Heart Stroke Research Articles

Daylight saving time transitions and risk of heart attack—a systematic review and meta-analysis

Daylight saving time transitions and risk of heart attack—a systematic review and meta-analysis

Feasibility of aligning creatine kinase MB activity and mass data in multicenter trials using generalized additive modeling.

Elevated serum creatine kinase isoenzyme MB (CK-MB) levels indicate myocardial ischaemia and periprocedural myocardial injury during treatment of heart diseases. We established a method to predict CK-MB mass from activity data based on a prospective pilot study in order to simplify multicentre trials. 38 elective cardiac surgery patients without acute myocardial ischaemia and terminal renal failure were recruited. CK-MB mass and activity were determined in venous blood samples drawn preoperatively, postoperatively, 6 h post-op, and 12 h post-op. Linear regression and generalized additive models (GAMs) were applied to describe the relationship of mass and activity. Influences of demographic and perioperative factors on the fit of GAMs was evaluated. The agreement of predicted and measured CK-MB masses was assessed by Bland-Altman analyses. Linear regression provided an acceptable overall fit (r2=0.834) but showed deviances at low CK-MB levels. GAMs did not benefit from the inclusion of age, body mass index, and surgical times. The minimal adequate model predicted CK-MB masses from activities, sex, and sampling time with an r2 of 0.981. Bland-Altman analyses confirmed narrow limits of agreement (spread: 8.87 µg/L) and the absence of fixed (p = 0.41) and proportional (p = 0.21) biases. GAM-based modelling of CK-MB data in a representative patient cohort allowed to predict CK-MB masses from activities, sex, and sampling time. This approach simplifies the integration of study centers with incompatible CK-MB data into multicentre trials in order to facilitate inclusion of CK-MB levels in statistical models.

Comparison of atrial fibrillation prevalence and in-hospital cardiovascular outcomes between patients undergoing allogeneic versus autologous hematopoietic stem cell transplantation: insights from the national inpatient sample

Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for several malignant and non-malignant hematologic conditions. However, patients undergoing HSCT are at increased risk of developing serious cardiovascular events. Whether cardiovascular risks differ by the type of transplantation strategy used, allogeneic versus autologous HSCT, is unknown. Leveraging the National Inpatient Sample (2016–2019), we assessed the incidence of early cardiovascular events by HSCT mode (allogeneic vs autologous). The primary outcome was the incidence of atrial fibrillation (AF). The secondary outcome was the occurrence of any major adverse cardiac events (MACE), defined as acute heart failure, myocardial infarction (MI), symptomatic atrial or ventricular arrhythmia or heart block, and cardiovascular death. Outcomes were compared between those undergoing allogeneic versus autologous HSCT. Multivariable regression, adjusting for cardiovascular and cancer-related factors, was used to define the association between pre-HSCT factors and MACE. We further assessed the effect of acute cardiovascular events on in-patient mortality by calculating adjusted odds ratio (aOR) with corresponding 95% confidence intervals (CI) and p-values. Overall, 64,705 weighted hospitalizations for HSCT were identified, of which 22,655 (35.0%) were allogeneic HSCT and 42,050 (65.0%) were autologous HSCT. The prevalence of AF was 9.1%, and 12.1% for any arrhythmia. In multivariable regression, allogeneic HSCT was associated with higher adjusted odds of peri-HSCT acute heart failure (aOR 2.64; 1.86–3.76; p < 0.0001), QT prolongation (aOR 1.40; 1.04–1.88; p = 0.025), MI (aOR 2.87; 1.16–7.11; p = 0.023), any major cardiovascular complication (aOR 1.16; 1.03–1.32; p = 0.016), and inpatient mortality (aOR 4.87; 3.60–6.58; p < 0.0001). Following cerebrovascular events, AF was the strongest predictor of mortality. Allogeneic HSCT was associated with higher odds of in-hospital cardiovascular complications among patients undergoing HSCT.

Alcohol consumption among Iranian population based on the findings of STEPS survey 2021

Alcohol production and consumption have been prohibited in Iran for over four decades, leading to a typical underestimation of its consumption. This study aimed to assess the prevalence of alcohol consumption, its associated factors, and estimate per capita alcohol consumption among Iran’s adult population. In this population-based survey, 27,874 adults from across Iran were selected using systematic proportional-to-size cluster sampling. Alcohol consumption was evaluated through a modified Persian version of the STEPS questionnaires from previous studies, applied over different timespans. Per capita consumption was calculated using the quantity-frequency method, expressed in liters of pure alcohol. Adjusted odds ratios were reported for associates of alcohol consumption concerning metabolic risk factors, sociodemographic elements, and lifestyle variables. The prevalence of lifetime alcohol consumption was 6.9% (95% CI 6.5–7.2) in the adult population, with a notable sex difference (males: 13.7% [95% CI 13–14.4]; females: 1.4% [95% CI 1.1–1.6]). The 12 month prevalence was 3.8% (95% CI 3.6–4.1). For individuals aged 18 and older, the per capita alcohol consumption in Iran was 0.12 L. Factors such as being a lifetime smoker, younger, wealthier, and having 7–12 years of education were significantly linked to higher alcohol consumption. Significant associations were also observed between alcohol consumption and having a history of heart attacks (OR = 2.04, 95% CI 1.44–2.89), and physical injuries (OR = 1.88, 95% CI 1.34–2.64). The estimated lifetime and 12-month prevalence of alcohol use in our study were higher among some of the subpopulations. The findings also revealed a complex relationship between alcohol consumption, behavioral risk factors, and metabolic profiles. Consequently, immediate preventive measures tailored to each factor’s association with alcohol use are recommended.

Diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia: systematic review and meta-analysis

BackgroundDyslipidemia is an imbalance of lipid profiles. It increases the chance of clogged arteries and may cause heart attacks, strokes, and other circulatory disorders. Dyslipidemia affects the general population, but its severity is higher in diabetic populations. As a result, the chance of dyslipidemia-associated morbidity and mortality is highest in diabetic patients. In Ethiopia, around 2 to 6.5% of the population live with diabetes, but their lipid profiles are inconsistent across the studies. Therefore, this study aimed to estimate the pooled prevalence of diabetic dyslipidemia and its predictors among people with diabetes in Ethiopia.MethodA systematic review and meta-analysis was conducted. The searches were carried out in MEDLINE via PubMed and OVID, EBSCO, Embase, and other supplementary gateways such as Google and Google Scholar, for articles published up to June 2023. The articles were searched and screened by title (ti), abstract (ab), and full text (ft). The quality of the eligible studies was assessed by the Newcastle–Ottawa scale. The heterogeneity was detected by the Cochrane Q statistic test and the I-squared (I2) test. Then subgroup analysis and meta-regression analysis were used to identify the source of the variations. A random or fixed-effect meta-analysis model was used to estimate the overall pooled prevalence and average effects. The publication bias was assessed by the funnel plot asymmetry test and/or Begg and Mazumdar’s test for rank correlation (p-value < 0.05). The protocol has been registered in an international database, the prospective register of systematic reviews (PROSPERO), with reference number CRD42023441572.ResultA total of 14 articles with 3662 participants were included in this review. The pooled prevalence of diabetic dyslipidemia in Ethiopia was found to be 65.7% (95% confidence interval (CI): 57.5, 73.9), I2 = 97%, and p-value < 0.001. The overall prevalence of triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) were found to be 51.8% (95% CI: 45.1, 58.6) and 44.2% (95% CI: 32.8, 55.7), respectively, among lipid profiles. In meta-regression analysis, the sample size (p value = 0.01) is the covariate for the variation of the included studies. Being female (adjusted odds ratio (AOR): 3.9, 95% CI: 1.5, 10.1), physical inactivity (AOR: 2.6, 95% CI: 1.5, 4.3), and uncontrolled blood glucose (AOR: 4.2, 95% CI: 1.9, 9.4) were found to be the determinants of dyslipidemia among diabetic patients.ConclusionThis review revealed that the prevalence of diabetic dyslipidemia is high among people with diabetes in Ethiopia. Being female, having physical inactivity, and having uncontrolled blood glucose were found to be predictors of dyslipidemia among people with diabetes. Therefore, regular screening of lipid profiles and the provision of lipid-lowering agents should be strengthened to reduce life-threatening cardiovascular complications. Furthermore, interventions based on lifestyle modifications, such as regular physical activity and adequate blood glucose control, need to be encouraged.

How collider bias affects the relationship between skin color and heart attack using directed acyclic graphs, propensity scores, and stepwise approaches

BackgroundStatistical methods are essential in epidemiology research, but they can generate erroneous estimates when selecting variables based only on statistical criteria. The use of directed acyclic graphs (DAG) helps to understand the causal relationships between variables and to avoid biases.ObjectiveCompare the estimate of the effect of skin color on heart attack obtained from three data analysis techniques: a stepwise approach based on statistical criteria, a propensity score technique, and a graphical approach based on causal criteria.MethodsPopulation-based cross-sectional study using data from the second National Health and Nutrition Examination Survey (NHANES). The exposure variable was skin color (black or non-black) and the outcome was heart attack (yes or no). Multivariable logistic regressions were carried out using the stepwise, propensity score techniques and the DAG-based approach to identify the association between the variables. In the stepwise technique, all variables potentially related to the outcome were included in the model and a forward or backward algorithm was used. The propensity score was applied, estimating the probability of exposure based on the covariates and helping to create balanced groups for comparison. Different possible causal models were developed between the variables in the DAG-based approach, identifying confounding, mediation, and collision factors. The models were created considering self-rated health as a confounding or collider variable, and the modeling results were verified.ResultsA total of 10,351 adults were evaluated, the majority female (52.1%), aged 20 to 39 years (48.5%), and with non-black skin color (90.4%). The prevalence of heart attacks was 3.0%, and 17% rated their health as fair or poor. Using different modeling techniques, no association was found between skin color and heart attack (p > 0.05), except when self-rated health, a collider variable, was included in the stepwise models. In this case, there was an inverse and biased association between the two variables, indicating a collision bias (stepwise-backward-OR 0.48; 95%CI 0.33–0.70; stepwise-forward-OR 0.64; 95%CI 0.44–0.94).ConclusionSkin color was not associated with heart attack when controlling for appropriate confounding factors. However, when adjusting for self-rated health in stepwise techniques, a colliding variable, there was an inverse and distorted association between the two variables, indicating a collider bias. The DAG-based approach and propensity score can avoid this bias by correctly identifying confounding factors and colliders.

INTERASPIRE a global cross-sectional survey of secondary prevention of cardiovascular disease (CVD) across six WHO regions

Abstract Introduction This survey of secondary prevention of CVD was conducted through National Societies of Cardiology across all WHO regions and included Kenya, Nigeria, Tanzania, Argentina, Colombia, Egypt, UAE, Poland, Portugal, Indonesia, China, Malaysia, Philippines and Singapore. Purpose The overall aim of INTERASPIRE was to assess the clinical implementation of risk reduction initiatives to reduce cardiovascular risk in line with lifestyle, risk factor and therapeutic targets defined in international and national guidelines on CVD prevention. Methods A consecutive sample of patients (&amp;gt; 18 and &amp;lt; 80 years) admitted to public hospitals in selected regions within each participating country with an acute ST elevation myocardial infarction (MI), Non-ST elevation MI, acute myocardial ischaemia or for elective revascularisation was identified retrospectively from medical record systems. Patients were invited to attend a clinical visit with trained research assistants at least 6 months but not more than 2 years after their event. The assessment included self-reported smoking status validated with an expired breath carbon monoxide measurement, self-reported participation in physical activity using the Godin validated questionnaire and standardised measurements of height, weight, blood pressure, blood lipids and blood glucose including an oral glucose tolerance test. Results 4548 (21.1% women) patients attended the clinical visit. 12.6% were smoking with wide variation across countries (1.9 – 27.3%). 48% of those who were smoking at the time of hospital admission had continued to smoke. 66.5% reported being sedentary with wide variation across countries (51.3 – 90.5%). 24% were obese and 40% centrally obese with a large difference between men (32.3%) and women (69.4%). 38% achieved a blood pressure target of &amp;lt; 130/80 mmHg, 19.2% achieved an LDL-C target of &amp;lt; 1.4 mmol/l and in patients with self-reported diabetes 56% achieved a target HbA1c of &amp;lt; 53 mmol/mol (7%). In those who did not report having diabetes, a further 9.8% had undetected diabetes and 26.9% impaired glucose tolerance. 48% were prescribed all four classes of cardioprotective drugs (antiplatelets, beta blockers, ACE/ARB, lipid lowering agents) with wide variation between countries (25% - 75%) and 88.3% were prescribed both antiplatelets and lipid lowering agents. Only 1219 (26.8%) were advised to attend cardiac rehabilitation with wide variation (4.5% to 58.9%) between countries. Overall only 9.0% (men 9.1%, women 9.1%) of all patients attended cardiac rehabilitation. Figure 1 shows the distribution of the INTERASPIRE Guideline Target Score. Conclusion There is substantial room for improvement in secondary prevention in patients with coronary disease globally. It is of concern that only 9% of patients received cardiac rehabilitation despite it being a Class 1 recommendation in all prevention guidelines with wide variation in advice and uptake between countries.Figure 1

Sleep disorders in patients with heart diseases - present knowledge

Abstract Introduction The problem of sleep disorders plays a significant role in the functioning of people in the contemporary world, particularly affecting cardiac patients. It entails a series of consequences that impact health. The study analyzed the occurrence of sleep disorders among cardiac patients. Purpose The project aimed to assess the available literature regarding described sleep disorders in patients with cardiovascular diseases and to analyze the impact of sleep disorders on the functioning of cardiac patients. Methods Materials available in PubMed and Google Scholar were analyzed using keywords such as "sleep disorders," "insomnia," "cardiovascular disease," "heart attack," "heart failure," "hypertension," "coronary artery disease" in various configurations. A comprehensive analysis of publications was conducted to identify studies on sleep disorders in cardiac patients, focusing on risk factors and management strategies for sleep problems in this patient group. Results Sleep disorders occur in cardiac patients and significantly affect their health. Sleep disorders also increase cardiovascular risk in healthy individuals. Sleep disorder management methods include problem recognition, lifestyle modifications, pharmacotherapy, and behavioral interventions. A crucial aspect of care appears to be the need for diagnosing sleep problems in cardiac patients and implementing integrated multidisciplinary care. Conclusions Sleep disorders pose a significant risk for cardiac patients, requiring an interdisciplinary therapeutic approach. Future research should assess the scale of sleep disorders in cardiac patients in Poland, as well as identify factors influencing sleep disorders in this patient group. Subsequently, treatment strategies and integrated care should be developed.

Increased heart attack mortality in a medium sized city in Germany: key informant interviews with local medical health care workers

Abstract Background Cardiovascular diseases are the leading cause of death worldwide. However, there are significant regional differences regarding mortality rates. A city located in Southwest Germany with approximately 125.000 inhabitants, has revealed a significantly increased heart attack mortality for the last two decades. In most of these years it recorded the highest rate in the federal state. Purpose The aim of this study was to assess influencing factors on the increased heart attack mortality in this city. Methods The study recruited health care workers in regular contact with heart attack patients in this city. Using a heterogenous sampling approach, the selection included different medical specializations (e.g. family doctor, intensive care nurse). We conducted qualitative interviews following a semi-structured guideline. Audio records of interviews were transcribed and processed using content analysis. Results We performed 17 interviews (female=6, immigration background=4). The central theme was an unhealthy cardiovascular lifestyle predominantly focusing on modifiable risk factors. Interviewees described the intensity of risk factors as much higher in the city than in the surrounding districts. Mostly they connected this to a high population share of people with low socioeconomic status or immigration background. Most interviewees did not see severe differences in health care provision and institutions in the city compared to other districts. Conclusion Socioeconomic factors were seen as the most powerful influence on the heart attack mortality. A healthier cardiovascular lifestyle of the population can only be achieved addressing social disparities within the city.

Pathophysiology, The Biochemical And Clinical Significance Of Lactate Dehydrogenase

Lactate dehydrogenase (LDH) is a family of enzymes that catalyzes oxidation-reduction enzymes, the interconversion between pyruvic acid and lactic acid. It is an enzyme that terminates the final catabolic reaction in which glucose id hydrolyzes anaerobically (glycolysis) resulting in lactate from pyruvate. These varied biochemical characteristics significantly influence its specificity to cells, tissues, and organs. Although LDH is mainly found in the cytoplasm, it is also located in multiple organelles. The presence of blood LDH implies an enzyme marker, and it may be a sign of death for many conditions such as ARDS, severe COVID-19, and some cancers. When LDH levels in the blood are increased they can reflect liver disease or anemia plus heart attack in addition to bone fracture — and muscle trauma. This also includes cancerous formations; infections like encephalitis or meningitis — along with HIV.

Functional capacity evaluation in acute isquemic patients

Abstract Background An acute ischemic event may cause a functional deterioration even in previously autonomous patients. The determination of functional capacity is relevant to determine health indicators for rehabilitation nursing care, allowing at the same time to determine the patient's functional status throughout their health-disease cycle and to prescribe exercise-based rehabilitation for home-based programs. The six-minute walking test is widely used in studies involving cardiac patients, however, reference values for ischemic population after immediate clinical stabilization are not known. Also the 6MWT has a prognostic value for cardiac patients, being of utmost importance to evaluate it, after clinical stabilization in order to properly determine goals for patient´s rehabilitation process. Aim Determine the functional capacity level of ischemic patients, by gender and type of event, after clinical stabilization using the 6-minute walking test. Methods Using the 6-minute walking test, the functional capacity of ischemic inpatients was evaluated at discharge, after clinical stabilization. Patients with acute coronary syndrome with and without ST-segment elevation were included. All patients were accompanied by the rehabilitation nursing team during the in-hospital stay period and performed phase 1 cardiac rehabilitation. The 6MWT was performed based on the 2016 ATS guidelines and the expected value of the distance covered was determined based on the Enright equation. The sample was divided by gender, taking into account their widely known differences in functional capacity and also by event, namely ST elevation and Non ST-segment elevation myocardial infraction. The profile of modifiable cardiovascular risk factors (CRF) was also evaluated, being considered the following: Hypertension, Dyslipidemia, obesity, tobacco, sedentary lifestyle and stress. Results A total of 303 patients were studied (229 male), with a mean age of 62 years (men) and 62 (women). About 36% of men and 7% of women were admitted with ST elevation Myocardial Infraction, with a mean number of cardiovascular risk factors (CVRF) of 3.2 in men and 3.9 in women. The most prevalent CVRF in females is dyslipidemia and sedentary lifestyle, while in males it is dyslipidemia. The sample was divided in two groups by type of event, namely ST-elevation (group A) and NonST-elevation (group B) and in each group, data was evaluated by gender. A statistically significant difference (p&amp;lt;0.01 for males and p&amp;lt;0.02 for female) was found between the value of the 6MWT performed (441.2 meters – males; 369.5 meters - females) compared to the value estimated by the equation (559.9 males; 482.8 female gender). There is a very significant difference between the expected value and the value actually covered in the walking test. It may be pertinent to define reference values for this typology of patients, so that their functional capacity can be properly measured.

Feature value quantization and reduction process for predicting heart attack possibility and the level of severity by a machine learning model

Heart disease is a prevalent condition nowadays that, if undiagnosed, can be deadly. To predict heart disease, researchers designed many machine learning models. In this study, we propose a model that chooses fewer attribute columns for training, and we use these chosen features to determine the heart problem severity. Correlation Repeated Heat map and Information Gain were used for selecting the features. To train our model we used the UCI Cleveland heart disease dataset. We removed duplicate data to improve the accuracy score, and we also encoded the categorical data collection using the OneHot(OH) encoding method, which can improve prediction accuracy. Support Vector, Logistic Regression, K-Nearest Neighbour, Naive Bayes, Decision Tree, Random Forest, Adaboost, and XGBoost are the eight classifier algorithms that are used in this process overall. Based on repeated heat map correlation, we compare the accuracy score each time. In this proposed method, the Adaboost classification algorithm used by the fbs row heat map achieves the highest accuracy for heart disease detection and it is 92%. By choosing features according to the information gain value, we compare the accuracy score each time in information gain. For both XGBoost and Logistic Regression, we got an accuracy score of 93.44%. However, compared to the XGBoost classification technique, Logistic Regression requires less time. Accuracy, precision, recall, f1-score, sensitivity, specificity, and the AUC of ROC charts were used to evaluate the performance of the model. Overall, the results of our model demonstrate that it is reliable and accurate in identifying cardiac disease and its level of severeness.

High salt intake and HIV infection on endothelial glycocalyx shedding in salt-sensitive hypertension

The endothelial glycocalyx is closely associated with various physiological and pathophysiological events. Significant modification of the endothelial glycocalyx is an early process in the pathogenesis of cardiovascular disease. High dietary salt and HIV infection damages the endothelial glycocalyx causing endothelial dysfunction and increasing the risk for salt-sensitive hypertension and cardiovascular disease. The two factors, HIV infection and dietary salt are critical independent predictors of hypertension and cardiovascular disease and often synergize to exacerbate and accelerate disease pathogenesis. Salt-sensitive hypertension is more common among people living with HIV and is associated with risk for cardiovascular disease, stroke, heart attack and even death. However, the underlying mechanisms linking endothelial glycocalyx damage to dietary salt and HIV infection are lacking. Yet, both HIV infection/treatment and dietary salt are closely linked to endothelial glycocalyx damage and development of salt-sensitive hypertension. Moreover, the majority of individuals globally, consume more salt than is recommended and the burden of HIV especially in sub-Sahara Africa is disproportionately high. In this review, we have discussed the missing link between high salt and endothelial glycocalyx shedding in the pathogenesis of salt-sensitive hypertension. We have further elaborated the role played by HIV infection and treatment in modifying endothelial glycocalyx integrity to contribute to the development of hypertension and cardiovascular disease.

Acute Medicine – Needs and Challenges: The Bangladesh Perspective

Bangladesh has an ageing population, with increased multi-morbidity and polypharmacy. Acute care is becoming more complex, with increased admission numbers and little alternative to hospital attendance and admission. Alternative models of care are discussed, that include new ways of working and use of novel training techniques including technology such as point of care testing including ultrasound. The use of ambulatory care is also proposed, with rapid access and even virtual outpatient clinics. The development of specialist acute generalists can enable other clinicians to develop more specialised skills including managing separate gastrointestinal bleeding rotas and heart attack or stroke units. Standardised care at the front door can reduce variability in practice and promote excellence in acute care for all patients. The potential pros and cons of developing an acute (internal) medicine model in Bangladesh are discussed. J MEDICINE 2024; 25: 159-165

Social vulnerability and surgery outcomes: a cross-sectional analysis

BackgroundPost-operative complications present a challenge to the healthcare system due to the high unpredictability of their incidence. Socioeconomic conditions have been established as social determinants of health. However, their contribution relating to postoperative complications is still unclear as it can be heterogeneous based on community, type of surgical services, and sex and gender. Uncovering these relations can enable improved public health policy to reduce such complications.MethodsIn this study, we conducted a large population cross-sectional analysis of social vulnerability and the odds of various post-surgical complications. We collected electronic health records data from over 50,000 surgeries that happened between 2012 and 2018 at a quaternary health center in St. Louis, Missouri, United States and the corresponding zip code of the patients. We built statistical logistic regression models of postsurgical complications with the social vulnerability index of the tract consisting of the zip codes of the patient as the independent variable along with sex and race interaction.ResultsOur sample from the St. Louis area exhibited high variance in social vulnerability with notable rapid increase in vulnerability from the south west to the north of the Mississippi river indicating high levels of inequality. Our sample had more females than males, and females had slightly higher social vulnerability index. Postoperative complication incidence ranged from 0.75% to 41% with lower incidence rate among females. We found that social vulnerability was associated with abnormal heart rhythm with socioeconomic status and housing status being the main association factors. We also found associations of the interaction of social vulnerability and female sex with an increase in odds of heart attack and surgical wound infection. Those associations disappeared when controlling for general health and comorbidities.ConclusionsOur results indicate that social vulnerability measures such as socioeconomic status and housing conditions could affect postsurgical outcomes through preoperative health. This suggests that the domains of preventive medicine and public health should place social vulnerability as a priority to achieve better health outcomes of surgical interventions.

Macrophage-mediated heart repair and remodeling: A promising therapeutic target for post-myocardial infarction heart failure.

Heart failure (HF) remains prevalent in patients who survived myocardial infarction (MI). Despite the accessibility of the primary percutaneous coronary intervention and medications that alleviate ventricular remodeling with functional improvement, there is an urgent need for clinicians and basic scientists to further reveal the mechanisms behind post-MI HF as well as investigate earlier and more efficient treatment after MI. Growing numbers of studies have highlighted the crucial role of macrophages in cardiac repair and remodeling following MI, and timely intervention targeting the immune response via macrophages may represent a promising therapeutic avenue. Recently, technology such as single-cell sequencing has provided us with an updated and in-depth understanding of the role of macrophages in MI. Meanwhile, the development of biomaterials has made it possible for macrophage-targeted therapy. Thus, an overall and thorough understanding of the role of macrophages in post-MI HF and the current development status of macrophage-based therapy will assist in the further study and development of macrophage-targeted treatment for post-infarction cardiac remodeling. This review synthesizes the spatiotemporal dynamics, function, mechanism and signaling of macrophages in the process of HF after MI, as well as discusses the emerging bio-materials and possible therapeutic agents targeting macrophages for post-MI HF.

The State of Lipid Metabolism in Old Rats in High Altitude Conditions Against the Background of the Use of Coenzyme Q10

The problem of population aging is relevant both in Kyrgyzstan and in the global space. At the same time, the preservation of the functional capabilities of the body of elderly people living in adverse climatic conditions is of particular importance. 20-30% of the inhabitants live in the mountainous area of Kyrgyzstan at an altitude of 2000-4000 meters above sea level. It is known that in high-altitude conditions, the body is influenced by extreme factors of the highlands, which accelerate the aging process and reduce life expectancy. This article presents data from experimental studies of energy metabolism disorders in old rats and its correction of coenzyme Q10 at an altitude of 3200 m above sea level. It was found that in old rats, under conditions of short-term adaptation in the mountains, an increase in the level of total cholesterol, triglycerides and low-density lipoproteins was shown, and the level of high-density lipoproteins decreased, indicating a violation of lipid metabolism. Also, due to oxidative stress in high-altitude conditions, the level of malondialdehyde, superoxide dismutase and catalase in the blood of animals was increased. Oral administration of coenzyme Q10 at a dose of 30 mg/kg of body weight 1 time per day for 30 days to old rats led to a decrease in total cholesterol, low-density lipoproteins, triglycerides and an increase in high-density lipoproteins, due to the fact that coenzyme Q10 protects the plasma membrane of the cell from lipid peroxidation, preventing oxidative modifications lipids, which leads to a reduced risk of coronary heart disease, heart attack and stroke.

Development of an efficient novel method for coronary artery disease prediction using machine learning and deep learning techniques.

Heart disease is a severe health issue that results in high fatality rates worldwide. Identifying cardiovascular diseases such as coronary artery disease (CAD) and heart attacks through repetitive clinical data analysis is a significant task. Detecting heart disease in its early stages can save lives. The most lethal cardiovascular condition is CAD, which develops over time due to plaque buildup in coronary arteries, causing incomplete blood flow obstruction. Machine Learning (ML) is progressively used in the medical sector to detect CAD disease. The primary aim of this work is to deliver a state-of-the-art approach to enhancing CAD prediction accuracy by using a DL algorithm in a classification context. A unique ML technique is proposed in this study to predict CAD disease accurately using a deep learning algorithm in a classification context. An ensemble voting classifier classification model is developed based on various methods such as Naïve Bayes (NB), Logistic Regression (LR), Decision Tree (DT), XGBoost, Random Forest (RF), Convolutional Neural Network (CNN), Support Vector Machine (SVM), K Nearest Neighbor (KNN), Bidirectional LSTM and Long Short-Term Memory (LSTM). The performance of the ensemble models and a novel model are compared in this study. The Alizadeh Sani dataset, which consists of a random sample of 216 cases with CAD, is used in this study. Synthetic Minority Over Sampling Technique (SMOTE) is used to address the issue of imbalanced datasets, and the Chi-square test is used for feature selection optimization. Performance is assessed using various assessment methodologies, such as confusion matrix, accuracy, recall, precision, f1-score, and auc-roc. When a novel algorithm achieves the highest accuracy relative to other algorithms, it demonstrates its effectiveness in several ways, including superior performance, robustness, generalization capability, efficiency, innovative approaches, and benchmarking against baselines. These characteristics collectively contribute to establishing the novel algorithm as a promising solution for addressing the target problem in machine learning and related fields. Implementing the novel model in this study significantly improved performance, achieving a prediction accuracy rate of 92% in the detection of CAD. These findings are competitive and on par with the top outcomes among other methods.

Short-term S100A8/A9 Blockade Promotes Cardiac Neovascularization after Myocardial Infarction.

Acute-phase inhibition of the pro-inflammatory alarmin S100A8/A9 improves cardiac function post-myocardial infarction (MI), but the mechanisms underlying the long-term benefits of this short-term treatment remain to be elucidated. Here, we assessed the effects of S100A8/A9 blockade with the small-molecule inhibitor ABR-238901 on myocardial neovascularization in mice with induced MI. The treatment significantly reduced S100A9 and increased neovascularization in the myocardium, assessed by CD31 staining. Proteomic analysis by mass-spectrometry showed strong myocardial upregulation of the pro-angiogenic proteins filamin A (~ 10-fold) and reticulon 4 (~ 5-fold), and downregulation of the anti-angiogenic proteins Ras homolog gene family member A (RhoA, ~ 4.7-fold), neutrophilic granule protein (Ngp, ~ 4.0-fold), and cathelicidin antimicrobial peptide (Camp, ~ 4.4-fold) versus controls. In-vitro, ABR-238901 protected against apoptosis induced by recombinant human S100A8/A9 in human umbilical vein endothelial cells (HUVECs). In conclusion, S100A8/A9 blockade promotes post-MI myocardial neovascularization by favorably modulating pro-angiogenic proteins in the myocardium and by inhibiting endothelial cell apoptosis.

Association between pulp stones and systemic diseases: A case-control study

Introduction: Pulp stones (PS) are calcifications commonly found in the pulp tissue that may be associated with systemic diseases. Objective: To evaluate the association between PS and systemic diseases. Methods: A case-control study with the inclusion of individuals from 18 to 65 years of age, of both sexes. Analysis was made of 1047 digital panoramic radiographs. The controls could not have any teeth with PS; the cases were the contrary. A questionnaire comprising demographic, habit, and general health (diabetes, problems with blood vessels, altered cholesterol level, heart attack, kidney or gallbladder stone, arthritis, or autoimmune disease, and for women, endometriosis, and ovarian cyst). Data were submitted to the Student's t-test to identify differences between groups about sex and age. The Chi-square test was applied to the cross-tabulation. The analyses were performed using SPSS®, version 25.0, with a 5% significance level. Results: 490 patients participated (242 cases and 248 controls). There was no difference between groups for the sex (p=0.966) and age (p=0.186). Only “kidney stone” was associated with the case group (p=0.001), being almost three times higher when compared to the control group. No significant differences were found in females about the presence or absence of PS (p&gt;0.05). Conclusion: In this research, it is suggested the existence of an association between kidney stones and the presence of pulp stones.