Cvd Prevention and Control最新文献

Chronic hepatitis C virus infection has been associated with several extrahepatic manifestations, among these, renal and cardiac involvement. However, morphological evidence of hepatitis C virus localization in various organs remains to be clarified.

We used immunohistochemistry to analyze the hepatitis C virus core and nonstructural antigens. Peripheral blood mononuclear cells were obtained from four patients with hepatitis C virus infection. Liver, kidney, heart, and bone marrow were taken from autopsy specimens from nine patients with hepatocellular carcinoma and three patients with cardiomyopathies with positive hepatitis C virus infection.

Antibody against hepatitis C virus core antigen stained peripheral blood mononuclear cells, and the majority of positive staining was seen in CD68-positive macrophages. Hepatitis C virus core and NS4 antibodies stained mostly infiltrating cells in the liver, heart, kidney, and bone marrow, but not hepatocytes, myocytes, or globular cells. Serial sections stained by CD68, CD3, and CD20 antibodies showed that most of the hepatitis C virus-positive cells were CD68-positive macrophages.

We demonstrate for the first time clear distribution of hepatitis C virus antigen in mononuclear cells in various organs from patients with hepatitis C virus infection. This study suggests that macrophages are the major target of hepatitis C virus infection.

Four hundred and 16 subjects (average age, 56.2 years; range, 20–92 years; Men/Women, 207/209) undergoing annual health check-up were studied for the effect of aging and hypertension on arterial compliance or elasticity index, which were measured after a 10 min rest in the supine position using CR-2000. Thirteen additional elderly patients with hypertension were also studied at rest in the supine position 30 min before and after 8 mg benidipine oral administration at the beginning of treatment and then repeatedly studied after a 10 min rest over at least 4–7 weeks to examine the effect of benidipine hydrochloride 8 mg on arterial compliance in a similar manner. Systolic blood pressure and pulse pressure were increased in subjects above 40 years of age. Diastolic blood pressure was also increased up to 60 years of age but after 60 years of age, it was decreased or rather it plateaued. Above 40 years of age, large and small arterial compliance levels were significantly decreased with advancing age. Small arterial compliance was much more decreased than large arterial compliance. In hypertensive subjects, small and large arterial compliance levels were significantly decreased in comparison with normotensive subjects. Benidipine hydrochloride 8 mg was given orally every morning in elderly hypertensive patients for at least 1 month, and blood pressure and arterial compliance were measured every week using CR-2000. Benidipine hydrochloride decreased blood pressure and improved arterial compliance gradually and safely without any adverse effect. Therefore, benidipine hydrochloride is thought to be a useful antihypertensive drug for elderly hypertensives because of its potential to improve arterial function and perhaps arterial properties.

During the last couple of years, the focus of attention has drifted from coronary risk to cardio-metabolic risk because of the growing epidemic of cardio-metabolic disorders such as obesity, metabolic syndrome, diabetes, and cardiovascular disease (CVD). Physical inactivity and consumption of high-energy foods are the root causes of this epidemic.

There are divergent criteria for the identification of metabolic syndrome (MetS), but all the definitions agree that obesity, insulin resistance, dyslipidemia and hypertension are core components of this syndrome. The MetS is associated with an increased risk of cardiovascular disease events in general populations. Well-designed prospective studies in Asian populations are very limited. This study characterizes nine parameters of the MetS in a population of diabetic patients without a history of cardiovascular disease in Bangladesh, and defines the influence of MetS on peripheral vascular disease. A total of 100 patients with diabetes who visited the outpatient department of BIRDEM for routine diabetic follow-up were included in this study. The prevalence of MetS was 66%. Sixty-seven percent of patients had a waist circumference above normal, 89% hypertriglyceridemia, and 87% a low HDL-C level, while elevated systolic blood pressure was found in 46% and diastolic blood pressure in 55%, according to IDF criteria. Peripheral vascular disease defined by a low ankle-brachial index (<0.9) was identified in 24% of patients with no history of a cardiovascular event.

Objective

This study aims to describe the different clinical outcomes of ST-Segment Elevated (STEMI) Myocardial Infarction patients of a tertiary care cardiac hospital in Bangladesh who went through Primary Per-cutaneous Coronary Intervention (PCI).

Methods

This study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh. Participants of the study were 80 patients with a diagnosis of acute STEMI. Information was collected on their demographic characteristics and clinical history. Relevant physical examination and laboratory investigations were performed. Percutaneous transluminal coronary angioplasty (PTCA) ± stent implantation was done in the culprit vessel. Coronary angiograms were done before and after the procedure. They were followed up thoroughly during the hospital stay.

Results

According to the 12 lead surface ECG, 25% had an extensive anterior MI, 20% anteroseptal MI, 35% an inferior MI, 10% an anterior MI, 7.5% an inferior with right ventricular infarction and 2.5% a lateral MI. The mean door to balloon time was 95.6 ± 33.4 min. LAD was the most common (51.2%) culprit vessel followed by RCA (38.5%) and LCX (10.2%).We compare, (1) ECG changes (return of ST segment towards isoelectric line in mm). (2) Improvement of TIMI flow. (3) Improvement of LV function (LVEF measured by echocardiography). (4) Complications (general, vascular). There was significant improvement in ECG changes (return of ST segment towards isoelectric line in mm). Pre and post-procedural mean ST elevation was 6.6 ± 2.7 mm and 0.5 ± 0.8 mm. Examining improvement of TIMI flow after the PCI, 87.5% had TIMI-3 flow, 7.5% had TIMI-2 flow, 2.5% had TIMI-1 and 2.5% had TIMI-0 flow (P < 0.001). The pre-procedural mean left ventricular ejection fraction (LVEF) was 41.6 ± 4.2% and the post-procedural mean LVEF was 51.8 ± 5.1% (P < 0.01). There were, 7.7% with post-procedural general complications and no vascular complications in any of the patients. In-terms of major adverse cardiac events (MACE), only 2(2.5%) patients died, one was due to a cardiac arrest 8 h after the procedure, and another was due to ventricular fibrillation followed by asystole 2 h after the procedure.

Conclusion

The study results show that with limited facilities and financial abilities, patients receiving Primary PCI had good in hospital outcomes which is similar to other studies done in different countries. So primary PCI may be the preferred method of reperfusion for the management of STEMI in the current Bangladeshi setting.

Background

Studies have shown that baseline serum γ-glutamyltransferase (GGT) is independently associated with cardiovascular disease (CVD) risk in men and women. However, less is known whether GGT is similarly associated with both stroke and heart disease (HD) risk in Asia. We examined an association between serum GGT and deaths from stroke and HD in Japanese men and women.

Methods

From 1990 to 2005, we followed 7488 adults (3089 men) randomly selected from 300 districts throughout Japan, aged 30–95 with no history of coronary disease nor stroke at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) according to sex-specific GGT strata.

Results

During the study period, observed deaths from HD and stroke were 165 (83 men), and 135 (66 men), respectively. After adjustment for confounding factors, HRs of HD death for 25th, 50th, 75th, and 90th GGT percentiles in reference to the lowest GGT stratum were 1.61, 2.28, 2.48, and 4.59 in women (P for trend = 0.001), and 0.90, 0.74, 1.42, and 1.56 in men (P for trend = 0.250). The corresponding HRs of total stroke death were 1.52, 0.95, 1.22, and 1.34 in women (P for trend = 0.785), and 0.75, 0.91, 1.26, and 1.02 in men (P for trend = 0.642). Results were similar when analysis was limited to never-drinkers.

Conclusion

This cohort study of representative Japanese men and women suggested that baseline GGT independently predicts future HD mortality risk, especially in women, but not stroke mortality risk in Asian.