 10,764 controls were included in the meta-analysis. Overall, no significant associations were found between TLR4 Asp299Gly polymorphism and CHD susceptibility in the dominant model (OR=0.89; 95%CI=0.74 to 1.06; P=0.20) pooled in the meta-analysis. In the subgroup analysis by CHD, non-significant associations were found in cases compared to controls. When stratified by control source, no significantly decreased risk was found in the additive model or dominant model. The present meta-analysis suggests that the TLR4 Asp299Gly polymorphism was not associated with decreased CHD risk in Caucasians.

  17. Associations between interleukin-1 gene polymorphisms and coronary heart disease risk: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Liang Zhou

    Full Text Available OBJECTIVE: A great number of studies regarding the associations between IL-1B-511, IL-1B+3954 and IL-1RN VNTR polymorphisms within the IL-1gene cluster and coronary heart disease (CHD have been published. However, results have been inconsistent. In this study, a meta-analysis was performed to investigate the associations. METHODS: Published literature from PubMed and Embase databases were searched for eligible publications. Pooled odds ratios (ORs with 95% confidence intervals (CIs were calculated using random- or fixed- effect model. RESULTS: Thirteen studies (3,219 cases/2,445 controls for IL-1B-511 polymorphism, nine studies (1,828 cases/1,818 controls for IL-1B+3954 polymorphism and twelve studies (2,987 cases/ 2,208 controls for IL-1RN VNTR polymorphism were included in this meta analysis. The results indicated that both IL-1B-511 and IL-1B+3954 polymorphisms were not associated with CHD risk (IL-1B-511 T vs. C: OR = 0.98, 95%CI 0.87-1.09; IL-1B+3954 T vs. C: OR = 1.06, 95%CI 0.95-1.19. Similarly, there was no association between IL-1RN VNTR polymorphism and CHD risk (*2 vs. L: OR = 1.00, 95%CI 0.85-1.17. CONCLUSIONS: This meta-analysis suggested that there were no associations between IL-1 gene cluster polymorphisms and CHD.

  18. Association Study of Gut Flora in Coronary Heart Disease through High-Throughput Sequencing.

    Science.gov (United States)

    Cui, Li; Zhao, Tingting; Hu, Haibing; Zhang, Wen; Hua, Xiuguo

    2017-01-01

    Objectives. We aimed to explore the impact of gut microbiota in coronary heart disease (CHD) patients through high-throughput sequencing. Methods. A total of 29 CHD in-hospital patients and 35 healthy volunteers as controls were included. Nucleic acids were extracted from fecal samples, followed by α diversity and principal coordinate analysis (PCoA). Based on unweighted UniFrac distance matrices, unweighted-pair group method with arithmetic mean (UPGMA) trees were created. Results. After data optimization, an average of 121312 ± 19293 reads in CHD patients and 234372 ± 108725 reads in controls was obtained. Reads corresponding to 38 phyla, 90 classes, and 584 genera were detected in CHD patients, whereas 40 phyla, 99 classes, and 775 genera were detected in controls. The proportion of phylum Bacteroidetes (56.12%) was lower and that of phylum Firmicutes was higher (37.06%) in CHD patients than those in the controls (60.92% and 32.06%, P UPGMA tree analysis showed that there were significant differences of gut microbial compositions between the two groups. Conclusion. The diversity and compositions of gut flora were different between CHD patients and healthy controls. The incidence of CHD might be associated with the alteration of gut microbiota.

  19. Relationships between coronary heart disease risk factors and serum ionized calcium in Kennedy Space Center Cohort

    Science.gov (United States)

    Goodwin, Lisa Ann; Frey, Mary Anne Bassett; Merz, Marion P.; Alford, William R.

    1987-01-01

    Kennedy Space Center (KSC) employees are reported to be at high risk for coronary heart disease (CHD). Risk factors for CHD include high serum total cholesterol levels, low levels of high-density lipoprotein cholesterol (HDLC), elevated triglyceride, smoking, inactivity, high blood pressure, being male, and being older. Higher dietary and/or serum calcium Ca(++) may be related to a lower risk for CHD. Fifty men and 37 women participated. Subjects were tested in the morning after fasting 12 hours. Information relative to smoking and exercise habits was obtained; seated blood pressures were measured; and blood drawn. KCS men had higher risk values than KCS women as related to HDLC, triglycerides, systolic blood pressure, and diastolic blood pressure. Smoking and nonsmoking groups did not differ for other risk factors or for serum Ca(++) levels. Exercise and sedentary groups differed in total cholesterol and triglyceride levels. Serum Ca(++) levels were related to age, increasing with age in the sedentary group and decreasing in the exercisers, equally for men and women. It is concluded that these relationships may be significant to the risk of CHD and/or the risk of bone demineralization in an aging population.

  20. Patterns of Physical Activity and the Risk of Coronary Heart Disease: A Pilot Study

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    Mustafa Al-Zoughool

    2018-04-01

    Full Text Available Background: In the current study, we investigated the effect of physical activity (PA on the risk of coronary heart disease (CHD. Methods: In total, 146 cases of CHD and 157 matched controls were included in the study. Data on sociodemographics, lifestyle, and medical history factors were collected using an interviewer-administered questionnaire. A standard World Health Organization (WHO-based lifestyle questionnaire was used to assess PA. The risk of CHD was analyzed in relation to PA patterns using logistic regression. Results: Vigorous-intensity leisure PA was not associated with a lower risk of CHD. Subjects in the highest tertile of moderate occupational PA had a significantly lower risk of CHD compared to the lowest tertile (adjusted odds ratio (OR 0.31, 95% confidence intervals (CI 0.17–0.56. Subjects in the highest tertile of walking hasd an adjusted OR of 0.37 (95% CI 0.20–0.70. Subjects in the medium and highest tertiles of sedentary behavior had adjusted ORs of 2.01 (95% CI 1.06–3.79 and 3.88 (95% CI 2.14–7.02, respectively (p-value for trend < 0.001. Conclusion: The current results showed that both moderate occupational PA and walking protected against CHD. Sedentary behavior increased the risk of CHD.

  1. A Systems Biology Framework Identifies Molecular Underpinnings of Coronary Heart Disease

    Science.gov (United States)

    Huan, Tianxiao; Zhang, Bin; Wang, Zhi; Joehanes, Roby; Zhu, Jun; Johnson, Andrew D.; Ying, Saixia; Munson, Peter J.; Raghavachari, Nalini; Wang, Richard; Liu, Poching; Courchesne, Paul; Hwang, Shih-Jen; Assimes, Themistocles L.; McPherson, Ruth; Samani, Nilesh J.; Schunkert, Heribert; Meng, Qingying; Suver, Christine; O'Donnell, Christopher J.; Derry, Jonathan; Yang, Xia; Levy, Daniel

    2013-01-01

    Objective Genetic approaches have identified numerous loci associated with coronary heart disease (CHD). The molecular mechanisms underlying CHD gene-disease associations, however, remain unclear. We hypothesized that genetic variants with both strong and subtle effects drive gene subnetworks that in turn affect CHD. Approach and Results We surveyed CHD-associated molecular interactions by constructing coexpression networks using whole blood gene expression profiles from 188 CHD cases and 188 age- and sex-matched controls. 24 coexpression modules were identified including one case-specific and one control-specific differential module (DM). The DMs were enriched for genes involved in B-cell activation, immune response, and ion transport. By integrating the DMs with altered gene expression associated SNPs (eSNPs) and with results of GWAS of CHD and its risk factors, the control-specific DM was implicated as CHD-causal based on its significant enrichment for both CHD and lipid eSNPs. This causal DM was further integrated with tissue-specific Bayesian networks and protein-protein interaction networks to identify regulatory key driver (KD) genes. Multi-tissue KDs (SPIB and TNFRSF13C) and tissue-specific KDs (e.g. EBF1) were identified. Conclusions Our network-driven integrative analysis not only identified CHD-related genes, but also defined network structure that sheds light on the molecular interactions of genes associated with CHD risk. PMID:23539213

  2. Physical activity in patients with stable coronary heart disease: an international perspective.

    Science.gov (United States)

    Stewart, Ralph; Held, Claes; Brown, Rebekkah; Vedin, Ola; Hagstrom, Emil; Lonn, Eva; Armstrong, Paul; Granger, Christopher B; Hochman, Judith; Davies, Richard; Soffer, Joseph; Wallentin, Lars; White, Harvey

    2013-11-01

    Despite the known benefits of regular exercise, the reasons why many coronary heart disease (CHD) patients engage in little physical activity are not well understood. This study identifies factors associated with low activity levels in individuals with chronic CHD participating in the STABILITY study, a global clinical outcomes trial evaluating the lipoprotein phospholipaseA2 inhibitor darapladib. Prior to randomization, 15 486 (97.8%) participants from 39 countries completed a lifestyle questionnaire. Total physical activity was estimated from individual subject self-reports of hours spend each week on mild, moderate, and vigorous exercise, corresponding approximately to 2, 4, and 8 METS, respectively. Multivariate logistic regression evaluated clinical and demographic variables for the lowest compared with higher overall exercise levels, and for individuals who decreased rather than maintained or increased activity since diagnosis of CHD. The least active 5280 subjects (34%) reported exercise of ≤ 24 MET.h/week. A total of 7191 subjects (46%) reported less exercise compared with before diagnosis of CHD. The majority of participants were either 'not limited' or 'limited a little' walking 100 m (84%), climbing one flight of stairs (82%), or walking 1 km/1/2; mile (68%), and physical activity and decreasing exercise after diagnosis of CHD included more co-morbid conditions, poorer general health, fewer years of education, race, and country (P physical activity was only partly explained by cardiovascular symptoms. Potentially modifiable societal and health system factors are important determinants of physical inactivity in patients with chronic CHD.

  3. Organizational stress and individual strain: A social-psychological study of risk factors in coronary heart disease among administrators, engineers, and scientists

    Science.gov (United States)

    Caplan, R. D.

    1971-01-01

    It is hypothesized that organizational stresses, such as high quantitative work load, responsibility for persons, poor relations with role senders, and contact with alien organizational territories, may be associated with high levels of psychological and physiological strain which are risk factors in coronary heart disease. It is further hypothesized that persons with coronary-prone Type A personality characteristics are most likely to exhibit strain under conditions of organizational stress. Measures of these stresses, personality traits, and strains were obtained from 205 male NASA administrators, engineers, and scientists. Type A personality measures included sense of time urgency, persistence, involved striving, leadership, and preference for competitive and environmentally overburdening situations.

  4. The antiarrhythmic effect of vagal stimulation after acute coronary occlusion: Role of the heart rate.

    Science.gov (United States)

    Manati, Waheed; Pineau, Julien; Doñate Puertas, Rosa; Morel, Elodie; Quadiri, Timour; Bui-Xuan, Bernard; Chevalier, Philippe

    2018-01-03

    Strong evidence suggests a causal link between autonomic disturbances and ventricular arrhythmias. However, the mechanisms underlying the antiarrhythmic effect of vagal stimulation are poorly understood. The vagal antiarrhythmic effect might be modulated by a decrease in heart rate. the proximal anterior interventricular artery was occluded in 16 pigs by clamping under general anaesthesia. Group 1: heart rates remained spontaneous (n = 6; 12 occlusions); Group 2: heart rates were fixed at 190 beats per minute (bpm) with atrial electrical stimulation (n = 10; 20 occlusions). Each pig received two occlusions, 30 min apart, one without and one with vagal stimulation (10 Hz, 2 ms, 5-20 mA). The antiarrhythmic effect of vagal activation was defined as the time to the appearance of ventricular fibrillation (VF) after occlusion. In Group 1, vagal stimulation triggered a significant decrease in basal heart rate (132 ± 4 vs. 110 ± 17 bpm, p coronary occlusion (1102 ± 85 vs. 925 ± 41 s, p acute coronary occlusion.

  5. Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure

    DEFF Research Database (Denmark)

    Snoer, Martin; Monk-Hansen, Tea; Olsen, Rasmus Huan

    2012-01-01

    AIMS: In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which...

  6. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  7. Coronary heart disease patients transitioning to a normal life: perspectives and stages identified through a grounded theory approach.

    Science.gov (United States)

    Najafi Ghezeljeh, Tahereh; Yadavar Nikravesh, Mansoureh; Emami, Azita

    2014-02-01

    To explore how Iranian patients with coronary heart disease experience their lives. Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease. Qualitative study using grounded theory for the data analysis. Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised. The main categories of the transition from acute phase to a modified or 'new normal' life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages. Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations. By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences. © 2013 John Wiley & Sons Ltd.

  8. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS.

    Science.gov (United States)

    Minneboo, Madelon; Peters, Ron J G; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J J

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were recruited. The commercial weight management intervention (Weight Watchers) promotes a hypoenergetic and balanced diet, increased physical activity, and group support. The program included weekly 30-minute in-hospital meetings with an experienced coach. The program was offered in parallel with a cardiac rehabilitation program. Thirty-five patients completed the program. Of these patients, 32 patients (91%) decreased body weight. Mean weight change was -5.8 kg (range: +0.6 kg to -15.4 kg), and 20 patients (57%) achieved the target of 5% weight loss of their initial weight. Twenty-seven patients continued the commercial weight loss program after 14 weeks, the mean followup of these patients was 34 weeks and their mean weight change was -9.1 kg (range: 0.0-23.0 kg). Obese patients, discharged after an acute coronary syndrome, who were referred to a commercial weight management program, achieved significant weight loss. Although this is a nonrandomized pilot study with patients who were selected by motivation and by the ability to participate in the program, the proportion of weight loss is significant and promising.

  9. Comparison of the HEART and TIMI Risk Scores for Suspected Acute Coronary Syndrome in the Emergency Department.

    Science.gov (United States)

    Sun, Benjamin C; Laurie, Amber; Fu, Rongwei; Ferencik, Maros; Shapiro, Michael; Lindsell, Christopher J; Diercks, Deborah; Hoekstra, James W; Hollander, Judd E; Kirk, J Douglas; Peacock, W Frank; Anantharaman, Venkataraman; Pollack, Charles V

    2016-03-01

    The emergency department evaluation for suspected acute coronary syndrome (ACS) is common, costly, and challenging. Risk scores may help standardize clinical care and screening for research studies. The Thrombolysis in Myocardial Infarction (TIMI) and HEART are two commonly cited risk scores. We tested the null hypothesis that the TIMI and HEART risk scores have equivalent test characteristics. We analyzed data from the Internet Tracking Registry of Acute Coronary Syndromes (i*trACS) from 9 EDs on patients with suspected ACS, 1999-2001. We excluded patients with an emergency department diagnosis consistent with ACS, or without sufficient data to calculate TIMI and HEART scores. The primary outcome was 30-day major adverse cardiovascular events, including all-cause death, acute myocardial infarction, and urgent revascularization. We describe test characteristics of the TIMI and HEART risk scores. The study cohort included 8255 patients with 508 (6.2%) 30-day major adverse cardiovascular events. Receiver operating curve and reclassification analyses favored HEART [c statistic: 0.753, 95% confidence interval (CI): 0.733-0.773; continuous net reclassification improvement: 0.608, 95% CI: 0.527-0.689] over TIMI (c statistic: 0.678, 95% CI: 0.655-0.702). A HEART score 0-3 [negative predictive value (NPV) 0.982, 95% CI: 0.978-0.986; positive predictive value (PPV) 0.103, 95% CI: 0.094-0.113; likelihood ratio (LR) positive 1.76; LR negative 0.28] demonstrates similar or superior NPV/PPV/LR compared with TIMI = 0 (NPV 0.978, 95% CI: 0.971-0.983; PPV 0.077, 95% CI: 0.071-0.084; LR positive 1.28; LR negative 0.35) and TIMI = 0-1 (NPV 0.963, 95% CI: 0.958-0.968; PPV 0.102, 95% CI: 0.092-0.113; LR positive 1.73; LR negative 0.58). The HEART score has better discrimination than TIMI and outperforms TIMI within previously published "low-risk" categories.

  10. Dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease

    Science.gov (United States)

    Malinova, Lidia I.; Simonenko, Georgy V.; Denisova, Tatyana P.; Tuchin, Valery V.

    2007-02-01

    Dynamics of glucose concentration in human organism is an important diagnostic characteristic for it's parameters correlate significantly with the severity of metabolic, vessel and perfusion disorders. 36 patients with stable angina pectoris of II and III functional classes were involved in this study. All of them were men in age range of 45-59 years old. 7 patients hospitalized with acute myocardial infarction (aged from 49 to 59 years old) form the group of compare. Control group (n = 5) was of practically healthy men in comparable age. To all patients intravenous glucose solution (40%) in standard loading dose was injected. Capillary and vein blood samples were withdrawn before, and 5, 60, 120, 180 and 240 minutes after glucose load. At these time points blood pressure and glucose concentration were measured. In prepared blood smears shape, deformability and sizes of erythrocytes, quantity and degree of shear stress resistant erythrocyte aggregates were studied. Received data were approximated by polynomial of high degree to receive concentration function of studied parameters, which first derivative elucidate velocity characteristics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease and practically healthy persons. Received data show principle differences in dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease as a possible mechanism of coronary blood flow destabilization.

  11. Polymorphism in Apoprotein-C III gene and coronary heart disease

    International Nuclear Information System (INIS)

    Hussain, Syed S.; Buraiki, J.; Dzimiri, N.; Butt, Abdul Isalm; Vencer, L.; Basco, M.C.; Khan, B.

    1999-01-01

    The aim of this study was to look into the association, if any, apoprotein-CIII variant allele with hypertriglyceridemia, hypercholesterolemia and coronary heart disease (CHD). The prevalence of a C to G substitution in the 3 untranslated regions of apoprotein-CIII was studied in a sample of 92 angiographed Saudi subjects, consisting of 65 males and 27 females. The subjects were genotyped by amplification followed by digestion of the gene fragment containing the polymorphic site with Sac I restriction enzyme. The variant allele of apoprotein-CIII was found to be associated neither with hypertriglyceridemia nor with hypercholesterolemia. However, a significant association of this allele (P<0.01) was found with coronary heart disease, independent of other risk factors such as smoking, diabetes and hypertension. An estimation of odds ratio using logistic regression with various risk factors in the model showed that the individuals with this rare allele were 3.4 times more at risk of developing coronary disease. This estimation of risk held even after analyzing a subset of individuals above 45 years of age. While the association between apoprotein-CIII variant allele and dyslipidemia could not be established in this study, the relationship between this marker and CHD was highlighted in the studied subjects. (author)

  12. Polymorphism in Apoprotein-C III gene and coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Hussain, Syed S; Buraiki, J; Dzimiri, N; Butt, Abdul Isalm; Vencer, L; Basco, M C; Khan, B [Dept. of Biological and Medical Research, Cardiovascular diseases and Biomedical Statistics and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia)

    1999-07-01

    The aim of this study was to look into the association, if any, apoprotein-CIII variant allele with hypertriglyceridemia, hypercholesterolemia and coronary heart disease (CHD). The prevalence of a C to G substitution in the 3 untranslated regions of apoprotein-CIII was studied in a sample of 92 angiographed Saudi subjects, consisting of 65 males and 27 females. The subjects were genotyped by amplification followed by digestion of the gene fragment containing the polymorphic site with Sac I restriction enzyme. The variant allele of apoprotein-CIII was found to be associated neither with hypertriglyceridemia nor with hypercholesterolemia. However, a significant association of this allele (P<0.01) was found with coronary heart disease, independent of other risk factors such as smoking, diabetes and hypertension. An estimation of odds ratio using logistic regression with various risk factors in the model showed that the individuals with this rare allele were 3.4 times more at risk of developing coronary disease. This estimation of risk held even after analyzing a subset of individuals above 45 years of age. While the association between apoprotein-CIII variant allele and dyslipidemia could not be established in this study, the relationship between this marker and CHD was highlighted in the studied subjects. (author)

  13. The evaluation of dobutamine 99mTc-MIBI myocardial perfusion imaging in the diagnosis of coronary heart disease

    International Nuclear Information System (INIS)

    He Qing; Qu Wanying; Gong Junhui; Zhou Ying

    1996-01-01

    The method and the clinical value of dobutamine stress test as a substitute for exercise test in 99m Tc-MIBI myocardial perfusion imaging was investigated. 40 Patients were intravenously infused with dobutamine through IVAC syringe pumps by incremental doses, and 99m Tc-MIBI was injected at the peak dobutamine heart rate. The myocardial imaging was then performed. The rest myocardial imaging was done after 48 hours. 30 of the 31 patients with coronary heart disease showed reversible perfusion defects in dobutamine 99m Tc-MIBI myocardial perfusion images and 7 of the 9 patients without coronary heart disease showed normal images. The sensitivity of this test was 96.8% and the specificity 77.8%. None of the studies was discontinued due to dobutamine side effect. Dobutamine 99m Tc-MIBI myocardial perfusion imaging is a safe and sensitive method in the diagnosis of coronary heart disease

  14. Direct effects of smoking on the heart: silent ischemic disturbances of coronary flow

    International Nuclear Information System (INIS)

    Deanfield, J.E.; Shea, M.J.; Wilson, R.A.; Horlock, P.; de Landsheere, C.M.; Selwyn, A.P.

    1986-01-01

    Cigarette smoking is strongly associated with ischemic heart disease and acute coronary events. The effect of smoking a single cigarette on regional myocardial perfusion was studied in 13 chronic smokers with typical stable angina pectoris using positron emission tomography and rubidium-82 ( 82 Rb). Findings were compared with the effects of physical exercise. After exercise, 8 patients (61%) had angina, ST depression and abnormal regional myocardial perfusion. Uptake of 82 Rb increased from 49 +/- 8 to 60 +/- 7 in remote myocardium, but decreased from 46 +/- 3 to 37 +/- 5 in an ischemic area. The remaining 5 patients (39%) had homogeneous increases in 82 Rb uptake without angina or ST depression. After smoking, 6 of the 8 patients with positive exercise test responses had a decrease in 82 Rb uptake, from 47 +/- 3 to 35 +/- 6 in the same segment of myocardium affected during exercise. However, in contrast to exercise, the events during smoking were largely silent. The absolute decreases in regional 82 Rb uptake after smoking occurred at significantly lower levels of myocardial oxygen demand than after exercise. This suggests that an impairment of coronary blood supply is responsible. Thus, in smokers with coronary artery disease, each cigarette can cause profound silent disturbances of regional myocardial perfusion that are likely to occur frequently during daily life. Such repeated insults may represent an important mechanism linking smoking with coronary events

  15. Acute heart failure with and without concomitant acute coronary syndromes: patient characteristics, management, and survival.

    Science.gov (United States)

    Tarvasmäki, Tuukka; Harjola, Veli-Pekka; Nieminen, Markku S; Siirilä-Waris, Krista; Tolonen, Jukka; Tolppanen, Heli; Lassus, Johan

    2014-10-01

    Acute coronary syndromes (ACS) may precipitate up to a third of acute heart failure (AHF) cases. We assessed the characteristics, initial management, and survival of AHF patients with (ACS-AHF) and without (nACS-AHF) concomitant ACS. Data from 620 AHF patients were analyzed in a prospective multicenter study. The ACS-AHF patients (32%) more often presented with de novo AHF (61% vs. 43%; P coronary procedures (angiography, percutaneous coronary intervention, coronary artery bypass graft surgery), were more frequent in ACS-AHF (P < .001 for all). Although 30-day mortality was significantly higher for ACS-AHF (13% vs. 8%; P = .03), survival in the 2 groups at 5 years was similar. Overall, ACS was an independent predictor of 30-day mortality (adjusted odds ratio 2.0, 95% confidence interval 1.07-3.79; P = .03). Whereas medical history and the manifestation and initial treatment of AHF between ACS-AHF and nACS-AHF patients differ, long-term survival is similar. ACS is, however, independently associated with increased short-term mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids.

    Science.gov (United States)

    Deckelbaum, Richard J; Leaf, Alexander; Mozaffarian, Dariush; Jacobson, Terry A; Harris, William S; Akabas, Sharon R

    2008-06-01

    After the symposium "Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids," faculty who presented at the conference submitted manuscripts relating to their conference topics, and these are presented in this supplement. The content of these manuscripts was reviewed, and 2 conference calls were convened. The objective was to summarize existing evidence, gaps in evidence, and future research needed to strengthen recommendations for specific intakes of n-3 fatty acids for different conditions relating to cardiovascular disease. The following 2 questions were the main items discussed. What are the roles of n-3 fatty acids in primary versus secondary prevention of coronary heart disease? What are the roles of n-3 fatty acids in hypertriglyceridemia, in the metabolic syndrome and type 2 diabetes, and in sudden cardiac death, cardiac arrhythmias, and vulnerable plaque? Each area was summarized by using 2 general categories: 1) current knowledge for which general consensus exists, and 2) recommendations for research and policy. Additional references for these conclusions can be found in the articles included in the supplement.

  17. C-reactive protein and lipoprotein-a as markers of coronary heart disease in polycystic ovary syndrome.

    Science.gov (United States)

    Güdücü, Nilgün; Işçi, Herman; Yiğiter, Alin Başgül; Dünder, Ilkkan

    2012-01-01

    The aim of this study was to investigate the risk factors of coronary heart disease, CRP and Lipoprotein-a in polycystic ovary syndrome patients. Prospectively collected data of polycystic ovary syndrome patients (n=62) and control group (n=40) were compared. PCOS patients had higher HOMA-IR, CRP, DHEAS, free testosterone, FAI, LH and prolactin levels when compared to the control group. Lipoprotein-a levels did not differ between the groups. The obese PCOS group had statistically significantly higher fasting blood glucose, total cholesterol, triglyceride, free testosterone, insulin, CRP and HOMA-IR and statistically significantly lower HDL and SHBG when compared to normal weight PCOS persons. Fasting blood glucose, total cholesterol, LDL, SHBG, CRP, Lipoprotein-a, FSH, LH, TSH, DHEAS and prolactin levels did not differ between the normal weight and obese control groups. CRP levels increase in polycystic ovary syndrome patients and can be used as a marker of coronary heart disease. Future studies can be directed at treatments to decrease CRP levels, including antiinflammatory treatments.

  18. Correlation of radiation dose and heart rate in dual-source computed tomography coronary angiography.

    Science.gov (United States)

    Laspas, Fotios; Tsantioti, Dimitra; Roussakis, Arkadios; Kritikos, Nikolaos; Efthimiadou, Roxani; Kehagias, Dimitrios; Andreou, John

    2011-04-01

    Computed tomography coronary angiography (CTCA) has been widely used since the introduction of 64-slice scanners and dual-source CT technology, but the relatively high radiation dose remains a major concern. To evaluate the relationship between radiation exposure and heart rate (HR), in dual-source CTCA. Data from 218 CTCA examinations, performed with a dual-source 64-slices scanner, were statistically evaluated. Effective radiation dose, expressed in mSv, was calculated as the product of the dose-length product (DLP) times a conversion coefficient for the chest (mSv = DLPx0.017). Heart rate range and mean heart rate, expressed in beats per minute (bpm) of each individual during CTCA, were also provided by the system. Statistical analysis of effective dose and heart rate data was performed by using Pearson correlation coefficient and two-sample t-test. Mean HR and effective dose were found to have a borderline positive relationship. Individuals with a mean HR >65 bpm observed to receive a statistically significant higher effective dose as compared to those with a mean HR ≤65 bpm. Moreover, a strong correlation between effective dose and variability of HR of more than 20 bpm was observed. Dual-source CT scanners are considered to have the capability to provide diagnostic examinations even with high HR and arrhythmias. However, it is desirable to keep the mean heart rate below 65 bpm and heart rate fluctuation less than 20 bpm in order to reduce the radiation exposure.

  19. Cigarettes, lung cancer, and coronary heart disease: the effects of inhalation and tar yield.

    Science.gov (United States)

    Higenbottam, T; Shipley, M J; Rose, G

    1982-06-01

    Ten-year mortality rates for lung cancer and coronary heart disease have been related to cigarette smoking habits in 17 475 male civil servants aged 40-64 and in sample of 8089 male British residents aged 35-69. Both diseases were more frequent in smokers. Lung cancer rates were higher overall for "non-inhalers", particularly in heavy smokers. Tar yield correlated with the risk of lung cancer in non-inhalers but less so in inhalers. Conversely, coronary deaths were more common among inhalers, and the effect of tar/nicotine yield (such as it was) was confined to inhalers. It appears that there are subtle interactions between the amount smoked, the tar/nicotine yield of the cigarette, and the style of smoking. Thus the effects of a change in cigarette characteristics are hard to predict, and they may be different for respiratory and cardiovascular disease.

  20. Association Between a Genetic Variant Related to Glutamic Acid Metabolism and Coronary Heart Disease in Type 2 Diabetes

    Science.gov (United States)

    Qi, Qibin; Prudente, Sabrina; Mendonca, Christine; Andreozzi, Francesco; di Pietro, Natalia; Sturma, Mariella; Novelli, Valeria; Mannino, Gaia Chiara; Formoso, Gloria; Gervino, Ernest V.; Hauser, Thomas H.; Muehlschlegel, Jochen D.; Niewczas, Monika A.; Krolewski, Andrzej S.; Biolo, Gianni; Pandolfi, Assunta; Rimm, Eric; Sesti, Giorgio; Trischitta, Vincenzo; Hu, Frank

    2013-01-01

    IMPORTANCE Diabetes is associated with an elevated risk of coronary heart disease (CHD). Previous studies have suggested that the genetic factors predisposing to excess cardiovascular risk may be different in diabetic and non-diabetic participants. OBJECTIVE To identify genetic determinants of CHD that are specific to diabetic patients. DESIGN, SETTING, AND PARTICIPANTS We studied five independent sets of CHD cases and CHD-negative controls from the Nurses Health Study (NHS; enrolled in 1976 and followed through 2008), Health Professionals Follow-up Study (HPFS; enrolled in 1986 and followed through 2008), Joslin Heart Study (enrolled in 2001-2008), Gargano Heart Study (enrolled in 2001-2008), and Catanzaro Study (enrolled in 2004-2010). Included were a total of 1,517 CHD cases and 2,671 CHD-negative controls, all with type 2 diabetes. Results in diabetic patients were compared with those in 737 non-diabetic CHD cases and 1,637 non-diabetic CHD-negative controls from the NHS and HPFS cohorts. EXPOSURE 2,543,016 common genetic variants occurring throughout the genome. MAIN OUTCOME CHD defined as fatal or non-fatal myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, or angiographic evidence of significant stenosis of the coronary arteries. RESULTS We identified a variant on chromosome 1q25 (rs10911021) consistently associated with CHD risk among diabetic participants with an odds ratio of 1.36 (95% confidence interval [CI] 1.22-1.51, P=2×10−8). No association between this variant and CHD was detected among non-diabetic participants (OR=0.99, P=0.89), consistent with a significant gene-by-diabetes interaction on CHD risk (P=2×10−4). As compared to protective allele homozygotes, rs10911021 risk allele homozygotes were characterized by a 32% decrease in the expression of the neighboring glutamate-ammonia ligase (GLUL) gene in human endothelial cells (P=0.0048). They also showed a decreased ratio between plasma

  1. HUMAN CORONARY ARTERIES- A STUDY BASED ON GROSS ANATOMY AND CORONARY CAST

    Directory of Open Access Journals (Sweden)

    Vijayamma K. N

    2018-01-01

    Full Text Available BACKGROUND Present study is an attempt to throw light upon the coronary arterial pattern, variations in arterial distribution and extent of intercoronary anastomosis and arterial preponderance in different age groups. MATERIALS AND METHODS Total of 115 hearts were made use for this study. Ninety hearts were dissected for the gross anatomical study of coronary arteries and 25 hearts including three fetal hearts were used for the coronary cast study. The right and left coronary arteries were traced from aortic sinus along the atrioventricular groove to the area of its termination. The atrial ventricular and septal branches were traced and looked for anastomosis. Coronary casts were prepared by injecting coloured liquid latex through the coronary ostia and the branching pattern and anastomosis were studied. The coronary arterial pattern, extent of distribution of its branches, arterial preponderance and variations were observed. RESULTS It was found that 73 % cases of SA nodal branch arise from right coronary artery and 27 % from circumflex branch of left coronary artery. SA node has dual blood supply from both coronary arteries in 4% cases. Right coronary preponderance was observed in 83% of cases and left coronary preponderance in 11 % cases, and balanced supply in 6% cases. Coronary cast was helpful to understand the branching pattern of vessels, and the anastomosis of small capillaries. It was also seen that all 11 % of left preponderance were seen in male hearts and all of the 31 female hearts dissected were right preponderant. CONCLUSION Coronary arteries are called end arteries functionally. Right coronary artery originates from anterior aortic sinus in all cases except one which takes origin from posterior left aortic sinus along with left coronary artery. Right coronary preponderance is observed in 83% cases. Left coronary artery branching pattern shows variability. Left coronary preponderance was observed in 11% and all cases are male

  2. Premature Coronary Heart Disease and Traditional Risk Factors-Can We Do Better?

    Directory of Open Access Journals (Sweden)

    Roxana Sadeghi

    2013-06-01

    Full Text Available Background: Traditional cardiovascular risk factors are strong predictors of an increased likelihood for premature CHD. Considering the benefits of risk factors᾿ management, it is imperative to find and treat them before looking for more unknown and weak risk factors. Objectives: Limited information is available about the demographic and historical characteristics of the patients with premature Coronary Heart Disease (CHD in IR Iran. The main objective of this study was to determine the prevalence of the traditional risk factors in these patients. Also, the researchers hypothesized that there are insufficient risk assessment and preventive intervention methods for the asymptomatic adult population. Methods: This study was conducted on 125 patients with premature CHD (age<50 years who were admitted in two academic hospitals with acute coronary syndromes. The patients were accepted since they had a definite CHD on the basis of acute myocardial infarction (elevated cardiac enzymes or documented CAD in coronary angiography. Results: The mean age of the study population was 42.50±5.65 (26 to 49 years. Among the patients,92 (73.6% were male, 113 (90.4% were married, 58 (46.4% were smokers,19 (15.2% were opium users, 97 (77.6% had dyslipidemia, 44 (35.2% had hypertension, and 33 (26.4% had diabetes mellitus. In addition, family history was presented in 54 patients (43.2%. Conclusions: Premature Coronary Heart Disease is a public health problem. However, there is lack of effective and intensive treatments of well-defined traditional risk factors and prevention methods for the majority of the patients experiencing premature CHD. In sum, there is still plenty of room for improvement of risk management in IR Iran.

  3. Coronary Heart Disease Preoperative Gesture Interactive Diagnostic System Based on Augmented Reality.

    Science.gov (United States)

    Zou, Yi-Bo; Chen, Yi-Min; Gao, Ming-Ke; Liu, Quan; Jiang, Si-Yu; Lu, Jia-Hui; Huang, Chen; Li, Ze-Yu; Zhang, Dian-Hua

    2017-08-01

    Coronary heart disease preoperative diagnosis plays an important role in the treatment of vascular interventional surgery. Actually, most doctors are used to diagnosing the position of the vascular stenosis and then empirically estimating vascular stenosis by selective coronary angiography images instead of using mouse, keyboard and computer during preoperative diagnosis. The invasive diagnostic modality is short of intuitive and natural interaction and the results are not accurate enough. Aiming at above problems, the coronary heart disease preoperative gesture interactive diagnostic system based on Augmented Reality is proposed. The system uses Leap Motion Controller to capture hand gesture video sequences and extract the features which that are the position and orientation vector of the gesture motion trajectory and the change of the hand shape. The training planet is determined by K-means algorithm and then the effect of gesture training is improved by multi-features and multi-observation sequences for gesture training. The reusability of gesture is improved by establishing the state transition model. The algorithm efficiency is improved by gesture prejudgment which is used by threshold discriminating before recognition. The integrity of the trajectory is preserved and the gesture motion space is extended by employing space rotation transformation of gesture manipulation plane. Ultimately, the gesture recognition based on SRT-HMM is realized. The diagnosis and measurement of the vascular stenosis are intuitively and naturally realized by operating and measuring the coronary artery model with augmented reality and gesture interaction techniques. All of the gesture recognition experiments show the distinguish ability and generalization ability of the algorithm and gesture interaction experiments prove the availability and reliability of the system.

  4. Systolic reconstruction in patients with low heart rate using coronary dual-source CT angiography

    International Nuclear Information System (INIS)

    Okada, Munemasa; Nakashima, Yoshiteru; Shigemoto, Youko; Matsunaga, Naofumi; Miura, Toshiro; Nao, Tomoko; Sano, Yuichi; Narazaki, Akiko; Kido, Shoji

    2011-01-01

    Objectives: The purpose of our study was to determine the relationship between the predictive factors and systolic reconstruction (SR) as an optimal reconstruction window in patients with low heart rate (LHR; less than 65 bpm). Methods: 391 patients (262 male and 129 female, mean age; 67.1 ± 10.1 years of age) underwent coronary CTA without the additional administration of a beta-blocker. Affecting factors for SR were analyzed in age, gender, body weight (BW), diabetes mellitus (DM), coronary arterial disease (CAD), ejection fraction (EF), systolic and diastolic body pressure (BP) and heart rate variability (HRV) during coronary CTA. Results: In 29 (7.4%) of the 391 patients, SR was needed, but there was no apparent characteristic difference between the systolic and diastolic reconstruction groups in terms of gender, age, BW, DM, CAD and EF. In a multivariate analysis, the co-existence of DM [P < 0.05; OR, 0.27; 95% CI, 0.092-0.80], diastolic BP [P < 0.01; OR, 0.95; 95% CI, 0.92-0.98] and HRV [P < 0.01; OR, 0.98; 95% CI, 0.96-0.99] were found to be the factors for SR. In gender-related analysis, HRV was an important factor regardless of sex, but co-existence of DM affected especially for female and BP for male. Conclusion: Especially in the patients with LHR who had a medication of DM, high HRV or high BP, SR, in addition to DR, was needed to obtain high-quality coronary CTA images.

  5. Systolic reconstruction in patients with low heart rate using coronary dual-source CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Munemasa, E-mail: radokada@yamaguchi-u.ac.jp [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Nakashima, Yoshiteru; Shigemoto, Youko; Matsunaga, Naofumi [Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 (Japan); Miura, Toshiro; Nao, Tomoko [Department of Cardiology, Yamaguchi University Graduate School of Medicine (Japan); Sano, Yuichi; Narazaki, Akiko [Department of Radiology, Yamaguchi University Hospital (Japan); Kido, Shoji [Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University (Japan)

    2011-11-15

    Objectives: The purpose of our study was to determine the relationship between the predictive factors and systolic reconstruction (SR) as an optimal reconstruction window in patients with low heart rate (LHR; less than 65 bpm). Methods: 391 patients (262 male and 129 female, mean age; 67.1 {+-} 10.1 years of age) underwent coronary CTA without the additional administration of a beta-blocker. Affecting factors for SR were analyzed in age, gender, body weight (BW), diabetes mellitus (DM), coronary arterial disease (CAD), ejection fraction (EF), systolic and diastolic body pressure (BP) and heart rate variability (HRV) during coronary CTA. Results: In 29 (7.4%) of the 391 patients, SR was needed, but there was no apparent characteristic difference between the systolic and diastolic reconstruction groups in terms of gender, age, BW, DM, CAD and EF. In a multivariate analysis, the co-existence of DM [P < 0.05; OR, 0.27; 95% CI, 0.092-0.80], diastolic BP [P < 0.01; OR, 0.95; 95% CI, 0.92-0.98] and HRV [P < 0.01; OR, 0.98; 95% CI, 0.96-0.99] were found to be the factors for SR. In gender-related analysis, HRV was an important factor regardless of sex, but co-existence of DM affected especially for female and BP for male. Conclusion: Especially in the patients with LHR who had a medication of DM, high HRV or high BP, SR, in addition to DR, was needed to obtain high-quality coronary CTA images.

  6. Risk of iron overload is decreased in beating heart coronary artery surgery compared to conventional bypass.

    Science.gov (United States)

    Mumby, S; Koh, T W; Pepper, J R; Gutteridge, J M

    2001-11-29

    Conventional cardiopulmonary bypass surgery (CCPB) increases the iron loading of plasma transferrin often to a state of plasma iron overload, with the presence of low molecular mass iron. Such iron is a potential risk factor for oxidative stress and microbial virulence. Here we assess 'off-pump' coronary artery surgery on the beating heart for changes in plasma iron chemistry. Seventeen patients undergoing cardiac surgery using the 'Octopus' myocardial wall stabilisation device were monitored at five time points for changes in plasma iron chemistry. This group was further divided into those (n=9) who had one- or two- (n=8) vessel grafts, and compared with eight patients undergoing conventional coronary artery surgery. Patients undergoing beating heart surgery had significantly lower levels of total plasma non-haem iron, and a decreased percentage saturation of their transferrin at all time points compared to conventional bypass patients. Plasma iron overload occurred in only one patient undergoing CCPB. Beating heart surgery appears to decrease red blood cell haemolysis, and tissue damage during the operative procedures and thereby significantly decreases the risk of plasma iron overload associated with conventional bypass.

  7. Scintigraphy of the heart using sup(99m)Tc diphosphonate in combination with selective coronary perfusion scintigraphy and coronaroangiography

    International Nuclear Information System (INIS)

    Neumann, G.; Trenckmann, H.; Duck, H.J.; Katzschmann, R.; Neugebauerova, A.; Schneider, G.; Gottschild, D.

    1980-01-01

    In 45 patients with ischemic heart disease the results obtained by myocardial scintigraphy using technetium-99m diphosphonate (Tc-99m-DP) were compared with those obtained at selective coronary angiography and selective coronary perfusion scintigraphy. The cumulation of activity in the heart muscle was seen in twelve patients. This group is analyzed in the present paper in more detail. The ventriculographic examination of the left ventricle showed disturbed motility of the wall in six patients, of whom five had a positive myocardial scintigram. In view of this, myocardial scintigraphy using Tc-99m-DP may be considered a complementary, non-invasive method for proving significant disturbances of the motility of the heart wall. Positive myocardial scintigrams were also found in angna pectoris, in a patient after aorto-coronary bypass, in cardiomyopathy and myocarditis. In view of the fact that myocardial scintigraphy using Tc-99m-DP is capable of proving disturbances of cells of the heart muscle taking place at the moment, conclusions can be drawn as to the activity in the heart muscle. It further follows that myocardial scintigraphy may be significant in indicating the aorto-coronary bypass. We failed to prove an unequivocal correlation between myocardial scintigraphy, the number of sclerotically changed coronary vessels and the degree of their narrowing. An immediate relationship could not be proved between the extent of perfusion disturbance and the results of myocardial scintigraphy

  8. Trends in Modifiable Risk Factors Are Associated With Declining Incidence of Hospitalized and Nonhospitalized Acute Coronary Heart Disease in a Population.

    Science.gov (United States)

    Mannsverk, Jan; Wilsgaard, Tom; Mathiesen, Ellisiv B; Løchen, Maja-Lisa; Rasmussen, Knut; Thelle, Dag S; Njølstad, Inger; Hopstock, Laila Arnesdatter; Bønaa, Kaare Harald

    2016-01-05

    Few studies have used individual person data to study whether contemporary trends in the incidence of coronary heart disease are associated with changes in modifiable coronary risk factors. We identified 29 582 healthy men and women ≥25 years of age who participated in 3 population surveys conducted between 1994 and 2008 in Tromsø, Norway. Age- and sex-adjusted incidence rates were calculated for coronary heart disease overall, out-of-hospital sudden death, and hospitalized ST-segment-elevation and non-ST-segment-elevation myocardial infarction. We measured coronary risk factors at each survey and estimated the relationship between changes in risk factors and changes in incidence trends. A total of 1845 participants had an incident acute coronary heart disease event during 375 064 person-years of follow-up from 1994 to 2010. The age- and sex-adjusted incidence of total coronary heart disease decreased by 3% (95% confidence interval, 2.0-4.0; Pcoronary risk factors accounted for 66% (95% confidence interval, 48-97; Pcoronary heart disease. Favorable changes in cholesterol contributed 32% to the decline, whereas blood pressure, smoking, and physical activity each contributed 14%, 13%, and 9%, respectively. We observed a substantial decline in the incidence of coronary heart disease that was driven by reductions in out-of-hospital sudden death and hospitalized ST-segment-elevation myocardial infarction. Changes in modifiable coronary risk factors accounted for 66% of the decline in coronary heart disease events. © 2015 American Heart Association, Inc.

  9. Coronary heart disease in the diabetic African: frequency clinical and angiographic features.

    Science.gov (United States)

    Touze, J E; Ekra, A; Darracq, R; Mardelle, T; Adoh, A; Ake, E; Chauvet, J; Bertrand, E

    1987-01-01

    The frequency and clinical and coronarographic features of coronary heart disease (CHD) in black African diabetic patients were assessed in a two-part study. The aim of part I was to determine the frequency of CHD in 50 diabetic patients selected by the following criteria: male, age between 40 and 60 years, diabetes history less than 20 years, no history of CHD and normal E.K.G. All 50 of these patients underwent a stress test and those who failed or for whom results were inconclusive were submitted to coronary arteriography. Part II was a retrospective study of 104 patients with CHD. Its aim was to compare the clinical and coronarographic features of CHD patients with (27 cases) and without (77 cases) diabetes mellitus. The frequency of CHD in the 50 diabetics selected for this study was 10% (31 negative exercise tests, 19 inconclusive exercise tests, 5 coronary arteriographies with significant narrowing). Of these 5 diabetics with CHD, 3 had single vessel involvement (left descending artery: 2 cases, circumflex artery: 1 case), 1 patient had double vessel involvement (right coronary circumflex artery) and 1 had triple vessel involvement (left descending, circumflex, and right coronary artery). In the retrospective study the clinical profile of the diabetic and non-diabetic CHD patients was the same with respect to sex, age, angina, myocardial infarction, and death rate. As regard the risk factors, blood cholesterol level was higher in diabetics while cigarette smoking was higher in non-diabetics. The frequency of hypertension was the same in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. The Association between Serum Resistin Level and Presence or Severity of Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Roozbeh Mortazavi

    2017-03-01

    Full Text Available Background: Obesity is a well-known principal risk factor for metabolic disorders and cardiovascular diseases. Resistin is one of adipocyte-derived molecules, which plays important roles in inflammation as well as in endocrine and cardiovascular systems. Objectives: The present study aimed to determine the association between serum resistin level and presence/severity of Coronary Heart Disease (CHD. Patients and Methods: This cross-sectional study was conducted on 155 individuals referred for coronary angiography. Information about the patients’ age, gender, and cardiovascular risk factors was recorded. Their weight, height, and waist and hip circumferences were measured, as well. Each coronary angiogram was reported for two scoring methods (number of vessel diseases (usual method and Gensini scoring system by one cardiologist who was not aware of the participants’ serum resistin levels. Then, the relationship between serum resistin level and presence/severity of CHD was evaluated. Results: The results revealed no significant associations between the mean serum resistin level and the presence of CHD by both methods of evaluation of the coronary angiograms after adjustment for all conventional risk factors for CHD. In addition, no significant association was detected between serum resistin level and the severity of CHD based on the usual method of reporting the coronary angiograms (number of vessel diseases (P = 0.332. Yet, serum resistin level was positively correlated to body mass index and waist and hip circumferences and negatively related to height and fasting blood sugar level. Moreover, no linear correlation was found between serum resistin level and Gensini score (P = 0.35. Finally, hip circumference (P = 0.002 and height (P = 0.018 were determined as the predictors of serum resistin level. Conclusions: This cross-sectional study showed no significant associations between serum resistin level and presence/severity of CHD.

  11. The balneoterapy in complex rehabilitation of patients with coronary heart diseases after surgical myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Olena Kolodenko

    2015-10-01

    these patients in the resort, which include hydrokinesitherapy in the pool with mineral water and ingestion of mineral water. Discussion: The efficiency of usage of the developed complexes was shown through the improvement of tolerance to physical loading (p<0.05, a significant decrease of fasting plasma glucose level and 2h-after-meal level, reduced insulin levels, normalization of lipid metabolism. As a result of resort treatment a positive effect on carbohydrate metabolism, especially in patients who used mineral water, was observed. The possible reduction in fasting glucose and 2h-after-meal was observed in both groups after resort treatment, namely by 16.9 and 20.3% (in the first group and 23.7 and 22.4 (in the 2nd group, respectively (p<0.05. A drop in insulin in both groups indicated a positive impact of the treatment with mineral water on the secretory function of the pancreas (19.6 and 37.9%, respectively.   Keywords: rehabilitation, resort treatment, coronary heart disease, surgical myocardial revascularization, diabetes mellitus.

  12. The impact of inflammation on the obesity paradox in coronary heart disease.

    Science.gov (United States)

    De Schutter, A; Kachur, S; Lavie, C J; Boddepalli, R S; Patel, D A; Milani, R V

    2016-11-01

    Despite the well-known adverse effects of obesity on almost all aspects of coronary heart disease, many studies of coronary heart disease cohorts have demonstrated an inverse relationship between obesity, as defined by body mass index (BMI), and subsequent prognosis: the 'obesity paradox'. The etiology of this and the potential role of inflammation in this process remain unknown. We studied 519 patients with coronary heart disease before and after cardiac rehabilitation, dividing them into groups based on C-reactive protein ((CRP)⩾3 mg l -1 and CRP3-year follow-up by National Death Index in both CRP groups. During >3-year follow-up, all-cause mortality was higher in the high inflammation and in the low BMI group. In proportional hazard analysis, even after adjusting for ejection fraction and peak O 2 consumption, higher BMI was associated with lower mortality in the entire population (hazard ratio (HR) 0.38; confidence interval 0.15-0.97) and a trend to lower mortality in both subgroups (HR 0.45 in low CRP, P=0.24 vs HR 0.32, P=0.06 in high CRP). High body fat, however, was associated with significantly lower mortality in the high CRP group (HR 0.22; P=0.03) but not in the low CRP group (HR 0.73; P=0.64). Conversely, high LMI was associated with markedly lower mortality in the low CRP group (HR 0.04; P=0.04). The obesity paradox has multiple underlying etiologies. Body composition has a different role in different populations with an obesity paradox by BMI. Especially in the subpopulation with persistently high CRP levels, body fat seems protective.

  13. Diagnostic value of CRP and Lp(a) in coronary heart disease.

    Science.gov (United States)

    Erbağci, Ayşe Binnur; Tarakçioğlu, Mehmet; Aksoy, Mehmet; Kocabaş, Ramazan; Nacak, Muradiye; Aynacioğlu, A Sükrü; Sivrikoz, Cumhur

    2002-06-01

    Increased lipoprotein (a) [Lp(a)] concentration was reported to be an independent risk factor for coronary heart disease (CHD). Recent epidemiological studies affirmed the value of C-reactive protein (CRP) as the strongest, univariate predictor of the cardiovascular events. We decided to establish cut-off levels providing maximum diagnostic efficiency for CHD. In this study we measured CRP and Lp(a) concentrations in patients with angiographically demonstrated CHD (group A, n: 120), patients without any angiographically demonstrable lesion (group B, n: 62) and a group of healthy subjects (group C, n: 41). Data were evaluated correcting for lipid and lipoprotein concentrations, diabetes mellitus, hypertension, smoking, age, and body mass index in men and women. ROC curve based cut-off values (comparing group A versus groups B and C) and associated diagnostic performances of the assays were evaluated. Significant increases were noted in serum CRP concentrations in men and women, in groups A vs. B,A vs. C, B vs. C. Lp(a) concentrations were not different among groups in men but were higher in group A vs. B and C in women. Optimal cut-off levels for CRP in women and men were found as 2.1 and 3.0 mg/l with the diagnostic values of 0.792 and 0.770, respectively. For Lp(a) optimal cut-off levels were found as 22.6 and 9.8 mg/dl with the diagnostic values of 0.612 and 0.596 in women and men, respectively. The CRP level is quite efficient for separation of patients from controls. Therefore keeping in mind the lack of specificity, the CRP level may be a useful tool in the diagnosis of coronary heart disease. However, the Lp(a) level is not efficient enough to support the use of Lp(a) measurement for management of coronary heart disease.

  14. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...

  15. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R; Zwisler, Ann-Dorthe; Rees, Karen; Martin, Nicole; Taylor, Rod S

    2016-01-05

    Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). The goal of this study is to update the Cochrane systematic review and meta-analysis of exercise-based CR for CHD. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk of bias. Studies were pooled using random effects meta-analysis, and stratified analyses were undertaken to examine potential treatment effect modifiers. A total of 63 studies with 14,486 participants with median follow-up of 12 months were included. Overall, CR led to a reduction in cardiovascular mortality (relative risk: 0.74; 95% confidence interval: 0.64 to 0.86) and the risk of hospital admissions (relative risk: 0.82; 95% confidence interval: 0.70 to 0.96). There was no significant effect on total mortality, myocardial infarction, or revascularization. The majority of studies (14 of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects. This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions and improvements in quality of life. These benefits appear to be consistent across patients and intervention types and were independent of study quality, setting, and publication date. Copyright © 2016 American College of Cardiology

  16. Mind-Body Medicine in the Secondary Prevention of Coronary Heart Disease.

    Science.gov (United States)

    Cramer, Holger; Lauche, Romy; Paul, Anna; Langhorst, Jost; Michalsen, Andreas; Dobos, Gustav

    2015-11-06

    In mind-body medicine (MBM), conventional lifestyle modification measures such as dietary counseling and exercise are supplemented with relaxation techniques and psychological motivational elements. This review studied the effect of MBM on cardiac events and mortality in patients with coronary heart disease (CHD). This review is based on publications up to and including January 2015 that were retrieved by a systematic search in PubMed, the Cochrane Library, and Scopus. Randomized controlled trials of the effect of MBM programs (versus standard treatment) on cardiac events, overall mortality, and/or cardiac mortality were analyzed. Atherosclerosis, blood pressure, LDL cholesterol, and the body mass index (BMI) were chosen as secondary outcomes. Random-effects meta-analyses were performed. The risk of bias was assessed with the Cochrane tool. Twelve trials, performed on a total of 1085 patients, were included in the analysis. Significant differences between groups were found with respect to cardiac events (odds ratio [OR]: 0.38; 95% confidence interval [CI]: 0.23-0.61; p<0.01; heterogeneity [I2]: 0%), but not overall mortality (OR: 0.82; 95% CI: 0.46-1.45; p = 0.49; I2: 0%) or cardiac mortality (OR: 0.98; 95% CI: 0.43-2.25; p = 0.97; I2: 0%). Significant differences between groups were also found with respect to atherosclerosis (mean difference [MD] = -7.86% diameter stenosis; 95% CI: -15.06-[-0.65]; p = 0.03; I2: 0%) and systolic blood pressure (MD = -3.33 mm Hg; 95% CI: -5.76-[-0.91]; p<0.01; I2: 0%), but not with respect to diastolic blood pressure, LDL cholesterol, or BMI. In patients with CHD, MBM programs can lessen the occurrence of cardiac events, reduce atherosclerosis, and lower systolic blood pressure, but they do not reduce mortality. They can be used as a complement to conventional rehabilitation programs.

  17. Sociodemographic differences in myocardial infarction risk perceptions among people with coronary heart disease

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Weinman, John; French, David P

    2007-01-01

    This study examines sociodemographic differences in myocardial infarction (MI) risk perceptions among people with coronary heart disease (CHD) (N = 3130). Two variables for comparative risk perceptions were computed: (1) own risk compared to that of an average person; and (2) own risk compared...... to that of an average person with CHD. Comparative optimism in MI risk perceptions was common, particularly among men and those with higher education. CHD severity and psychosocial resources mediated these sociodemographic differences. These results suggest challenges for secondary prevention in CHD, particularly...

  18. Protein Interaction-Based Genome-Wide Analysis of Incident Coronary Heart Disease

    DEFF Research Database (Denmark)

    Jensen, Majken Karoline; Pers, Tune Hannes; Dworzynski, Piotr

    2011-01-01

    in genes associated with risk of coronary heart disease (CHD). Methods and Results-Genome-wide association analyses of approximately approximate to 700 000 single-nucleotide polymorphisms in 899 incident CHD cases and 1823 age-and sex-matched controls within the Nurses' Health and the Health Professionals...... complex. Conclusions-The integration of a GWA study with PPI data successfully identifies a set of candidate susceptibility genes for incident CHD that would have been missed in single-marker GWA analysis. (Circ Cardiovasc Genet. 2011; 4:549-556.)...

  19. Multilocus Heterozygosity and Coronary Heart Disease: Nested Case-Control Studies in Men and Women

    DEFF Research Database (Denmark)

    Mukamal, Kenneth J.; Jensen, Majken K.; Pers, Tune Hannes

    2015-01-01

    genome scans in parallel case-control studies of coronary heart disease (CHD) nested in the Health Professionals Follow-up Study and Nurses' Health Study. We examined ∼ 700,000 single nucleotide polymorphisms (SNPs) in 435 men with incident CHD and 878 matched controls and 435 women with incident CHD...... to risk of CHD in either men or women (adjusted odds ratios per 2000 heterozygous SNPs 1.01 [95% confidence interval, 0.91-1.13] in women and 0.94 [0.84-1.06] in men). We also found no consistent associations of genome-wide heterozygosity with levels of lipids, inflammatory markers, adhesion molecules...

  20. COMPARATIVE EFFICACY OF THE STATINS IN PREVENTING AND TREATING OF THE CORONARY HEART DISEASE

    Directory of Open Access Journals (Sweden)

    S. V. Shalaev

    2010-01-01

    Full Text Available The possibility to stabilize and reverse the atherosclerotic plaques in coronary arteries due to therapy with atorvastatin and rosuvastatin was demonstrated in recent studies. The advantage of aggressive lipid-lowering therapy compared with standard therapy is proven in patients with both stable and acute forms of ischemic heart disease (IHD. Pleiotropic effects, in particular, effect on endothelial function, ability to reduce the blood level of C-reactive protein are important in the statins mode of action. Risk reduction of cardiovascular complications and slow down of atherosclerosis progression in patients with IHD was significantly associated with decrease in levels of both atherogenic lipids and C-reactive protein.

  1. Coronary Heart Disease Alters Intercellular Communication by Modifying Microparticle-Mediated MicroRNA Transport

    Science.gov (United States)

    Finn, Nnenna A.; Eapen, Danny; Manocha, Pankaj; Kassem, Hatem Al; Lassegue, Bernard; Ghasemzadeh, Nima; Quyyumi, Arshed; Searles, Charles D.

    2013-01-01

    Coronary heart disease (CHD) is characterized by abnormal intercellular communication and circulating microRNAs (miRNAs) are likely involved in this process. Here, we show that CHD was associated with changes in the transport of circulating miRNA, particularly decreased miRNA enrichment in microparticles (MPs). Additionally, MPs from CHD patients were less efficient at transferring miRNA to cultured HUVECs, which correlated with their diminished capacity to bind developmental endothelial locus-1 (Del-1). In summary, CHD was associated with distinct changes in circulating miRNA transport and these changes may contribute to the abnormal intercellular communication that underlies CHD initiation and progression. PMID:24042051

  2. Intensity versus duration of cycling, impact on all-cause and coronary heart disease mortality

    DEFF Research Database (Denmark)

    Schnohr, Peter; Marott, Jacob L; Jensen, Jan S

    2012-01-01

    Background: Current recommendations prescribe that every adult should accumulate 30¿minutes or more of moderate physical activity in leisure time, preferably every day of the week. The optimal intensity, duration, and frequency still have to be established. The aim of this study was to examine......: Our findings indicate that the relative intensity, and not the duration of cycling, is of more importance in relation to all-cause and coronary heart disease mortality. Thus our general recommendations to all adults would be that brisk cycling is preferable to slow....

  3. Concept analysis of risk in relation to coronary heart disease among Filipino-Americans.

    Science.gov (United States)

    Dalusung-Angosta, Alona

    2010-01-01

    To analyze the concept of risk in relation to coronary heart disease (CHD) among Filipino-Americans (FAs) and provide a new definition of risk. Published literature. This concept analysis provided a new meaning of risk in relation to CHD among FAs and shed light on further understanding of risk. Risk has been laced with negativity in health care, but based on the current literature, risk can be conceptualized in a positive perspective, especially in the area of chronic health disease such as CHD. However, further research is needed in the conceptualization of risk related to CHD for consistency, adequacy, and meaning. © 2010 Wiley Periodicals, Inc.

  4. How do patients at risk portray candidates for coronary heart disease? A qualitative interview study

    DEFF Research Database (Denmark)

    Frich, J.C.; Malterud, K.; Fugelli, P.

    2007-01-01

    OBJECTIVE: To explore how patients at risk of coronary heart disease (CHD) portray candidates for CHD. DESIGN: Qualitative interview study. SETTING: Norway. SUBJECTS: A total of 20 men and 20 women diagnosed with heterozygous familial hypercholesterolemia (FH) recruited through a lipid clinic. MAIN...... considered their notions to be valid for assessing people's risk of CHD, others questioned how valid their notions were. CONCLUSION: Doctors should recognize that distancing is a way patients cope with risk and that such a strategy may have psychological and moral reasons. When communicating about risk...

  5. Loci influencing lipid levels and coronary heart disease risk in 16 European population cohorts

    DEFF Research Database (Denmark)

    Aulchenko, Yurii S; Ripatti, Samuli; Lindqvist, Ida

    2008-01-01

    Recent genome-wide association (GWA) studies of lipids have been conducted in samples ascertained for other phenotypes, particularly diabetes. Here we report the first GWA analysis of loci affecting total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) .......8% of variation in lipids and were also associated with increased intima media thickness (P = 0.001) and coronary heart disease incidence (P = 0.04). The genetic risk score improves the screening of high-risk groups of dyslipidemia over classical risk factors....

  6. Requirements of a coronary heart disease risk factor intervention ...

    African Journals Online (AJOL)

    Health education programmes to promote the prudent diet are required. The need for. appropriately trained health educators in schools, workplaces, health clinics and all hospitals has been identified. An extensive health education service should be expanded by including the use 'of mass media, particularly television, ...

  7. The effects of centre-based rehabilitation after acute myocardial infarction on exercise capacity and risk factors for coronary heart disease

    Directory of Open Access Journals (Sweden)

    Polona Mlakar

    2014-11-01

    Full Text Available Background Rehabilitation following acute myocardial infarction (AMI is a crucial part of secondary prevention for coronary heart disease. The aim of our study was to determine the efficiency of our national in-patient rehabilitation program in improving exercise capacity and lowering risk factors for coronary heart disease.Methods 25 patients 3-9 weeks after AMI, undergoing 2 week in-patient cardiac rehabilitation, were included in our study. We performed exercise stress testing and measurement of classic risk factors before and after the rehabilitation. Classic risk factors were compared with 25 age matched adults without known risk factors for coronary heart disease.Results Patients after AMI had lower exercise capacity than healthy adults (p≤0.002 for double product, maximal load, systolic blood pressure, heart rate and time of load. Patients recieved appropriate drug therapy after myocardial infarction, which presented as lower diastolic and a trend to lower systolic blood pressure (p=0.002 and 0.080, lower total and LDL cholesterol values (both p<0.001 than healthy adults, but higher values of metabolic syndrome parameters (higher waist cifcumference p=0.045, higher hip-waist ratio, lower HDL cholesterol, both p<0.001, and a trend to higher body mass index. Although we observed significant increases in exercise capacity (higher, maximal load, systolic blood pressure,double product and time of load, all p≤0.003, no changes in classic risk factors during rehabilitaiton were demonstrated.Conclusions In-patient program of cardiac rehabilitation efficiently elevates exercise capacity in patients after AMI, but fails to influence classic risk factors for coronary heart disease, which might be due to lack of controlled cardioprotective diet during rehabilitation.

  8. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Thompson, David R; Oldridge, Neil

    2016-01-01

    artery disease. We included RCTs that reported at least one of the following outcomes: mortality, MI, revascularisations, hospitalisations, health-related quality of life (HRQL), or costs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all identified references for inclusion...... based on the above inclusion and exclusion criteria. One author extracted data from the included trials and assessed their risk of bias; a second review author checked data. We stratified meta-analysis by the duration of follow up of trials, i.e. short-term: 6 to 12 months, medium-term: 13 to 36 months.......16) or PCI (18 trials; RR 0.85, 95% CI 0.70 to 1.04).There was little evidence of statistical heterogeneity across trials for all event outcomes, and there was evidence of small study bias for MI and hospitalisation, but no other outcome. Predictors of clinical outcomes were examined across the longest...

  9. The "Chaos Theory" and nonlinear dynamics in heart rate variability analysis: does it work in short-time series in patients with coronary heart disease?

    Science.gov (United States)

    Krstacic, Goran; Krstacic, Antonija; Smalcelj, Anton; Milicic, Davor; Jembrek-Gostovic, Mirjana

    2007-04-01

    Dynamic analysis techniques may quantify abnormalities in heart rate variability (HRV) based on nonlinear and fractal analysis (chaos theory). The article emphasizes clinical and prognostic significance of dynamic changes in short-time series applied on patients with coronary heart disease (CHD) during the exercise electrocardiograph (ECG) test. The subjects were included in the series after complete cardiovascular diagnostic data. Series of R-R and ST-T intervals were obtained from exercise ECG data after sampling digitally. The range rescaled analysis method determined the fractal dimension of the intervals. To quantify fractal long-range correlation's properties of heart rate variability, the detrended fluctuation analysis technique was used. Approximate entropy (ApEn) was applied to quantify the regularity and complexity of time series, as well as unpredictability of fluctuations in time series. It was found that the short-term fractal scaling exponent (alpha(1)) is significantly lower in patients with CHD (0.93 +/- 0.07 vs 1.09 +/- 0.04; P chaos theory during the exercise ECG test point out the multifractal time series in CHD patients who loss normal fractal characteristics and regularity in HRV. Nonlinear analysis technique may complement traditional ECG analysis.

  10. Depressive disorder, coronary heart disease, and stroke: dose-response and reverse causation effects in the Whitehall II cohort study.

    Science.gov (United States)

    Brunner, Eric J; Shipley, Martin J; Britton, Annie R; Stansfeld, Stephen A; Heuschmann, Peter U; Rudd, Anthony G; Wolfe, Charles D A; Singh-Manoux, Archana; Kivimaki, Mika

    2014-03-01

    Systematic reviews examining associations of depressive disorder with coronary heart disease and stroke produce mixed results. Failure to consider reverse causation and dose-response patterns may have caused inconsistencies in evidence. This prospective cohort study on depressive disorder, coronary heart disease, and stroke analysed reverse causation and dose-response effects using four 5-year and three 10-year observation cycles (total follow up 24 years) based on multiple repeat measures of exposure. Participants in the Whitehall II study (n = 10,036, 31,395 person-observations, age at start 44.4 years) provided up to six repeat measures of depressive symptoms via the 30-item General Health Questionnaire (GHQ-30) and one measure via Center for Epidemiologic Studies Depression Scale (CES-D). The cohort was followed up for major coronary events (coronary death/nonfatal myocardial infarction) and stroke (stroke death/morbidity) through the national mortality register Hospital Episode Statistics, ECG-screening, medical records, and self-report questionnaires. GHQ-30 caseness predicted stroke over 0-5 years (age-, sex- and ethnicity-adjusted HR 1.60, 95% CI 1.1-2.3) but not over 5-10 years (HR 0.94, 95% CI 0.6-1.4). Using the last 5-year observation cycle, cumulative GHQ-30 caseness was associated with incident coronary heart disease in a dose-response manner (1-2 times a case: HR 1.12, 95% CI 0.7-1.7; 3-4 times: HR 2.06, 95% CI 1.2-3.7), and CES-D caseness predicted coronary heart disease (HR 1.81, 95% CI 1.1-3.1). There was evidence of a dose-response effect of depressive symptoms on risk of coronary heart disease. In contrast, prospective associations of depressive symptoms with stroke appeared to arise wholly or partly through reverse causation.

  11. Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals.

    Science.gov (United States)

    Dragano, Nico; Siegrist, Johannes; Nyberg, Solja T; Lunau, Thorsten; Fransson, Eleonor I; Alfredsson, Lars; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G David; Kivimäki, Mika

    2017-07-01

    Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. This multicohort study (the "IPD-Work" consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain. Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

  12. Progressive epicardial coronary blood flow reduction fails to produce ST-segment depression at normal heart rates.

    Science.gov (United States)

    de Chantal, Marilyn; Diodati, Jean G; Nasmith, James B; Amyot, Robert; LeBlanc, A Robert; Schampaert, Erick; Pharand, Chantal

    2006-12-01

    ST-segment depression is commonly seen in patients with acute coronary syndromes. Most authors have attributed it to transient reductions in coronary blood flow due to nonocclusive thrombus formation on a disrupted atherosclerotic plaque and dynamic focal vasospasm at the site of coronary artery stenosis. However, ST-segment depression was never reproduced in classic animal models of coronary stenosis without the presence of tachycardia. We hypothesized that ST-segment depression occurring during acute coronary syndromes is not entirely explained by changes in epicardial coronary artery resistance and thus evaluated the effect of a slow, progressive epicardial coronary artery occlusion on the ECG and regional myocardial blood flow in anesthetized pigs. Slow, progressive occlusion over 72 min (SD 27) of the left anterior descending coronary artery in 20 anesthetized pigs led to a 90% decrease in coronary blood flow and the development of ST-segment elevation associated with homogeneous and transmural myocardial blood flow reductions, confirmed by microspheres and myocardial contrast echocardiography. ST-segment depression was not observed in any ECG lead before the development of ST-segment elevation. At normal heart rates, progressive epicardial stenosis of a coronary artery results in myocardial ischemia associated with homogeneous, transmural reduction in regional myocardial blood flow and ST-segment elevation, without preceding ST-segment depression. Thus, in coronary syndromes with ST-segment depression and predominant subendocardial ischemia, factors other than mere increases in epicardial coronary resistance must be invoked to explain the heterogeneous parietal distribution of flow and associated ECG changes.

  13. Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry).

    Science.gov (United States)

    AlFaleh, Hussam; Elasfar, Abdelfatah A; Ullah, Anhar; AlHabib, Khalid F; Hersi, Ahmad; Mimish, Layth; Almasood, Ali; Al Ghamdi, Saleh; Ghabashi, Abdullah; Malik, Asif; Hussein, Gamal A; Al-Murayeh, Mushabab; Abuosa, Ahmed; Al Habeeb, Waleed; Kashour, Tarek S

    2016-05-20

    Little is know about the outcomes of acute heart failure (AHF) with acute coronary syndrome (ACS-AHF), compared to those without ACS (NACS-AHF). We conducted a prospective registry of AHF patients involving 18 hospitals in Saudi Arabia between October 2009 and December 2010. In this sub-study, we compared the clinical correlates, management and hospital course, as well as short, and long-term outcomes between AHF patients with and without ACS. Of the 2609 AHF patients enrolled, 27.8 % presented with ACS. Compared to NACS-AHF patients, ACS-AHF patients were more likely to be old males (Mean age = 62.7 vs. 60.8 years, p = 0.003, and 73.8 % vs. 62.7 %, p coronary angiography and had higher prevalence of multi-vessel coronary artery disease (p < 0.001 for all comparisons). The unadjusted hospital and one-month mortality were higher in ACS-AHF patients (OR = 1.6 (1.2-2.2), p = 0.003 and 1.4 (1.0-1.9), p = 0.026 respectively). A significant interaction existed between the level of left ventricular ejection fraction and ACS-AHF status. After adjustment, ACS-AHF status was only significantly associated with hospital mortality (OR = 1.6 (1.1-2.4), p = 0.019). The three-years survival following hospital discharge was not different between the two groups. AHF patients presenting with ACS had worse hospital prognosis, and an equivalent long-term survival compared to AHF patients without ACS. These findings underscore the importance of timely recognition and management of AHF patients with concomitant ACS given their distinct presentation and underlying pathophysiology compared to other AHF patients.

  14. Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study

    Directory of Open Access Journals (Sweden)

    Alessandra C. Goulart

    2013-01-01

    Full Text Available OBJECTIVES: To describe the ERICO study (Strategy of Registry of Acute Coronary Syndrome, a prospective cohort to investigate the epidemiology of acute coronary syndrome. METHODS: The ERICO study, which is being performed at a secondary general hospital in São Paulo, Brazil, is enrolling consecutive acute coronary syndrome patients who are 35 years old or older. The sociodemographic information, medical assessments, treatment data and blood samples are collected at admission. After 30 days, the medical history is updated, and additional blood and urinary samples are collected. In addition, a retinography, carotid intima-media thickness, heart rate variability and pulse-wave velocity are performed. Questionnaires about food frequency, physical activity, sleep apnea and depression are also applied. At six months and annually after an acute event, information is collected by telephone. RESULTS: From February 2009 to September 2011, 738 patients with a diagnosis of an acute coronary syndrome were enrolled. Of these, 208 (28.2% had ST-elevation myocardial infarction (STEMI, 288 (39.0% had non-ST-elevation myocardial infarction (NSTEMI and 242 (32.8% had unstable angina (UA. The mean age was 62.7 years, 58.5% were men and 77.4% had 8 years or less of education. The most common cardiovascular risk factors were hypertension (76% and sedentarism (73.4%. Only 29.2% had a prior history of coronary heart disease. Compared with the ST-elevation myocardial infarction subgroup, the unstable angina and non-ST-elevation myocardial infarction patients had higher frequencies of hypertension, diabetes, prior coronary heart disease (p<0.001 and dyslipidemia (p = 0.03. Smoking was more frequent in the ST-elevation myocardial infarction patients (p = 0.006. CONCLUSIONS: Compared with other hospital registries, our findings revealed a higher burden of CV risk factors and less frequent prior CHD history.

  15. Investigating perioperative heart migration during robot-assisted coronary artery bypass grafting interventions.

    Science.gov (United States)

    Linte, Cristian A; Cho, Daniel S; Wedlake, Chris; Moore, John; Chen, Elvis; Bainbridge, Daniel; Patel, Rajni; Peters, Terry; Kiaii, Bob B

    2011-09-01

    : For robot-assisted coronary artery bypass graft interventions, surgeons typically use a preoperative thoracic computed tomography scan of the patient to plan the procedure. However, the cardiac anatomy is prone to changes induced perioperatively in the effort to access the heart and surgical targets, which, in turn, may invalidate the initial plan. This article presents a method to estimate the perioperative heart migration, information which can be further exploited to refine the preoperative surgical plan. : Tracked transesophageal ultrasound images of four patients' hearts were acquired at each stage in the procedure: before lung deflation, after lung deflation, and after both lung deflation and CO2 thoracic insufflation. Anatomic features of interest-the mitral and aortic valves-were identified from each dataset, and their movement between the different procedure stages was recorded and used to estimate the global heart displacement. Moreover, the local morphology of the features of interest was investigated to provide insight on the extent of the deformation the heart has undergone during the workflow. : The study suggested that the heart does undergo substantial displacement-on the order of 10 to 15 mm in each direction (axial, coronal, and sagittal) after lung deflation and CO2 thoracic insufflation. However, no significant differences (P > 0.1) were observed in the morphologic characteristics of the features of interest across the multiple workflow stages, suggesting that local deformations occur at a much smaller scale compared with the global migration. : The quantification of the perioperatively induced changes is critical to track the displacement of the heart and surgical targets. The recorded migration patterns should not be ignored but rather be used to update the surgical plan to better suit the intraoperative environment.

  16. Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD among a sample in India

    Directory of Open Access Journals (Sweden)

    Ku Melvin

    2009-02-01

    Full Text Available Abstract Background The prevalence of Coronary Atherosclerotic Heart Disease (CASHD is increasing in India. Several modifiable risk factors contribute directly to this disease burden. Public knowledge of such risk factors among the urban Indian population is largely unknown. This investigation attempts to quantify knowledge of modifiable risk factors of CASHD as sampled among an Indian population at a large metropolitan hospital. Methods A hospital-based, cross sectional study was conducted at All India Institute of Medical Sciences (AIIMS, a major tertiary care hospital in New Delhi, India. Participants (n = 217 recruited from patient waiting areas in the emergency room were provided with standardized questionnaires to assess their knowledge of modifiable risk factors of CASHD. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Identifying 3 or less risk factors was regarded as a poor knowledge level, whereas identifying 4 or more risk factors was regarded as a good knowledge level. A multiple logistic regression model was used to isolate independent demographic markers predictive of a participant's level of knowledge. Results 41% of the sample surveyed had a good level of knowledge. 68%, 72%, 73% and 57% of the population identified smoking, obesity, hypertension, and high cholesterol correctly, respectively. 30% identified diabetes mellitus as a modifiable risk factor of CASHD. In multiple logistic regression analysis independent demographic predictors of a good knowledge level with a statistically significant (p Conclusion An Indian population in a hospital setting shows a lack of knowledge pertaining to modifiable risk factors of CASHD. By isolating demographic predictors of poor knowledge, such as current smokers and persons who do not exercise regularly, educational interventions can be effectively targeted and implemented as primary and secondary prevention strategies

  17. Economic burden and cost determinants of coronary heart disease in rural southwest China: a multilevel analysis.

    Science.gov (United States)

    Le, C; Fang, Y; Linxiong, W; Shulan, Z; Golden, A R

    2015-01-01

    To estimate the economic burden of coronary heart disease (CHD) in a given year (2010), including direct and indirect costs, and examine the impact of contextual and individual socio-economic (SES) predictors on the costs of CHD among adults in rural southwest China. Cross-sectional community survey. In total, 4595 adults (aged ≥18 years) participated in this study. A prevalence-based cost-of-illness approach was used to estimate the economic burden of CHD. Information on demographic characteristics of the study population and the economic consequences of CHD was obtained using a standard questionnaire. Multilevel linear regression was used to model the variation in costs of CHD. In the study population, the overall prevalence of CHD was 2.9% (3.5% for males, 2.3% for females). The total cost of CHD was estimated to be US$17 million. Inpatient hospitalizations represented the main component of direct costs of CHD, and direct costs accounted for the greatest proportion of the economic burden of CHD. Males were more likely to have a higher economic burden of CHD than females. A positive association was found between the individual's level of education and the economic burden of CHD. Residence in a higher-income community was associated with higher costs related to CHD. This study found that both contextual and individual SES were closely associated with the costs of CHD. Future strategies for CHD interventions and improved access to affordable medications to treat and control CHD should focus on less-educated individuals and communities with lower SES. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. LINE-1 Hypomethylation is Associated with the Risk of Coronary Heart Disease in Chinese Population

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Li [Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin (China); Liu, Shuchuan [Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin (China); Su, Zhendong; Cheng, Rongchao; Bai, Xiuping; Li, Xueqi, E-mail: xueqi-li@163.com [Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin (China)

    2014-05-15

    Global methylation level in blood leukocyte DNA has been associated with the risk of coronary heart disease (CHD), with inconsistent results in various populations. Similar data are lacking in Chinese population where different genetic, lifestyle and environmental factors may affect DNA methylation and its risk relationship with CHD. To examine whether global methylation is associated with the risk of CHD in Chinese population. A total of 334 cases with CHD and 788 healthy controls were included. Global methylation in blood leukocyte DNA was estimated by analyzing LINE-1 repeats using bisulfite pyrosequencing. In an initial analysis restricted to control subjects, LINE-1 level reduced significantly with aging, elevated total cholesterol, and diagnosis of diabetes. In the case-control analysis, reduced LINE-1 methylation was associated with increased risk of CHD; analysis by quartile revealed odds ratios (95%CI) of 0.9 (0.6-1.4), 1.9 (1.3-2.9) and 2.3 (1.6-3.5) for the third, second and first (lowest) quartile (P{sub trend} < 0.001), respectively, compared to the fourth (highest) quartile. Lower (

  19. Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses.

    Directory of Open Access Journals (Sweden)

    Mathieu Gayda

    Full Text Available Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and [Formula: see text] peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC, 20 age-matched old healthy controls (OHC and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis, cardiac hemodynamic (impedance cardiography and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher [Formula: see text] peak, maximal cardiac index (CI max, cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery and cognitive function (for all items (P<0.05. Compared to OHC, CHD patients had lower [Formula: see text] peak, CI max, cerebral oxygenation-perfusion (during recovery and short term-working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05. [Formula: see text] peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005. Cerebral oxygenation-perfusion (exercise was related to cognitive function (P<0.005. Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with [Formula: see text] peak, CI max and cerebral oxygenation-perfusion.

  20. Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

    Science.gov (United States)

    Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

    2009-05-18

    To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

  1. THE FREQUENCY AND ASSOCIATION OF RISK FACTORS IN DEVELOPMENT OF CORONARY HEART DISEASE IN DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Dušan Sokolović

    2003-01-01

    Full Text Available The coronary heart disease (CHD is a leading cause of lethality in both sexes. The risk for development of CHD is 2-4 times higher in non insulin dependent diabetes mellitus (NIDDM than in nondiabetics, and annual rate of fatal and non-fatal cardiovascular diseases in NIDDM is 2-5%. The etiology of CHD is still unknown until the risk factors connected to the development of CHD are well known.The purpose of this research was to establish the frequency and importance of the risk factors in development of CHD in NIDDM.The research included 60 patients with NIDDM who were by presence of CHD classified into two groups. We determined body mass index and waist hip ratio, total and HDL cholesterol, triglicerides, LDL cholesterols, uric acid and fibrinogen.Values of BMI were statistically higher in patients with CHD than in diabetics without CHD 29.67+3.31 vs. 27.87±3.17 kg/m2 (p<0.05. Raised risk levels of cholesterol had90% with CHD and 76% without CHD (Hi2=6.12, p<0.05. Larger percentage of patients in group with CHD had raised lipid risk levels of triglicerides 70% than in patients without CHD 56.5% (Hi2=4.36, p<0.05. The obesity was relatively rare in patients without CHD than in diabetics with CHD (13.6% vs. 76%, p<0.01.The frequency of risk factors was very high in NIDDM patients, which clearly points at their cumulative effect in development of CHD in diabetics.

  2. Exposure to loud noise, bilateral high-frequency hearing loss and coronary heart disease.

    Science.gov (United States)

    Gan, Wen Qi; Moline, Jacqueline; Kim, Hyun; Mannino, David M

    2016-01-01

    Bilateral high-frequency hearing loss is an indicator for chronic exposure to loud noise. This study aimed to examine the association between bilateral high-frequency hearing loss and the presence of coronary heart disease (CHD). This study included 5223 participants aged 20-69 years who participated in the audiometry examination of the National Health and Nutrition Examination Survey 1999-2004. Bilateral high-frequency hearing loss was defined as the average high-frequency (3, 4 and 6 kHz) hearing threshold ≥25 dB in both ears. CHD was defined as self-reported diagnoses by doctors or other health professionals. Compared with those with normal high-frequency hearing, participants with bilateral high-frequency hearing loss were more likely to have CHD (OR 1.91; 95% CI 1.28 to 2.85) after adjustment for various covariates. This association was particularly strong for currently employed workers who were exposed to loud occupational noise (OR 4.23; 95% CI 1.32 to 13.55). For this subgroup, there was no significant association of CHD with unilateral high-frequency hearing loss, and unilateral or bilateral low-frequency hearing loss. Furthermore, there was no significant association of CHD with any types of hearing loss for participants who were not exposed to loud noise. Stratified analyses for participants exposed to loud noise showed that the observed association was particularly strong for those who were less than 50 years of age, less educated and current smokers. On the basis of an objective indicator for personal chronic exposure to loud noise, this study confirmed that exposure to loud occupational noise is associated with the presence of CHD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Outcomes associated with comorbid atrial fibrillation and heart failure in Medicare beneficiaries with acute coronary syndrome.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeff

    2014-02-20

    Atrial fibrillation (AF) and heart failure (HF) are both common comorbid conditions of elderly patients with acute coronary syndrome (ACS), but published data on their associated clinical and economic outcomes are limited. Our study included patients from the Medicare Current Beneficiary Survey with an incident hospitalization for ACS between 03/01/2002 and 12/31/2006. Applying population weights, we identified 795 incident ACS patients, representing more than 2.5 million Medicare beneficiaries. Of this population, 13.1% had comorbid AF, and 22.9% had HF, which were identified from Medicare claims during the 6 months prior to the first ACS event (index date) Subsequent cardiovascular (CV) hospitalizations and mortality were compared using Kaplan-Meier curves. Cox proportional hazards regressions were used to estimate the relative risk of AF and HF on CV events and mortality. Healthcare costs were summarized for the calendar year in which the incident ACS event occurred. HF was associated with a 41% higher risk of mortality (HR = 1.41; 95% confidence interval [CI] 1.05-1.89). Both AF (HR = 1.46; 95% CI 1.14-1.87) and HF (HR = 1.61; 95% CI 1.26-2.06) were associated with higher risks of subsequent CV events. During the year of the incident ACS event, ACS patients with comorbid AF or HF had approximately $18,000 higher total healthcare costs than those without these comorbidities. Using a nationally representative sample of Medicare beneficiaries, we observed a significantly higher clinical and economic burden of patients hospitalized for ACS with comorbid AF and HF compared with those without these conditions.

  4. LINE-1 Hypomethylation is Associated with the Risk of Coronary Heart Disease in Chinese Population

    International Nuclear Information System (INIS)

    Wei, Li; Liu, Shuchuan; Su, Zhendong; Cheng, Rongchao; Bai, Xiuping; Li, Xueqi

    2014-01-01

    Global methylation level in blood leukocyte DNA has been associated with the risk of coronary heart disease (CHD), with inconsistent results in various populations. Similar data are lacking in Chinese population where different genetic, lifestyle and environmental factors may affect DNA methylation and its risk relationship with CHD. To examine whether global methylation is associated with the risk of CHD in Chinese population. A total of 334 cases with CHD and 788 healthy controls were included. Global methylation in blood leukocyte DNA was estimated by analyzing LINE-1 repeats using bisulfite pyrosequencing. In an initial analysis restricted to control subjects, LINE-1 level reduced significantly with aging, elevated total cholesterol, and diagnosis of diabetes. In the case-control analysis, reduced LINE-1 methylation was associated with increased risk of CHD; analysis by quartile revealed odds ratios (95%CI) of 0.9 (0.6-1.4), 1.9 (1.3-2.9) and 2.3 (1.6-3.5) for the third, second and first (lowest) quartile (P trend < 0.001), respectively, compared to the fourth (highest) quartile. Lower (

  5. Correlation analysis of levels of adiponectin and matrix metalloproteinase-9 with stability of coronary heart disease.

    Science.gov (United States)

    Li, Ya

    2015-01-01

    To analyze the changes of adiponection (ANP) and matrix metalloproteinase-9 (MMP-9) in patients with coronary heart diseases (CHD) of different types, to investigate the correlation between these changes and stability of coronary artery plague. Inpatients of our hospital were divided into 56 cases with acute myocardial infarction (AMI), 56 cases with unstable angina pectoris (UA), 54 cases with stable angina pectoris (SA), and 60 cases with CHD excluded by using coronary arteriongraphy as the control group. Changes of ANP and MMP-9 were determined, and the correlation was analyzed. 1. ANP and MMP-9 levels in CHD group were higher than those of control group (P < 0.01). 2. Serum ANP and MMP-9 levels in AMI and UA groups were significantly higher than those in control group and SA group (P < 0.05). 3. MMP-9 level in AMI group was significantly higher than that in UA group (P < 0.01). 1. Increased ANP and MMP-9 levels are the independent risk factors of CHD; 2. Increased levels of ANP and MMP-9 in patients with CHD suggest instability of atherosclerotic plaque.

  6. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

    NARCIS (Netherlands)

    Kivimäki, M.; Jokela, M.; Nyberg, S.T.; Singh-Manoux, A.; Fransson, E.I.; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Casini, A.; Clays, E.; Bacquer, D. de; Dragano, N.; Erbel, R.; Geuskens, G.A.; Hamer, M.; Hooftman, W.E.; Houtman, I.L.; Jöckel, K.H.; Kittel, F.; Knutsson, A.; Koskenvuo, M.; Lunau, T.; Madsen, I.E.; Nielsen, M.L.; Nordin, M.; Oksanen, T.; Pejtersen, J.H.; Pentti, J.; Rugulies, R.; Salo, P.; Shipley, M.J.; Siegrist, J.; Steptoe, A.; Suominen, S.B.; Theorell, T.; Vahtera, J.; Westerholm, P.J.M.; O'Reilly, D.; Kumari, M.; Batty, G.D.; Ferrie, J.E.; Virtanen, M.

    2015-01-01

    Background: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. Methods: We identified

  7. Insertion/deletion polymorphism in the angiotensin-I-converting enzyme gene is associated with coronary heart disease in IDDM patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Tarnow, L; Cambien, Francois; Rossing, P

    1995-01-01

    Insulin-dependent diabetic (IDDM) patients with diabetic nephropathy have a highly increased morbidity and mortality from coronary heart disease. An insertion (I) /deletion (D) polymorphism in the angiotensin-I-converting enzyme (ACE) gene has been shown to be associated with coronary heart disea...

  8. Increased mortality associated with low use of clopidogrel in patients with heart failure and acute myocardial infarction not undergoing percutaneous coronary intervention: a nationwide study

    DEFF Research Database (Denmark)

    Bonde, Lisbeth; Sorensen, Rikke; Fosbøl, Emil Loldrup

    2010-01-01

    We studied the association of clopidogrel with mortality in acute myocardial infarction (AMI) patients with heart failure (HF) not receiving percutaneous coronary intervention (PCI).......We studied the association of clopidogrel with mortality in acute myocardial infarction (AMI) patients with heart failure (HF) not receiving percutaneous coronary intervention (PCI)....

  9. STEPS to a Healthier Heart: Improving Coronary Heart Disease (CHD) Knowledge among African American Women

    Science.gov (United States)

    Brown, Cynthia Williams; Alexander, Dayna S.; Cummins, Kayla; Price, Amanda Alise; Anderson-Booker, Marian

    2018-01-01

    Background: African American women have the highest risk of death from heart disease among all racial, ethnic, and gender groups due to sedentary behaviors. Purpose: This article describes an intervention among 2 groups--a program group and an information group (intervention and comparison)--that assessed cardiovascular risk factor knowledge among…

  10. The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease.

    Science.gov (United States)

    DiNicolantonio, James J; Lucan, Sean C; O'Keefe, James H

    2016-01-01

    Dietary guidelines continue to recommend restricting intake of saturated fats. This recommendation follows largely from the observation that saturated fats can raise levels of total serum cholesterol (TC), thereby putatively increasing the risk of atherosclerotic coronary heart disease (CHD). However, TC is only modestly associated with CHD, and more important than the total level of cholesterol in the blood may be the number and size of low-density lipoprotein (LDL) particles that contain it. As for saturated fats, these fats are a diverse class of compounds; different fats may have different effects on LDL and on broader CHD risk based on the specific saturated fatty acids (SFAs) they contain. Importantly, though, people eat foods, not isolated fatty acids. Some food sources of SFAs may pose no risk for CHD or possibly even be protective. Advice to reduce saturated fat in the diet without regard to nuances about LDL, SFAs, or dietary sources could actually increase people's risk of CHD. When saturated fats are replaced with refined carbohydrates, and specifically with added sugars (like sucrose or high fructose corn syrup), the end result is not favorable for heart health. Such replacement leads to changes in LDL, high-density lipoprotein (HDL), and triglycerides that may increase the risk of CHD. Additionally, diets high in sugar may induce many other abnormalities associated with elevated CHD risk, including elevated levels of glucose, insulin, and uric acid, impaired glucose tolerance, insulin and leptin resistance, non-alcoholic fatty liver disease, and altered platelet function. A diet high in added sugars has been found to cause a 3-fold increased risk of death due to cardiovascular disease, but sugars, like saturated fats, are a diverse class of compounds. The monosaccharide, fructose, and fructose-containing sweeteners (e.g., sucrose) produce greater degrees of metabolic abnormalities than does glucose (either isolated as a monomer, or in chains as starch

  11. [Endothelial dysfunction as a marker of vascular aging syndrome on the background of hypertension, coronary heart disease, gout and obesity].

    Science.gov (United States)

    Vatseba, M O

    2013-09-01

    Under observation were 40 hypertensive patients with coronary heart disease, gout and obesity I and II degree. Patients with hypertension in combination with coronary heart disease, gout and obesity, syndrome of early vascular aging is shown by increased stiffness of arteries, increased peak systolic flow velocity, pulse blood presure, the thickness of the intima-media complex, higher level endotelinemia and reduced endothelial vasodilation. Obtained evidence that losartan in complex combination with basic therapy and metamaks in complex combination with basic therapy positively affect the elastic properties of blood vessels and slow the progression of early vascular aging syndrome.

  12. Early Menopause Predicts Future Coronary Heart Disease and Stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

    Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

    2012-01-01

    Objective Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if a self-reported early menopause (menopause at an age menopause (either natural menopause or surgical removal of ovaries at an age menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank p=menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors. PMID:22692332

  13. Short-term Prediction of Coronary Heart Disease Mortality in the Czech Republic Based on Data from 1968-2014.

    Czech Academy of Sciences Publication Activity Database

    Reissigová, Jindra; Zvolský, M.

    2018-01-01

    Roč. 26, č. 1 (2018), s. 10-15 ISSN 1210-7778 Institutional support: RVO:67985807 Keywords : mortality * coronary heart diseases * short-term prediction * long-term prediction * national health registries Subject RIV: BB - Applied Statistics, Operational Research OBOR OECD: Applied mathematics Impact factor: 0.682, year: 2016 https://cejph.szu.cz/artkey/cjp-201801-0002_short-term-prediction-of-coronary- heart -disease-mortality-in-the-czech-republic-based-on-data-from-1968-2014.php

  14. Increased serum iron associated with coronary heart disease among nigerian adults

    International Nuclear Information System (INIS)

    Orimadegun, B.E.; Taylor, G.O.; Onuegbu, J.A.; Olisekodiaka, J.M.

    2007-01-01

    To examine the concentrations of serum iron and some risk factors of coronary heart disease in Nigerians with evidence of Coronary Heart Disease. The concentration of serum iron, the plasma cholesterol level, the hip-waist ratio and body mass index of 70 patients with evidence of CHD seen at a Cardiology Unit of a Specialist Hospital in Ibadan and 70 healthy subjects selected randomly were determined. Subjects were grouped into four age categories and three socioeconomic classes (high, middle and low). The age of the subjects ranged from 31-70 years with the mean of 53.6+-11.0 years and 50.1+-10.5 years for patients and controls respectively. The mean serum iron and plasma cholesterol levels were significantly higher among patients than controls irrespective of age and sex (p<0.05). No correlation was found between serum iron and the variables; plasma cholesterol level, age, body mass index (BMI) and hip-waist ratio. Significantly higher serum iron levels found in patients with evidence of CHD appears to support the hypothesis that there is a potential association between iron status and CHD. (author)

  15. Radiologically revealed spine osteoporosis in male with hypertension and coronary heart disease

    Directory of Open Access Journals (Sweden)

    P A Chizhov

    2005-01-01

    Full Text Available Radiologically revealed spine osteoporosis in male with hypertension and coronary heart disease Objective. To study prevalence and intensity of spine osteoporosis (OP in men suffering from hypertension (H and coronary heart disease (CHD. Material and methods. 101 men with H and CHD aged 50 to 78 years (mean age 60,6±0,85 years and 37 men of control group without cardiovascular diseases aged 50-66 years (mean age 58,6±0,74 years were examined. Clinical examination, radiological, radiomorphometric spine examination and echocardioscopy were performed. Results. OP was revealed in 34,65% of main group pts what is 3,2 times more frequent than in control group (10,8%, p<0,05. OP intensity in men with H and CHD was significantly higher than in healthy people. Vfertebral fractures were revealed in 12,87+3,3% of main group pts and only in 2,7±2,7% in control group (p<0,05. OP development dependence from cardiac history duration and cardiac pathology severity was demonstrated. Conclusion. The results of the study show significantly higher prevalence of spine OP among men suffering from H and CHD. Long history and severity of cardiovascular pathology clinical signs promote OP frequency and severity increase.

  16. Initial heart rate and cardiovascular outcomes in patients presenting with acute coronary syndrome.

    Science.gov (United States)

    Asaad, Nidal; El-Menyar, Ayman; AlHabib, Khalid F; Shabana, Adel; Alsheikh-Ali, Alawi A; Almahmeed, Wael; Al Faleh, Hussam; Hersi, Ahmad; Al Saif, Shukri; Al-Motarreb, Ahmed; Sulaiman, Kadhim; Al Nemer, Khalid; Amin, Haitham; Al Suwaidi, Jassim

    2014-06-01

    To assess the impact of on-admission heart rate (HR) in patients presenting with acute coronary syndrome (ACS). Data were collected retrospectively from the second Gulf Registry of Acute Coronary Events. Patients were divided according to their initial HR into: (I: < 60, II: 60-69, III: 70-79, IV: 80-89 and V: ≥ 90 bpm). Patients' characteristics and hospital and one- and 12-month outcomes were analyzed and compared. Among 7939 consecutive ACS patients, groups I to V represented 7%, 13%, 20%, 23.5%, and 37%, respectively. Mean age was higher in groups I and V. Group V were more likely males, diabetic and hypertensive. ST-elevation myocardial infarction was the main presentation in groups I and V. Reperfusion therapies were less likely given to group V. Beta blockers were more frequently prescribed to group III in comparison to groups with higher HR. Groups I and V were associated with worse hospital outcomes. Multivariate analysis showed initial tachycardia as an independent predictor for heart failure (OR 2.2; 95%CI: 1.39-3.32), while bradycardia was independently associated with higher one-month mortality (OR 2.0; 95%CI: 1.04-3.85) CONCLUSION: The majority of ACS patients present with tachycardia. However, low or high HR is a marker of high risk that needs more attention and management.

  17. Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study.

    Science.gov (United States)

    Nabi, Hermann; Kivimäki, Mika; Batty, G David; Shipley, Martin J; Britton, Annie; Brunner, Eric J; Vahtera, Jussi; Lemogne, Cédric; Elbaz, Alexis; Singh-Manoux, Archana

    2013-09-01

    Response to stress can vary greatly between individuals. However, it remains unknown whether perceived impact of stress on health is associated with adverse health outcomes. We examined whether individuals who report that stress adversely affects their health are at increased risk of coronary heart disease (CHD) compared with those who report that stress has no adverse health impact. Analyses are based on 7268 men and women (mean age: 49.5 years, interquartile range: 11 years) from the British Whitehall II cohort study. Over 18 years of follow-up, there were 352 coronary deaths or first non-fatal myocardial infarction (MI) events. After adjustment for sociodemographic characteristics, participants who reported at baseline that stress has affected their health 'a lot or extremely' had a 2.12 times higher (95% CI 1.52-2.98) risk of coronary death or incident non-fatal MI when compared with those who reported no effect of stress on their health. This association was attenuated but remained statistically significant after adjustment for biological, behavioural, and other psychological risk factors including perceived stress levels, and measures of social support; fully adjusted hazard ratio: 1.49 (95% CI 1.01-2.22). In this prospective cohort study, the perception that stress affects health, different from perceived stress levels, was associated with an increased risk of coronary heart disease. Randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health.

  18. Optimized imaging quality and radiation dose for coronary artery angiography using 128-slice, dual-source Flash Spiral CT under the natural heart rate

    International Nuclear Information System (INIS)

    Xue Yuejun; Qian Nong; Shao Yanhui; Pan Changjie; Rong Weiliang; Xu Yiqun; Tao Zhiwei

    2011-01-01

    Objective: To compare the quality and radiation doses of coronary artery angiography under the natural heart rate condition between Flash spiral heart mode and prospective electrocardiogram- triggering sequence mode using dual-source, in order to choose personalized low doses of coronary artery scanning mode. Methods: Sixty patients who underwent coronary angiography (CTA) on a 128-slice, dual- source CT scanner were divided into 2 group i.e, group A (27 cases) and group B (33 cases). Flash spiral heart scan mode was employed for group A. Inclusion criteria included: heart rate 75 bpm), date acquisition was set at 30%-50% of the R-R interval. (3) At the arrhythmias, premature beat, fibrillation atrial, date acquisition was set at 20%-90% of the R-R interval. In both groups, patients with a BMI ≥ 25.0 kg/m 2 were examined with a tube voltage of 120 kV, while the other patients with a BMI 2 were examined with a tube voltage of 100 kV. The BMI was (24.6±1.0) kg/m 2 in group A, while that was (24.6±0.9) kg/m 2 in group B. In both groups, all images were transferred to the workstation for further processing and analysis. The imaging quality of coronary artery segments and the radiation dose were compared with t test. Results: A total of 336 coronary artery segments were evaluated in group A and 412 segments were evaluated in group B. The imaging quality of coronary artery segments were scored. Excellent or good was achieved in 98.2% (330 of 336) artery segments in group A, and that was 98.1% (404 of 412) in group B. There was no statistical difference in imaging quality between the two groups (t=0.513, P=0.608). The average effective dose was (0.74±0.29) mSv in group A, whereas that was (3.67± 1.37) mSv in group B. There was a significant difference between the two groups (t=-10.858, P= 0.000). Conclusions: The personalized low doses coronary artery scanning mode can substantially reduce radiation damage while preserving good imaging quality. (authors)

  19. The relationship between coronary artery calcification detected by non-gated multi-detector CT in patients with suspected ischemic heart disease and myocardial ischemia detected by thallium exercise stress testing

    International Nuclear Information System (INIS)

    Nishida, Chikako; Okajima, Kaoru; Yamamoto, Takashi; Hattori, Ryuichi; Kudo, Takashi; Nishimura, Yasumasa

    2005-01-01

    The objective of this study was to examine whether we could predict myocardial ischemia when coronary artery calcification is detected by non-gated multidetector CT in patients with suspected ischemic