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The use of polypills in cardiovascular disease management: Benefits vs challenges 在心血管疾病管理中使用多丸剂:益处与挑战。
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-16 DOI: 10.1016/j.ijcrp.2024.200313
Yamaan Adil, Shanezehra Siddiqui
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引用次数: 0
Association of stress hormones and the risk of cardiovascular diseases systematic review and meta-analysis 压力荷尔蒙与心血管疾病风险的关系 系统回顾与元分析
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-10 DOI: 10.1016/j.ijcrp.2024.200305
Szu-Ying Tsai , Jui-Yun Hsu , Ching-Huang Lin , Yen-Chun Kuo , Chi-Han Chen , Hsing-Yuan Chen , Shu-Jung Liu , Kuo-Liong Chien

Background

The roles of endogenous stress hormones (norepinephrine, epinephrine, and cortisol) in cardiovascular diseases have been discussed. However, the higher versus lower level of stress hormones in relation to cardiovascular risks remained uncertain.

Methods

We searched databases from their inception to 31, March 2023. We conducted a meta-analysis to estimate the effect of higher to lower level of stress hormones with random effect model. Subgroup and meta-regression analysis were done to clarify the heterogeneity.

Results

In total, 33 studies involving 43641 participants were included. With regard to cardiovascular disease risks, a higher risk for individuals with higher level of all stress hormones (risk ratio (RR), 1.63; 95 % Confidence intervals (CIs): 1.36, 1.97) was noted compared with lower level of all stress hormones. The meta-regression showed that as the follow-up year increased per year, the impact of higher level of all stress hormones on the risk of cardiovascular disease declined significantly (RR, −0.09; 95 % CIs: 0.15, −0.03, p = 0.006). A significantly higher risk of cardiovascular diseases for individuals with higher level of norepinephrine (RR, 1.68; 95 % CIs: 1.37, 2.06), with higher level of epinephrine (RR, 1.58; 95 % CIs: 1.10, 2.26), and with higher level of cortisol (RR, 1.60; 95 % CIs: 1.04, 2.26) were noted compared with a lower level of each stress hormone.

Conclusion

Higher levels of stress hormones were significantly associated with higher risks of cardiovascular diseases compared with lower levels of stress hormones.

背景人们一直在讨论内源性应激激素(去甲肾上腺素、肾上腺素和皮质醇)在心血管疾病中的作用。然而,应激激素水平的高低与心血管风险的关系仍不确定。方法我们检索了从开始到 2023 年 3 月 31 日的数据库。我们采用随机效应模型进行了荟萃分析,以估计应激激素水平高低的影响。结果 共纳入 33 项研究,涉及 43641 名参与者。在心血管疾病风险方面,与所有应激激素水平较低的人相比,所有应激激素水平较高的人患心血管疾病的风险更高(风险比(RR),1.63;95% 置信区间(CIs):1.36,1.97)。元回归结果表明,随着随访年份的逐年增加,所有应激激素水平较高对心血管疾病风险的影响显著下降(RR,-0.09;95 % 置信区间:0.15,-0.03,P = 0.006)。去甲肾上腺素水平较高者(RR,1.68;95 % CIs:1.37,2.06)、肾上腺素水平较高者(RR,1.58;95 % CIs:1.10,2.26)和皮质醇水平较高者(RR,1.结论与较低水平的应激激素相比,较高水平的应激激素与较高的心血管疾病风险显著相关。
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引用次数: 0
The relative impact of components of high residual risk on the long-term prognosis after AMI 高残余风险因素对急性心肌梗死后长期预后的相对影响
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-06 DOI: 10.1016/j.ijcrp.2024.200310
Gian Francesco Mureddu , Paola D'Errigo , Stefano Rosato , Pompilio Faggiano , Gabriella Badoni , Roberto Ceravolo , Vito Altamura , Mirko Di Martino , Marco Ambrosetti , Fabrizio Oliva , Paola Ciccarelli , Giovanni Baglio

Background

The reduction in long-term mortality after acute myocardial infarction (AMI) is less pronounced than that of in-hospital mortality among patients with AMI complicated by heart failure (HF) and/or in those with a high residual thrombotic risk (HTR).

Aim

To investigate the relative prognostic significance of HTR and HF in AMI survivors.

Methods

This retrospective cohort study enrolled patients admitted for AMI in 2014–2015 in all Italian hospitals. HTR was defined as at least one of the following conditions: previous AMI, ischemic stroke or other vascular disease, type 2 diabetes, renal failure. Patients were classified into four categories: uncomplicated AMI; AMI with HTR; AMI with HF and AMI with both HTR and HF (HTR + HF). Cox proportional hazard model was used to evaluate the impact of HTR, HF and HTR + HF on the 5-year prognosis. A time-varying coefficient analysis was performed to estimate the 5-year trend of HR for major averse cardiac and cerebrovascular events (MACCE).

Results

a total of 174.869 AMI events were identified. The adjusted 5-year HR for MACCE was 1.74 (p < 0.0001) and 1.75 (p < 0.0001) in HTR and HF patients vs uncomplicated patients, respectively. The coexistence of HTR and HF furtherly increased the risk of MACCE (HR = 2.43, p < 0.0001) over the first 3 years after AMI.

Conclusion

Either HRT and HF confer an increased 5-year hazard of MACCE after AMI. The coexistence of HTR and HF doubled the overall 5-year risk of MACCE after AMI.

背景在急性心肌梗死(AMI)并发心力衰竭(HF)和/或有高残余血栓风险(HTR)的患者中,急性心肌梗死后长期死亡率的降低不如院内死亡率的降低明显。方法这项回顾性队列研究纳入了 2014-2015 年在意大利所有医院因急性心肌梗死入院的患者。HTR的定义是至少患有以下一种疾病:既往AMI、缺血性中风或其他血管疾病、2型糖尿病、肾功能衰竭。患者被分为四类:无并发症急性心肌梗死;急性心肌梗死伴有HTR;急性心肌梗死伴有高血压;急性心肌梗死伴有HTR和高血压(HTR + 高血压)。采用 Cox 比例危险模型评估 HTR、HF 和 HTR + HF 对 5 年预后的影响。结果共发现174 869例AMI事件。HTR和HF患者与无并发症患者相比,MACCE的调整后5年HR分别为1.74(p < 0.0001)和1.75(p < 0.0001)。HTR和HF并存进一步增加了AMI术后头3年发生MACCE的风险(HR = 2.43,p < 0.0001)。HRT和HF并存会使AMI后5年MACCE的总体风险增加一倍。
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引用次数: 0
Corrigendum to “Impact of heart failure severity and major bleeding events after percutaneous coronary intervention on subsequent major adverse cardiac events” [Int. J. Cardiol. Cardiovasc. Risk and Prev. 2023 Jun 25:18:200193] 经皮冠状动脉介入治疗后心力衰竭严重程度和大出血事件对后续重大心脏不良事件的影响》更正 [Int. J. Cardiol. Cardiovasc. Risk and Prev. 2023 Jun 25:18:200193]
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-05 DOI: 10.1016/j.ijcrp.2024.200304
So Ikebe , Masanobu Ishii , Yasuhiro Otsuka , Taishi Nakamura , Kenichi Tsujita , Tetsuya Matoba , Takahide Kohro , Yusuke Oba , Tomoyuki Kabutoya , Yasushi Imai , Kazuomi Kario , Arihiro Kiyosue , Yoshiko Mizuno , Kotaro Nochioka , Masaharu Nakayama , Takamasa Iwai , Yoshihiro Miyamoto , Hisahiko Sato , Naoyuki Akashi , Hideo Fujita , Ryozo Nagai
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引用次数: 0
Predictors of uncontrolled hypertension among type 2 diabetic patients in Ethiopia: Multicenter cross-sectional study 埃塞俄比亚 2 型糖尿病患者高血压失控的预测因素:多中心横断面研究
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-04 DOI: 10.1016/j.ijcrp.2024.200308
Leteslase Hagos Gebreziher , Melak Gedamu Beyene , Desalew Mekonnen , Assefa Mulu Baye

Background

Hypertension (HTN) is the commonest comorbidity among people with type 2 diabetes mellitus (T2DM). Uncontrolled HTN is a major risk factor for several diseases. This study aimed to determine the magnitude and predictors of uncontrolled HTN among T2DM patients.

Methods

A multicenter cross-sectional study was conducted among hypertensive from September 19, 2021 to 17 December 2021. Logistic regression model was conducted to identify predictors of uncontrolled HTN. Uncontrolled BP was defined by systolic BP of ≥130 mmHg and/or diastolic BP of ≥80 mmHg.

Results

A total of 400 study participants were included in the analysis, of which 208 (52 %) were females. The mean age of the participants was 60.6 with SD of 10.25 years. The target blood pressure achieved in 156 (39 %) of participants. Age, non-adherence to medications (OR; 2.0; 95 % CI: 1.1–3.6; P = 0.02), not reducing dietary salt (OR; 2.4; 95 % CI: 1.5–3.8; P < 0.001), uncontrolled blood sugar (OR:2.4; 95 % CI: 1.4–4.3; P = 0.002), obesity (OR; 3.2; 95 % CI:1.2–8.7; P = 0.03) and having every fourth month and above follow up (OR; 2.3; 95 % CI:1.3–4.3; P = 0.049) were significantly associated with uncontrolled blood pressure.

Conclusions

The target blood pressure achieved was suboptimal. Hypertensive T2DM patients who were younger, non-adherent to their medications, not reducing dietary salt, obese, with a longer frequency of follow-up, and with poor glycemic control were more likely to have uncontrolled blood pressure. Improving medication adherence, dietary salt reduction, frequent follow up and glycemic control are important to control hypertension.

背景高血压(HTN)是 2 型糖尿病(T2DM)患者最常见的合并症。未控制的高血压是多种疾病的主要风险因素。本研究旨在确定 T2DM 患者中未控制的高血压的程度和预测因素。方法于 2021 年 9 月 19 日至 2021 年 12 月 17 日在高血压患者中开展了一项多中心横断面研究。采用逻辑回归模型确定高血压未控制的预测因素。未控制血压的定义是收缩压≥130 mmHg 和/或舒张压≥80 mmHg。参与者的平均年龄为 60.6 岁,标准差为 10.25 岁。156名参与者(39%)达到了目标血压。年龄、不坚持服药(OR;2.0;95 % CI:1.1-3.6;P = 0.02)、不减少饮食盐分(OR;2.4;95 % CI:1.5-3.8;P <;0.001)、血糖未得到控制(OR:2.4;95 % CI:1.4-4.3;P = 0.002)、肥胖(OR;3.2;95 % CI:1.2-8.7;P = 0.03)和每 4 个月及以上随访(OR;2.3;95 % CI:1.3-4.3;P = 0.049)与血压失控显著相关。年轻、不坚持服药、不减少膳食盐分、肥胖、随访时间较长、血糖控制不佳的高血压 T2DM 患者更容易出现血压失控。改善服药依从性、减少饮食中的盐分、频繁随访和血糖控制对控制高血压非常重要。
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引用次数: 0
Temporal trends in acute decompensated heart failure outcomes: A single-center 11-year retrospective analysis 急性失代偿性心力衰竭预后的时间趋势:单中心 11 年回顾性分析
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-04 DOI: 10.1016/j.ijcrp.2024.200306
Gil Marcus , Mohammad Najjar , Antionette Monayer , Ady Orbach , Shiri L. Maymon , Eran Kalmanovich , Gil Moravsky , Avishay Grupper , Shmuel Fuchs , Sa'ar Minha

Background

Acute Decompensated Heart Failure (ADHF) is associated with frequent hospitalizations, posing a significant health and economic burden globally. Despite advancements in heart failure management, studies delineating temporal trends in ADHF outcomes are sparse.

Methods: in this retrospective analysis, ADHF patients admitted to Shamir Medical Center from 2007 to 2017 were categorized into two cohorts: early (2007–2011) and recent (2012–2017). Clinical characteristics, in-hospital interventions, and outcomes were compared. Survival analysis was performed using Kaplan-Meier methods with log-rank tests.

Results

8332 admitted patients were analyzed, 4366 (52.4 %) in the early period, and 3966 (47.6 %) in the recent period. In the recent cohort, ischemic heart disease decreased significantly (from 45.2 % to 34.7 %), while hypertension and smoking rates increased. Additionally, a significant increase in coronary artery bypass grafting (from 0.8 % to 3.5 %) and beta-blockers prescription (from 45.5 % to 63.4 %) post-discharge was observed. However, no substantial improvement in in-hospital mortality (8.9 % in early vs. 8.0 % in recent), 30-day (3.2 % in early vs. 3.1 % in recent), 1-year (23.3 % in early vs. 23.8 % in recent), or 5-year survival rates was noted between cohorts. A subset analysis of patients admitted to cardiology departments showed a significant reduction in in-hospital mortality in the recent cohort (12.3 % in early vs. 6.3 % in recent), yet without a corresponding long-term survival benefit.

Conclusions

Advancements in heart failure management over the 11-year study period did not demonstrate an improvement in clinical outcomes for ADHF patients, highlighting the challenge of translating advancements in the medical care of ADHF patients into long-term survival benefits.

背景急性失代偿性心力衰竭(ADHF)与频繁住院有关,在全球范围内造成了巨大的健康和经济负担。方法:在这项回顾性分析中,2007 年至 2017 年入住沙米尔医疗中心的 ADHF 患者被分为两个队列:早期队列(2007-2011 年)和近期队列(2012-2017 年)。比较了临床特征、院内干预和预后。结果分析了 8332 名入院患者,其中早期患者 4366 人(52.4%),近期患者 3966 人(47.6%)。在近期组群中,缺血性心脏病患者明显减少(从 45.2% 降至 34.7%),而高血压和吸烟率则有所上升。此外,还观察到出院后冠状动脉旁路移植术(从 0.8% 增加到 3.5%)和β-受体阻滞剂处方率(从 45.5% 增加到 63.4%)明显增加。不过,不同组别之间的院内死亡率(早期为 8.9%,近期为 8.0%)、30 天死亡率(早期为 3.2%,近期为 3.1%)、1 年存活率(早期为 23.3%,近期为 23.8%)或 5 年存活率均无显著改善。对心脏科住院患者的子集分析显示,近期队列的院内死亡率显著降低(早期为12.3%,近期为6.3%),但长期生存率却没有相应的改善。结论在11年的研究期间,心衰管理的进步并没有改善ADHF患者的临床预后,这凸显了将ADHF患者医疗护理的进步转化为长期生存率的挑战。
{"title":"Temporal trends in acute decompensated heart failure outcomes: A single-center 11-year retrospective analysis","authors":"Gil Marcus ,&nbsp;Mohammad Najjar ,&nbsp;Antionette Monayer ,&nbsp;Ady Orbach ,&nbsp;Shiri L. Maymon ,&nbsp;Eran Kalmanovich ,&nbsp;Gil Moravsky ,&nbsp;Avishay Grupper ,&nbsp;Shmuel Fuchs ,&nbsp;Sa'ar Minha","doi":"10.1016/j.ijcrp.2024.200306","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200306","url":null,"abstract":"<div><h3>Background</h3><p>Acute Decompensated Heart Failure (ADHF) is associated with frequent hospitalizations, posing a significant health and economic burden globally. Despite advancements in heart failure management, studies delineating temporal trends in ADHF outcomes are sparse.</p><p>Methods: in this retrospective analysis, ADHF patients admitted to Shamir Medical Center from 2007 to 2017 were categorized into two cohorts: early (2007–2011) and recent (2012–2017). Clinical characteristics, in-hospital interventions, and outcomes were compared. Survival analysis was performed using Kaplan-Meier methods with log-rank tests.</p></div><div><h3>Results</h3><p>8332 admitted patients were analyzed, 4366 (52.4 %) in the early period, and 3966 (47.6 %) in the recent period. In the recent cohort, ischemic heart disease decreased significantly (from 45.2 % to 34.7 %), while hypertension and smoking rates increased. Additionally, a significant increase in coronary artery bypass grafting (from 0.8 % to 3.5 %) and beta-blockers prescription (from 45.5 % to 63.4 %) post-discharge was observed. However, no substantial improvement in in-hospital mortality (8.9 % in early vs. 8.0 % in recent), 30-day (3.2 % in early vs. 3.1 % in recent), 1-year (23.3 % in early vs. 23.8 % in recent), or 5-year survival rates was noted between cohorts. A subset analysis of patients admitted to cardiology departments showed a significant reduction in in-hospital mortality in the recent cohort (12.3 % in early vs. 6.3 % in recent), yet without a corresponding long-term survival benefit.</p></div><div><h3>Conclusions</h3><p>Advancements in heart failure management over the 11-year study period did not demonstrate an improvement in clinical outcomes for ADHF patients, highlighting the challenge of translating advancements in the medical care of ADHF patients into long-term survival benefits.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200306"},"PeriodicalIF":1.9,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000710/pdfft?md5=d39564b9ef9ea497e9696c75470623e1&pid=1-s2.0-S2772487524000710-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542871","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}
引用次数: 0
Distinct circulating cytokine levels in patients with angiography-proven coronary artery disease compared to disease-free controls 与无病对照组相比,血管造影证实的冠心病患者体内的循环细胞因子水平不同
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-04 DOI: 10.1016/j.ijcrp.2024.200307
Eveliina Maaniitty , Sami Sinisilta , Juho Jalkanen , Tuija Vasankari , Fausto Biancari , Jarmo Gunn , Sirpa Jalkanen , K.E. Juhani Airaksinen , Maija Hollmén , Tuomas Kiviniemi

Background

Systemic inflammation has a critical role in the development of symptomatic coronary artery disease (CAD). Identification of inflammatory pathways may provide a platform for novel therapeutic approaches. We sought to determine whether there are differences in circulating cytokine profiles between patients with CAD and disease-free controls as well as according to the severity of the disease.

Methods

Case-control study's population consisted of 452 patients who underwent diagnostic invasive coronary angiography due to clinical indications. We measured the serum concentrations of 48 circulating cytokines. Extent of CAD was assessed using the SYNTAX Score in 116 patients. Cytokine differences between groups were tested using Mann-Whitney U test and associations with CAD were explored using a logistic regression model.

Results

Overall, 310 patients had angiographically verified CAD whereas 142 had no angiographically-detected coronary atherosclerosis. In multivariable logistic regression models adjusted for age, sex, hypertension, atrial fibrillation, history of smoking and treatment for diabetes and hyperlipidemia, increased levels of interleukin 9 (OR 1.359, 95%CI 1.046–1.766, p = 0.022), IL-17 (1.491, 95%CI 1.115–1.994, p = 0.007) and tumor necrosis factor alpha (TNF-α) (OR 1.440, 95%CI 1.089–1.904, p = 0.011) were independently associated with CAD. Patients with SYNTAX Score>22 had increased levels of stromal cell-derived factor 1 alfa (SDF-1α), beta-nerve growth factor (β-NGF), IL-3 and decreased level of IL-17 compared to those with score ≤22 when adjusted for smoking and use of beta-blockers.

Conclusions

Patients with CAD have distinct circulating cytokine profiles compared to disease-free controls. Distinct cytokines may have pivotal roles at different stages of coronary atherosclerosis. ClinicalTrials.gov Identifier: NCT03444259 (https://clinicaltrials.gov/study/NCT03444259).

背景系统性炎症在无症状冠状动脉疾病(CAD)的发展过程中起着至关重要的作用。炎症通路的鉴定可为新型治疗方法提供一个平台。我们试图确定 CAD 患者与无病对照组之间的循环细胞因子谱是否存在差异,以及这种差异是否与疾病的严重程度有关。我们测量了血清中 48 种循环细胞因子的浓度。使用 SYNTAX 评分评估了 116 名患者的 CAD 程度。采用 Mann-Whitney U 检验法检测了不同组间细胞因子的差异,并采用逻辑回归模型探讨了细胞因子与 CAD 的关系。结果 总体而言,310 名患者经血管造影证实患有 CAD,而 142 名患者经血管造影未发现冠状动脉粥样硬化。在调整了年龄、性别、高血压、心房颤动、吸烟史以及糖尿病和高脂血症治疗后的多变量逻辑回归模型中,白细胞介素 9 水平升高(OR 1.359,95%CI 1.046-1.766,p = 0.022)、IL-17(1.491,95%CI 1.115-1.994,p = 0.007)和肿瘤坏死因子α(TNF-α)(OR 1.440,95%CI 1.089-1.904,p = 0.011)水平升高与 CAD 独立相关。与评分≤22的患者相比,SYNTAX评分>22患者的基质细胞衍生因子1α(SDF-1α)、β-神经生长因子(β-NGF)、IL-3水平升高,而IL-17水平降低,这与吸烟和使用β-受体阻滞剂有关。不同的细胞因子可能在冠状动脉粥样硬化的不同阶段起着关键作用。ClinicalTrials.gov Identifier:NCT03444259 (https://clinicaltrials.gov/study/NCT03444259)。
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引用次数: 0
Myocardial infarction & C-reactive protein levels among Mexican adults with arthritis: Findings from the Mexican Health and Aging Study 患有关节炎的墨西哥成年人中的心肌梗死和 C 反应蛋白水平:墨西哥健康与老龄化研究的结果
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-03 DOI: 10.1016/j.ijcrp.2024.200309
Alan F. Villarreal Rizzo , Elizabeth I. Davis , Wissam I. Khalife , M. Kristen Peek , Brian Downer

Background

Studies of adult populations in high-income countries have found an association between arthritis and myocardial infarction (MI) due to high levels of systemic inflammation. Our objectives were to examine the association between arthritis and MI among Mexican adults and to assess the mediating effect of C-reactive protein (CRP) on this association.

Methods

Data came from the 2012, 2015, and 2018 observation waves of the Mexican Health and Aging Study. Our sample included 11,707 participants aged 50 and older with no prior MI before 2012. We used self-reported information for arthritis, joint pain, medication use, and limitations to daily activities in 2012. Logistic regression was used to model the association between arthritis and self-reported MI in 2015 or 2018. We used a sub-sample of 1602 participants to assess the mediating effect of CRP.

Results

In the full sample, participants with arthritis that limited their daily activities had higher odds of MI than participants with no arthritis (OR = 1.40; 95 % CI = 1.04–1.88). In the sub-sample, arthritis that limited daily activities was associated with higher mean CRP (5.2 mg/dL; 95 % CI = 4.10–6.21) than arthritis with no limitations (3.5 mg/dL; 95 % CI = 2.93–4.01). However, CRP levels had a small mediating effect, and the relationship between arthritis with physical limitations and MI remained statistically significant.

Conclusion

Mexican adults with arthritis that limits their daily activities are at an increased risk for MI. Continued research is needed to identify factors that contribute to this increased risk.

背景对高收入国家成年人群的研究发现,由于全身炎症水平较高,关节炎与心肌梗死(MI)之间存在关联。我们的目标是研究墨西哥成年人中关节炎与心肌梗死之间的关联,并评估C反应蛋白(CRP)对这种关联的中介作用。方法数据来自墨西哥健康与老龄化研究2012、2015和2018年的观察波。我们的样本包括 11707 名 50 岁及以上的参与者,他们在 2012 年之前均未患过心肌梗死。我们使用了2012年自我报告的关节炎、关节疼痛、药物使用和日常活动受限的信息。我们使用 Logistic 回归来模拟关节炎与 2015 年或 2018 年自我报告的心肌梗死之间的关联。结果在全样本中,患有关节炎且日常活动受限的参与者发生心肌梗死的几率高于无关节炎的参与者(OR = 1.40; 95 % CI = 1.04-1.88)。在亚样本中,与无限制的关节炎(3.5 mg/dL;95 % CI = 2.93-4.01)相比,限制日常活动的关节炎与较高的平均 CRP(5.2 mg/dL;95 % CI = 4.10-6.21)相关。结论患有关节炎且日常活动受限的墨西哥成年人罹患心肌梗死的风险增加。需要继续开展研究,以确定导致风险增加的因素。
{"title":"Myocardial infarction & C-reactive protein levels among Mexican adults with arthritis: Findings from the Mexican Health and Aging Study","authors":"Alan F. Villarreal Rizzo ,&nbsp;Elizabeth I. Davis ,&nbsp;Wissam I. Khalife ,&nbsp;M. Kristen Peek ,&nbsp;Brian Downer","doi":"10.1016/j.ijcrp.2024.200309","DOIUrl":"https://doi.org/10.1016/j.ijcrp.2024.200309","url":null,"abstract":"<div><h3>Background</h3><p>Studies of adult populations in high-income countries have found an association between arthritis and myocardial infarction (MI) due to high levels of systemic inflammation. Our objectives were to examine the association between arthritis and MI among Mexican adults and to assess the mediating effect of C-reactive protein (CRP) on this association.</p></div><div><h3>Methods</h3><p>Data came from the 2012, 2015, and 2018 observation waves of the Mexican Health and Aging Study. Our sample included 11,707 participants aged 50 and older with no prior MI before 2012. We used self-reported information for arthritis, joint pain, medication use, and limitations to daily activities in 2012. Logistic regression was used to model the association between arthritis and self-reported MI in 2015 or 2018. We used a sub-sample of 1602 participants to assess the mediating effect of CRP.</p></div><div><h3>Results</h3><p>In the full sample, participants with arthritis that limited their daily activities had higher odds of MI than participants with no arthritis (OR = 1.40; 95 % CI = 1.04–1.88). In the sub-sample, arthritis that limited daily activities was associated with higher mean CRP (5.2 mg/dL; 95 % CI = 4.10–6.21) than arthritis with no limitations (3.5 mg/dL; 95 % CI = 2.93–4.01). However, CRP levels had a small mediating effect, and the relationship between arthritis with physical limitations and MI remained statistically significant.</p></div><div><h3>Conclusion</h3><p>Mexican adults with arthritis that limits their daily activities are at an increased risk for MI. Continued research is needed to identify factors that contribute to this increased risk.</p></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"22 ","pages":"Article 200309"},"PeriodicalIF":1.9,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772487524000746/pdfft?md5=16b93f4385fc33b3cd0c511b237d8b16&pid=1-s2.0-S2772487524000746-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141542929","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}
引用次数: 0
Sex-specific associations between prolonged serum uric acid levels and risk of major adverse cardiovascular events 血清尿酸水平延长与主要不良心血管事件风险之间的性别特异性关联
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-06-20 DOI: 10.1016/j.ijcrp.2024.200302
Hsiu-Ting Chien , Yu-Wen Lin , Li-Jiuan Shen , Song-Chou Hsieh , Lian-Yu Lin , Yi-An Chen , Fang-Ju Lin

Background

While hyperuricemia has been correlated with cardiovascular (CV) diseases, further evidence is required to evaluate the implications of stable serum uric acid (sUA) levels, especially concerning low sUA. This study aimed to investigate prolonged stable sUA levels and CV events/mortality.

Methods

We conducted a retrospective cohort study at a medical center using electronic medical records linked with the national claims database. Patients with at least two sUA measurements, with intervals ranging from 6 months to 4 years, were included. The mean of the first two eligible sUA measurements were analyzed, stratified by sex. Outcomes of interest comprised major adverse cardiovascular events (MACE), heart failure hospitalization, CV and all-cause mortality.

Results

This study included 33,096 patients (follow-up: men 6.6 years, women 6.4 years). After multivariable adjustment, cubic spline models showed that long-term high sUA levels were consistently associated with a higher risk of MACE, heart failure hospitalization, CV and all-cause mortality. A U-shaped association was observed between sUA levels and all-cause mortality in both sexes and between sUA levels and CV mortality in women. The impact of sUA, especially lower levels, on CV events and mortality was more pronounced in women than in men.

Conclusion

Long-term high sUA levels are consistently associated with increased risk of CV events and mortality. A U-shaped association between sUA levels and all-cause mortality was observed in both men and women and was pronounced in women. The findings underscore the importance of considering sUA levels, especially in women, when assessing CV risk.

背景虽然高尿酸血症与心血管疾病(CV)有关,但还需要进一步的证据来评估血清尿酸(sUA)水平稳定的影响,尤其是低 sUA。本研究旨在调查长期稳定的 sUA 水平与心血管事件/死亡率的关系。方法我们在一家医疗中心开展了一项回顾性队列研究,使用的是与国家索赔数据库相连的电子病历。研究纳入了至少进行过两次sUA测量的患者,测量时间间隔从6个月到4年不等。按照性别分层,对符合条件的前两次sUA测量值的平均值进行了分析。研究结果包括主要不良心血管事件(MACE)、心力衰竭住院、心血管疾病和全因死亡率。经多变量调整后,立方样条模型显示,长期高sUA水平始终与MACE、心衰住院、CV和全因死亡的较高风险相关。在男性和女性的 sUA 水平与全因死亡率之间,以及在女性的 sUA 水平与心血管疾病死亡率之间,均观察到 U 型关系。与男性相比,女性的 sUA(尤其是较低水平的 sUA)对心血管事件和死亡率的影响更为明显。在男性和女性中都观察到了 sUA 水平与全因死亡率之间的 U 型关系,在女性中更为明显。这些发现强调了在评估心血管风险时考虑 sUA 水平(尤其是女性)的重要性。
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引用次数: 0
Association of overweight and obesity with coronary risk factors and the presence of multivessel disease in patients with obstructive coronary artery disease – A nationwide registry study 阻塞性冠状动脉疾病患者超重和肥胖与冠状动脉风险因素和多血管疾病的关系--一项全国范围的登记研究
IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-06-19 DOI: 10.1016/j.ijcrp.2024.200299
Maria Hang Xuan Pham , Daniel Mølager Christensen , Andreas Torp Kristensen , Charlotte Middelfart , Caroline Sindet-Pedersen , Gunnar Gislason , Niels Thue Olsen

Background

The growing prevalence of obesity is expected to increase the burden of coronary artery disease. This study examined the prevalence of overweight and obesity in patients with a first-time diagnosis of obstructive coronary artery disease in a contemporary population. The association of body-mass-index (BMI) with age, traditional risk factors, and the presence of multivessel disease were explored.

Methods and results

Using the Danish Nationwide registries, we identified 49,733 patients with a first-time diagnosis of obstructive coronary artery disease in the period 2012–2018. We investigated the association between BMI and coronary risk factors by multivariate logistic regression. Mean age was 65.8 ± 11.8 years, mean BMI was 27.5 kg/m2 ± 7.2, and 73.2 % were men. 66.3 % had a BMI ≥25 kg/m2 and 1.3 % were underweight. The prevalence of patients with BMI ≥25 kg/m2 decreased with increasing age and was 69 % in patients <50 year vs. 46.2 % in patients ≥80 years (p < 0.001). In all age groups, higher odds of BMI ≥25 kg/m2 were observed in males, former smokers, and patients with hypertension. In multivariate logistic regression, BMI ≥25 kg/m2 was not associated with presence of multivessel disease (p = 0.74).

Conclusion

In this large, nationwide study, 66.3 % of patients with first time diagnosis of obstructive coronary disease had BMI ≥25 kg/m2. Young patients had higher BMI and were more likely to be current smokers. Overweight or obesity was independently associated with the presence of diabetes and hypertension. BMI ≥25 kg/m2 was not independently associated with the presence of multivessel disease.

背景肥胖症的发病率越来越高,预计会加重冠状动脉疾病的负担。本研究调查了当代人群中首次诊断为阻塞性冠状动脉疾病的患者中超重和肥胖的发生率。我们探讨了体重指数(BMI)与年龄、传统风险因素以及是否存在多血管疾病之间的关系。方法和结果通过丹麦全国范围的登记,我们确定了2012-2018年间首次诊断为阻塞性冠状动脉疾病的49733名患者。我们通过多变量逻辑回归研究了体重指数与冠状动脉风险因素之间的关系。平均年龄为 65.8 ± 11.8 岁,平均体重指数为 27.5 kg/m2 ± 7.2,73.2% 为男性。66.3%的患者体重指数≥25 kg/m2,1.3%体重不足。随着年龄的增长,体重指数≥25 kg/m2的患者比例下降,50岁患者的比例为69%,而≥80岁患者的比例为46.2%(P< 0.001)。在所有年龄组中,男性、曾吸烟者和高血压患者的体重指数≥25 kg/m2的几率较高。在多变量逻辑回归中,BMI ≥25 kg/m2 与是否存在多血管疾病无关(p = 0.74)。年轻患者的体重指数较高,而且更有可能是吸烟者。超重或肥胖与糖尿病和高血压的存在有独立关联。体重指数≥25 kg/m2与是否存在多血管疾病没有独立关联。
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International Journal of Cardiology Cardiovascular Risk and Prevention
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