Cardiovascular Risk Factors In Patients Research Articles

Apolipoproteins as predictors of cardiovascular risk in patients with chronic pancreatitis.

Patients with pancreatic diseases are at increased risk of cardiovascular events. Investigating various apolipoprotein forms as important atherogenesis components may improve cardiovascular risk (CVR) prediction. This study aimed to investigate CVR factors in patients with chronic pancreatitis. The study enrolled 70 patients (40 males and 30 females, mean age 55.2 years) with chronic pancreatitis and treated pancreatic exocrine insufficiency. We assessed CVR by apolipoproteins A-I, A-II, B, and C-III, lipid profile; score systems [SCORE risk chart and Framingham Risk Score (FRS)], diabetes mellitus; chronic pancreatitis by M-ANNHEIM classification. Statistics were performed via SPSS v. 22. Low apolipoprotein A-I and high apolipoprotein B levels with increased atherogenic potential were observed in 37 and 26 patients. 45.71% demonstrated a high risk of myocardial infarction with high apolipoprotein B/apolipoprotein A-I ratio. Men are at higher CVR risk. Apolipoproteins A-I and A-II correlated with the cardioprotective high-density lipoprotein (HDL) in contrast to apolipoproteins B and C-III, which correlated strongly with low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG). Increased CVR assessed by FRS correlated with significantly lower apolipoprotein A-I and higher apolipoprotein B and apolipoprotein B/apolipoprotein A-I ratio. With the increase in chronic pancreatitis severity, we observed decreased apolipoproteins and increased apolipoprotein B/apolipoprotein A-I ratio. Apolipoproteins are valuable CVR indicators. Further studies are required to establish a CVR screening panel in this population.

Modern determinants of cardiovascular risk factors in patients with psoriatic arthritis: Relation to disease activity and severity

Aim of the workTo evaluate the frequency of cardiovascular (CV) risk factors in psoriatic arthritis (PsA) patients. Patients and methodsThe study included 97 PsA patients and 30 control. Lipid profile and serum homocysteine level were assessed. The endothelium-dependent vasodilation (EDVD) evaluated. The QRISK-3 scale was used to assess CV risk. Disease activity PsA (DAPSA) and psoriasis area and severity index (PASI) were recorded. ResultsReduced EDVD (<10 %) was significantly more frequent in PsA compared to control (75.3 % vs. 6.7 %, p < 0.001), with significant differences in lipid profile (p < 0.001), homocysteine (p < 0.001), QRISK (p < 0.001), CRP (p < 0.001), DAPSA (p < 0.001), and disease duration (p < 0.001) between PsA patients with reduced and normal EDVD. Average CV risk was 7.7 times higher than in control, and the classical risk factors did not account for the reduced EDVD. Linear regression analysis identified disease duration (β 0.5; OR 1.65, p < 0.001) and disease activity (β 0.09; OR 1.09, p < 0.001) as significant predictors of CV risk in PsA patients. The predictive accuracy of DAPSA (sensitivity 69 %, specificity 86.4 %, 95 % CI: 0.7–0.9; p < 0.001) and disease duration (sensitivity 91 %, specificity 55 %, 95 % CI: 0.95–1; p < 0.001) for CV risk was determined. ConclusionA heightened CV risk in PsA patients is highlightened independent of traditional risk factors. The significance of disease activity and disease duration as robust predictors of CV risk in PsA patients is emphasized. The data on hyperhomocysteinemia and its association with endothelial dysfunction emphasize the intricate link between PsA, homocysteine levels, and increased CV risk.

Clinical presentation and cardiovascular risk factors in patients with STEMI due to spontaneous coronary artery dissection (SCAD)

Abstract Background Spontaneous coronary artery dissection (SCAD) may occur in the absence of atherosclerotic and traumatic etiology and can lead to severe clinical manifestations such as ST-segment elevation myocardial infarction (STEMI). Compared to atherosclerotic STEMI, younger patients and females are predominantly affected. Hence, underdiagnosis is an important concern. We therefore systematically analyzed the prevalence of SCAD among a large cohort of young patients presenting with STEMI, as well as risk factors and presenting symptoms. Methods We retrospectively identified a consecutive cohort of 631 patients younger than 55 years who underwent coronary angiography due to STEMI between 01/2005 and 10/2022. Systematic review of coronary angiograms allowed identification of all STEMI caused by SCAD (n=20, 3.2%), including patients previously misdiagnosed as atherosclerotic STEMI. By reviewing medical records, we identified symptoms at presentation and cardiovascular risk factors in patients with SCAD-STEMI. Results Out of the 20 patients &amp;lt;55 years presenting with SCAD-STEMI, 16 (80%) were female, and the mean age was 49.5 years. By far the most common presentation was typical angina (75%, n=15), being reported by all 4 male and 11/16 female patients (100% vs. 69%, respectively). Importantly, three patients presented with cardiac arrest due to malignant ventricular arrhythmia (15%). In 6 patients, symptoms were mild and atypical (nausea/vomiting, n = 3, 15%; atypical chest pain, n = 2, 10%; and diaphoresis, n = 1, 5%). There was no significant difference of symptoms between men and women. 11 patients (55%) were treated by primary PCI, none received emergency coronary artery bypass grafting (CABG). The mean maximum serum creatin kinase (CK) level was 1410 U/l (range 139-86144 U/l). Mean left ventricular ejection fraction (LVEF) was 50% (range 30-60%). Symptoms at presentation did not correlate with maximum CK levels, nor with LVEF. In this caucasian cohort, the most common cardiovascular risk factor was arterial hypertension (n = 12, 60%), followed by smoking (n = 9, 45%). Six patients had hyperlipidemia (30%), and three (15%) were obese. Diabetes and a positive family history for cardiovascular events were rare (n = 2, 10% vs. n = 1, 5%, respectively). Conclusion In this large caucasian cohort of young patients with STEMI, SCAD accounted for 3.2 % of cases. Typical angina was the most common symptom at presentation, but cardiac arrest due to ventricular fibrillation was frequent. Symptoms in men and women were similar and did not correlate with LVEF, nor with maximum CK levels.

Heart rate variability and cardiovascular risk factors in patients with rheumatoid arthritis: A longitudinal study.

It is established that the risk of cardiovascular disease (CVD) is increased in patients with Rheumatoid Arthritis (RA). Heart rate variability (HRV) is a method for evaluating the activity in the cardiac autonomic nervous system. Our aim was to assess the longitudinal development of HRV in patients with RA and compare with healthy controls. Furthermore, we wanted to investigate associations between HRV, inflammatory disease activity and cardiovascular complications in patients with RA over time. HRV was assessed with frequency-domain analysis at baseline and after five years in 50 patients with early RA, all being younger than 60years. HRV indices were age-adjusted based on the estimated age-dependency in 100 age and sex matched healthy controls. Additionally, clinical data including serological markers, disease activity, and blood pressure were collected from the patients. Eleven years after inclusion CVD was assessed. At baseline, patients with RA presented with lower HRV compared to controls during deep breathing (6 breaths/min), paced normal breathing (12 breaths/min) and after passive tilt to the upright position. No significant change in HRV was observed at the five-year follow-up. A significant negative correlation was found between HRV parameters and systolic blood pressure (SBP) at baseline. A significant positive correlation was found between heart rate and inflammatory markers at baseline but not after five years. Nine patients had developed CVD after 11years, but no significant association was found with baseline HRV data. This study showed that patients with RA have autonomic imbalance both at an early stage of the disease and after five years, despite anti-rheumatic medication, but no correlation between HRV and inflammation markers were observed. Reduced HRV was also significantly negatively correlated with increased SBP. Hypertension is a common finding in patients with RA. Thus, significant decline of HRV could be a useful early marker for development of hypertension in patients with RA.

Evaluation of cardiovascular risk factors, prevalence and determinants of coronary artery disease in renal transplant patients: a single center experience

Aims: Cardiovascular disease is the leading cause of morbidity and mortality in renal transplant patients. In our study, we aimed to determine the cardiovascular (CV) risk factors, the prevalence and determinants of coronary artery disease (CAD) in patients who underwent kidney transplantation in our center.&#x0D; Methods: One hundred sixty nine patients who underwent kidney transplantation in our center were included in the study retrospectively. Demographic and clinical characteristics of the patients, cardiac evaluation findings and further examination results were scanned from the database of our center.&#x0D; Results: The mean age of the patients was 42.86±12.97 years and 43.19% were female. The most common etiological factors for the development of end-stage renal disease were hypertension (HT) and diabetes mellitus (DM). Ninety seven patients (57.4%) were undergoing dialysis, 4 of whom were on peritoneal dialysis. Renal transplant was performed from a cadaver in two patients and from a living donor in the other patients. CAD was detected in 29 patients (17.15%). The most prevalent CV risk factors were HT and hyperlipidemia (HL). Multivariate logistic regression analysis revealed that age, DM, HL and dialysis history were independent risk factors for the development of CAD. In the postoperative follow-ups, no death or acute coronary syndrome was observed during the hospitalization period.&#x0D; Conclusion: Prevalence of CV risk factors is high in renal transplant candidates. Our findings support the need for a detailed cardiac evaluation and effective management of CV risk factors in patients preparing for kidney transplantation.

Cardiovascular risk factors in patients with ulcerative colitis

Given the current trends in increasing the life expectancy of patients with ulcerative colitis (UC), the study of the risk of atherothrombotic events in them requires study. For effective prevention of cardiovascular diseases, it is necessary to assess cardiovascular risk factors since the concept of their timely detection is the basic one when planning preventive measures. To assess the prevalence of cardiovascular risk factors in patients with UC. One hundred eighty four UC patients participated in the case-control study; 56 participants were included in the control group. The studied parameters are unmodified, behavioral, and biological factors of cardiovascular risk. The study participants were surveyed, examined, measured blood pressure, height, weight, the level of total cholesterol was studied, and the lipid spectrum was analyzed in 80 patients with UC. Parametric and nonparametric statistical methods were used. UC patients consumed fruit less often, drank tea and coffee with sugar more often, exercised less often and experienced high levels of stress. A higher incidence of arterial hypertension in UC patients was established, even though the fact of taking glucocorticosteroids was considered. No significant differences were found in the assessment of relative and total cardiovascular risk. Risk management of cardiovascular diseases in UC patients should focus on a personalized approach and timely screening of modifiable cardiovascular risk factors with their subsequent correction. The absence of significant differences in the level of relative and total cardiovascular risk indicates a limited contribution of traditional risk factors to the development of cardiovascular diseases in UC patients.

FRI181 Increased LDL Particle And Apolipoprotein B Concentrations In Patients With Nonfunctioning And Cortisol Secreting Adrenal Adenomas

Abstract Disclosure: R. Sandooja: None. A. Kittithaworn: None. P. Dogra: None. D. Gruppen: None. E. Atkinson: None. S. Achenbach: None. K. Yu: None. M. Connelly: None. V. Simha: None. R.P. Dullaart: None. I. Bancos: None. INTRODUCTION: Based on the spectrum of cortisol excess, adrenal adenomas are classified as adenomas with Cushing syndrome (CS), adenomas with mild autonomous cortisol secretion (MACS), and non-functioning adenomas (NFA). Patients with adrenal adenomas demonstrate a high prevalence of cardiovascular morbidity and mortality proportional to the degree of hypercortisolism. Evidence on whether dyslipidemia is a contributing cardiovascular risk factor in patients with NFA and MACS is discrepant. We aimed to characterize (apo) lipoprotein abnormalities across the spectrum of cortisol excess in patients with adenomas as compared to referent subjects. METHODS: Study Design: Single center cross sectional study between 01/2015 - 05/2021.Patients: Adults with NFA, MACS, or CS were consecutively enrolled. MACS was diagnosed based on post-dexamethasone cortisol &amp;gt;1.8 mcg/dL. Referent subjects were recruited from local population of patients with available abdominal imaging and no adrenal disorders. All subjects provided fasting ethylenediaminetetraacetic acid (EDTA) venous samples. Measurements: Nuclear magnetic resonance (NMR) spectroscopy measurements included total cholesterol (TC), low-density lipoprotein (LDL) and LDL particle concentrations, high-density lipoprotein (HDL) subclasses, apolipoprotein B (apo B), triglycerides (TG) and TG-rich lipoprotein concentrations. RESULTS: Participants included 101 patients with CS (median age 44 years, IQR 31-58, 85% women), 158 patients with MACS (median age 62 years, IQR 51-70, 62% women), 166 patients with NFA (median age 60 years, IQR 53--66, 63% women) and 136 referent subjects (median age 68 years, IQR 57-77, 52% women). Patients had higher BMI (32 vs 27 kg/m2), higher prevalence of hypertension (72% vs 46%) and diabetes mellitus (27% vs 9%) as compared to reference subjects. Statin therapy was used in 32% of patients and referent subjects. After adjusting for age, sex, BMI, smoking, diabetes, hypertension, and statin therapy, as compared to referent subjects, we found inconsistent increase in TC, LDL cholesterol and TG across CS, MACS and NFA and no consistent differences in LDL size, HDL variables, TG and TG-rich lipoproteins. However, when compared to referent subjects, LDL particle concentrations- CS(OR 1.78, 95% CI 1.33-2.39), MACS (OR 1.31, 95% CI 1.03-1.67), and NFA (OR 1.43, 95% CI 1.12-1.82) and Apo B levels were higher in all patient categories: CS (OR 2.26, 95% CI 1.57-3.24), MACS (OR 1.36 95% CI 1.00-1.85 ), and NFA (OR 1.54 95% CI 1.13-2.09). These differences were particularly evident in patients not on statin therapy. CONCLUSIONS: We found that LDL particle and Apo B concentrations were elevated in all patient groups, including those with MACS and NFA. In comparison to conventional lipid measurements, LDL particle and Apo B may serve as a better biomarker of the future cardiovascular risk in patients with adrenal adenomas. Presentation: Friday, June 16, 2023

Antihypertensive treatment with hydrochlorothiazide-hydralazine combination aggravates medial vascular calcification in CKD rats with mineral bone disorder.

Arterial stiffness and medial vascular calcification, leading to isolated systolic blood pressure (BP), are major cardiovascular risk factors in patients with chronic kidney disease (CKD) and mineral bone disorders (MBD). The impact of BP on MBD-induced medial vascular calcification in CKD remains uncertain. We investigated whether BP reduction improves arterial stiffness and medial vascular calcification in a rat model of CKD-MBD. CKD was induced in Wistar rats by subtotal nephrectomy. Then, MBD was generated by a Ca/P-rich diet with calcitriol supplementation to induce medial vascular calcification. Two antihypertensive treatments were evaluated: (1) the angiotensin AT1 receptor antagonist losartan, and (2) the combination of the thiazide diuretic hydrochlorothiazide and the direct vasodilator hydralazine (HCTZ/HY). After 5 weeks, mean BP (MBP), pulse pressure (PP), and pulse wave velocity (PWV) were determined. Vascular calcification was assessed in the thoracic aorta. While MBP was similar in CKD-MBD and control CKD rats, PP and PWV were increased in CKD-MBD rats. The heightened arterial stiffness in CKD-MBD rats was associated with diffused medial calcification along the thoracic aorta. Although both losartan and HCTZ/HY reduced MBP in CKD-MBD rats, losartan did not affect PP and PWV nor medial vascular calcification, whereas HCTZ/HY, unexpectedly, further increased arterial stiffness and medial vascular calcification. In the rat model of CKD-MBD, antihypertensive treatment with losartan did not affect arterial stiffness or medial vascular calcification. However, HCTZ/HY treatment aggravated arterial stiffness and vascular calcification despite a similar reduction of MBP, suggesting a blood pressure-independent mechanism for vascular calcification.

Smoking and cardiovascular disease in patients with type 2 diabetes: a prospective observational study.

Cigarette smoking is a major risk factor for cardiovascular disease. In type 2 diabetes mellitus (T2D), medications such as antihypertensives and statins can reduce the increased cardiovascular risk. The aim of this study was to evaluate the impact of cigarette smoking on major adverse cardiovascular event (MACE) and all-cause mortality in patients with T2D in a relatively well treated Swedish cohort. Seven hundred and sixty-one patients with T2D aged 55-66 years were followed in the prospective observational CArdiovascular Risk factors in patients with DIabetes - a Prospective study in Primary care (CARDIPP) study. Baseline data included blood samples of markers of dysglycemia and inflammation, blood pressure as well as questionnaire responses regarding cigarette smoking. Participants were followed for incidence of MACE and all-cause mortality. Of the included 663 participants, the mean age was 60.6 (SD 3.1) years and 423 (63.8%) were men. Levels of C-reactive protein and vitamin D, as well as the proportion of participants treated with antihypertensives, acetylic salicylic acid, statins, and diabetes medications, were similar between smokers and nonsmokers. Median follow-up time was 11.9 (Q1-Q3 10.8-12.7) years. Cigarette smoking was associated with all-cause mortality [hazard ratio 2.24 (95% confidence interval, 95% CI 1.40-3.56), P < 0.001], but not MACE [hazard ratio 1.30 (95% CI 0.77-2.18), P = 0.328]. In patients with T2D, cigarette smoking was not associated with an increased risk of MACE. This raises the question of whether cardioprotective drugs in individuals with T2D to some degree mitigate the cardiovascular harm of smoking, even though they do not affect other dire consequences of smoking.

ОЦЕНКА ЭФФЕКТИВНОСТИ ПРИМЕНЕНИЯ АНАЛОГА ЧЕЛОВЕЧЕСКОГО ГЛЮКАГОНОПОДОБНОГО ПЕПТИДА-1 ЛИРАГЛУТИДА У ПАЦИЕНТОВ С ПОДАГРОЙ И МЕТАБОЛИЧЕСКИ НЕЗДОРОВЫМ ФЕНОТИПОМ ОЖИРЕНИЯ

Introduction. Obesity is a global problem of the XXI century. The most important aspect of metabolic disorders that develop with obesity is a change in the level of serum uric acid (UA) in the blood and the development of gout. Currently, the dynamics of cardiovascular risk factors in patients with obesity on the background of drug therapy is being widely studied. The aim of our study is to study the level of UA, vaspin (VsP), visfatin (VF), omentin (ITLN1), retinol-binding protein-4 (RBP4) in patients with gout and metabolically unhealthy obesity (MNHO) during diet therapy and 3 months of treatment with the drug from the group of human glucagon-like peptide-1 analog (aGLP-1) Liraglutide. Materials and methods: 25 men with gout were examined, the average age was 43.6±7.3 years. Gout was diagnosed according to the classification criteria ACR/EULAR, 2015, Wallace S.L., 1977. Metabolic syndrome was established according to the criteria of GNCA (2013): abdominal obesity - waist circumference ≥ 94 cm in combination with any 2 from the following criteria - an increase in triglycerides (TG) ≥ 1.7 mmol / l; a decrease in high-density lipoproteins (HDL) &lt; 1.0 mmol / l, an increase in low-density lipoproteins (LDL) ≥3.0 mmol / l, blood pressure (BP) ≥ 140/90 mm Hg; increase in plasma glucose ≥ 6.1 mmol / l. At the time of inclusion in the study, all patients had an interictal period of gout. Body mass index (BMI) was calculated using the Quetelet formula: body weight (kg)/height (m²). To assess the type of distribution of adipose tissue, the waist circumference (WT, cm) and hip circumference (HB) were measured with a flexible centimeter tape, with the calculation of the W/H ratio. The concentration of VsP, VF, ITLN1, RBP4 was studied using the enzyme-linked immunosorbent assay method using the kits; the concentration of the level of UA in blood serum and daily urine was studied using the colorimetric method. Liraglutide was injected into the subcutaneous fat of the anterior abdominal wall at a dose of 0.6 mg once a day for the first week. Escalation by 0.6 mg every week was then recommended until a dose of 18 mg per day was reached. Participants then received injections at a dose of 1.8 mg for 3 months. Thus, the observation period was 3 months. Laboratory studies and assessment of anthropometric parameters were carried out initially, as well as after 3 months. The control group consisted of 16 healthy men matched in age. Statistical data processing was carried out using the statistical software package Statistica 13.0. Results. 3 months after treatment, a statistically significant decrease in body weight, BMI and WC was noted (in all cases, p&lt;0.01). Median BMI before treatment was ˗ 38.4 [35.4; 39.2] kg/m², against the background of ongoing therapy - 33.2 [31.4; 34.2] kg/m², and thus the loss of body weight was 23% (p&lt;0.05). Serum UA level decreased by 30.1% (p&lt;0.05) during therapy with a drug from the GLP-1 group. In patients with gout, BMI and regression of obesity were associated with a significant decrease in VsP by 17.2%, VF by 13.8% and RBP4 by 10.4%, and a significant increase in ITLN1 by 12.6%. A direct correlation was established between BMI and WC with the content of VsP, RBP4 and VF in blood serum (correlation coefficients from 0.44 to 0.57, p&lt;0.05) and an inverse correlation with the content of ITLN1 (correlation coefficient -0.29, p&lt;0.05). A direct correlation was found between the serum UA index and the content of VsP, VF, RBP4 (correlation coefficients from 0.31 to 0.49, p&lt;0.05). Conclusion. Patients with gout in combination with MNZO showed a significant increase in serum levels of UA, VsP, RBP4 and VF, against the background of a decrease in the concentration of ITLN1. The use of diet therapy using a drug from the GLP-1 group showed a statistically significant decrease in BMI, WC, serum UA, pro-inflammatory adipokines (VsP, VF and RBP4), and a significant increase in anti-inflammatory cytokines (ITLN1).

Psychiatric comorbidities, quality of life, and cardiovascular risk factors in patients with heart failure

Background: Heart failure (HF) leads to various changes including physiological (neurohormonal) changes and an increase in stress level, which can become a risk factor for the development of various psychiatric disorders, further worsening quality of life (QOL). Methods: Patients of HF between 18 and 60 years of age attending the outpatient department of the Department of Cardiology were enrolled. Patients were screened for psychiatric illness by applying Mini International Neuropsychiatric Interview 7.0.2. The diagnosis was made through the Diagnostic and Statistical Manual of Mental Disorders-5. The severity of anxiety and depression was assessed by applying the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. Sleep quality was measured by applying the Pittsburgh Sleep Quality Index. Subsyndromal symptoms were assessed via SADS-CB. QOL was measured by the World Health Organization QOL-BREF. Data were statistically analyzed. Results: Out of 70 enrolled patients, 32 patients did not have any psychiatric illness (Group A), 20 patients were in the subsyndromal group (Group B), and 18 patients had psychiatric disorders (Group C). Tobacco use and the number of risk factors of HF present were significantly higher in Group C. A significantly higher number of patients in Group C were lying in the New York Heart Association (NYHA) II class (patients lying in NYHA III and NYHA IV classes were excluded) than in other groups. In addition, sleep and QOL (especially among patients under NYHA I class) were significantly impaired in Group C. Conclusion: Psychiatric illness is common in patients with HF. Despite guidelines to screen for them, clinicians either do not screen for them or otherwise miss the psychiatric illness. These psychiatric illnesses may further impair the outcome of heart diseases and worsen QOL.

P10-11: Associations between blood levels of trace elements and cardiovascular risk factors in patients with rheumatoid arthritis

P10-11: Associations between blood levels of trace elements and cardiovascular risk factors in patients with rheumatoid arthritis

Poor control of modifiable cardiovascular risk factors among Congolese patients in the acute and sequelae phase of stroke : A cross-sectional study

PurposeTo assess the level of the control of the cardiovascular risk factors in patients with a history of stroke in the Democratic Republic of the Congo. MethodsThe level of the control of arterial hypertension, diabetes mellitus, and dyslipidemias was analyzed in two hundred and seventy-four (274) patients followed for stroke. ResultsAmong 188 patients with a prior diagnosis of arterial hypertension, only 100 (53.2%) were treated, 27 (27.0%) had their blood pressure well controlled [12.3% in acute stroke vs. 46.5% in sequelae phase; p = 0.0002]. Among 42 (71.2%) diabetics treated, 23 (63.9%) had glycaemia levels > 200 mg/dl, 60.0% in acute phase and 83.3% in sequelae phase (p = 0.28). Finally, 87.0% of the patients had a non-HDL-C > 85 mg/dl. ConclusionsThis study shows a poor control of modifiable cardiovascular risk factors in patients with very high cardiovascular risk due to stroke. There is a need for an effective program to combat non-communicable diseases in our environment.

Does Therapy with Glucagon-like Peptide 1 Receptor Agonists Have an Effect on Biochemical Markers of Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD)? Pleiotropic Metabolic Effect of Novel Antidiabetic Drugs in Patients with Diabetes-Interventional Study.

Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD) is associated with the excessive collection of lipids in hepatocytes. Over 75% of diabetes patients typically have MASLD, and, at the same time, the presence of MASLD increases the risk of diabetes by more than two times. Type 2 diabetes and MASLD are independent cardiovascular disease (CVD) risk factors. New diabetes treatment should also take into account pleiotropic effects that reduce cardiovascular risk. The aim of our study is to investigate whether analogs of GLP1 receptors have a pleiotropic metabolic effect and global impact to decrease cardiovascular risk, and also reduce the risk of hepatic fibrosis in patients with MASLD. This study involved 41 patients with diabetes and dyslipidemia who also had atherosclerotic plaque and hepatic steatosis verified by ultrasonography and who were eligible to begin one of the GLP1 receptor agonists treatments. We observed a statistically significant decrease in: BMI (p < 0.001) waist and hip circumference (p < 0.001), glycated hemoglobin (p < 0.001) and creatinine (p < 0.05). Additionally, we obtained a decrease in FIB-4 (p < 0.001) and in the De Ritis (AST/ALT aminotransferase ratio) (p < 0.05). The positive correlation between the FIB-4 value and BMI, WHR, waist circumference and the De Ritis index was observed. In conclusion, semaglutide and dulaglutide had a beneficial effect on metabolic and cardiovascular risk factors in patients with type 2 diabetes. These medications had a positive effect on MASLD biochemical markers.

Relationship of the occurrence of self-reported anxiety and depression symptoms and achievement of cardiovascular risk factors control

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Nicolaus Copernicus University in Torun. Introduction Anxiety and depression influence lifestyle and therefore interfere with preventive measures aimed at eliminating or reducing the severity of modifiable risk factors for cardiovascular diseases (CVD). Aim The study aimed to evaluate the influence of self-reported anxiety and depression symptoms on achieving the control of cardiovascular (CV) risk factors in patients without a history of atherosclerotic coronary heart disease (CHD). Methods A total of 200 patients from the Polish arm of the EUROASPIRE V were included. The median age was 52.0 years (IQR 43.0-60.5). Patients were assessed regarding the control of major CV risk factors: blood pressure, BMI, waist circumference, physical activity, smoking, and the concentration of LDL cholesterol, triglycerides, and blood glucose. Risk factors were considered adequately controlled when the therapeutic target was achieved. The number of controlled CV risk factors was assessed for each individual, as well as the rate of patients who achieved the therapeutic target for particular risk factor was analyzed. Total CVD risk was analyzed with the SCORE scale. The level of anxiety and depression was evaluated based on the results of the Hospital Anxiety and Depression Scale (HADS), which consists of two subscales (HADS Anxiety and HADS Depression). For each subscale obtained score indicated normal, borderline, or abnormal level. Results The median score of anxiety (HADS Anxiety) and depression (HADS Depression) levels were 3.0 (IQR 2.0-6.0) and 3.0 (IQR 1.0-5.0), respectively. In the studied group the median of adequately controlled CV risk factors was 4.0 (IQR 3.0-5.0) and the median SCORE result was 2.0% (IQR 1.0-3.0%). No relationship between the level of anxiety or depression and the CVD risk measured by the SCORE sale was observed (Table 1.). Patients with self-reported anxiety or depression symptoms (borderline and abnormal level) had a significantly lower median number of adequately controlled CV risk factors (HADS Anxiety p = 0.0014; HADS Depression p = 0.0304) (Table 1.). A significantly lower rate of patients with adequate waist circumference (HADS Anxiety p = 0.0464; HADS Depression p = 0.0200) and with regular physical activity (HADS Anxiety p = 0.0431; HADS Depression p = 0.0055) was observed in groups with anxiety or depression symptoms (Table 2.). In patients with anxiety symptoms, a significantly lower rate of normal BMI (p = 0.0218) and adequate triglycerides concentration (p = 0.0278) was found (Table 2.). Conclusion The occurrence of anxiety and depression might influence the achievement of therapeutic targets regarding the control of CV risk factors in patients without a history of CHD.

Risk factors in cardiovascular patients: Challenges and opportunities to improve secondary prevention.

Effective management of major cardiovascular risk factors is of great importance to reduce mortality from cardiovascular disease (CVD). The Survey of Risk Factors in Coronary Heart Disease (SURF CHD) II study is a clinical audit of the recording and management of CHD risk factors. It was developed in collaboration with the European Association of Preventive Cardiology and the European Society of Cardiology (ESC). Previous studies have shown that control of major cardiovascular risk factors in patients with established atherosclerotic CVD is generally inadequate. Azerbaijan is a country in the South Caucasus, a region at a very high risk for CVD. To assess adherence to ESC recommendations for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed CHD at different hospitals in Baku (Azerbaijan). Six tertiary health care centers participated in the SURF CHD II study between 2019 and 2021. Information on demographics, risk factors, physical and laboratory data, and medications was collected using a standard questionnaire in consecutive patients aged ≥ 18 years with established CHD during outpatient visits. Data from 687 patients (mean age 59.6 ± 9.58 years; 24.9% female) were included in the study. Only 15.1% of participants were involved in cardiac rehabilitation programs. The rate of uncontrolled risk factors was high: Systolic blood pressure (BP) (SBP) (54.6%), low-density lipoprotein cholesterol (LDL-C) (86.8%), diabetes mellitus (DM) (60.6%), as well as overweight (66.6%) and obesity (25%). In addition, significant differences in the prevalence and control of some risk factors [smoking, body mass index (BMI), waist circumference, blood glucose (BG), and SBP] between female and male participants were found. The cardiovascular health index score (CHIS) was calculated from the six risk factors: Non- or ex-smoker, BMI < 25 kg/m2, moderate/vigorous physical activity, controlled BP (< 140/90 mmHg; 140/80 mmHg for patients with DM), controlled LDL-C (< 70 mg/dL), and controlled BG (glycohemoglobin < 7% or BG < 126 mg/dL). Good, intermediate, and poor categories of CHIS were identified in 6%, 58.3%, and 35.7% of patients, respectively (without statistical differences between female and male patients). Implementation of the current ESC recommendations for CHD secondary prevention and, in particular, the control rate of BP, are insufficient. Given the fact that patients with different comorbid pathologies are at a very high risk, this is of great importance in the management of such patients. This should be taken into account by healthcare organizers when planning secondary prevention activities and public health protection measures, especially in the regions at a high risk for CVD. A wide range of educational products based on the Clinical Practice Guidelines should be used to improve the adherence of healthcare professionals and patients to the management of CVD risk factors.

Undiagnosed cardiovascular risk factors including elevated lipoprotein(a) in patients with ischaemic heart disease.

This study aims to investigate the prevalence of undiagnosed cardiovascular risk factors in patients with ischaemic heart disease (IHD). We assessed the prevalence of previously undiagnosed cardiovascular risk factors, including elevated lipoprotein(a) [Lp(a)], among consenting patients with IHD who were admitted to hospital. Clinical information, including dietary history, from patients with newly diagnosed IHD and known IHD were compared. Of the 555 patients, 82.3% were males and 48.5% of Chinese ethnicity. Overall, 13.3% were newly diagnosed with hypertension, 14.8% with hypercholesterolemia, and 5% with type 2 diabetes (T2DM). Patients with newly diagnosed IHD, compared to those with known IHD, had a higher prevalence of new diagnoses of hypercholesterolemia (29.1% vs. 2.0%, p < 0.001), hypertension (24.5% vs. 3.4%, p < 0.001) and T2DM (7.3% vs. 3.1%, p = 0.023). Active smoking was prevalent in 28.3% of patients, and higher in newly diagnosed IHD (34.1% vs. 23.2%, p = 0.005). Elevated Lp(a) of ≥120 nmol/L was detected in 15.6% of all patients, none of whom were previously diagnosed. Dietary habits of >50% of patients in both groups did not meet national recommendations for fruits, vegetables, wholegrain and oily fish intake. However, patients with known IHD had a more regular omega-3 supplement intake (23.4% vs. 10.3%, p = 0.024). Increased detection efforts is necessary to diagnose chronic metabolic diseases (hypertension, hypercholesterolemia, T2DM) especially among patients at high risk for IHD. Cardiovascular risk factors, in particular elevated Lp(a), smoking, and suboptimal dietary intake in patients with IHD deserve further attention.

Burden of cardiovascular disease risk factors among subjects with Type 2 Diabetes Mellitus in Southeastern Nigeria

Diabetes is associated with a high degree of cardiovascular morbidity and mortality. The co-existence of other cardiovascular risk factors alongside diabetes confers the cumulative risk of adverse outcomes. The prevalence of cardiovascular risk factors has been rising in sub-Saharan Africa, but their degree of co-existence with diabetes is not well known. The objective of this study was to determine the burden of cardiovascular risk factors in patients with Type 2 Diabetes Mellitus (T2DM) in a urban southeastern Nigerian population. This was a cross-sectional study consisting of consecutively recruited diabetic patients aged ≥40 years attending the diabetes clinic at Enugu State University of Science and Technology Teaching Hospital (ESUTH). Five cardiovascular risk factors were evaluated: Hypertension, overweight/obesity, cigarette smoking, physical inactivity, and poor glycemic control We studied 410 T2DM patients (31.5% male) with a mean age of 58.9 years and a mean duration of diabetes of 7.4 years. The most prevalent cardiovascular risk factor in the study was physical inactivity (69.5%), and 80.1% of respondents had 2 or more risk factors. Females had a significantly higher prevalence of physical inactivity, overweight/obesity, and poor glycemic control when compared to males (73% vs 62%; 73.3% vs 58.9%; 72.2% vs 60.5%, respectively). Our study has shown a high burden of cardiovascular risk factors in diabetic patients in an urban southeastern Nigerian population. Female diabetic subjects had a significantly higher prevalence of most of the cardiovascular risk factors except for smoking.

Low Ang-(1-7) and high des-Arg9 bradykinin serum levels are correlated with cardiovascular risk factors in patients with COVID-19.

It is predictable that the renin-angiotensin-aldosterone and kinin-kallikrein systems are dysregulated in COVID-19 (COV) patients because SARS-CoV-2 requires ACE2 to cause an infection. This study aimed to assess the serum levels of des-arg(9)-bradykinin (DABK) and angiotensin 1-7 (ang-(1-7)) in patients with COV who had the above-mentioned cardiovascular disease risk factors. In a cross-sectional study, 69 COV patients were selected among patients referred to the main referral center for these patients, in Kerman, Iran, and 73 matched control (non-COV) individuals among individuals who participated in the KERCARD cohort study. Serum levels of DABK and ang-(1-7) were measured by ELISA in the groups of CTL (healthy), HTN, DM, OB, COV, COV + HTN, COV + DM, and COV + OB. Ang-(1-7) levels were lower in the COV + HTN group compared to the HTN group. DABK levels were higher in the COV, HTN, and OB groups and in DM + COV subjects compared to their corresponding control group. The levels of ang-(1-7) and DABK were related to HTN and OB, respectively. According to the findings, we can infer that an increase in DABK production in those with the cardiovascular disease risk factors of diabetes, obesity, and hypertension or a decrease in ang-(1-7) in those with hypertension may contribute to the adverse outcomes of SARS-CoV-2 infection.

Evaluation of carotid intima-media thickness and cardiovascular risk factors in benign prostatic hyperplasia patients

&lt;b&gt;Objective:&lt;/b&gt; To assess the carotid intima-media thickness and cardiovascular risk factors in patients with benign prostatic hyperplasia.&lt;br /&gt; &lt;b&gt;Material and methods:&lt;/b&gt; This was a prospective observational study conducted over two years in 100 patients who presented with benign prostatic hyperplasia (BPH). IPSS questionnaire was used to evaluate the symptomatology of BPH. Patients were examined for cardiovascular risk factors. All patients underwent echocardiographic examination for left ventricular function. A single experienced sonographer, blinded to all clinical information, assessed the common carotid artery.&amp;nbsp;&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The patients mean age was 69.32 years. The mean BMI was 28.91 kg/m². Of the total mild symptom score cases, 75 % (N=6) cases had Grade I prostatomegaly (26 – 40 cc). 98.38 % (N=61) cases had Grade II prostatomegaly (41 – 60 cc), 93.33 % (N=28) cases had Grade III prostatomegaly (&amp;gt;60cc). A mean carotid intima-media thickness (IMT) of 0.56 mm was found in cases having mild IPSS scores (Score 1-7), 0.73 mm was found in cases having moderate IPSS score (Score 8-19), 0.92 mm was found in cases having severe IPSS scores (Score 20-35). Significant association was present between mean BMI, diabetes mellitus, hypertension, hyperlipidemia, smoking and mean Carotid IMT with IPSS as p-value was &amp;lt;0.05. Significant association was present between total cholesterol, HDL, LDL and prostate volume with p-value &amp;lt;0.0001.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; This study found that prostatic tissue had a strong relationship with carotid IMT and cardiovascular risk factors in BPH patients. These data suggest a possible link between carotid IMT and cardiovascular risk factors and BPH.