Cardiovascular Patients Research Articles

Mortality After Pediatric Cardiac Surgery in Patients From Disadvantaged Neighborhoods

BackgroundDisadvantaged socioeconomic status correlates with adverse outcomes for patients with congenital heart disease. We examined individual and neighborhood characteristics associated with adverse short-term surgical outcomes and investigated potential drivers of disparities. MethodsSingle-center retrospective analysis collected clinical and demographic information on cardiovascular surgery patients over a 15-year period (2007-2022) from the District of Columbia metropolitan area. Neighborhood socioeconomic status, determined by the Child Opportunity Index, compared disadvantaged neighborhoods with advantaged neighborhoods. A stepwise multivariable model examined operative mortality and major surgical complication outcomes. ResultsOf the 2562 patients, one-half (49.6%) resided in disadvantaged neighborhoods. In bivariable analysis, nonmodifiable clinical factors were associated with higher operative mortality. Patients from disadvantaged neighborhoods had higher odds of surgical mortality compared with patients from advantaged neighborhoods (odds ratio, 1.52; 95% CI, 0.993-2.315; P = .054), though this relationship was not present in multivariable analysis (odds ratio, 0.91; 95% CI, 0.52-1.58; P = .73). Surgical factors such as The Society of Thoracic Surgeons - European Association for Cardio-Thoracic Surgery (STAT) category, patient size, and genetic abnormalities predicted higher odds of operative mortality and major surgical complications. ConclusionsIncreased operative mortality experienced by patients from disadvantaged neighborhoods is influenced by nonmodifiable factors such as surgical complexity, patient size, and the presence of a genetic abnormality. To address these disparities, we must reconceptualize care for the preoperative patient.

Remnant cholesterol as a residual risk in atherosclerotic cardiovascular disease patients under statin-based lipid-lowering therapy: A post hoc analysis of the RACING trial

Remnant cholesterol as a residual risk in atherosclerotic cardiovascular disease patients under statin-based lipid-lowering therapy: A post hoc analysis of the RACING trial

Assessing Exercise Habits of Cardiovascular Risks in Middle-Aged Adults: A Descriptive Study

ABSTRACT Background: Cardiovascular problems are the leading cause of death among adults in our country. These illnesses primarily affect metropolitan populations, particularly in major cities. To prevent these diseases, efforts have focused on identifying and controlling cardiovascular risk factors such sedentary lifestyle. Aim: The study aimed to assess the exercise habits of cardiovascular risks middle-aged adults. Materials and Methods: The research approach used in this study was quantitative approach with descriptive design. Purposive sampling technique was used to select the samples. Totally 60 cardiovascular patients were recruited from Saveetha Medical College and Hospital Thandalam, Chennai. Data were gathered by using structured questionnaires and risk score calculator. Collected data were analyzed by using descriptive and inferential statistics. Results: The above Table 1 shows that 59 (98.33%) had moderate level of physical activity and 1 (1.67%) had high level of physical activity among middle-aged adults. The mean and standard deviation of physical activity among middle-aged adults was 62.26 ± 5.92. The median was 62.0 with minimum score of 38.0 and maximum score of 73.0. The demographic variable age (χ 2 = 6.610, P = 0.037) had statistically significant association with level of physical activity among middle-aged adults at P < 0.05 level and the other demographic variables had not shown statistically significant association with level of physical activity among middle-aged adults. Conclusion: Physical activity promotion and support should be a global priority because of the health benefits it provides for adults.

Vitamin D deficiency and associated parameters among Cardiovascular Patients in a Tertiary Care Institution of Southern Rajasthan

Vitamin D deficiency and associated parameters among Cardiovascular Patients in a Tertiary Care Institution of Southern Rajasthan

ERRATUM: Genetic testing for inherited cardiovascular diseases. A position statement of the Polish Cardiac Society endorsed by Polish Society of Human Genetics and Cardiovascular Patient Communities.

According to the latest guidelines of European and American medical societies, genetic testing (GT) is essential in cardiovascular diseases for establishing diagnosis, predicting prognosis, enabling initiation of disease-modifying therapy, and preventing sudden cardiac death. The GT result may be relevant for cascade GT in the patient's relatives, for planning his/her profession and physical activity, and for procreative counseling. This position statement has been prepared due to the scarcity of GT in cardiovascular diseases in Poland and the need to expand its availability. We give a concise description of the genetic background of cardiomyopathies, channelopathies, aortopathies, familial hypercholesterolemia, pheochromocytomas, and paragangliomas. The article discusses various aspects of GT in specific populations, such as children or athletes, and also presents prenatal genetic diagnostics. We propose recommendations for GT and counselling, which take into account Polish needs and capabilities. We give an outline of legal regulations, good clinical practice in GT with respect for patient rights, the role of cardiologists and clinical geneticists in GT planning and post-test counseling, and the requirements for laboratories performing genetic tests. The Polish Cardiac Society and Polish Society of Human Genetics experts speak with one voice with cardiovascular patient communities to underline the need for a law on GT and increasing the availability of GT for cardiovascular patients.

Primary Prevention of Coronary Heart Disease: Issues of Concern

In the Russian Federation, cardiovascular diseases are one of the leading causes of both morbidity and mortality and high economic costs of healthcare. Early identification of risk factors for cardiovascular diseases and their primary prevention underlie the ongoing process to reduce these indicators. The purpose of this work was to conduct a clinical and epidemiological study to analyze the prevalence of risk factors for cardiovascular diseases in young and middle-aged people living in the Oryol region. Materials and methods: The prospective study included 353 young and middle-aged patients with acute forms of coronary artery disease (unstable angina and myocardial infarction) and 112 apparently healthy individuals. All respondents were assessed for cardiovascular risk factors and patient adherence to treatment, for a total of 21 parameters. Results: according to the study, it was found that among young and middle-aged patients living in the Oryol region, IHD develops against the background of traditional risk factors for cardiovascular diseases, the prevailing ones being arterial hypertension (88.6 %), sedentary lifestyle (68 %), poor nutrition (53.0 %) and alcohol consumption (52 %), their gender differences were established. Conclusion. The analysis of the frequency of occurrence of cardiovascular risk factors showed their widespread prevalence among the population, low awareness of the population and insufficient adherence of patients to treatment.

Perioperative platelet reactivityover time inpatients undergoing vascular surgery: An observational pilot study.

Despite Antiplatelet therapy (APT), cardiovascular patients undergoing revascularisation remain at high risk for thrombotic events. Individual response to APT varies substantially, resulting in insufficient protection from thrombotic events due to high on-treatment platelet reactivity (HTPR) in ≤40% of patients. Individual variation in platelet response impairs APT guidance on a single patient level. Unfortunately, little is known about individual platelet response to APT over time, timing for accurate residual platelet reactivity measurement, or the optimal test to monitor residual platelet reactivity. To investigate residual platelet reactivity variability over time in individual patients undergoing carotid endarterectomy (CEA) treated with clopidogrel. Platelet reactivity was determined in patients undergoing CEA in a prospective, single-centre, observational study using the VerifyNow (change in turbidity from ADP-induced binding to fibrinogen-coated beads), the VASP assay (quantification of phosphorylation of vasodilator-stimulated phosphoprotein), and a flow-cytometry-based assay (PACT) at four perioperative time points. Genotyping identified slow (CYP2C19*2 and CYP2C19*3) and fast (CYP2C19*17) metabolisers. Between December 2017 and November 2019, 50 patients undergoing CEA were included. Platelet reactivity measured with the VerifyNow (p = < .001) and VASP (p = .029) changed over time, while the PACT did not. The VerifyNow identified patients changing HTRP status after surgery. The VASP identified patients changing HTPR status after eight weeks (p = .018). CYP2C19 genotyping identified 13 slow metabolisers. In patients undergoing CEA, perioperative platelet reactivity measurements fluctuate over time with little agreement between platelet reactivity assays. Consequently, HTPR status of individual patients measured with the VerifyNow and VASP assay changed over time. Therefore, generally used perioperative platelet reactivity measurements seem unreliable for adjusting perioperative APT strategy.

Survival analysis of diabetes mellitus and cardiovascular patients with COVID-19: a secondary data analysis

Background: Patients with diabetes mellitus (DM) and cardiovascular disorders who suffer from COVID-19 may have an increased risk of death. Objective: This study aims to analyze the time of death and influencing factors in patients with DM and cardiovascular disorders with COVID-19. Methods: We used a retrospective observational cohort study using medical records of COVID-19 patients treated at Dr Soeradji and Penembahan Senopati hospitals from March 2020 to June 2022. There were 2,959 participants: patients without comorbidities, with DM, and with cardiovascular problems. We extracted sociodemographic and clinical data on patient characteristics using medical records. Data analysis used Kaplan-Meier and Cox regression analysis to estimate survival probability and investigate predictors of death with a 5% significance level. Results: The median survival time was highest in the group without comorbidities (70.00) and lowest in the DM+others group (21.75). Years of treatment, age, presence of comorbidities, and type of hospital were related to the survival rate of COVID-19 patients (p&lt;0.05). Diabetes mellitus and cardiovascular system disorders are significantly associated with survival of COVID-19 patients (p&lt;0.001). There were significant differences between patients without cardiovascular disorders and patients with cardiovascular disorders (Non-Hypertension, Hypertension, and Hypertension + Others) adjusted by year, gender, age, and hospital type (p&lt;0.001). There were significant differences between patients without DM and patients with DM (DM only, DM+Hypertension, and DM+Others) adjusted by year, gender, age, and hospital type(p&lt;0.001). Conclusion: Years of treatment, age, gender, comorbid DM, and cardiovascular problems are associated with the survival rate of COVID-19 patients. Older age, DM patients who have comorbidities other than hypertension, and patients with cardiovascular issues other than hypertension show a greater risk of death than other groups. Key words: COVID-19, Diabetes Mellitus, Hypertension, Cardiovascular Diseases, Survival Rate.

Detection of Cardiotoxicity Using Right Ventricular Free Wall Longitudinal Strain in Low Cardiovascular Risk Breast Cancer Patients Receiving Low-Dose Anthracycline Treatment.

Objective Breast cancer patients who receive chemotherapy may develop cancer therapy-related cardiovascular toxicity, particularly if they have pre-existing cardiovascular risk factors. Notably, right ventricle dysfunction may manifest before the left ventricle. Our study aims to compare conventional echocardiography with global longitudinal strain (GLS) in low cardiovascular risk patients on low-dose anthracycline, focusing on early cardiotoxicity detection. Additionally, we explore the predictive role of right ventricular free wall longitudinal strain (RVFWLS) in cardiotoxicity. Methods In a recent study, 28 women with low cardiovascular risk who underwent low-dose anthracycline chemotherapy for breast cancer were assessed for cardiac function using two-dimensional echocardiography and speckle-tracking echocardiography. The measurements included left ventricular ejection fraction (LVEF), right ventricular systolic function (RVS'), tricuspid annular plane systolic excursion (TAPSE), left ventricular global longitudinal strain (LVGLS), and RVFWLS. All patients had normal LVEF at the beginning of the study. Cardiotoxicity was defined as a new decrease in LVEF by 10% or below 53% and/or changes in LVGLS/RVFWLS by 15%. Results In our study, no significant changes were observed in the LVEF following chemotherapy treatment. The LVEF values remained stable, changing slightly from 63 ± 3.7 to 65.0 ± 3.4, with a t-test value of 1.790 and a p-value of 0.079. Similarly, the analysis found no significant changes in RVS' and TAPSE values following chemotherapy treatment. However, significant changes were observed in strain measurements. LVGLS decreased from -21.2 ± 2.1 to -18.6 ± 2.6 (t-test = -4.116; df = 54, p=0.001), and RVFWLS decreased from -25.2 ± 2.9 to -21.4 ± 4.4 (t-test = -3.82; df = 54, p=0.001). Notably, 35% of participants showed changes in RVFWLS greater than 15%, whereas LVGLS changed by less than 15%. This indicates that RVFWLS is more sensitive to the treatment compared to LVGLS. Conclusions The study results indicate that during the initial phases of chemotherapy treatment in low cardiovascular risk patients, early changes in strain measures reveal subclinical cardiotoxicity. This suggests that GLS measurements are more effective at detecting early signs of myocardial damage and potential deterioration in cardiac function than traditional echocardiographic parameters. Additionally, it is noteworthy that RVFWLS exhibits greater sensitivity to these changes, regardless of the chemotherapy dosage and regimen.

MAFLD in adults: non-invasive tests for diagnosis and monitoring of MAFLD.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the liver manifestation of a metabolic syndrome and is highly prevalent in the general population. There has been significant progress in non-invasive tests for MAFLD, from the diagnosis of fatty liver and monitoring of liver fat content in response to intervention, to evaluation of liver fibrosis and its change over time, and from risk stratification of patients within the context of clinical care pathways, to prognostication. Various non-invasive tests have also been developed to assess for fibrotic metabolic dysfunction-associated steatohepatitis, which has emerged as an important diagnostic goal, particularly in the context of clinical trials. Non-invasive tests can be used to diagnose clinically significant portal hypertension so that intervention can be administered to reduce the risk of decompensation. Furthermore, the use of risk stratification algorithms can identify at-risk patients for hepatocellular carcinoma surveillance. Beyond the liver, various tests that evaluate cardiovascular disease risk, assess sarcopenia and measure patient reported outcomes, can be utilized to improve the care of patients with MAFLD. This review provides an up-to-date overview of these non-invasive tests and the limitations of liver biopsy in the management of patients with MAFLD.

Usefulness of the cardiopulmonary exercise test up to the anaerobic threshold for pati-ents aged ≥ 80 years with cardiovascular disease on cardiac rehabilitation.

A cardiopulmonary exercise test provides information regarding appropriate exercise intensity, but there have been few reports on its use in patients over 80 years of age. Retrospective observational study. A total of 511 cardiovascular disease patients who performed a cardiopulmonary exercise test from February 2011 to January 2020 were investigated. Patients were stratified according to age: < 70 years, 70-79 years, and ≥ 80 years, and the results of the cardiopulmonary exercise test up to anaerobic threshold were compared. Patients in the < 70 age bracket showed higher oxygen consumption, carbon dioxide output, and ventilatory volume and lower ventilation equivalents per oxygen consumption and carbon dioxide output in all time periods. However, there were no significant differences in these parameters or the work rate (70-79 years of age: 41.4 ± 11.7 watts, vs ≥ 80 years: 42.2 ± 10.9 watts, p = 0.95) or oxygen consumption per body weight at anaerobic threshold (12.2 ± 0.2 ml/min/kg, vs 12.1 ± 0.4 ml/min/kg, p = 0.97) between the 70-79 year age bracket and the ≥ 80 year age bracket. Even for cardiovascular disease patients age ≥ 80 years, a cardiopulmonary exercise test up to anaerobic threshold can supply useful information for guiding cardiac rehabilitation.

Sedentary behaviour may cause differences in physical outcomes and activities of daily living in older cardiovascular disease patients participating in phase I cardiac rehabilitation

This study aimed to investigate the rate of sedentary behaviour and differences in physical outcomes and activities of daily living (ADL) based on sedentary behaviour time of hospitalized older cardiovascular disease patients undergoing phase I cardiac rehabilitation. Older cardiovascular disease patients were enrolled from October 2020 to September 2023 and were divided into the high sedentary behaviour group (≥ 480 min/day) and low sedentary behaviour group (< 480 min/day). Patients’ clinical characteristics, usual gait speed, and Five Times Sit to Stand Test time were compared as indices of physical outcomes. Motor, cognitive, and total Functional Independence Measure (FIM) scores were used as indices of ADL and compared between groups using analysis of covariance. Final analysis included 402 patients (mean age: 76.7 years, female: 35.3%). The high sedentary behaviour group included 48.5% of the study patients. After adjustment for baseline characteristics, gait speed (0.80 ± 0.27 vs. 0.96 ± 0.23 m/s, p < 0.001) was lower and FTSST time (11.31 ± 4.19 vs. 9.39 ± 3.11 s, p < 0.001) was higher in the high sedentary behaviour group versus low sedentary behaviour group. Motor (85.82 ± 8.82 vs. 88.09 ± 5.04 points, p < 0.001), cognitive (33.32 ± 2.93 vs. 34.04 ± 2.24 points, p < 0.001), and total FIM scores (119.13 ± 10.66 vs. 122.02 ± 6.30 points, p < 0.001) were significantly lower in the high sedentary behaviour group versus low sedentary behaviour group after adjustment. In older cardiovascular disease patients in phase I cardiac rehabilitation, sedentary behaviour time might influence physical outcomes and ADL at discharge. It is thus important to consider the amount of sedentary behaviour time spent by these patients during daily life while hospitalized.

The potential of the transformer-based survival analysis model, SurvTrace, for predicting recurrent cardiovascular events and stratifying high-risk patients with ischemic heart disease.

Ischemic heart disease is a leading cause of death worldwide, and its importance is increasing with the aging population. The aim of this study was to evaluate the accuracy of SurvTrace, a survival analysis model using the Transformer-a state-of-the-art deep learning method-for predicting recurrent cardiovascular events and stratifying high-risk patients. The model's performance was compared to that of a conventional scoring system utilizing real-world data from cardiovascular patients. This study consecutively enrolled patients who underwent percutaneous coronary intervention (PCI) at the Department of Cardiovascular Medicine, University of Tokyo Hospital, between 2005 and 2019. Each patient's initial PCI at our hospital was designated as the index procedure, and a composite of major adverse cardiovascular events (MACE) was monitored for up to two years post-index event. Data regarding patient background, clinical presentation, medical history, medications, and perioperative complications were collected to predict MACE. The performance of two models-a conventional scoring system proposed by Wilson et al. and the Transformer-based model SurvTrace-was evaluated using Harrell's c-index, Kaplan-Meier curves, and log-rank tests. A total of 3938 cases were included in the study, with 394 used as the test dataset and the remaining 3544 used for model training. SurvTrace exhibited a mean c-index of 0.72 (95% confidence intervals (CI): 0.69-0.76), which indicated higher prognostic accuracy compared with the conventional scoring system's 0.64 (95% CI: 0.64-0.64). Moreover, SurvTrace demonstrated superior risk stratification ability, effectively distinguishing between the high-risk group and other risk categories in terms of event occurrence. In contrast, the conventional system only showed a significant difference between the low-risk and high-risk groups. This study based on real-world cardiovascular patient data underscores the potential of the Transformer-based survival analysis model, SurvTrace, for predicting recurrent cardiovascular events and stratifying high-risk patients.

Perioperative transfusion study (PETS): Does a liberal transfusion protocol improve outcome in high-risk cardiovascular patients undergoing non-cardiac surgery? A randomised controlled pilot study.

Small studies have shown that patients with advanced coronary artery disease might benefit from a more liberal blood transfusion strategy. The goal of this pilot study was to test the feasibility of a blood transfusion intervention in a group of vascular surgery patients who have elevated cardiac troponins in rest. We conducted a single-centre, randomised controlled pilot study. Patients with a preoperative elevated high-sensitive troponin T undergoing non-cardiac vascular surgery were randomised between a liberal transfusion regime (haemoglobin >10.4 g/dL) and a restrictive transfusion regime (haemoglobin 8.0-9.6 g/dL) during the first 3 days after surgery. The primary outcome was defined as a composite endpoint of all-cause mortality, myocardial infarction or unscheduled coronary revascularization. In total 499 patients were screened; 92 were included and 50 patients were randomised. Postoperative haemoglobin was different between the intervention and control group; 10.6 versus 9.8, 10.4 versus 9.4, 10.9 versus 9.4 g/dL on day one, two and three respectively (p < 0.05). The primary outcome occurred in four patients (16%) in the liberal transfusion group and in two patients (8%) in control group. This pilot study shows that the studied transfusion protocol was able to create a clinically significant difference in perioperative haemoglobin levels. Randomisation was possible in 10% of the screened patients. A large definitive trial should be possible to provide evidence whether a liberal transfusion strategy could decrease the incidence of postoperative myocardial infarction in high risk surgical patients.

Demonstration of angioplasty using a balloon catheter in tetra-hybrid nano-bloodstream within an electrified stenotic arterial cavity under a magnetic field: Artificial neural network analysis

This article focuses on the critical role of advanced computational techniques in enhancing medical diagnostics and treatment planning, especially in procedures like angioplasty. It presents a detailed examination of ballooned catheterization (balloon angioplasty) in a bloodstream carrying tetra-hybrid nanoparticles within a negatively charged stenotic arterial cavity, influenced by a magnetic field. The study models the streaming of blood, considering factors like heat generation, Joule heating, interfacial nanolayers, nanoparticle size, and velocity and thermal slip conditions. The model simplifies complex dynamics through the lubricant and Debye–Hückel linearization approaches and employs the homotopy perturbation method (HPM) for solving dimensionless equations. Mathematica and Matlab are used to illustrate key parameters like velocity, temperature, pressure gradient, wall shear stress (WSS), heat transfer coefficient (HTC), and blood bolus trapping. The study reveals that increasing the balloon catheter’s height boosts blood velocity in the annulus’s central zone, while a thicker interfacial nanolayer diminishes blood temperature and HTC. Larger nanoparticles elevate the blood temperature profile, and increased electro-osmotic parameters enhance the pressure gradient. The tetra-hybrid nano-blood (THNB) shows superior HTC compared to other forms. The study also delves into bolus trapping phenomena, emphasizing the significant changes induced by electro-osmotic forces. Additionally, an artificial neural network (ANN) model, developed using HPM-derived data, accurately predicts WSS and HTC, achieving high accuracy rates of 99.97% in testing and 99.92% in validation for THNB flow. This study paves the way for more targeted, safer, and efficient use of balloon catheters in treating arterial blockages, significantly impacting cardiovascular medicine and patient care.

A Study on Case Fatality of COVID-19 Patients with Ischemic Heart Disease in Selected Hospitals in Dhaka City

Objective: To identify the significant level of Case fatality of Covid-19 Patients with Ischemic Heart Disease in selected hospitals in Dhaka city. Method: This cross sectional study was carried out at NICVD/ Lab aid cardiac hospital/ Universal cardiac hospital from January 2023 to February 2023. Where a total of 384 adults (&gt;18 ages) with Ischemic Heart Disease who admitted in hospital and tested positive for Covid- 19 were included as a sample population. After collecting data from sample population, data was checked and re-checked for completeness and correctness. The Collected data was analyze via statistical Software’s like STATA, SPSS etc. Results: during the study, majority were belonging to 51-60 years age group, 32.81%. followed by 27.60% were belong to 41-50 years age group and 23.18% belong to &gt;61 years age group and majority were male, 80%.42.71% had normal weight whereas 28.13% were overweight &amp; 24.74% were obese. 80.47% had chest pain, followed by 13.28% had dyspnea, 12.50% had cough, 10.68% had palpitation, 4.17% had vomiting. where 46.61% had STEMI, followed by 17.19% had NSTEMI, 19.27% had unstable angina, 25.78% had systemic hypertension, 21.88% had diabetes mellites, 6.77% had Heart valve disease, 4.43% had Arrhythmia. Plus, majority didn’t get their vaccination, 89.60%.49.48% had abnormal level of anxiety status whereas 55.73% had abnormal level of depression. Multivariable logistic regression found residence, age, profession, and income to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Plus, Chronic disease, STEMI, NSTEMI to be statistically significantly associated with anxiety after controlling for the other factors found to be significant at the univariate level. Cardiovascular Drug Therapy at Hospitalization of Covid-19 shows Medical therapy included ACE inhibitors (22.1% of the patients), ARBs (20.57%). mean length of hospital stay was 10.7±2.7 days, with an overall in-hospital mortality of 5.8% (515 of 8910 patients) in this population of patients with completed outcomes. Conclusion: Our findings indicate that health care providers, particularly cardiologists and nurses, should take extra care to detect and evaluate all heart disease patients for level of anxiety and depression in a clinical setting. There is a need to develop a quick screening approach in hospitals dealing with cardiovascular inpatients to identify those needing extra evaluation and care.

Understanding Digital Health Literacy and Attitudes Towards eHealth Technologies Among Cardiovascular Patients: Implications for Secondary Prevention (Preprint)

Understanding Digital Health Literacy and Attitudes Towards eHealth Technologies Among Cardiovascular Patients: Implications for Secondary Prevention (Preprint)

The association of carotid plaque burden and composition and the coronary artery calcium score in intermediate cardiovascular risk patients.

Both the carotid ultrasound and coronary artery calcium (CAC) score quantify subclinical atherosclerosis and are associated with cardiovascular disease and events. This study investigated the association between CAC score and carotid plaque quantity and composition. Adult participants (n = 43) without history of cardiovascular disease were recruited to undergo a carotid ultrasound. Maximum plaque height (MPH), total plaque area (TPA), carotid intima-media thickness (CIMT), and plaque score were measured. Grayscale pixel distribution analysis of ultrasound images determined plaque tissue composition. Participants then underwent CT to determine CAC score, which were also categorized as absent (0), mild (1-99), moderate (100-399), and severe (400+). Spearman correlation coefficients between carotid variables and CAC scores were computed. The mean age of participants was 63 ± 11 years. CIMT, TPA, MPH, and plaque score were significantly associated with CAC score (ρ = 0.60, p < 0.0001; ρ = 0.54, p = 0.0002; ρ = 0.38, p = 0.01; and ρ = 0.49, p = 0.001). Echogenic composition features %Calcium and %Fibrous tissue were not correlated to a clinically relevant extent. There was a significant difference in the TPA, MPH, and plaque scores of those with a severe CAC score category compared to lesser categories. While carotid plaque burden was associated with CAC score, plaque composition was not. Though CAC score reliably measures calcification, carotid ultrasound gives information on both plaque burden and composition. Carotid ultrasound with assessment of plaque features used in conjunction with traditional risk factors may be an alternative or additive to CAC scoring and could improve the prediction of cardiovascular events in the intermediate risk population.

Rate of Polypharmacy and Its Determinants Among Older Adult Cardiovascular Patients at Hiwot Fana Comprehensive Specialized Hospital in Eastern Ethiopia

IntroductionsUnderstanding the rate of polypharmacy in cardiovascular patients is crucial due to its increasing occurrence and its association with potentially inappropriate prescribing practices and negative health outcomes, particularly among elderly individuals with cardiovascular conditions. According to the best of the literature search knowledge, the magnitude of polypharmacy and associated factors were not done among older cardiovascular patients in eastern Ethiopia. ObjectiveThe aim of this study was to assess the rate of polypharmacy and its determinants among older adult cardiovascular patients at Hiwot Fana Comprehensive Specialized Hospital in eastern Ethiopia. Methods and materialsA cross-sectional study design was undertaken, involving a cohort of 364 individuals aged 65 years and older who were receiving follow-up care for cardiovascular disease. A data abstraction sheet was used to gather the data. The convenience sampling technique was employed. To identify factors related to the rate of polypharmacy, multivariable logistic regression analysis was employed. ResultsThe analysis included the medical records of 325 patients, revealing a polypharmacy prevalence rate of 20.7%. Individuals who were 77 years of age or older had a 1.12 times higher likelihood of having polypharmacy than individuals who were 65 to 70 years old. The presence of comorbidities along with cardiovascular diseases was a significant factor related to polypharmacy. Polypharmacy was prevalent among individuals with a larger number of comorbidities. ConclusionThis study showed one in five cardiovascular patients at chronic clinic was on polypharmacy. Age (≥77 years), comorbidities, three or more comorbid diseases, duration cardiovascular of disease (≥5years), and years taking cardiovascular drugs (≥5) were associated with higher odds of polypharmacy. Healthcare providers should be cautious about prescribing multiple medications to this population and training in the prevention of inappropriate polypharmacy is crucial to reducing the trend of polypharmacy and its associated burden

Long-term exercise program in cardiovascular patients: the impact on quality of life

Long-term exercise program in cardiovascular patients: the impact on quality of life