Pub Date : 2024-05-31DOI: 10.1016/j.ijcrp.2024.200292
H.A. Nati-Castillo , David Aristizabal-Colorado , Carolina López Ordoñez , Diego Egas Proaño , Esteban Ortiz-Prado , Juan S. Izquierdo-Condoy
Background
Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality.
Objective
The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer.
Case
A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed.
Conclusion
Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.
{"title":"Takotsubo syndrome as an acute cardiac complication following combined chemotherapy","authors":"H.A. Nati-Castillo , David Aristizabal-Colorado , Carolina López Ordoñez , Diego Egas Proaño , Esteban Ortiz-Prado , Juan S. Izquierdo-Condoy","doi":"10.1016/j.ijcrp.2024.200292","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200292","url":null,"abstract":"<div><h3>Background</h3><p>Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality.</p></div><div><h3>Objective</h3><p>The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer.</p></div><div><h3>Case</h3><p>A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed.</p></div><div><h3>Conclusion</h3><p>Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200292"},"PeriodicalIF":2.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000576/pdfft?md5=bb7fbb4891a2536b1f96af8c86c64fdc&pid=1-s2.0-S2772487524000576-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Limited data exists on upfront combination therapy for portopulmonary hypertension. We evaluated the clinical efficacy, long-term outcomes, and safety of upfront combination therapy in patients with portopulmonary hypertension.
Methods
We performed a retrospective, single-center cohort study involving a final analysis of 33 consecutive patients diagnosed with portopulmonary hypertension who were taking pulmonary arterial hypertension-specific medication. We compared hemodynamic parameters, risk profiles, composite clinical worsening events, and safety between monotherapy (n = 23) and upfront combination therapy (n = 10).
Results
Twenty-seven patients (82 %) were classified into the Child–Pugh A stage. The change ratios of pulmonary vascular resistance (−32 % vs. −57 %, P = 0.006) were significantly better with upfront combination therapy. Upfront combination therapy also showed significant improvement in risk profiles. Kaplan–Meier analysis showed that the composite event-free rate was significantly lower in patients who received upfront combination therapy than in those who received monotherapy (P = 0.016), although no statistical differences were observed in all-cause death. In the univariate Cox proportional hazards analysis, upfront combination therapy was a factor for decreasing composite clinical worsening outcomes (hazard ratio 0.190, 95 % confidence interval 0.042–0.854; P = 0.030). No significant hepatic impairments were observed over 2 years of follow-up in the upfront combination group.
Conclusions
In patients with portopulmonary hypertension, upfront combination therapy significantly improved symptoms and short-term hemodynamics, and reduced long-term clinical worsening events without serious adverse effects. This study's findings suggest that patients with portopulmonary hypertension presenting with mild hepatic impairment benefit from upfront combination therapy.
{"title":"Clinical outcomes of upfront combination therapy for portopulmonary hypertension","authors":"Takatoyo Kiko , Ryotaro Asano , Hiroyuki Endo , Naruhiro Nishi , Hiroya Hayashi , Jin Ueda , Tatsuo Aoki , Akihiro Tsuji , Takeshi Ogo","doi":"10.1016/j.ijcrp.2024.200294","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200294","url":null,"abstract":"<div><h3>Background</h3><p>Limited data exists on upfront combination therapy for portopulmonary hypertension. We evaluated the clinical efficacy, long-term outcomes, and safety of upfront combination therapy in patients with portopulmonary hypertension.</p></div><div><h3>Methods</h3><p>We performed a retrospective, single-center cohort study involving a final analysis of 33 consecutive patients diagnosed with portopulmonary hypertension who were taking pulmonary arterial hypertension-specific medication. We compared hemodynamic parameters, risk profiles, composite clinical worsening events, and safety between monotherapy (n = 23) and upfront combination therapy (n = 10).</p></div><div><h3>Results</h3><p>Twenty-seven patients (82 %) were classified into the Child–Pugh A stage. The change ratios of pulmonary vascular resistance (−32 % vs. −57 %, P = 0.006) were significantly better with upfront combination therapy. Upfront combination therapy also showed significant improvement in risk profiles. Kaplan–Meier analysis showed that the composite event-free rate was significantly lower in patients who received upfront combination therapy than in those who received monotherapy (P = 0.016), although no statistical differences were observed in all-cause death. In the univariate Cox proportional hazards analysis, upfront combination therapy was a factor for decreasing composite clinical worsening outcomes (hazard ratio 0.190, 95 % confidence interval 0.042–0.854; P = 0.030). No significant hepatic impairments were observed over 2 years of follow-up in the upfront combination group.</p></div><div><h3>Conclusions</h3><p>In patients with portopulmonary hypertension, upfront combination therapy significantly improved symptoms and short-term hemodynamics, and reduced long-term clinical worsening events without serious adverse effects. This study's findings suggest that patients with portopulmonary hypertension presenting with mild hepatic impairment benefit from upfront combination therapy.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200294"},"PeriodicalIF":2.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277248752400059X/pdfft?md5=05e38f9b9c971dcf588cf7bd1f11bc24&pid=1-s2.0-S277248752400059X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1016/j.ijcrp.2024.200293
Bryan Mouser , James R. Howe , Olivia Atari , Joseph S. Dillon , Chandrikha Chandrasekharan , Kalpaj R. Parekh , Mohammad A. Bashir
Background
Screening for carcinoid heart disease (CHD), has historically lacked consensus expert guidelines. In 2017, the North American Neuroendocrine Tumor Society (NANETS) released expert recommendations for CHD screening among NET patients to improve CHD detection. The objective of this study is to evaluate CHD screening trends and utility of screening guidelines over more than two decades at a single tertiary care center.
Materials and methods
Patients with NETs referred for abdominal surgical evaluation at a single tertiary care center were included, 300 patients from 1999 to 2018 and 34 patients from 2021 to 2022. Lab values for the following NANETS-proposed criteria at any point during their treatments were recorded: NETs with liver metastasis, blood serotonin >5 times upper limit of normal (>1000 ng/mL), NT-ProBNP >260 pg/mL and clinical features suggestive of CHD.
Results
85 % (285/334) of patients included in this study met one or more expert-recommended CHD screening criteria. However, 40 % (132/285) of patients meeting one or more criteria received CHD screening via echocardiogram at some point following NET diagnosis. While rates of screening for patients increased from the first decade to the second decade (32 % vs 40.6 %), the rates were much higher after guideline publication (70 %, 24/34). Furthermore, patients meeting multiple screening criteria were more likely to have evidence of structural valve disease.
Conclusions
Results of this study suggest that utilization of these four expert-recommended screening criteria have greatly increased rates of CHD screening via echocardiogram and could assist in improving early CHD detection, especially for patients meeting multiple criteria.
背景类癌性心脏病（CHD）筛查历来缺乏专家共识指南。2017年，北美神经内分泌肿瘤学会（NANETS）发布了对NET患者进行CHD筛查的专家建议，以提高CHD的检出率。本研究的目的是评估一家三级医疗中心二十多年来的CHD筛查趋势和筛查指南的实用性。材料和方法纳入了一家三级医疗中心转诊进行腹部手术评估的NET患者，其中1999年至2018年有300例患者，2021年至2022年有34例患者。记录了治疗期间任何时间点的以下NANETS提出的标准的实验室值：NET伴肝转移、血清素>正常值上限的5倍（>1000 ng/mL）、NT-ProBNP>260 pg/mL以及提示CHD的临床特征。结果85%（285/334）纳入本研究的患者符合一项或多项专家建议的CHD筛查标准。然而，在符合一项或多项标准的患者中，有 40% （132/285）的患者在确诊为 NET 后的某个阶段接受了超声心动图检查。虽然患者的筛查率从第一个十年上升到第二个十年（32% vs 40.6%），但在指南发布后，筛查率要高得多（70%，24/34）。此外，符合多项筛查标准的患者更有可能有结构性瓣膜疾病的证据。结论这项研究的结果表明，采用专家推荐的这四项筛查标准大大提高了通过超声心动图进行心脏病筛查的比例，有助于改善早期心脏病的检测，尤其是符合多项标准的患者。
{"title":"Screening for carcinoid heart disease: Trends and future Perspectives","authors":"Bryan Mouser , James R. Howe , Olivia Atari , Joseph S. Dillon , Chandrikha Chandrasekharan , Kalpaj R. Parekh , Mohammad A. Bashir","doi":"10.1016/j.ijcrp.2024.200293","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200293","url":null,"abstract":"<div><h3>Background</h3><p>Screening for carcinoid heart disease (CHD), has historically lacked consensus expert guidelines. In 2017, the North American Neuroendocrine Tumor Society (NANETS) released expert recommendations for CHD screening among NET patients to improve CHD detection. The objective of this study is to evaluate CHD screening trends and utility of screening guidelines over more than two decades at a single tertiary care center.</p></div><div><h3>Materials and methods</h3><p>Patients with NETs referred for abdominal surgical evaluation at a single tertiary care center were included, 300 patients from 1999 to 2018 and 34 patients from 2021 to 2022. Lab values for the following NANETS-proposed criteria at any point during their treatments were recorded: NETs with liver metastasis, blood serotonin >5 times upper limit of normal (>1000 ng/mL), NT-ProBNP >260 pg/mL and clinical features suggestive of CHD.</p></div><div><h3>Results</h3><p>85 % (285/334) of patients included in this study met one or more expert-recommended CHD screening criteria. However, 40 % (132/285) of patients meeting one or more criteria received CHD screening via echocardiogram at some point following NET diagnosis. While rates of screening for patients increased from the first decade to the second decade (32 % vs 40.6 %), the rates were much higher after guideline publication (70 %, 24/34). Furthermore, patients meeting multiple screening criteria were more likely to have evidence of structural valve disease.</p></div><div><h3>Conclusions</h3><p>Results of this study suggest that utilization of these four expert-recommended screening criteria have greatly increased rates of CHD screening via echocardiogram and could assist in improving early CHD detection, especially for patients meeting multiple criteria.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200293"},"PeriodicalIF":2.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000588/pdfft?md5=7140b5fc3926a586566315e96ee509a2&pid=1-s2.0-S2772487524000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-24DOI: 10.1016/j.ijcrp.2024.200290
Abdullahi Adejare, Ahmed Oloyo, Yusuf Dahud, Morufat Adeshina, Abiola Agbaje, Clinton Ejim, Khadijah Ismail-Badmus, Smith Jaja
Background
Hypertension is associated with cardiovascular dysfunction, dysregulation of the antioxidant system and alteration of the level of some enzymes in the metabolic pathway. The possible modulatory effect of acute renal denervation (ARD) on cardiovascular function and the antioxidant system is still a subject of intense debate. This study sought to ascertain the ameliorative effects of ARD on cardiovascular parameters, antioxidant system, creatine kinase and lactate dehydrogenase levels.
Methods
Thirty-six Sprague-Dawley rats (5–6 weeks old) were divided into 6 groups of 6 animals each consisting of Normal Salt, High Salt, Normal Salt + Sham Denervation, High Salt + Sham Denervation, Normal Salt + Renal Denervation and High Salt + Renal Denervation. Induction of hypertension with 8 % salt in the diet lasted for 8 weeks. Renal or Sham denervation was thereafter done on selected groups. At the end of the experimental period, cardiovascular parameters, plasma antioxidant status, plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels were assessed. Significance level was set at p < 0.05.
Results
Salt-loading significantly increased systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), rate pressure product (RPP) while reducing superoxide dismutase (SOD), reduced glutathione (GSH) and catalase (CAT). Acute renal denervation significantly (p < 0.0001) reduced SBP, DBP, MABP, RPP, LDH and norepinephrine level while increasing SOD, GSH and CAT. ARD did not significantly alter CK level.
Conclusion
Acute renal denervation, by reducing sympathetic activity, ameliorates cardiovascular and antioxidant functions as well as reduces LDH level without significantly altering CK level in salt-induced hypertension.
{"title":"Renal denervation ameliorated salt-induced hypertension by improving cardiac work, cardiac enzyme and oxidative balance in Sprague-Dawley rats","authors":"Abdullahi Adejare, Ahmed Oloyo, Yusuf Dahud, Morufat Adeshina, Abiola Agbaje, Clinton Ejim, Khadijah Ismail-Badmus, Smith Jaja","doi":"10.1016/j.ijcrp.2024.200290","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200290","url":null,"abstract":"<div><h3>Background</h3><p>Hypertension is associated with cardiovascular dysfunction, dysregulation of the antioxidant system and alteration of the level of some enzymes in the metabolic pathway. The possible modulatory effect of acute renal denervation (ARD) on cardiovascular function and the antioxidant system is still a subject of intense debate. This study sought to ascertain the ameliorative effects of ARD on cardiovascular parameters, antioxidant system, creatine kinase and lactate dehydrogenase levels.</p></div><div><h3>Methods</h3><p>Thirty-six Sprague-Dawley rats (5–6 weeks old) were divided into 6 groups of 6 animals each consisting of Normal Salt, High Salt, Normal Salt + Sham Denervation, High Salt + Sham Denervation, Normal Salt + Renal Denervation and High Salt + Renal Denervation. Induction of hypertension with 8 % salt in the diet lasted for 8 weeks. Renal or Sham denervation was thereafter done on selected groups. At the end of the experimental period, cardiovascular parameters, plasma antioxidant status, plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels were assessed. Significance level was set at p < 0.05.</p></div><div><h3>Results</h3><p>Salt-loading significantly increased systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), rate pressure product (RPP) while reducing superoxide dismutase (SOD), reduced glutathione (GSH) and catalase (CAT). Acute renal denervation significantly (p < 0.0001) reduced SBP, DBP, MABP, RPP, LDH and norepinephrine level while increasing SOD, GSH and CAT. ARD did not significantly alter CK level.</p></div><div><h3>Conclusion</h3><p>Acute renal denervation, by reducing sympathetic activity, ameliorates cardiovascular and antioxidant functions as well as reduces LDH level without significantly altering CK level in salt-induced hypertension.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200290"},"PeriodicalIF":2.3,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000552/pdfft?md5=bde730d7d3ea10844068f0e764006c71&pid=1-s2.0-S2772487524000552-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1016/j.ijcrp.2024.200289
Mirza Faris Ali Baig , Kalyan Chaliki
Background
Third-degree atrioventricular (AV) blocks are rare but cause significant symptoms and require immediate intervention. Coronary artery disease (CAD) is felt to be the most common etiology. Although smoking is a prominent risk factor for CAD, there is a paucity of data assessing the direct effect of smoking on third-degree AV block.
Methods
We performed a retrospective cohort study on adult-weighted admissions in 2019–2020 with a primary diagnosis of third-degree AV block and a history of smoking using the National Inpatient Sample (NIS) database. In-hospital mortality, rates of pacemaker insertion, cardiogenic shock, cardiac arrest, acute kidney injury (AKI), stroke, tracheal intubation, mechanical ventilation, mechanical circulatory support, vasopressor use, length of stay (LOS), and total hospitalization costs were analyzed using regression analysis. We performed a secondary analysis using propensity score matching to confirm the results.
Results
A total of 77,650 admissions met inclusion criteria (33,625 females [43.3 %], 58,315. Caucasians [75 %], 7030 African American [9 %], 6155 Hispanic [7.9 %]; mean [SD] age 75.4.[10.2] years) before propensity matching. A total of 29,380 (37.8 %) patients with AV block were smokers.A total of 5560 patients with and without a history of smoking were matched for the analysis. Smokers had.decreased odds of mortality (aOR, 0.59; CI, 0.44–0.78; p < 0.001), cardiogenic shock, cardiac arrest, tracheal intubation, mechanical ventilation, shorter LOS, and lower total hospital costs in both the multivariable regression and propensity-matched analyses.
Conclusion
Third-degree AV block had lower in-hospital mortality, cardiogenic shock, cardiac arrest, LOS, and total hospitalization cost in patients with smoking history.
{"title":"The impact of smoking on third-degree atrioventricular block outcomes: A propensity-matched analysis","authors":"Mirza Faris Ali Baig , Kalyan Chaliki","doi":"10.1016/j.ijcrp.2024.200289","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200289","url":null,"abstract":"<div><h3>Background</h3><p>Third-degree atrioventricular (AV) blocks are rare but cause significant symptoms and require immediate intervention. Coronary artery disease (CAD) is felt to be the most common etiology. Although smoking is a prominent risk factor for CAD, there is a paucity of data assessing the direct effect of smoking on third-degree AV block.</p></div><div><h3>Methods</h3><p>We performed a retrospective cohort study on adult-weighted admissions in 2019–2020 with a primary diagnosis of third-degree AV block and a history of smoking using the National Inpatient Sample (NIS) database. In-hospital mortality, rates of pacemaker insertion, cardiogenic shock, cardiac arrest, acute kidney injury (AKI), stroke, tracheal intubation, mechanical ventilation, mechanical circulatory support, vasopressor use, length of stay (LOS), and total hospitalization costs were analyzed using regression analysis. We performed a secondary analysis using propensity score matching to confirm the results.</p></div><div><h3>Results</h3><p>A total of 77,650 admissions met inclusion criteria (33,625 females [43.3 %], 58,315. Caucasians [75 %], 7030 African American [9 %], 6155 Hispanic [7.9 %]; mean [SD] age 75.4.[10.2] years) before propensity matching. A total of 29,380 (37.8 %) patients with AV block were smokers.A total of 5560 patients with and without a history of smoking were matched for the analysis. Smokers had.decreased odds of mortality (aOR, 0.59; CI, 0.44–0.78; p < 0.001), cardiogenic shock, cardiac arrest, tracheal intubation, mechanical ventilation, shorter LOS, and lower total hospital costs in both the multivariable regression and propensity-matched analyses.</p></div><div><h3>Conclusion</h3><p>Third-degree AV block had lower in-hospital mortality, cardiogenic shock, cardiac arrest, LOS, and total hospitalization cost in patients with smoking history.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200289"},"PeriodicalIF":2.3,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000540/pdfft?md5=e7d46c6285150833aa138c55c4795a46&pid=1-s2.0-S2772487524000540-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-17DOI: 10.1016/j.ijcrp.2024.200288
Mohammed Mecha , Yordanos Sisay , Tsegaye Melaku
Background
Diabetes mellitus (DM) is a chronic metabolic condition that considerably increases the risk of stroke. According to studies, stroke patients with diabetes have a greater mortality rate and are more likely to have repeated strokes than those without diabetes. Therefore, this systematic review and meta-analysis determined the pooled prevalence of diabetes mellitus among stroke patients in Ethiopia.
Methods
The searches were conducted in electronic databases such as PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, and Google Scholar. Observational study designs were selected, and studies published until November 30, 2023, addressing the prevalence of diabetes mellitus among stroke patients were identified. EndNote Citation Manager software version X9 for Windows was used to collect and organize the search outcomes and remove duplicate articles. Relevant data were extracted from the included studies using a format prepared in Microsoft Excel and exported to STATA 18.0 software for outcome measures analyses and subgrouping.
Results
Twenty-eight research articles were included in the final analysis. The studies included an evaluation of 6589 stroke patients, among whom 645 were diagnosed with DM. This resulted in a pooled prevalence estimate of 10 % (95 % CI: 8–13 %)] DM. The subgroup analysis by region revealed that the highest pooled prevalence of DM was 16 % [95 % CI: (9 %–24 %)], which was from the Oromia region, followed by Addis Ababa city 12 % [95 % CI: (10 %–14 %)]. The other three regions (Tigray, South Nations nationalities and people's region and Amhara) had similar pooled prevalence of DM 7 % [95 % CI: (3 %–10 %)], 7 % [95 % CI: (3 %–11 %)], 7 % [95 % CI: (4 %–9%)], respectively.
Conclusion
Overall, the prevalence of DM among stroke patients is high. Notably, the Oromia region exhibited the highest prevalence rate at 16 %, followed by Addis Ababa city at 12 %. Conversely, the other three regions displayed similar rates of 7 %. These findings underscore the critical importance of screening and managing DM in stroke patients.
{"title":"Prevalence of diabetes mellitus among stroke patients in Ethiopia: Systematic review and meta-analysis","authors":"Mohammed Mecha , Yordanos Sisay , Tsegaye Melaku","doi":"10.1016/j.ijcrp.2024.200288","DOIUrl":"10.1016/j.ijcrp.2024.200288","url":null,"abstract":"<div><h3>Background</h3><p>Diabetes mellitus (DM) is a chronic metabolic condition that considerably increases the risk of stroke. According to studies, stroke patients with diabetes have a greater mortality rate and are more likely to have repeated strokes than those without diabetes. Therefore, this systematic review and meta-analysis determined the pooled prevalence of diabetes mellitus among stroke patients in Ethiopia.</p></div><div><h3>Methods</h3><p>The searches were conducted in electronic databases such as PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, and Google Scholar. Observational study designs were selected, and studies published until November 30, 2023, addressing the prevalence of diabetes mellitus among stroke patients were identified. EndNote Citation Manager software version X<sub>9</sub> for Windows was used to collect and organize the search outcomes and remove duplicate articles. Relevant data were extracted from the included studies using a format prepared in Microsoft Excel and exported to STATA 18.0 software for outcome measures analyses and subgrouping.</p></div><div><h3>Results</h3><p>Twenty-eight research articles were included in the final analysis. The studies included an evaluation of 6589 stroke patients, among whom 645 were diagnosed with DM. This resulted in a pooled prevalence estimate of 10 % (95 % CI: 8–13 %)] DM. The subgroup analysis by region revealed that the highest pooled prevalence of DM was 16 % [95 % CI: (9 %–24 %)], which was from the Oromia region, followed by Addis Ababa city 12 % [95 % CI: (10 %–14 %)]. The other three regions (Tigray, South Nations nationalities and people's region and Amhara) had similar pooled prevalence of DM 7 % [95 % CI: (3 %–10 %)], 7 % [95 % CI: (3 %–11 %)], 7 % [95 % CI: (4 %–9%)], respectively.</p></div><div><h3>Conclusion</h3><p>Overall, the prevalence of DM among stroke patients is high. Notably, the Oromia region exhibited the highest prevalence rate at 16 %, followed by Addis Ababa city at 12 %. Conversely, the other three regions displayed similar rates of 7 %. These findings underscore the critical importance of screening and managing DM in stroke patients.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200288"},"PeriodicalIF":2.3,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000539/pdfft?md5=73edd33b2f51a8674bf14aafe0191329&pid=1-s2.0-S2772487524000539-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141048503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1016/j.ijcrp.2024.200286
Tian-Kai Shan , Ling-Ling Qian , Xu-Dong Han , Bo Deng , Ling-Feng Gu , Ze-Mu Wang , Ye He , Ting Zhu , Peng Jing , Qi-Ming Wang , Zi-Dun Wang , Ru-Xing Wang , Si-Bo Wang , Lian-Sheng Wang
Background
Ventricular arrhythmias (VAs) mainly occur in the early post-myocardial infarction (MI) period. However, studies examining the association between total myocardial ischemia time interval and the risk of new-onset VAs during a long-term follow-up are scarce.
Methods
This study (symptom-to-balloon time and VEntricular aRrhYthmias in patients with STEMI, VERY-STEMI study) was a multicenter, observational cohort and real-world study, which included patients with ST-segment elevation MI (STEMI) undergoing percutaneous coronary intervention (PCI). The primary endpoint was cumulative new-onset VAs during follow-up. The secondary endpoints were the major adverse cardiovascular events (MACE) and changes in left ventricular ejection fraction (ΔLVEF, %).
Results
A total of 517 patients with STEMI were included and 236 primary endpoint events occurred. After multivariable adjustments, compared to patients with S2BT of 24 h-7d, those with S2BT ≤ 24 h and S2BT > 7d had a lower risk of primary endpoint. RCS showed an inverted U-shaped relationship between S2BT and the primary endpoint, with an S2BT of 68.4 h at the inflection point. Patients with S2BT ≤ 24 h were associated with a lower risk of MACE and a 4.44 increase in LVEF, while there was no significant difference in MACE and LVEF change between the S2BT > 7d group and S2BT of 24 h-7d group.
Conclusions
S2BT of 24 h-7d in STEMI patients was associated with a higher risk of VAs during follow-up. There was an inverted U-shaped relationship between S2BT and VAs, with the highest risk at an S2BT of 68.4 h.
{"title":"Symptom-to-balloon time and risk of ventricular arrhythmias in patients with STEMI undergoing percutaneous coronary intervention: The VERY-STEMI study","authors":"Tian-Kai Shan , Ling-Ling Qian , Xu-Dong Han , Bo Deng , Ling-Feng Gu , Ze-Mu Wang , Ye He , Ting Zhu , Peng Jing , Qi-Ming Wang , Zi-Dun Wang , Ru-Xing Wang , Si-Bo Wang , Lian-Sheng Wang","doi":"10.1016/j.ijcrp.2024.200286","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200286","url":null,"abstract":"<div><h3>Background</h3><p>Ventricular arrhythmias (VAs) mainly occur in the early post-myocardial infarction (MI) period. However, studies examining the association between total myocardial ischemia time interval and the risk of new-onset VAs during a long-term follow-up are scarce.</p></div><div><h3>Methods</h3><p>This study (symptom-to-balloon time and <strong>VE</strong>ntricular a<strong>R</strong>rh<strong>Y</strong>thmias in patients with <strong>STEMI</strong>, VERY-STEMI study) was a multicenter, observational cohort and real-world study, which included patients with ST-segment elevation MI (STEMI) undergoing percutaneous coronary intervention (PCI). The primary endpoint was cumulative new-onset VAs during follow-up. The secondary endpoints were the major adverse cardiovascular events (MACE) and changes in left ventricular ejection fraction (ΔLVEF, %).</p></div><div><h3>Results</h3><p>A total of 517 patients with STEMI were included and 236 primary endpoint events occurred. After multivariable adjustments, compared to patients with S2BT of 24 h-7d, those with S2BT ≤ 24 h and S2BT > 7d had a lower risk of primary endpoint. RCS showed an inverted U-shaped relationship between S2BT and the primary endpoint, with an S2BT of 68.4 h at the inflection point. Patients with S2BT ≤ 24 h were associated with a lower risk of MACE and a 4.44 increase in LVEF, while there was no significant difference in MACE and LVEF change between the S2BT > 7d group and S2BT of 24 h-7d group.</p></div><div><h3>Conclusions</h3><p>S2BT of 24 h-7d in STEMI patients was associated with a higher risk of VAs during follow-up. There was an inverted U-shaped relationship between S2BT and VAs, with the highest risk at an S2BT of 68.4 h.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200286"},"PeriodicalIF":2.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000515/pdfft?md5=3921e323f95c87618314696ca25b5983&pid=1-s2.0-S2772487524000515-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141067380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertensive crises are a leading cause of visits to emergency departments, carrying grave health implications. A significant number of patients presenting with these crises have a known history of hypertension.
Objective
The aim of this systematic review and meta-analysis is to examine the combined prevalence of hypertensive crises among individuals with either a history of hypertension or unknown status (newly diagnosed with a hypertensive crisis).
Methods
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the Prospective Register of Systematic Reviews (PROSPERO). Research databases, including PubMed, Embase, Scopus, Africa Index Medicus, Science Direct, HINARI, and Google Scholar, were systematically searched. Study quality was evaluated using the Newcastle–Ottawa Scale, while publication bias was explored through Egger's regression test, funnel plots, and sensitivity analyses. Data collection adhered to the Joanna Briggs Institute (JBI) format. Meta-analysis was performed using STATA version 17, employing the random-effects DerSimonian–Laird model.
Results
Amongst the 15 studies analyzed, the application of the random-effects DerSimonian-Laird statistical model indicated that the prevalence of hypertensive crisis was determined to be 9.09 %, with a 95 % confidence interval (CI) ranging from 7.41 % to 10.77 %. Factors such as poor medication adherence (POR 5.00; 95 % CI: 3.61, 6.93), patients with comorbidities (POR 4.73; 95 % CI: 3.29, 6.80), patients with a history of hypertension (POR 5.64; 95 % CI: 4.57, 6.94), patients aged >65 (POR 2.77; 95 % CI: 2.16, 6.59), and excessive alcohol intake (POR 5.01; 95 % CI: 3.82, 6.58) were associated with higher odds of hypertensive crisis.
Conclusion
The findings indicate a markedly higher incidence of hypertensive crisis among hospital-presenting patients in Africa. Factors such as medication non-adherence, co-existing comorbidities, historical hypertension, being over 65, and alcohol misuse significantly contribute to this condition. These insights call for a comprehensive healthcare strategy that targets both the management of hypertension and its complications, aiming to improve the overall health outcomes of affected patients.
{"title":"Hypertensive crisis and its predictors in Africa: Systematic review and meta-analysis, 2024","authors":"Ousman Adal , Natnael Kebede , Amare Mebrat Delie , Eyob Ketema Bogale , Tadele Fentabil Anagaw , Misganaw Guadie Tiruneh , Eneyew Talie Fenta , Destaw Endeshaw","doi":"10.1016/j.ijcrp.2024.200285","DOIUrl":"10.1016/j.ijcrp.2024.200285","url":null,"abstract":"<div><h3>Introduction</h3><p>Hypertensive crises are a leading cause of visits to emergency departments, carrying grave health implications. A significant number of patients presenting with these crises have a known history of hypertension.</p></div><div><h3>Objective</h3><p>The aim of this systematic review and meta-analysis is to examine the combined prevalence of hypertensive crises among individuals with either a history of hypertension or unknown status (newly diagnosed with a hypertensive crisis).</p></div><div><h3>Methods</h3><p>This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the Prospective Register of Systematic Reviews (PROSPERO). Research databases, including PubMed, Embase, Scopus, Africa Index Medicus, Science Direct, HINARI, and Google Scholar, were systematically searched. Study quality was evaluated using the Newcastle–Ottawa Scale, while publication bias was explored through Egger's regression test, funnel plots, and sensitivity analyses. Data collection adhered to the Joanna Briggs Institute (JBI) format. Meta-analysis was performed using STATA version 17, employing the random-effects DerSimonian–Laird model.</p></div><div><h3>Results</h3><p>Amongst the 15 studies analyzed, the application of the random-effects DerSimonian-Laird statistical model indicated that the prevalence of hypertensive crisis was determined to be 9.09 %, with a 95 % confidence interval (CI) ranging from 7.41 % to 10.77 %. Factors such as poor medication adherence (POR 5.00; 95 % CI: 3.61, 6.93), patients with comorbidities (POR 4.73; 95 % CI: 3.29, 6.80), patients with a history of hypertension (POR 5.64; 95 % CI: 4.57, 6.94), patients aged >65 (POR 2.77; 95 % CI: 2.16, 6.59), and excessive alcohol intake (POR 5.01; 95 % CI: 3.82, 6.58) were associated with higher odds of hypertensive crisis.</p></div><div><h3>Conclusion</h3><p>The findings indicate a markedly higher incidence of hypertensive crisis among hospital-presenting patients in Africa. Factors such as medication non-adherence, co-existing comorbidities, historical hypertension, being over 65, and alcohol misuse significantly contribute to this condition. These insights call for a comprehensive healthcare strategy that targets both the management of hypertension and its complications, aiming to improve the overall health outcomes of affected patients.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"21 ","pages":"Article 200285"},"PeriodicalIF":2.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000503/pdfft?md5=0150cd9ba5dcf624a11bc4150adad1ab&pid=1-s2.0-S2772487524000503-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.1016/j.ijcrp.2024.200283
Ruihuan Shen , Xuantong Guo , Tong Zou , Lihong Ma
Background
Metabolic syndrome (MetS) could increase the risk of cardiovascular disease (CVD) by 2-fold. Ideal control of modifiable risk factors in Life's Simple 7 (LS7) could reduce the CVD risk among the general population. This study aimed to investigate the effects of controlling modifiable risk factors using LS7 in MetS to prevent CVD.
Methods
44463 participants in NHANES 1999–2018 were included. The primary endpoint was a composite of CVD, including angina pectoris, coronary artery disease, myocardial infarction, congestive heart failure, and stroke. Multivariable weighted logistic regression analyses estimated the associations. The diagnosis of MetS complied with Harmonized International Diabetes Federation Criteria. Measurement of modifiable risk factors used the 2010 American Heart Association LS7 guideline and was indicated by cardiovascular health (CVH).
Results
14034 individuals were diagnosed with MetS. 4835 participants had CVD. The weighted mean CVH was 8.06 ± 0.03. Intermediate and poor CVH were associated with increased risk for CVD in participants with similar metabolic states compared to ideal CVH. By taking participants with metabolic health and ideal CVH as health control, participants with MetS and poor CVH were demonstrated to have a 3-fold (adjusted odds ratio, 4.00; 95 % confidence interval, 3.21–4.98) greater risk for CVD. Notably, under the condition of ideal CVH, the risk of having CVD was comparable between metabolic health and MetS after fully adjusted.
Conclusion
Ideal control of Life's Simple 7 in metabolic syndrome contributes to a comparable risk of cardiovascular disease with healthy subjects. LS7 could be recognized as a guideline for secondary prevention in MetS.
{"title":"Modifiable risk factors and metabolic health in risk of cardiovascular disease among US adults: A nationwide cross-sectional study","authors":"Ruihuan Shen , Xuantong Guo , Tong Zou , Lihong Ma","doi":"10.1016/j.ijcrp.2024.200283","DOIUrl":"10.1016/j.ijcrp.2024.200283","url":null,"abstract":"<div><h3>Background</h3><p>Metabolic syndrome (MetS) could increase the risk of cardiovascular disease (CVD) by 2-fold. Ideal control of modifiable risk factors in Life's Simple 7 (LS7) could reduce the CVD risk among the general population. This study aimed to investigate the effects of controlling modifiable risk factors using LS7 in MetS to prevent CVD.</p></div><div><h3>Methods</h3><p>44463 participants in NHANES 1999–2018 were included. The primary endpoint was a composite of CVD, including angina pectoris, coronary artery disease, myocardial infarction, congestive heart failure, and stroke. Multivariable weighted logistic regression analyses estimated the associations. The diagnosis of MetS complied with Harmonized International Diabetes Federation Criteria. Measurement of modifiable risk factors used the 2010 American Heart Association LS7 guideline and was indicated by cardiovascular health (CVH).</p></div><div><h3>Results</h3><p>14034 individuals were diagnosed with MetS. 4835 participants had CVD. The weighted mean CVH was 8.06 ± 0.03. Intermediate and poor CVH were associated with increased risk for CVD in participants with similar metabolic states compared to ideal CVH. By taking participants with metabolic health and ideal CVH as health control, participants with MetS and poor CVH were demonstrated to have a 3-fold (adjusted odds ratio, 4.00; 95 % confidence interval, 3.21–4.98) greater risk for CVD. Notably, under the condition of ideal CVH, the risk of having CVD was comparable between metabolic health and MetS after fully adjusted.</p></div><div><h3>Conclusion</h3><p>Ideal control of Life's Simple 7 in metabolic syndrome contributes to a comparable risk of cardiovascular disease with healthy subjects. LS7 could be recognized as a guideline for secondary prevention in MetS.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200283"},"PeriodicalIF":2.3,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000485/pdfft?md5=2816abd5ac7bf2208c565b70b2f3afb5&pid=1-s2.0-S2772487524000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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