Cardiovascular Disease Research Articles

Analysing premature cardiovascular disease mortality in the United States by obesity status and educational attainment

Abstract Background In the United States (US), premature cardiovascular disease (CVD) mortality rates (35–74 years) have exhibited increases in recent years, particularly in younger adults, and large differentials by educational attainment. This trend has occurred concurrently with high and increasing obesity prevalence, which also show significant differences by education. This study aims to jointly model premature CVD mortality trends in the US according to obesity status and educational attainment. Methods We used multiple cause of death data from the National Center for Health Statistics, obesity prevalence data from the National Health and Nutrition Examination Survey (NHANES), and educational attainment data from the American Community Survey and NHANES. We applied Bayes’ theorem to these data to calculate the conditional probability of premature CVD mortality given obesity status and educational attainment for 2003–2019. We then projected this conditional probability for 2020–2029 using the Lee-Carter model. Results The probability of premature CVD mortality was greatest for obesity and low education (not graduated high school) and was substantially higher (females 6.7 times higher, males 5.9) compared with non-obesity and high education (Bachelor’s degree or higher) in 2019. There was a widening of the gap in premature CVD mortality from 2003 to 2019 between the obese and non-obese populations, which occurred at each education level and was projected to continue in 2020–2029, especially for males. The conditional probability of premature CVD death for obesity and middle education (finished high school but no Bachelor’s degree) increased substantially and was projected to surpass the level for non-obesity and low education in coming years for males and in younger age groups. At high education, the conditional probability of premature CVD death for the obese population was projected to increase to 2029, while for non-obesity it was projected to remain steady for females and fall for males; this projected widening is greatest at older age groups. Conclusions The findings demonstrate the public health challenge to reduce premature US CVD mortality posed by continued high obesity prevalence, especially for younger ages, lower education groups and males. The relative importance of obesity in influencing premature CVD mortality trends has risen partly due to the decline in CVD mortality attributable to other risk factors.

“Behavioural and metabolic risk factors of cardiovascular diseases among post-menopausal women: A cross-sectional study in Itahari sub-metropolitan city of Nepal”

Background and objectives Cardiovascular diseases (CVDs) are main cause of mortality and morbidity among women globally. Menopause, aging and different factors in collaboration leads to increased risk for CVDs among postmenopausal women but study on risk factors of CVDs among postmenopausal women is limited in Nepal. Therefore, we aimed to assess prevalence of behavioural and metabolic risk factors of cardiovascular disease among post-menopausal women. Materials & methods Community based cross-sectional study was carried among 390 post-menopausal women of the Itahari sub-metropolitan city. Multistage simple random sampling technique was used to collect data. Modified semi structured questionnaire STEP I, STEP II and STEP III was used as data collection tool. SPSS version 11.5 used for data analysis. Chi-square test and logistic regressions were performed at 95% confidence interval to find predictors of raised blood pressure and overweight/obesity. Results The mean age of respondents was 63.37 years. The prevalence of current smokers, current alcohol use, less than 5 servings of fruits and vegetables per day, low level of physical activity, overweight/obesity and raised blood pressure was 9.2%, 18.2%, 86.4%, 52.3%, 56.2% and 44.4% respectively. On multivariate analysis strong predictors of overweight obesity were age ≤59 years (AOR: 3.21, CI 1.49–6.89), poor economic status (AOR: 1.764, CI: 1.120–2.779) and low physical activity (AOR: 2.132, CI: 1.350–3.370). Predictors of raised blood pressure were age ≥75 years (AOR: 2.04, CI: 1.01–4.11), unmarried and widow (AOR: 1.815, CI: 1.108–2.971), higher economic status (AOR: 1.752, CI: 1.119–2.740) and smoking (AOR: 4.109, CI: 1.737–9.718). Conclusion Prevalence of behavioural and metabolic risk factors among postmenopausal women in Itahari sub-metropolitan city were alarmingly high. This calls for an early need of intervention and policies at local, provincial and institutional level to address risk factors of CVDs.

Use of Aspirin and Initial Cardiovascular and Bleeding Risk in Patients with Chronic Kidney Disease

Background: Despite the high cardiovascular risk in patients with chronic kidney disease (CKD), the role of aspirin in primary prevention remains unclear. This study aimed to investigate the association between aspirin initiation in adults with CKD without prior cardiovascular disease (CVD) and the first cardiovascular and bleeding events using Korean nationwide cohort data. Methods: Among individuals aged 40–79 years with an estimated glomerular filtration rate between 15 and 59 mL/min/1.73 m2 who underwent routine health examinations between 2011 and 2016, 15,861 individuals who were newly prescribed aspirin at a dose of 100 mg/day were matched with 79,305 aspirin non-users by propensity score matching. The primary efficacy outcome was a composite of nonfatal atherosclerotic CVD or cardiovascular death. The primary safety outcome was hospitalization due to intracranial or gastrointestinal bleeding. Results: During a mean follow-up of 6.9±2.9 years, the incidence rates for the primary efficacy outcome in aspirin users and non-users were 8.0 and 9.0 per 1,000 person-years, respectively. Aspirin therapy initiation was not associated with the primary efficacy outcome (hazard ratio [HR], 0.93; 95% confidence intervals [CI], 0.86-1.04). However, the primary safety outcome of major bleeding was more frequent in aspirin users than in non-users (6.7 versus 4.7 per 1,000 person-years). The HR for this outcome in aspirin users versus non-users was 1.45 (95% CI, 1.32-1.59). Conclusions: No association was observed between aspirin use and the risk of nonfatal atherosclerotic CVD or cardiovascular death in patients with CKD stages G3 and G4 without prior CVD. Aspirin use was associated with higher risk of major bleeding.

Association Between Amount of Physical Activity and Clinical Outcomes After Treatment for Cardiovascular Disease in Cancer Survivors

Association Between Amount of Physical Activity and Clinical Outcomes After Treatment for Cardiovascular Disease in Cancer Survivors

Treatment of prehypertension among adults with HIV: a randomized clinical trial

Objective: Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti. Design: An unblinded randomized clinical trial (enrolled April 2021–March 2022) with 12-month follow-up. Setting: GHESKIO Centres, Port-au-Prince, Haiti. Participants: Two hundred fifty adults with HIV with prehypertension (SBP 120–138 or DBP 80–89) not on medication, aged 18–65 years, virally suppressed, and without pregnancy, diabetes, or kidney disease. Intervention: Participants were randomized to treatment (amlodipine 5 mg) or control (no amlodipine unless two BP ≥140/90 mmHg). Main outcome measure: Primary outcome was mean change in SBP between intervention versus control groups from enrollment to 12 months. Results: Among 250 adults, median age was 49 years, 40.8% were women. Baseline median BP was 129/78 mmHg intervention versus 128/77 mmHg control. After 12 months, the difference in mean change between study groups for SBP was -5.9 mmHg [95% confidence interval (95% CI) -8.8 to -3.0] and for DBP was -5.5 mmHg (95% CI -7.9 to -3.2). At 12 months, 5.6% intervention and 23.0% control participants developed incident hypertension (hazard ratio 0.18; 95% CI 0.07–0.47). There were no differences in viral load suppression at 12 months or drug-related serious adverse events. Intervention acceptability was high among providers and participants in qualitative interviews. Conclusion: In PWH in a resource-poor setting, prehypertension treatment was feasible, acceptable, and effective in reducing mean SBP and incident hypertension. Registration: Clinicaltrials.gov NCT04692467

Multi-trait association analysis reveals shared genetic loci between Alzheimer’s disease and cardiovascular traits

AbstractSeveral cardiovascular traits and diseases co-occur with Alzheimer’s disease. We mapped their shared genetic architecture using multi-trait genome-wide association studies. Subsequent fine-mapping and colocalisation highlighted 16 genetic loci associated with both Alzheimer’s and cardiovascular diseases. We prioritised rs11786896, which colocalised with Alzheimer’s disease, atrial fibrillation and expression of PLEC in the heart left ventricle, and rs7529220, which colocalised with Alzheimer’s disease, atrial fibrillation and expression of C1Q family genes. Single-cell RNA-sequencing data, co-expression network and protein-protein interaction analyses provided evidence for different mechanisms of PLEC, which is upregulated in left ventricular endothelium and cardiomyocytes with heart failure and in brain astrocytes with Alzheimer’s disease. Similar common mechanisms are implicated for C1Q in heart macrophages with heart failure and in brain microglia with Alzheimer’s disease. These findings highlight inflammatory and pleomorphic risk determinants for the co-occurrence of Alzheimer’s and cardiovascular diseases and suggest PLEC, C1Q and their interacting proteins as potential therapeutic targets.

Effect of Different Dietary Patterns on Cardiometabolic Risk Factors: An Umbrella Review of Systematic Reviews and Meta-Analyses

Background/Objectives: Lifestyle interventions such as dietary changes have been proposed to control the cardiometabolic risk factors and thus prevent cardiovascular (CV) disease (CVD). We performed an umbrella review to investigate whether different dietary patterns affect CV risk in individuals with at least one cardiometabolic risk factor (hypertension, dyslipidemia, obesity, diabetes, metabolic syndrome) but not established CVD. Methods: We systematically searched the PubMed and Scopus databases (up to August 2024) for the systematic reviews and meta-analyses of randomized controlled trials (RCTs). Articles should be written in English and refer to a specific dietary pattern (such as Mediterranean diet, etc.). The population studied referred to adults with at least one cardiovascular (CV) risk factor. Results: From 4512 records identified, we finally included 25 meta-analyses with a total of 329 associations. Strong evidence for a benefit was found for LCD with reductions in BW [MD: −4.79 (95% CI −5.85, −3.72) kg, p ≤ 0.001], SBP [MD: −6.38 (95% CI −7.84, −4.93) mmHg, p ≤ 0.001], TG [WMD: −5.81 (95% CI −7.96, −3.66) mg/dL, p ≤ 0.001], and fasting plasma insulin [MD: −15.35 (95% CI −19.58, −11.12) pmol/L, p ≤ 0.001], as well as for low-GI diet for the reduction of BW [SMD: −0.66 (95% CI −0.90, −0.43) kg, p ≤ 0.001]. Conclusions: Across many dietary patterns, LCD showed strong or highly suggestive evidence for a benefit on SBP, BW reduction, and lipid profile improvement. Secondarily, low-GI, DASH, and Portfolio and Nordic diets suggested beneficial effects on controlling CV risk.

Cardiorespiratory fitness, body mass index and mortality: a systematic review and meta-analysis

ObjectiveThe purpose of this review was to assess the joint relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all-cause mortality risk.DesignA systematic review and meta-analysis was conducted. Pooled HR and 95% CI were calculated using a three-level restricted maximum likelihood estimation random-effects model with robust variance estimation. The reference group was normal weight-fit and was compared with normal weight-unfit, overweight-unfit and fit, and obese-unfit and fit.Data sourcesElectronic databases (PubMed/MEDLINE, Web of Science and SportDiscus) were searched following registration on PROSPERO.Eligibility criteriaArticles meeting the following criteria were included: (1) published between January 1980 and February 2023, (2) prospective cohort study, (3) CRF assessed using a maximal or VO2peak exercise test, (4) BMI reported and directly measured, (5) joint impact of CRF and BMI on all-cause mortality or CVD mortality were analysed, and (6) the reference group was normal weight, fit individuals.Results20 articles were included in the analysis resulting in a total of 398 716 observations. Compared with the reference group, overweight-fit (CVD HR (95% CI): 1.50 (0.82–2.76), all-cause HR: 0.96 (0.61–1.50)) and obese-fit (CVD: 1.62 (0.87–3.01), all-cause: 1.11 (0.88–1.40)) did not have a statistically different risk of mortality. Normal weight-unfit (CVD: 2.04 (1.32–3.14), all-cause: 1.92 (1.43–2.57)), overweight-unfit (CVD: 2.58 (1.48–4.52), all-cause: 1.82 (1.47–2.24)) and obese-unfit (CVD: 3.35 (1.17–9.61), all-cause: 2.04 (1.54–2.71)) demonstrated 2–3-fold greater mortality risks.ConclusionsCRF is a strong predictor of CVD and all-cause mortality and attenuates risks associated with overweight and obesity. These data have implications for public health and risk mitigation strategies.

Relationship between liver and cardiometabolic health in type 1 diabetes

IntroductionType 1 diabetes (T1D) is a chronic condition marked by insulin deficiency and hyperglycemia, with an increasing global incidence, particularly among children. Despite improvements in diabetes management, individuals with T1D continue to experience higher rates of cardiovascular disease (CVD), the leading cause of mortality in this population. Traditional CVD risk factors such as dyslipidemia and poor glycemic control are insufficient to fully explain the elevated risk in T1D, prompting further investigation into additional factors. Emerging evidence suggests that metabolic dysfunction-associated steatotic liver disease (MASLD) plays a critical role in this heightened CVD risk.ObjectiveThis narrative review aims to explore the relationship between MASLD and CVD in individuals with T1D. The review focuses on the prevalence of MASLD, its contributing risk factors, and the potential impact of liver dysfunction on cardiovascular outcomes in this population.MethodsA review of existing literature was conducted, focusing on observational studies, cohort studies, and meta-analyses that investigate the prevalence of MASLD in T1D populations and its association with CVD. The review also examines the physiological mechanisms linking MASLD and CVD, including insulin resistance, systemic inflammation, and hepatic dyslipidemia. Key studies were evaluated to identify patterns in MASLD prevalence based on diagnostic modalities and to assess the independent contribution of MASLD to cardiovascular risk in T1D patients.ConclusionMASLD is increasingly recognized as a significant contributor to CVD in individuals with T1D, particularly in those with shared risk factors like obesity and insulin resistance. Evidence suggests that MASLD exacerbates hepatic and systemic metabolic dysfunction, increasing CVD risk through mechanisms such as chronic inflammation and atherogenic lipid profiles. Routine liver health assessments and tailored management strategies targeting MASLD should be incorporated into clinical care for individuals with T1D to mitigate long-term cardiovascular complications.

Mediterranean diet as an element of treatment and prevention of cardiovascular diseases

Currently, the issues of treatment and prevention of cardiovascular diseases are still relevant, as cardiovascular pathology remains one of the leading causes of disability and mortality in all developed countries of the world. In the Russian Federation there is a high incidence of the diseases of the circulatory system, so they have the top priority among health problems, despite a slight decrease in morbidity in recent years. The main purpose of this review is to study the experience of applying the Mediterranean diet and its components in therapy and prevention of cardiovascular pathology. Research method: we searched electronic databases PubMed, Scopus, Web of Science, MedLine, Science Direct and eLIBRARY.RU using the following terms: "Mediterranean diet", "cardiovascular diseases", "prevention of cardiovascular diseases", "diet therapy of cardiovascular diseases". On the basis of numerous world clinical studies analysis, it can be assumed that the Mediterranean diet is one of the most reliable and well-studied in terms of prevention of cardiovascular pathology. The aim of this review is to draw the attention of the medical community to such a long-known, extensively studied, scientifically confirmed, accessible and simple way of rationalizing daily nutrition as the consumption of elements of the Mediterranean diet in the daily one. Further wide informing of patients about this way of nutrition from different specialists (general practitioners, cardiologists, nutritionists, gerontologists and others) is required.

Influence of intestinal microbiota on the metabolism of main cardiotropic drugs

The intestinal microbiota is one of the most important pathogenetic links in the development of cardiovascular diseases. Every year the world scientific community finds new interactions at the level of signaling molecules, metabolites and microorganisms, identifying more and more patterns and cause-and-effect relationships which indicate the commonality of the intestinal microbiota (GM) and cardiovascular diseases. The state of the host's intestinal community, its qualitative and quantitative composition, directly and indirectly affects the fundamental pathogenetic mechanisms of the development of cardiovascular diseases. Despite the fact that there are scientifically based methods of treatment, cardiovascular diseases remain the leading cause of death in the world. This phenomenon is partly due to wide variations in individual response to cardiovascular drugs. The pharmacological effects of cardiotropic drugs are quite different even within groups of patients comparable in age and gender. Every year intestinal microbiota is more and more evident to be responsible for this intraspecific variability. Gut microbes influence drug metabolism in several pharmacokinetic ways, and conversely, drugs can have significant effects on the microbiome and therefore pharmacodynamic processes. Drugs can alter the gut microenvironment and microbial metabolism, influence bacterial growth, thereby changing the composition and functions of the microbial community. One of the most important functions of GM, related to “intestinal-cardiovascular system”, is participation in the metabolism of major cardiotropic medications, such as digoxin, statins, ezetimibe, antithrombotic drugs, calcium channel blockers (CCBs), beta blockers (BB), gliflozins and inhibitors of the renin-angiotensin-aldosterone system (RAAS).

Impact of serum carotenoids on cardiovascular mortality risk in middle-aged and elderly adults with metabolic syndrome

BackgroundMetabolic syndrome (MetS), characterized by abdominal adiposity, hypertension, hyperglycemia, and dyslipidemia, is associated with dysregulated immune function, elevated oxidative stress, and chronic low-grade inflammation. Aging exacerbates insulin resistance and the prevalence of MetS. Dietary antioxidants, such as carotenoids, may play a role in preventing cardiovascular disease (CVD) mortality, but evidence remains mixed, particularly among middle-aged and elderly individuals with MetS.MethodsWe analyzed data from 6,601 participants aged 40 years and above with MetS from the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and NHANES 2001–2006 cycles. Serum concentrations of α-carotene, β-carotene, lycopene, β-cryptoxanthin, and combined lutein/zeaxanthin were quantified. Participants were followed for a median of 16.8 years. Cox proportional-hazards models were used to assess the association between serum carotenoid concentrations and CVD mortality risk, with adjustment for potential confounders.ResultsDuring the follow-up period, 1,237 CVD deaths were identified. Analysis revealed an inverse dose–response relationship between serum lycopene levels and cardiovascular mortality risk. Compared to the lowest quartile, the multivariable-adjusted hazard ratios (95% confidence intervals) for ascending quartiles of serum lycopene were 0.84 (0.71, 1.00), 0.87 (0.74, 1.03), and 0.77 (0.61, 0.97), with a significant trend (p = 0.039). No significant associations were observed for other carotenoids.ConclusionIn this prospective cohort study of 40-year-old and older individuals with MetS, we observed an inverse association between serum lycopene levels and CVD mortality risk.

The Anti-Elixir Triad: Non-Synced Circadian Rhythm, Gut Dysbiosis and Telomeric Damage

Aging is an inevitable life process which is accelerated by lifestyle and environmental factors. It is an irreversible accretion of molecular and cellular damage associated with changes in the body composition and deterioration in physiological functions. Each cell (other than stem cells), reaches the limit of its ability to replicate, known as cellular or replicative senescence and consequently, the organs lose their physiological functions resulting in overall impairment. Other factors that promote aging include smoking, alcohol, UV rays, sleep habits, food, stress, sedentary life style and genetic abnormalities. These stress factors, can alter our endogenous clock (the circadian rhythm) and the microbial commensals. As a result of effect of these stressors, the microorganisms that generally support human physiological processes become baleful. The disturbance of natural physiology instigates many age-related pathologies, such as cardiovascular diseases, chronic obstructive pulmonary disorder, cerebrovascular diseases, opportunistic infections, high blood pressure, cancer, diabetes, kidney diseases, dementia, and Alzheimer’s disease. The present review covers the three most essential processes of the circadian clock; the circadian gene mechanism and regulation, the mitotic clock (which plays a vital role in the telomere’s attrition) and gut microbiota and their metabolome that drive aging and lead to age-related pathologies. In conclusion, maintaining a synchronized circadian rhythm, a healthy gut microbiome and telomere integrity is essential for mitigating the effects of aging and promoting longevity. The interplay among these factors underscores the importance of lifestyle choices in enhancing overall health and lifespan.

Association between triglyceride glucose index and endometriosis in adults in the United States: A comprehensive study from the National Health and Nutrition Examination Survey (NHANES)

Background The triglyceride glucose (TyG) index has been well recognized as a reliable marker of insulin resistance and substantially correlated with the pathogenesis and progression of hypertension and cardiovascular diseases. However, no study has investigated the association between the TyG index and endometriosis. Therefore, this study aimed to uncover an association between the TyG index and endometriosis. Methods This cross-sectional investigation employed the extensive dataset derived from the National Health and Nutrition Examination Survey (NHANES) (1999–2006). To explore the potential connection between the TyG and endometriosis, a multivariate weighted logistic regression model was established. The nonlinear relationship between the TyG index and the risk of endometriosis was explored using restricted cubic spline models (RCS). Furthermore, subgroup analyses were conducted. Results Ultimately, 2,508 individuals were included in this investigation. The findings unveiled a robust positive correlation between the TyG index and the susceptibility to endometriosis (OR [95% CI]: 1.52 [1.024,2.258]; P < 0.05). This positive association remained consistent across diverse subgroups. Age, birthplace, and whether one ovary was removed were identified as significant risk factors. In RCS analysis, the TyG index showed a nearly linear relationship with the risk of endometriosis (P-nonlinear > 0.05). Conclusions The findings indicate a positive association between the TyG index and the risk of endometriosis, exhibiting an approximate non-linear relationship.

Ayurvedic Approaches to Holistic Management of Polycystic Ovary Syndrome (PCOS)

ABSTRACT The female reproductive system relies on the intact uterine adnexa and the hypothalamic-pituitary-ovarian axis. An imbalance can lead to pathogenesis. PCOS is characterized by ovarian cysts, hyperandrogenism, and irregular ovulation. Over time, it can lead to symptoms such as changes in menstruation, obesity, infertility, depression, and increased risk of diabetes, cardiovascular disease, and endometrial cancer. In Ayurveda, PCOS is a condition affecting Rasa, Rakta, and Medas, the three Dhatus. Rakta, Rasa, and Artavavaha are the Srotas that are implicated in this illness. Symptoms that may appear include Anartava (amenorrhea), Vandhyatwa, Pushpagni, and Abeeja Rutuchakra (an ovular hemorrhage). A 23-year-old woman presented at the outpatient department with complaints of irregular menstruation and rapid weight gain. An ultrasound revealed left-sided polycystic ovary syndrome (PCOS). Palliative treatments such as Kaklarakshak Yog, Trikatu, and Triphala Churna were administered for 2 months. The patient experienced a significant reduction in symptoms and a return to a normal menstrual cycle within two months.

The Roles of Vitamin D Levels, Gla-Rich Protein (GRP) and Matrix Gla Protein (MGP), and Inflammatory Markers in Predicting Mortality in Intensive Care Patients: A New Biomarker Link?

Objectives: Identifying reliable biomarkers to predict mortality in critically ill patients is crucial for optimizing management in intensive care units (ICUs). Inflammatory and metabolic markers are increasingly recognized for their prognostic value. This study aims to evaluate the association of various inflammatory and metabolic markers with ICU mortality. Methods: This prospective observational study was conducted from January 2023 to January 2024 in the City Hospital’s ICU. A total of 160 critically ill patients were enrolled. Laboratory parameters, including white blood cell (WBC) count, red cell distribution width (RDW), platelet count, neutrophil count, mean platelet volume (MPV), monocyte count, lymphocyte count, procalcitonin (PCT), C-reactive protein (CRP), calcium (Ca++), and vitamin D levels, were analyzed. Additionally, ratios such as the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory index (SII), and pan-immune-inflammation value (PIV) were calculated. Plasma levels of Gla-rich protein (GRP) and dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP) were measured using ELISA. Results: The mean age of the patients included in the study was 60.5 ± 15.8 years. Cardiovascular disease was present in 72 patients (45%), respiratory system disease in 58 (36%), and chronic kidney disease (CKD) in 38 (24%). Additionally, 61 patients (38%) had diabetes, and 68 (42%) had hypertension. Inflammatory markers, including PLR, NLR, and PIV, were all significantly higher in non-survivors, while calcium and vitamin D levels were lower (p < 0.05). Higher WBC, RDW, neutrophil count, PLR, NLR, PIV, CRP, procalcitonin, GRP, and dp-ucMGP levels were positively correlated with longer hospital stays and increased mortality. In contrast, platelet and lymphocyte counts were negatively correlated with both outcomes (p < 0.05). Vitamin D levels showed an inverse relationship with both hospital stay and mortality, indicating that lower levels were associated with worse outcomes (p < 0.05). In multiple logistic regression analysis, elevated WBC count (OR = 1.20, p = 0.02), RDW (OR = 1.35, p = 0.01), neutrophil count (OR = 1.25, p = 0.01), MPV (OR = 1.20, p = 0.02), PLR (OR = 1.30, p = 0.01), NLR (OR = 1.40, p = 0.001), PIV (OR = 1.50, p = 0.001), CRP (OR = 1.32, p = 0.01), procalcitonin (OR = 1.45, p = 0.001), GRP (OR = 1.40, p = 0.001), and dp-ucMGP (OR = 1.30, p = 0.001) levels were significantly associated with increased mortality. Conclusions: Inflammatory and metabolic markers, particularly NLR, PLR, PIV, GRP, and dp-ucMGP, are strong predictors of mortality in ICU patients. These markers provide valuable insights for risk stratification and early identification of high-risk patients, potentially guiding more targeted interventions to improve outcomes.

Glucagon-like peptide-1 receptor agonists and the risk of erectile dysfunction: a drug target Mendelian randomization study

BackgroundGlucagon-like peptide-1 receptor agonists (GLP-1RAs) have been widely used for type 2 diabetes (T2D) and weight management. However, the causal relationship of GLP-1RAs with erectile dysfunction (ED) was still unclear.MethodsMendelian randomization (MR) analysis was conducted to reveal the association of genetically proxied GLP-1RAs with ED. The proportion of potential mediators mediating GLP-1RAs to ED was also assessed by two-step MR. Finally, a series of sensitivity analyses and Two-Sep cis-MR (TSCMR) were performed to evaluate the robustness of the results.ResultsMR evidence suggested that genetically proxied GLP-1RAs reduced the risk of ED [odds ratio (OR): 0.493; 95% confidence interval (95% CI): 0.430 to 0.565; P<0.001]. Further mediation analysis via two-step MR showed that this effect was partly mediated through reduced T2D, obesity, hypertension and cardiovascular disease (CVD), with mediated proportions of 2.89% (95% CI: 1.28% to 4.49%), 6.83% (95% CI: 2.25% to 11.41%), 3.22% (95% CI: 1.21% to 5.23%), and 3.06% (95% CI: 0.51% to 5.62%), respectively.ConclusionsGLP-1RAs were associated with a reduced risk of ED, and to a lesser extent, T2D, obesity, hypertension and CVD mediated this effect. Nevertheless, the potential implications of our results for ED prevention policies required validation in further clinical randomized controlled trials.

Associations Between Plasma Levels of NLRP3 Protein, Interleukin-1 Beta and Features of Acute ST-Elevation Myocardial Infarction

Background. Phenotyping inflammation in ST-elevation myocardial infarction (STEMI) is a challenge for modern cardiology. NLRP3 inflammasome is a proven predictor of adverse outcomes in cardiovascular disease, but its specificity in stratifying inflammatory activity in patients with myocardial infarction (MI) has not been demonstrated. The aim of this paper is to describe the levels of NLRP3 protein and IL-1β concentrations and their changes in dynamics and associations with clinical, laboratory and instrumental characteristics of patients with STEMI. Methods. A total of 45 patients with STEMI were enrolled. Concentrations of NLRP3 and IL-1β were evaluated in arterial and venous EDTA blood from the infarct-related coronary and peripheral arteries and veins on days 1, 3 and 7 after MI. Results and Conclusions. The concentrations of markers were higher on the first day after MI with a maximum decrease on the third day. The levels of both markers in venous plasma correlated with those in arterial blood, allowing their routine determination in venous plasma on the first day after MI. IL-1β levels correlated directly with the wall motion index and inversely with left ventricular ejection fraction and stroke volume, which characterize the potential contribution to adverse myocardial remodeling. There were two multidirectional trends in changes in NLRP3 and IL-1β levels during hospitalization. Initially higher levels with a gradual decrease by day 7 were associated with a longer duration of myocardial ischemia and higher plasma troponin I levels. Further evaluation of the long-term outcomes of MI will allow identifying inflammatory factors that input to the development of secondary major adverse cardiac events and will provide a new step in the understanding of inflammatory phenotyping.

Cardiodermatology: the heart of the connection between the skin and cardiovascular disease

Cardiodermatology: the heart of the connection between the skin and cardiovascular disease

Burden of Non-Communicable Disease and It’s Association with Weight Status: A Cross-Sectional Study in a Rural Community of Bangladesh

Background: Non-Communicable Diseases (NCDs) are now the leading causes of morbidity and mortality worldwide. Bangladesh has also experienced a rapid epidemiological shift from communicable diseases to non-communicable diseases due to growing urbanization and lifestyle alteration over the last few decades and this transition is also prominent in rural community of the country. Among all modifiable factors, overweight or obesity is the key risk factor for NCDs. This study aimed to determine the burden of NCD and its link to the body weight status of the rural population of Bangladesh. Materials and methods: This cross-sectional study was conducted in a village of Gomostapur Upazila under Chapainawabganj district from February to April 2024 among 135 people. The data were collected with face-to-face interview and Body Mass Index was measured. The data were compiled and tabulated according to key variables and analyzed with IBM SPSS 29.0.2. Results: Majority 44.5% of the study people belonged to age group 21-40 years. Among them 47.4% were male and 52.6% were female. Maximum respondents were of low-middle socioeconomic condition. Among them around 3/4th of the population was suffering from NCDs. Most of the respondents 24.4% had bone and joint pain followed by Hypertension, Asthma, COPD, Diabetes and Heart Disease at 20.7%, 17.0%, 14.1% and 10.4% respectively. Hypertension, Diabetes, Cardiovascular Disease, Stroke and Cancers were more prevalent in the older age group. Hypertension, Diabetes, Stroke and Bone-Joint Pain were seen more in female participants whereas male respondents had more prevalence of Asthma, COPD. Most of the study population had BMI above 25 kg/m2 and the study showed maximum NCDs were prevalent considerably in overweight and obese groups. Conclusion: The study revealed that, NCDs are highly prevalent among obese older rural population of Bangladesh while management, prevention, awareness and research are low. The integrated programs must be designed and implemented through a primary health care approach and high risk-group targeted interventions should be procurable to combat the rising burden of NCDs. IAHS Medical Journal Vol 7(1), June 2024; 74-79