Male Coronary Artery Disease Patients Research Articles

Effectiveness of health education and counseling on stages of change, decisional balance, and smoking cessation self-efficacy: A prospective self-control study

ObjectiveTo examine the effectiveness of health education and counseling on the stages of change, decisional balance, and smoking cessations elf-efficacy in smokers with no intention of quitting. MethodsA prospective self-controlled design was conducted between December 2020 and December 2022. The research period was divided into a control stage (first to fourth weeks) and an experimental stage (fifth to eighth weeks). Patients with coronary artery disease (CAD) and habitually smoked were recruited. Pearson correlation and a one-factor repeated-measurement analysis were performed to assess the effectiveness of the intervention. ResultsIn total, 108 male CAD patients with a mean age of 58.1 years were recruited. After 4 weeks of the intervention, 55 (51%) exhibited behavior change (X 2 = 18.03, p = .001). The decisional balance and smoking cessation self-efficacy scores significantly improved in the experimental stage. No significant differences were observed in the control stage. ConclusionsFour weeks of health education and counseling could effectively improve participants’ stage of change, decisional balance, and smoking cessation self-efficacy. Practice implicationHealthcare professionals can play key roles in helping CAD patients successfully quit smoking through individual education and counseling.

Anti-Lipoprotein Lipase Antibody as a Useful Marker for Plaque Vulnerability in Patients with Stable Angina.

Identifying patients with vulnerable plaque who have poor prognosis among those with coronary artery disease (CAD) is crucial to deciding future therapeutic interventions. We previously reported that male CAD patients with low anti-apolipoprotein B-100 autoantibody (anti-apoB-100 Ab) levels were at an increased risk of developing unstable plaque lesions. This study focused on the autoantibodies against lipoprotein lipase (LPL), a key enzyme in triglyceride metabolism, which is another risk factor for atherosclerosis, and investigated their association with plaque characteristics. We measured serum anti-LPL Ab levels using a homemade enzyme-linked immunosorbent assay in 80 male CAD patients. Coronary plaque properties were evaluated using iMAP®-intravascular ultrasound. Serum anti-LPL Ab levels were not correlated with plaque burden but were significantly negatively and positively correlated with fibrotic and necrotic plaques, respectively. High-risk patients with low anti-apoB-100 Ab levels were divided into groups according to their anti-LPL Ab levels. The group with high anti-LPL Ab levels exhibited more necrotic plaques and fewer fibrotic plaques as well as higher remnant-like lipoprotein particle levels than the group with low anti-LPL Ab levels. Serum anti-LPL Ab levels can serve as a marker of plaque instability in CAD patients and can help identify higher-risk cases when combined with anti-apoB-100 Ab levels.

Circulatory soluble LOX-1 is a novel predictor for coronary artery disease patients.

This study investigated the biomarker effect of soluble lectin-like oxidised low-density lipoprotein (sLOX-1) levels for the evaluation of stable and unstable coronary heart disease, correlating it with aging. This case-control study was conducted at the Cardiology Department of Xiangya Hospital between June 2015 and September 2018. Stable coronary artery disease (CAD) patients were confirmed by an invasive coronary angiogram, and American College of Cardiology as well as European Cardiology Society clinical protocols were used for the diagnosis of unstable CAD subjects. Plasma sLOX-1 levels were determined from 226 stable CAD patients, 138 unstable CAD subjects and 75 healthy participants by enzyme-linked immunosorbent assay. Plasma sLOX-1 expressions were significantly elevated in stable CAD patients (4.5-fold) and unstable CAD patients (5.8-fold) above that of volunteer healthy participants. Moreover, between the stable and unstable patient groups, sLOX-1 concentrations were also statistically significantly different (p < 0.001). Levels of plasma sLOX-1 in the healthy female (30-60 years), and stable and unstable CAD female subjects (61-84 years) were markedly elevated compared with healthy male (30-60 years), as well as stable and unstable CAD male patients (61-84 years) (p < 0.001). Besides, in the female unstable CAD (61-84 years) subjects, circulatory sLOX-1 expressions were much higher than in the younger female unstable CAD (30-60 years) patients (p < 0.001). The stable CAD patients were clearly differentiated from healthy subjects with a high sensitivity of the area under the curve (AUC = 0.895). Unstable CAD patients and healthy subjects were also markedly different with a high sensitivity, as shown by AUC (0.902). Stable and unstable CAD subjects were differentiated with an AUC of 0.867. Elevated plasma sLOX-1 levels could be regarded as a novel biomarker for detecting CAD patients and there was a significant association with gender and aging.

Depression is a predictor for both smoking and quitting intentions among male coronary artery disease patients

Coronary artery disease (CAD) is the third most prominent cause of death globally, and smoking is the most common risk factors for CAD. However, few studies have examined both smoking and smoking cessation intentions in patients with CAD. The study aims to explore the predictors for smoking and quitting intentions among male CAD patients. This was a cross-sectional study. A total of 368 male CAD patients were recruited and classified into never smoked, quit smoking, and continuing to smoke three groups. Demographic information, level of nicotine dependence, carbon monoxide concentration, depression, and resilience were analyzed by using t-test, one- way analysis of variance (ANOVA), and least significant difference (LSD) post-hoc test and the multiple logistic regression analysis. The results revealed that among participants, 23.1% had never smoked, 40.5% had quit smoking, and 36.4% continued to smoke. Multiple logistic regression analysis revealed that age (OR=0.95, 95% CI=0.90–0.99), carbon monoxide (OR=1.74, 95% CI=1.51–2.01), and depression (OR=1.13, 95% CI=1.04–1.23) predicted participants who continued to smoke. Among the 134 participants who continued to smoke, 35.8% exhibited no intention to quit, and 64.2% planned to quit. Nicotine dependence (OR=0.79, 95% CI=0.66–0.94) and depression (OR=1.10, 95% CI=1.02–1.20) were significant predictors in participants who intended to quit smoking. The study demonstrates that depression is a significant predictor for both smoking and quitting intentions among male CAD patients.

Whether exercises and testosterone replacement therapy support a treatment for cardiovascular and atherosclerotic patients with iliac artery stenosis and low total testosterone and high-density lipoprotein cholesterol after endovascular procedure?

Serum levels of testosterone (ST) and high-density lipoprotein (HDL) are generally associated with atherosclerosis in male patients over 50 years with critic iliac stenosis (TASC II A and B) and cardiovascular disease with significant changes in HDL and low-density lipoprotein (LDL). In addition to the standard therapy, combined medicamentous therapy and adequate model of exercise are also important factors as medicines can improve HDL levels and primary bypass and endovascular potency impacting positively on improvement of ST or it can be the following testosterone replacement therapy (TRT) comprising cardiovascular disease prevention and vascular treatment as adjunct therapy options after endovascular and vascular surgical procedures. The aim of the study is to identify the association between HDL and ST after surgical and endovascular intervention on the iliac segment (TASCII A and B), as well as cardiovascular risk factors with modified medium activity (MET) &lt;6 with short interval increase over &gt;6 (MET), with total duration of 30–60 minutes. It also attempts to remodel a patient behavioral pattern, optimize ST levels and link them to outcomes and patency of vascular procedures on the iliac segment. Materials and methods. 108 selected male patients with cardiovascular disease combined with metabolic syndrome and critical iliac artery stenosis (TASC II A and B) were examined during 2014–2018, 4 years after invasive and minimal invasive treatment (54 patients were treated with surgical Dacron reconstruction and 54 patients – with endovascular treatment on short segment of critical iliac artery stenosis (TASC II A and B). Results. In the total population, no difference was observed in changes of constraint-induced movement therapy between the standard exercise group and the control one after 4 years from baseline. However, there was no significant interaction between the effect of exercise trainings and primary bypass potency within 4 years. Conclusions. Primary effects of endovascular procedure and Dacron bypass revascularization raise the risk of elevated testosterone levels after 4 years of group training but does not provide adequate answers to questions as to whether higher levels of ST have any major influence on primary bypass potency preventing further progression of cardiovascular disease and general symptomatic and asymptomatic atherosclerosis. However, exercise and TRT can be potential adjunctive therapeutic options for a future supporting postsurgical and endovascular illiac treatment in cardiovascular patients with low testosterone levels.

Abstract 10918: Sex Differences in the Association of Triglyceride Glucose Index in Patients With Obstructive Coronary Artery Disease

Background: Insulin resistance is associated with cardiovascular disease due to direct or associated risk factors. We aimed to investigate the association of the Triglyceride glucose (TyG) index, as the surrogate marker of insulin resistance and obstructive coronary artery disease (CAD) between sex, especially for patients without diabetes. Methods: Patients with stable angina pectoris requiring invasive coronary angiography were enrolled, and they were divided into two groups according to the TyG index (ln[triglyceride x fasting plasma glucose]/2). Obstructive CAD was defined according to invasive coronary angiography results. Results: Patients with a higher TyG index (TyG index≧8.60) were associated with higher BMI, the prevalence of hypertension (HTN), diabetes mellitus (DM), and abnormal lipid profile compared with lower TyG index (TyG index &lt; 8.60). In women without diabetes, higher TyG index patients had a greater prevalence of obstructive CAD than the lower TyG index group (19.5% vs. 37.7%, p-value: 0.011). There was no difference in the majority of obstructive CAD in male patients between lower and higher TyG index. In multivariate logistic regression analysis, a higher TyG index remained the independent association of obstructive CAD only in women without diabetes (adjusted odds ratio (OR): 2.568, 95% CI: 1.238-5.327, p= 0.011) but not in the DM group. Conclusion: Higher TyG index, a marker of insulin resistance, was significantly related to a higher risk of obstructive CAD with gender disparity in patients without diabetes. Further larger-scale studies are needed to confirm our findings.

Differential Expression of Cardiac Fat Long Non‐Coding RNAs in Coronary Artery Disease

Coronary artery disease (CAD) is characterized by the buildup of atherosclerotic plaques within the coronary arteries, leading to serious complications. CAD affects 7.2% and 4.2% of males and females, respectively. Epicardial adipose tissue (EAT) interacts with the heart and vasculature, but its mechanistic role in CAD is not completely understood. A more comprehensive view of non‐coding RNA (ncRNA) expression in EAT is needed to better characterize its role in CAD. To conduct this characterization, in an IRB‐approved investigation, we isolated the microRNA (miRNA), long non‐coding RNA (lncRNA), and messenger RNA (mRNA) from the EAT and subcutaneous adipose tissue (SAT) of male and female CAD patients undergoing coronary artery bypass graft as well as from non‐CAD patients undergoing aortic valve replacement. Differential expression of these RNAs between tissues, disease status, and sex was determined using next generation sequencing (mRNA) and microarrays (miRNA and lncRNA). Functional and pathological associations of the differentially expressed RNAs were determined using Ingenuity Pathway Analysis, GO, KEGG, and TAM 2.0. DIANA‐LncBase was used to identify experimentally verified miRNA‐lncRNA interactions. NGS showed differential expression of mRNAs associated with cardiovascular function in EAT but not in SAT. miRNA microarray showed that ncRNA expression within the EAT of CAD patients is distinct from its expression in non‐CAD patients. 14 miRNAs were differentially expressed in EAT from patients with CAD compared to those without CAD. Similarly, lncRNA RT2 PCR array showed a downregulation of three lncRNAs: IPW, TINCR, and linc00853, between the EAT of CAD compared to non‐CAD male patients but not in the EAT of female patients. DIANA‐LncBase showed high confidence pairings of IPW with three miRNAs that were upregulated in the EAT of patients with CAD: hsa‐miR‐24‐3p, hsa‐miR‐26b‐5p, and hsa‐29c‐3p. This suggests that IPW may serve as a ‘sponge’ for these three miRNAs in the EAT of patients without CAD, but its downregulation in CAD reduces that interaction. TAM 2.0 showed these three miRNAs to be associated with functional pathways such as vascular inflammation, apoptosis, adipogenesis, etc. Overall, these findings both reveal potential ncRNA biomarkers for CAD and elucidates possible pathological roles of EAT in CAD mediated by ncRNAs.

Sex Difference in the Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease.

The neutrophil to lymphocyte ratio (NLR) is a predictor of cardiovascular risk. However, little was known about the influence of sex in this relationship. The present study was designed to evaluate the association between NLR and coronary artery disease (CAD) risk and severity in males and females. A total of 810 patients (478 males and 332 females) who had undergone coronary angiography at the Beijing Chaoyang Hospital were enrolled. CAD severity was evaluated using the Gensini and SYNTAX scores. For males, the NLR was higher in CAD patients than that in non-CAD patients (all P < .001). But there was no significant difference in NLR between female CAD and non-CAD patients (P = .222). The NLR correlated with the Gensini and SYNTAX scores in male CAD patients (both P < .001), but this correlation was not found in female counterparts (both P > .10). Logistic regression analyses and receiver operator characteristic curve (ROC) analyses showed that the NLR was an independent risk factor and a predictor of CAD in males (both P < .01) but not in females (both P > .10). In conclusion, the NLR was closely related to the presence and severity of CAD in males but not in females.

Prevalence of coronary artery disease and its associated risk factors in Aljouf region of Saudi Arabia

Objective:Toevaluate the prevalence of coronary artery disease (CAD) with its associated risk factors among Saudi population in Aljouf, Sakaka, Saudi Arabia. Methods: This is a retrospective hospital based study conducted at King Abdul Aziz specialized hospital Sakaka Aljouf, Saudi Arabia by selecting participants with diagnosed CAD by coronary angiogram, the meanage 55.1 ± 10.8 yrs ( range 35-75-years)over a period ofJanuary 2019to December 2019. Demographic characteristics included age, sex,diabetes, hypertension, smoking and family history of CAD. Laboratory data included such as total cholesterol, triglyceride, LDL and HDL levels. Collected data were analyzed by using SPSS 20.00software. Results: One hundred two participants, out of eight hundred fifty five were diagnosed CADwhich included 64.7% stable angina and 35.2% unstable angina. The total prevalence of CAD obtained from this study was11.9% among male and female was7.89% and 4.621% respectively (P&lt;0.0001). Diabetes (85.7%) and dyslipidemia 94.2%weremost important risk factors in female compared to male 59.1% and 62.2% respectively, while hypertension 82% higher in male than female 51.4 % considers as a significant (p&lt;0.001). Smoking considered as an individual risk factor of 94% for male coronary artery disease patients. Conclusion:The prevalence of CAD was higher in male 7.89 % than female 4.21% and its associated risk factors including hypertension and cigarette smoking. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 201-205

Frequency of antiplatelet therapy in coronary artery disease. Data from the disease management programme CAD

Abstract Background Physicians always aim to improve their patients' health and consequently also improve community health. Continued medical education (CME) should be designed to support this goal and thus not only provide knowledge transfer, but also influence clinical decision-making and close performance gaps. However, the relative weight of CME in this process needs to be determined. Purpose Main purpose of the study was to analyse APT prescription rates and differences between subgroups of patients in a disease management programme (DMP) for coronary artery disease (CAD). Methods In a retrospective study we analysed prescription rates for APT in 254,932 CAD patients (male: 64.4%), treated in a total of 3,405 practices in 2019 in a DMP in the region of North Rhine, Germany, to delineate the potential for change by CME to further improve community health. Analyses were run for the whole study population stratified by sex as well as for subgroups of patients suffering from myocardial infarction / acute coronary syndrome (MI/ACS), or who have been treated with percutaneous coronary intervention (PCI) or bypass surgery. Subgroup differences were analysed in a logistic regression model. Results Patients mean age was 72.7±11.2 years (mean ± 1SD), mean duration of DMP participation was 7.2±4.7 years and mean cumulative number of DMP visits was 27±17. APT prescription rates were 85.0% in male and 78.8% in female CAD patients. In subgroups of male CAD patients APT prescription rates were between 89.7% and 92.8%, in the same subgroups of female CAD patients the corresponding rates were between 87.8% and 92.0%. Rates for a missing APT prescription per practice were between 0.0044% and 0.0062% for male and female CAD patients respectively. Rates for a missing APT prescription per practice and DMP visit were 0.0002% for both sexes. In a multivariate model significant positive predictors of APT prescription were male sex (OR=1.37, 95% CI: 1.34–1.40), age ≥76 yrs (OR=1.11, 95% CI: 1.08–1.14), participation in DMP ≥4 and &amp;lt;10 yrs (OR=1.19, 95% CI: 1.16–1.22), MI/ACS (OR=1.14, 95% CI: 1.08–1.20), PCI (OR=1.97, 95% CI: 1.88–2.06) and bypass surgery (OR=1.14, 95% CI: 1.08–1.21). Conclusion Our study demonstrates that a multifaceted intervention, like a DMP, can achieve high attainment rates for APT in CAD. To describe the benchmark for CME to further improve attainment rates, consideration of absolute numbers of eligible patients per practice or physician is probably more appropriate than expression of performance as percentage values. This is especially true if attainment rates show substantial variations between subgroups, if subgroups show substantial variation in size, if attainment rates are already in the order of magnitude of 80% or higher, and if there are disparities in the evidence base underlying treatment recommendations related to subgroups. Funding Acknowledgement Type of funding sources: None.

Gender Differences in the Relationship of Waist Circumference to Coronary Artery Lesions and One-Year Re-Admission Among Coronary Artery Disease Patients with Normal Body Mass Index.

PurposeThe study explored the association of waist circumference (WC) with the severity of cardiovascular diseases and hospital readmission of coronary artery disease (CAD) patients with normal body mass index (BMI).Patients and Methods213 female and 431 male normal-BMI CAD patients were enrolled and assigned in three groups based on their gender-specific WC tertiles. Their cardiovascular risk factors and coronary angiography characteristics were analyzed in a cross-sectional study, and the gender-specific relationship between WC and one-year re-admission rate was prospectively explored.ResultsThe cross-sectional analysis showed that for male normal-BMI CAD patients, diabetes and dyslipidemia prevalence, Apo B/A1, hs-CRP, and uric acid levels triglycerides-glucose index, the incidence of left main disease, three vessel disease, calcification lesion, total occlusive lesion, and complex lesion, as well as Gensini score was in the order of WC tertile 3 > WC tertile 2 > WC tertile 1. In addition, male normal-BMI CAD patients in the highest WC tertile were at an increased risk of severe CAD (OR=2.21), and the correlation was still statistically significant even after adjusting for potential cardiovascular risk factors (OR=1.87). For female normal-BMI CAD patients, as the WC tertiles increased, uric acid level, the prevalence of three vessel disease, diffuse lesion, and complex lesion gradually increased (P <0.05), but no significant difference was found in the risk of severe CAD among different WC groups (all P >0.05). Prospective analyses showed that the higher the WC tertile was, the higher the one-year re-admission rate in men, but not in women, and after adjusting for other risk factors, men with the highest WC tertile showed more than twice the risk of patients with the lowest WC tertile.ConclusionMale but not female, normal-BMI CAD patients with increased WC had more severe CAD and a higher risk of one-year re-admission rate.

Priors comparison in Bayesian Models of risk factor of Malaysian coronary artery disease male patients

Coronary artery disease (CAD) continues to be one of the leading causes of morbidity and mortality globally. Of particular relevance for this issue is that major efforts should be focused on understanding the risk factor involved. In this study, three types of Bayesian models, each with different prior distribution were considered to identify associated risk factors in CAD among Malaysian male patients presenting with ST-Elevation Myocardial Infarction (STEMI) and to obtain a feasible model to fit the data. The results of the three models were compared to find the best model. A total of 7180 STEMI male patients from the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate and multivariate analyses for the three models were performed using one of the Bayesian Markov Chain Monte Carlo (MCMC) simulation approach known as Gibbs sampling. Models’ performances are evaluated through overall model fit. Bayesian model C which used both Beta and Dirichlet prior distributions, consisted of six significant variables namely diabetes mellitus, family history of cardiovascular disease, chronic lung disease, renal disease, Killip class and age group was considered as the best model. The same set of variables that were observed to be significant in the Bayesian model C was also found to be significant in models A and B which used single prior distribution, respectively. Model C has a better fit than models A and B as the deviance value produced was the smallest. This study showed that posterior estimation was mostly influenced by the existing prior knowledge. Though applying the non-informative prior which were both Beta and Dirichlet distribution priors, model C can minimise uncertainty in making effective clinical decisions and provides better parameters estimates of the posterior distribution.

The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease.

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes.Method:The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment.Results:HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly.Conclusions:As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.

Sarcopenia is associated with severe coronary atherosclerosis in male patients with coronary artery disease

Aim. To investigate the association between coronary atherosclerosis and sarcopenia in male patients with coronary artery disease (CAD). Material and Methods. We enrolled 79 male patients with CAD verified by coronary angiography (median age 63 (57; 66) years). Patients were stratified according to the severity of coronary atherosclerosis: 1) 1 or 2 affected coronary arteries; 2) 3 affected coronary arteries; 3) lesions in the left main coronary artery (LMCA), with or without other coronary arteries involved. Sarcopenia was diagnosed according to the recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP) which include examination examining of muscle strength, mass and function. Patients were also divided into those without sarcopenia (n = 31), those with presarcopenia (n = 21), and those with sarcopenia (n = 27). Results. Severity of coronary atherosclerosis inversely correlated with the musculoskeletal index (r = - 0.227, p = 0.047). A higher prevalence of LMCA lesions was noted in patients with sarcopenia compared with those with presarcopenia or without sarcopenia (29.6% vs. 20.0% vs. 13.3%, respectively). Severe CAD (3 affected coronary arteries or LMCA lesions was associated with a reduction in the musculoskeletal index with sensitivity of 68.1% and specificity of 56.7% (area under the curve = 0.634; 95% CI: 0.515-0.741; p = 0.028; Youden's index 0.248). Conclusion. Sarcopenia is associated with increased severity of CAD.

Investigation of metabolic effects of CETP gene rs289714 variation in coronary artery patients: A case-control study

The aim of this study was to investigate the effects of the CETP gene rs289714 polymorphism on the serum lipid profile and other metabolic parameters in Turkish patients with coronary artery disease (CAD). The CETP rs289714 variant was examined in 104 patients with CAD and 77 controls using the polymerase chain reaction-restriction fragment length polymorphism method. The CETP rs289714 genotype and allele distribution was not statistically different between the groups (p>0.05). The body mass index (BMI) values in men with CAD were higher in patients with the G allele compared with those carrying the AA genotype (p=0.05). Logistic regression analysis showed that the G allele in male CAD patients was a risk factor for a BMI of ≥ 27 kg/m2 (odds ratio: 0.269, 95% confidence interval: 0.075–0.966; p=0.044). The G allele in female patients was associated with lower HDL-C levels than the AA genotype (p=0.049). The results suggest that the CETP rs289714 polymorphism may cause risk for the development of CAD due to its effects on high-density lipoprotein cholesterol values in female patients and BMI in male patients.

P2501Validation of FRIEND and ACSM equations for cardiorespiratory fitness: comparison to direct measurement in male CAD patients

Abstract Introduction Cardiorespiratory fitness (CRF) is associated with a high risk of cardiovascular disease and all-cause mortality. The regression equation of American College of Sports Medicine (ACSM) was a preferred method for estimating maximal oxygen consumption (VO2max). It is well-known that CRF is overestimated in ACSM equation. Recently, Kokkinos reported more precise equation from the Fitness Registry and the Importance of Exercise National Database (FRIEND). Both equations were made from western healthy people. Purpose In this study, we compared VO2max estimated by ACSM and FRIEND equations to VO2max directly measured in male coronary artery disease (CAD) patients. Methods We analyzed 103 male CAD patients who underwent percutaneous coronary intervention and who participated in cardiac rehabilitation between June 2015 and December 2018. VO2max was directly measured by the gas exchange analysis during treadmill test with modified Bruce protocol. Exclusive criteria were pulmonary disease, chronic kidney disease on hemodialysis, malignancy, peripheral artery disease, insufficient cardiopulmonary exercise test and orthopedic injuries. Directly measured VO2max were compared to ACSM and FRIEND equations. Results Age-specific VO2max values, which were directly measured from male CAD patients, were shown in Table. Smaller CRF difference was shown in FRIEND equation than ACSM equation. Compared to the measured value, CRF estimated by ACSM equation was overestimated by 22%, but the one estimated by FRIEND equation had only 2% gap. Figure presents Bland-Altman plots. ACSM equation had the higher bias (5.52ml/kg/min) compared with FRIEND equation (0.200ml/kg/min). Comparison table of VO2max estimated by ACSM and FRIEND equations with directly measured VO2max in male CAD patients Age Number VO2max (ml/kg/min) Measured ACSM % predicted FRIEND % predicted 30–39 4 29.5 ± (6.6) 35.7 ± (6.1) 122.3 ± (8.5) 29.1 ± (4.3) 100.1 ± (8.7) 40–49 20 29.1 ± (5.1) 35.7 ± (5.4) 123.6 ± (11.1) 29.1 ± (3.8) 101.2 ± (9.5) 50–59 32 25.6 ± (4.3) 31.5 ± (5.1) 123.8 ± (10.1) 26.2 ± (3.6) 103.2 ± (8.5) 60–69 27 26.0 ± (5.1) 31.1 ± (2.6) 120.5 ± (12.6) 25.9 ± (4.0) 100.8 ± (10.5) 70–79 18 21.2 ± (6.0) 26.8 ± (5.4) 123.2 ± (14.8) 22.8 ± (3.9) 105.2 ± (12.0) &gt;80 2 25.0 ± (10.1) 22.8 ± (2.6) 97 ± (28.9) 19.9 ± (1.9) 85.1 ± (27.0) Total 103 25.7 ± (5.6) 31.4 ± (6.0) 122.2 ± (12.4) 26.1 ± (4.3) 102.1 ± (10.4) Data are presented as mean ± (standard deviation). Bland-Altman plots Conclusions FRIEND equation can estimate CRF more accurately than ACSM equation, even in Asian patients with CAD.

Increased Risk of Carotid Atherosclerosis in Male Patients with Chronic Periodontitis: A Nationwide Population-Based Retrospective Cohort Study.

Carotid artery stenosis is a narrowing or constriction of any part of the carotid arteries, usually caused by atherosclerosis. However, no studies have specifically evaluated the association between carotid atherosclerosis (CA) and chronic periodontitis (CP). This study was to investigate the role of CP in increasing the subsequent risk of CA in the overall Taiwanese population. We carried out this retrospective cohort study, employing data derived from the National Health Insurance Research Database. A total of 72,630 patients who were newly diagnosed with CP from 2001 to 2012 were selected. For a propensity-matched control group, 72,630 healthy patients without CP were picked at random, matched according to age, sex, and index year from the general population. Cox proportional hazard regression analysis, which included sex, age, and comorbidities, was adopted to assess the hazard ratio (HR) of CA between the CP cohort and non-CP cohort. The average ages of the CP and non-CP groups were 44.02 ± 14.63 years and 44.15 ± 14.41 years, respectively. The follow up durations were 8.65 and 8.59 years for CP and non-CP groups, respectively. The results demonstrated that 305 and 284 patients with newly diagnosed CA were found in the CP cohort and non-CP cohort, respectively. There was no significant difference of developing CA in the CP cohort compared with the non-CP cohort (adjusted HR) 1.01, 95% confidence interval (CI, 0.86–1.19). However, multivariate Cox regression analysis indicated that the male group had significantly higher incidence risk of CA (log rank p = 0.046). In conclusion, this nationwide retrospective cohort study indicated that male patients with CP exhibited a significantly higher risk of CA than those without CP.

Omega-3 fatty acids and vitamin E supplementation can affect gene expressions of SIRT1, FOXO1 and UCP-2 in coronary artery disease patients

AimsThis randomized controlled trial (RCT) study was carried out to assess effects of omega-3 supplementation alone and in combination with vitamin E on gene expressions of SIRT1, SIRT3, SIRT6, FOXO1, FOXO3 and UCP-2 in patients with coronary artery disease (CAD). MethodsParticipants of this RCT included 60 male CAD patients who classified into three study groups using block randomization, including 1) OE receiving omega-3 fatty acids (EPA: 720 mg, DHA: 480 mg) and vitamin E (400 IU); 2) OP receiving omega3 fatty acids (EPA: 720 mg, DHA: 480 mg) and vitamin E placebo; and 3) PP receiving omega-3 and vitamin E placebos for two months. ResultsIn compared to PP group, gene expression of SIRT1 increased significantly in OE group (P = 0.037) while this group experienced significant decrease in gene expression of UCP-2 (P = 0.035). The expression of FOXO1 increased significantly in both OE and OP groups in compared to PP group (P = 0.021 and P = 0.035, respectively). However, gene expressions of SIRT3, SIRT6 and FOXO3 were not different between study groups. ConclusionThe current study has shown that omega-3 fatty acids and vitamin E supplementation can increase gene expressions of SIRT1, FOXO1 while it can decrease gene expression of UCP-2 in CAD patients.

Assessment of lipid per-oxidation and endothelial dysfunction in patients of coronary artery disease

Assessment of lipid per-oxidation and endothelial dysfunction in patients of coronary artery disease - IJCBR- Print ISSN No: - 2394-6369 Online ISSN No:- 2394-6377 Article DOI No:- 10.18231/2394-6377.2019.0003, International Journal of Clinical Biochemistry and Research-Int J Clin Biochem Res

Energy expenditure during an exercise training session for cardiac patients.

Increasing energy expenditure (EE) in cardiac patients remains a challenge. Exercise approaches in cardiac rehabilitation/secondary prevention programs (CR/SP) have consistently resulted in minimal weight loss, due in part to the low exercise-related EE. The purpose of this study was to measure the EE among patients participating in a routine exercise session of Phase III maintenance CR/SP, where a recreational activity was introduced. Twelve overweight/obese male patients with coronary artery disease (aged 62.6 ± 8.5 years) had their total EE measured during a combined aerobic (circuit workout (ACW) and recreational activity) and resistance training (RT) session using a portable gas analyzer. Subjects were instructed to exercise at 60%-70% of heart rate reserve. Activity EE was calculated from total EE and resting EE. The duration of the session was 75.3 ± 1.5 min, of which 59.7 ± 8.8 min were above moderate intensity (3-6 METs). Activity EE was 309 ± 76 kcal, concurring to a total EE of 457 ± 80 kcal (3.9 ± 0.8 METs-h). ACW, recreational activity, and RT fulfilled 34.4% ± 6.4%, 25.0% ± 5.3%, and 14.2% ± 2.7% of the activity EE, respectively. Absolute intensities (METs) were significantly different between the RT (3.9 ± 1.0) and the ACW (6.9 ± 1.8) and recreational activity (5.9 ± 0.8). In conclusion, a combined aerobic and resistance training following standard exercise prescription practices, coupled with a recreational activity, is an effective tool to promote exercise above moderate intensity in male coronary artery disease patients. Clinicians can adopt concepts from recreational activity to develop CR/SP sessions.