Cardiovascular Disease In Patients Research Articles

Long-term cardiovascular risk reduction after gastric cancer surgery: a nationwide cohort study.

Gastrectomy for gastric cancer is associated with postoperative changes in cardiovascular risk factors, however, the impact of gastrectomy on cardiovascular events remains unclear. We assessed the incidence of cardiovascular events between patients undergoing gastrectomy or endoscopic resection for gastric cancer, and the general population. This retrospective nationwide cohort study included patients with gastric cancer undergoing gastrectomy(n=37,698), endoscopic resection(n=2,773), and matched control population(n=161,887) between 2004 and 2013. We included patients without a history of cancer other than gastric cancer, myocardial infarction, or ischemic stroke. The primary outcome was the incidence of major adverse cardiovascular events (MACE) such as acute myocardial infarction, revascularization, or acute ischemic stroke, in patients with gastric cancer. Among patients who underwent gastrectomy for gastric cancer, 2.9% (4.69 per 1000 person-years) developed novel MACE within the seven-year follow-up period. The gastrectomy group demonstrated a significantly decreased risk for MACE than the control population (hazard ratio[HR], 0.65; 95% confidence interval[CI], 0.61-0.69; P <0.001). Among the patients undergoing endoscopic resection for gastric cancer, 5.4% (8.21 per 1000 person-years) developed novel MACE within the seven-year follow-up period. The risk for MACE in the endoscopic resection group was not significantly different from the control population. Patients with gastric cancer who have undergone gastrectomy exhibit a reduced risk of cardiovascular diseases in comparison to the general population. In contrast, the risk for cardiovascular diseases in patients with gastric cancer who underwent endoscopic resection did not demonstrate a significant difference in cardiovascular risk in comparison to the general population.

Adipocines and longevity: connections and paradoxes

Adipose tissue is an active endocrine organ that regulates energy homeostasis throughout the body by releasing hundreds of biologically active substances called adipokines. Dysregulation of adipokines is a key feature of insulin resistance with the development of metabolic syndrome and type 2 diabetes mellitus, which is an age-dependent pathology. In turn, dysregulation of adipokines and insulin resistance are associated with the development of metabolic deficiency and senile asthenia syndrome in older age groups. Previous studies have shown that the absence of insulin resistance and low prevalence of diabetes among centenarians are metabolic prerequisites for increased lifespan, suggesting a possible role for adipokine homeostasis in healthy longevity. Among numerous adipokines, adiponectin is considered a protective factor, showing a negative correlation with major metabolic disorders associated with age and obesity, and a positive association with life expectancy and insulin sensitivity among centenarians. Despite all the apparent protective effects of adiponectin, large-scale epidemiological studies have revealed the opposite aspect of adiponectin as a predictor of all-cause mortality and cardiovascular disease in patients with heart failure as well as kidney disease. In this review, the clinical significance of adiponectin is considered in centenarians from the point of view of the development of the main geriatric syndrome - senile asthenia, as well as cardiovascular risk and mortality.

Novel Biomarkers in Evaluating Cardiac Function in Patients on Hemodialysis-A Pilot Prospective Observational Cohort Study.

Chronic kidney disease patients treated by hemodialysis present a high cardiovascular morbidity and mortality. There is an imperative need for novel biomarkers for identifying these patients and to offer possible therapeutically interventions. We performed a prospective observational cohort study on 77 patients in the period of October 2021-October 2023. We measured serum plasma levels of interleukin 1-beta, galectin 3, human suppression of tumorigenicity factor 2, bone morphogenetic protein 2 and fibroblastic growth factor 23 at the inclusion site. We evaluated the correlations of these biomarkers with cardiac function and structure evaluated by echocardiography. The mean age was 61.02 (±11.81) years, with 45 (56.2%) males and with a dialysis vintage of 4.95 (2.4-7.8) years. Median ejection fraction was 51 (43-54%), and more than two-thirds of the patients presented valvular calcifications. Overall mortality was 22%. Interleukin 1-beta was correlated positively with ejection fraction and global longitudinal strain and negatively with left atrium diameter and left ventricle telesystolic diameter. Galectin 3 values were negatively correlated with aortic valve fibrosis and mitral valve calcifications, and human suppression tumorigenicity factor 2 was negatively correlated with mitral valve calcifications. Some of these novel biomarkers could be used to better assess cardiovascular disease in patients on maintenance hemodialysis.

Circulating miRNA-21 is an innovative biomarker for cardiovascular events in erectile dysfunction patients.

It is well-known that circulating microRNAs (miRNAs) play a relevant role in many kinds of diseases by regulating the expression of genes involved in various pathophysiologic processes, including erectile dysfunction (ED) and cardiovascular diseases (CVD). This study aimed to identify the miRNA-21 profile in the blood samples of patients with ED, CVD, and the combination of both pathologies to elucidate the potential function of miRNA-21. A total of 45 patients with CVD and/or who underwent the erectile function test were included and divided into the following categories: CVD with ED (cases, n = 29) and controls (n = 16) with either ED or CVD. Real-time polymerase chain reaction analysis verified the results. miRNA-21 expression was quantified, and informatics analysis was applied to predict the functions of this differentially expressed miRNA-21. A total of 64% of cases (63 ± 9 years, 66% with severe ED, 56% with CV ejection fraction) first presented ED as the sentinel clinical manifestation. Serum miRNA-21 levels in the control ED were significant, up to 10-fold higher than in the CVD controls and cases. A significant inverse (p = 0.0368, β = -2.046) correlation was found between erectile function and miRNA-21 levels. Our study provides comprehensive insights into the functional interaction between miRNA-21 and ED in CVD patients. Its relevance lies in the potential of miRNA as a biomarker to be applied in the cardiovascular predictive medicine field.

Genetic evidence for T-wave area from 12-lead electrocardiograms to monitor cardiovascular diseases in patients taking diabetes medications.

Aims Many studies indicated use of diabetes medications can influence the electrocardiogram (ECG), which remains the simplest and fastest tool for assessing cardiac functions. However, few studies have explored the role of genetic factors in determining the relationship between the use of diabetes medications and ECG trace characteristics (ETC). Methods Genome-wide association studies (GWAS) were performed for 168 ETCs extracted from the 12-lead ECGs of 42,340 Europeans in the UK Biobank. The genetic correlations, causal relationships, and phenotypic relationships of these ETCs with medication usage, as well as the risk of cardiovascular diseases (CVDs), were estimated by linkage disequilibrium score regression (LDSC), Mendelian randomization (MR), and regression model, respectively. Results The GWAS identified 124 independent single nucleotide polymorphisms (SNPs) that were study-wise and genome-wide significantly associated with at least one ETC. Regression model and LDSC identified significant phenotypic and genetic correlations of T-wave area in lead aVR (aVR_T-area) with usage of diabetes medications (ATC code: A10 drugs, and metformin), and the risks of ischemic heart disease (IHD) and coronary atherosclerosis (CA). MR analyses support a putative causal effect of the use of diabetes medications on decreasing aVR_T-area, and on increasing risk of IHD and CA. ConclusionPatients taking diabetes medications are prone to have decreased aVR_T-area and an increased risk of IHD and CA. The aVR_T-area is therefore a potential ECG marker for pre-clinical prediction of IHD and CA in patients taking diabetes medications.

Abstract P225: Heartfelt Savings: Health Savings Accounts Assist in Alleviating Financial Burdens and Prompt Timely Treatment for Patients With Cardiovascular Disease

Background: Cardiovascular diseases (CVD) are among most costly in the U.S, with a significant portion of CVD patients unable to afford care. Use of health savings accounts (HSA) to increase financial savings for medical expenditures is controversial. While HSA have shown to not decrease medical expenditures, the financial impact of HSA on patients with CVD remains unknown. Methods: This cross-sectional study used data from the Medical Expenditure Panel Survey for 2014-19 and included patients aged 18-64 who reported having at least one CVD (i.e., hypertension, angina, myocardial infarction, heart failure, stroke, or all other CVD). A survey-weighted model was utilized to determine the adjusted odds ratios (OR) for associations between CVD patients with HSA and 1) demographics factors and 2) metrics associated with financial difficulty by adjusting for age, sex, race, total out of pocket (OOP) yearly premiums, total yearly medical expenditures, total OOP yearly medical expenditures, total yearly income, annual deductibles, and other demographic factors (Figure 1) . Results: CVD patients with HSA were significantly less likely to experience financial difficulties such as affording medical care (OR 0.586, 95% CI 0.344-0.998, p = 0.049) and trouble paying medical bills (OR 0.762, 95% CI 0.582-0.996, p = 0.047). Furthermore, CVD patients with HSA were significantly less likely to delay medical care (OR 0.614, 95% CI 0.389-0.970, p = 0.037) and preventive medicine (OR 0.575, 95% CI 0.336-0.983, p = 0.046) due to cost. However, CVD patients who earn lower income, self-identify as Hispanic or Black, from the South or West, or have lower years of education were significantly less likely to benefit from an HSA (Figure 1) . Conclusions: CVD patients with HSA were significantly associated with decreased financial difficulties and were less likely to delay care. Policies intended to support minority and lower-income CVD patients such as increased financial education may reduce healthcare disparities and promote access to care.

Avocado-derived extracellular vesicles loaded with ginkgetin and berberine prevent inflammation and macrophage foam cell formation.

Atherosclerosis, a chronic inflammatory disease of aorta, remains the major cause of morbidity and mortality among cardiovascular disease patients. Macrophage foam cell formation and inflammation are critically involved in early stages of atherosclerosis, hence chemopreventive targeting of foam cell formation by nutraceuticals may be a promising approach to curbing the progression of atherosclerosis. However, many nutraceuticals including berberine and ginkgetin have low stability, tissue/cell penetration and bioavailability resulting in inadequate chemotherapeutic effects of these nutraceuticals. We have used avocado-derived extracellular vesicles (EV) isolated from avocado (EVAvo ) as a novel carrier of nutraceuticals, in a strategy to alleviate the build-up of macrophage foam cells and expression of inflammatory genes. Our key findings are: (i) Avocado is a natural source of plant-derived EVs as shown by the results from transmission electron microscopy, dynamic light scattering and NanoBrook Omni analysis and atomic force microscopy; (ii) EVAvo are taken up by macrophages, a critical cell type in atherosclerosis; (iii) EVAvo can be loaded with high amounts of ginkgetin and berberine; (iv) ginkgetin plus berberine-loaded EVAvo (EVAvo(B+G) ) suppress activation of NFκB and NLRP3, and inhibit expression of pro-inflammatory and atherogenic genes, specifically Cd36, Tnfα, Il1β and Il6; (v) EVAvo(B+G) attenuate oxidized low-density lipoprotein (oxLDL)-induced macrophage foam cell formation and (vi) EVAvo(B+G) inhibit oxLDL uptake but not its cell surface binding during foam cell formation. Overall, our results suggest that using EVAvo as a natural carrier of nutraceuticals may improve strategies to curb the progression of atherosclerosis by limiting inflammation and pro-atherogenic responses.

Examining the interplay between cardiovascular disease and cancer incidence: Data from NHANES III and continuous

IntroductionThis study aimed to investigate the relationship between risk factors of cancer among individuals with existing cardiovascular disease (CVD). MethodsThe analysis included 438 and 2100 CVD patients aged 65+ from NHANES-III and Continuous datasets, respectively. Competing risk models with subdistribution hazards ratio (aHR) were used to identify risk factors. ResultsFemales in NHANES-III had lower cancer risk (aHR 0.39, P = 0.001) compared to males. Poor physical activity was associated with increased cancer risk in both datasets (aHR 2.59 in NHANES-III, aHR 1.59 in Continuous). In NHANES-Continuous, age (aHR 1.07, P < 0.001) and current smoking (aHR 2.55, P = 0.001) also showed a significant association with developing cancer. No other factors investigated showed significant associations. DiscussionThis study highlights the interplay between traditional risk factors and the elevated risk of cancer in CVD patients. Further research with larger samples and wider age ranges is needed to solidify these findings and inform intervention strategies.

Utilization of Complementary Medicine among Patients with Cardiovascular Disease in Iran: A Cross-Sectional Study

Complementary Alternative Medicine (CAM) has been widely used globally, but limited data are available on the use of CAM in Cardiovascular Disease (CVD). The present study aimed to evaluate CAM use in CVD patients. The present cross-sectional study was performed in Shiraz, Iran, during the summer of 2021. Cardiovascular patients aged ≥ 18 years were included in the study. Demographic information on left ventricular ejection fraction and satisfaction with CAM utilization was collected using validated questionnaires. A total of 304 patients (194 males and 110 females) were recruited for this study. The frequency of patients identified as CAM users was 56.9% (n = 173). Patients with implanted pacemakers were less likely to use CAM than others (OR = 0.50, p = 0.031). Meanwhile, the likelihood of CAM utilization was approximately 2 and 4 times higher in the patients categorized in class I of the New York Heart Association (NYHA) functional classification compared to those in the second and third classes, respectively. Most CAM users used herbs, dietary supplements, and praying to prevent diseases, while Traditional Persian Medicine (TPM) remedies and acupuncture were more commonly used to treat acute and chronic illnesses, respectively. Praying for health, herbal therapy, and dietary supplementation were the most popular CAM types utilized by Iranian CVD patients. However, future investigations seem to be required to determine the exact physiological impacts, probable adverse effects, and long-term benefits of CAM therapies in this population.

Association of serum concentrations of remnant cholesterol with incident cardiovascular disease in patients with rheumatoid arthritis: A real-world data from 2001 to 2022

BackgroundRemnant cholesterol (RC) promotes cardiovascular disease (CVD) in the general population, but its role among rheumatoid arthritis (RA) patients remains unknown. We aimed to investigate circulating RC levels associated with incident CVD among Chinese patients with RA. MethodsA total of 1018 RA patients free of baseline CVD were included and followed up in a prospective RA CVD cohort from 2001 to 2022. Fasting serum levels of triglycerides, total cholesterol (TC), low-density (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured, while RC and Non-HDL-C levels were calculated. The primary exposure was RC levels. A LASSO Cox model was used to select covariates. The Fine-Gray competing risk model was used to estimate hazard ratios (HRs). ResultsRA patients had a mean age of 53.9 years, and 802 (78.8%) were females. After a median follow-up of 5.54 years, 131 patients developed CVD with an incidence rate of 21.6 per 1000 person-years. Continuous and quartile-categorized RC levels were associated with incident CVD before and after multivariate adjustment and Bonferroni correction (all P < 0.001). There were no robust associations of other lipids with incident CVD. The fully adjusted HRs for RC were 2.30 (95% CI 1.58–3.35) per 1 mmol/L increase, and 2.40 (1.36–4.25) and 2.81 (1.60–4.94) for patients in the 3rd and 4th versus the 1st quartile, respectively. ConclusionsCirculating RC levels are positively associated with incident CVD among Chinese RA patients independent of known risk factors, implying its clinically preferable use for improving the stratification of CVD risk in RA patients.

Lipoprotein(a) as a risk factor for atherosclerotic cardiovascular disease in patients in non-metropolitan areas of Brandenburg, Germany.

In the non-metropolitan region of Brandenburg (Germany), which is characterized by high rates of cardiovascular diseases and underserved medical care, there is a lack of awareness regarding lipoprotein(a) [Lp(a)] as a risk factor. In addition, data from patients with atherosclerotic cardiovascular disease (ASCVD) in diverse regional backgrounds, including the understudied Brandenburg cohort, and various healthcare statuses remain insufficient. In this WalkByLab study, Lp(a) levels were monitored in a non-metropolitan cohort (n = 850) in Brandenburg, Germany, comprising 533 patients at high cardiovascular risk and 317 healthy controls. Patients underwent a comprehensive angiological screening, which included blood serum analysis, assessment of medical and family history, cardiovascular risk, and disease status, and evaluation of lifestyle and quality of life. All parameters were evaluated with regard to two groups based on Lp(a) levels: low (<50 mg/dl) and high (≥50 mg/dl). Brandenburg patients with cardiovascular diseases showed higher Lp(a) levels than healthy controls (24.2% vs. 14.8%, p = 0.001). Logistic regression analysis with different characteristics revealed that Lp(a) was an independent risk factor significantly associated with ASCVD (OR 2.26, 95% CI 1.32-3.95, p = 0.003). The high-Lp(a) group showed a higher proportion of patients with coronary artery disease, peripheral artery disease, or cerebrovascular disease compared to the low-Lp(a) group (50% vs. 36.8%; 57.7% vs. 45.8%; 17.6% vs. 9.2%; p = 0.004); also, a higher percentage of patients in the high-Lp(a) group had heart failure (72.8% vs. 53.2%, p = 0.014) and myocardial infarction (24.7% vs. 13.9%, p = 0.001). The high-Lp(a) group exhibited higher rates of statins (63.1% vs. 50.4%, p = 0.003), ezetimibe (14.8% vs. 5.5.%, p = 0.001), and beta-blockers (55.7% vs. 40.7%, p = 0.001) use. Lp(a) levels were found to be independent of physical activity or smoking behavior and did not change over time (12 months). Our study highlights the significance of elevated Lp(a) levels in Brandenburg cardiovascular patients and identifies them as an independent risk factor for ASCVD, which has implications for addressing cardiovascular health of non-metropolitan populations.

Vitamin C as Scavenger of Reactive Oxygen Species during Healing after Myocardial Infarction.

Currently, coronary artery bypass and reperfusion therapies are considered the gold standard in long-term treatments to restore heart function after acute myocardial infarction. As a drawback of these restoring strategies, reperfusion after an ischemic insult and sudden oxygen exposure lead to the exacerbated synthesis of additional reactive oxidative species and the persistence of increased oxidation levels. Attempts based on antioxidant treatment have failed to achieve an effective therapy for cardiovascular disease patients. The controversial use of vitamin C as an antioxidant in clinical practice is comprehensively systematized and discussed in this review. The dose-dependent adsorption and release kinetics mechanism of vitamin C is complex; however, this review may provide a holistic perspective on its potential as a preventive supplement and/or for combined precise and targeted therapeutics in cardiovascular management therapy.

Challenges in Effective Referral of Cardiovascular Diseases in Nepal: A Qualitative Study from Health Workers' and Patients' Perspective.

Nepal, currently facing a high burden of noncommunicable diseases (NCDs), including cardiovascular diseases (CVDs), which poses the highest mortality rate in the country, does not seem to have a proper referral strategy. This study explored the wide range of factors and challenges that affect the referral system of CVD cases in Nepal. In this qualitative study, we conducted face-to-face and telephone interviews with purposely selected 57 key participants which included 35 healthcare professionals from tertiary, secondary, and primary levels from Bagmati Province and 22 CVD patients (myocardial infarction and stroke) from Bagmati and Madhesh Provinces. We interviewed them using an interview guide with open-ended questions for in-depth information in a local language and in a private space. The interviews were audio-recorded, transcribed verbatim, coded, and analyzed using the thematic approach. The findings indicated that the referral system for CVD cases from primary- to secondary- to tertiary-level care is inadequate and malfunctioning. The major factors affecting referral of CVD cases are centralization of CVD-specific services in few urban areas, inadequate systematic communication between the centers, self-referential, lack of human resources for CVD care, and obstacles to patient transfer due to geographical and financial reasons. A referral system for CVD patients is absent in the context of Nepal. Understanding and addressing key factors that affect the referral system of CVD patients may help to improve cardiac outcomes and ultimately save lives.

Network analysis to examine sex differences linked to emotional well-being in cardiovascular disease.

Psychosocial dimensions are essential to guarantee an optimal approach to improve emotional well-being in patients with cardiovascular disease (CVD). There is evidence of sex differences regarding these dimensions. Thus, the connections between them are crucial to implement personalized therapies. Network model analyses were conducted on data from 593 CVD patients. The models included scores from the Hospital Anxiety and Depression Scale (HADS), positive (PA) and negative affect (NA), positivity (PS), satisfaction of life (SLS), social support (SS), self-efficacy on emotion regulation (RESE), cardiac self-efficacy (CSE) and the Short Form-12 Health Survey. The main sex differences were found in: PA-PS (p = 0.03), SS-RESE (p = 0.04), for which the positive associations are stronger for men than for women and PA-RESE (p < 0.01) for which the positive association is stronger for women than for men. These nuances should be considered to implement tailored and integrative therapies for each CVD patient.

Cardiometabolic characteristics of type 2 diabetes patients depending on obesity phenotypes

Background. The problem of studying the causes and mechanisms of metabolic disorders in metabolic syndrome and type 2 diabetes mellitus (T2DM) is one of the most important questions in modern medicine. It is due to the growing prevalence of dysmeta­bolic conditions and their serious consequences for the population health in the modern world. The initial hypothesis was that the differences in hormonal and metabolic conditions in patients with T2DM can be explained by the peculiarities of the anabolic-catabo­lic balance in different metabolic phenotypes. The aim of the work was to study the features of anthropometric and compositional parameters, indicators of carbohydrate, lipid and purine metabolism, anabolic-catabolic balance as predictors of cardiovascular diseases in patients with T2DM, depending on the phenotype. Materials and methods. One hundred and sixty-five patients with T2DM were included in the study, 71 women and 94 men aged from 32 to 82 years (59.0 ± 8.3 years). They had a level of glycated hemoglobin higher than 6.7 % (8.3 ± 1.8 %) against the background of taking oral hypoglycemic agents. Results. During the examination, it was found that the metabolism of patients without general obesity has a predominantly catabolic orientation, which, compared to those with general obesity, is manifested in a lower absolute accumulation of total and visceral fat, a reduced level of uricemia (due to a lower reabsorption of urate in the renal tubules, a lower activity of the anabolic pathway of reutilization), which is accompanied by a lower level of anabolic hormones, insulin and dehydroepiandrosterone sulfate (DHEA-S), and a higher level of the catabolic stress hormone cortisol. General obesity in patients with body mass index ≥ 30 kg/m2 is caused by the predominant influence of anabolic hormones (insulin, DHEA-S), which contribute to the de novo synthesis of fatty acids and purine bases, the reutilization of purines and the reabsorption of uric acid. This leads to the accumulation of fat in the subcutaneous and visceral adipose tissue and an increase in the level of uricemia under the conditions of a lower content of the catabolic hormone cortisol. Conclusions. The application of a set of anthropometric, composition biochemical and hormonal indicators allows for a differential diagnosis of alimentary hypokinetic (anabolic) and stress (catabolic) phenotypes in patients with T2DM. An additional characteristic of the metabolic status in T2DM may be the assessment of uric acid production and excretion in patients with varying degrees of obesity. The listed signs indicate an anabolic type of metabolism in obesity.

Association of Circulating Autophagy Proteins ATG5 and Beclin 1 with Acute Myocardial Infarction in a Case-Control Study

Introduction: Acute myocardial infarction (AMI) is a main contributor of sudden cardiac death worldwide. The discovery of new biomarkers that can improve AMI risk prediction meets a major clinical need for the identification of high-risk patients and the tailoring of medical treatment. Previously, we reported that autophagy a highly conserved catabolic mechanism for intracellular degradation of cellular components is involved in atherosclerotic plaque phenotype and cardiac pathological remodeling. The crucial role of autophagy in the normal and diseased heart has been well described, and its activation functions as a pro-survival process in response to myocardial ischemia. However, autophagy is dysregulated in ischemia/reperfusion injury, thus promoting necrotic or apoptotic cardiac cell death. Very few studies have focused on the plasma levels of autophagy markers in cardiovascular disease patients, even though they could be companion biomarkers of AMI injury. The aims of the present study were to evaluate (1) whether variations in plasma levels of two key autophagy regulators autophagy-related gene 5 (ATG5) and Beclin 1 (the mammalian yeast ortholog Atg6/Vps30) are associated with AMI and (2) their potential for predicting AMI risk. Methods: The case-control study population included AMI patients (n = 100) and control subjects (n = 99) at high cardiovascular risk but without known coronary disease. Plasma levels of ATG5 and Beclin 1 were measured in the whole population study by enzyme-linked immunosorbent assay. Results: Multivariate analyses adjusted on common cardiovascular factors and medical treatments, and receiver operating characteristic curves demonstrated that ATG5 and Beclin 1 levels were inversely associated with AMI and provided original biomarkers for AMI risk prediction. Conclusion: Plasma levels of autophagy regulators ATG5 and Beclin 1 represent relevant candidate biomarkers associated with AMI.

ACHIEVEMENT OF TARGET LDL-C IN TYPE 2 DM PATIENTS IN SAUDI ARABIA

Background: Diabetes mellitus (DM) is one of the most common diseases in the world and Cardiovascular diseases (CVD) is among the most common preventable complication of DM. Low-density lipoprotein cholesterol (LDL-C) is known to be a major risk factor for developing CVD. Many guidelines have suggested that controlling LDL-C can contribute to lower the mortality among CVD patients. Aim: To assess Achievement of Target LDL-C in type 2 DM patients in Saudi Arabia, and the prevalence of Lipid lowering agents use among these patients. Data sources: PubMed, Cochrane Library, Science Direct, Embase, and Google Scholar. Methods: Non interventional retrospective cross sectional study. Results: The study included 100 patients, age range was between 25 – 82 years old with a Mean age of 51,60. 51% of the participants were males, while 49% were females. 23% of the patients had optimal LDL cholesterol levels below 1,8 mmol/L, while 77% of had suboptimal levels above 1,8 mmol/L. Spearman’s rank correlation was computed to assess the relationship between LDL and BMI. There was a positive correlation between the two variables, r = 0,071, p = 0,484. The correlation was not significant at the 0,05 level of significance. Spearman’s rank correlation was computed to assess the relationship between LDL and A1C. There was a positive correlation between the two variables, r = 0,051, p = 0,612. The correlation was not significant at the 0,05 level of significance. The most used medication for lowering cholesterol was atorvastatin, which was taken by 64% of the patients, followed by rosuvastatin, 23% of the patients, 4% of the patients used simvastatin, and 9% of the patients did not receive any treatment and was not offered to them in their follow up visit. 54% of patients who were receiving Lipid lowering therapy did not had dose adjustments during their regular follow up. Conclusion: It is extremely important to achive targeted LDL-C in diabetic patients. Physicians should always aim to reach the targeted level by following the latest guidelines and encouraging patients compliance to medications and lifestyle modifications hence preventing the complications.

Association of the trajectory of plasma aldosterone concentration with the risk of cardiovascular disease in patients with hypertension: a cohort study

The purpose of this study was to determine the long-term pattern of plasma aldosterone concentration (PAC) trajectories and to explore the relationship between PAC trajectory patterns and cardiovascular disease (CVD) risk in patients with hypertension. Participants were surveyed three times between 2010 and 2016, and latent mixed modeling was employed to determine the trajectory of PAC over the exposure period (2010–2016). A Cox regression analysis was used to examine the association between PAC trajectory patterns and the risk of CVD (stroke and myocardial infarction). Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were calculated and reported. During a median follow-up of 4.10 (3.37–4.50) years, 82 incident CVD cases (33 myocardial infarction cases and 49 stroke cases) were identified. Among all three PAC models, the high-stability PAC pattern exhibited the highest risk of CVD. After full adjustment for all covariables, HRs were 2.19 (95% CI 1.59–3.01) for the moderate-stable pattern and 2.56 (95% CI 1.68–3.91) for the high-stable pattern in comparison to the low-stable pattern. Subgroup and sensitivity analyses verified this association. The presence of a high-stable PAC trajectory pattern is associated with an elevated risk of CVD in hypertensive patients. Nevertheless, more studies are warranted to confirm these findings.

Evaluation of Tumor Necrosis Factor Alpha, Insulin, glucose, HbA1c% and HOMA-IR as Predictors for Cardiovascular Diseases in Patients with Type 2 Diabetes

Evaluation of Tumor Necrosis Factor Alpha, Insulin, glucose, HbA1c% and HOMA-IR as Predictors for Cardiovascular Diseases in Patients with Type 2 Diabetes

Monitoring of patients with cardiovascular disease

Cardiovascular disease accounts for about one-third of deaths worldwide. Not surprisingly, health administrators and insurances are interested in monitoring healthcare performance and outcomes through standardized indicators obtained from reliable data. Hospital-based registries of cardiovascular disease patients are currently considered the reference standard in documenting how patients are treated relative to best practice recommendations outside the ideal world of clinical trials. Monitoring is done by special monitors designed to observe patients’ physiological state like heart rate and rhythm, blood pressure, respiration and oxygen saturation and have become a standard device for diagnosis, observation, assessment and treatment in coronary care. Changes in vital signs frequently precede deterioration in a patient’s condition and monitors provide valuable information and increase patient safety. Cardiac monitoring is a vital component in the management of the patients with cardiovascular disease. Knowledge of the general condition, location, and extent of a myocardial infarction and effective use of continuous cardiac monitoring will aid the nurse participate in the process of diagnosis and treatment.