Cardiovascular Risk Factors Research Articles

Coronary artery calcium and atherosclerotic cardiovascular disease risk scores in patients with calcium pyrophosphate deposition disease.

Calcium pyrophosphate deposition (CPPD) disease is associated with an increased risk for cardiovascular (CV) events. We examined the atherosclerotic burden by coronary artery calcium scores (Agatston score) and compared 10-year atherosclerotic CV (ASCVD) risk scores in patients with vs without chondrocalcinosis, a radiographic marker of CPPD. We performed a cross-sectional analysis at an academic medical center, 1991-2022. Among all patients with an Agatston score in routine care, we defined a cohort with chondrocalcinosis detected before the coronary artery calcium scan. Comparators without chondrocalcinosis were matched 2:1 on age and sex-the primary analysis excluded statin users. We compared Agatston scores between the chondrocalcinosis cohort and comparators. We also tested for differences between cohorts in 10-year ASCVD risk score frequencies (low, borderline/intermediate, or high). 756 patients with chondrocalcinosis were matched to 1554 comparators (mean age 68 years, 53% female). CV risk factor burden was high in both cohorts, and statin use was infrequent. The unadjusted Agatston score was non-significantly higher in the chondrocalcinosis cohort (mean 359.1, SD 737.9) than in matched comparators (mean 297.1, SD 644.9) (p= 0.08). High 10-year ASCVD risk scores were significantly more common in the chondrocalcinosis cohort than comparators (p< 0.01). Coronary atherosclerosis burden by CAC was not significantly different between patients with chondrocalcinosis and matched comparators, though 10-year ASCVD risk scores were higher in the chondrocalcinosis cohort, suggesting that factors beyond coronary artery calcification contribute to the increased CV event rate in patients with CPPD disease.

Analysis of Right Ventricular Strain in Heart Failure with Preserved Ejection Fraction

Introduction: The complexity of the geometry and the unique architecture of the right ventricular (RV) myocardial fibers make the study of its function a significant challenge. However, the advent of new imaging techniques, such as RV strain imaging, has improved our understanding of its function. The aim of our study is to specify the principles of studying right ventricular deformation and its impact on the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). Materials and Methods: This is a two-year prospective study comparing echocardiographic parameters of right ventricular function in 87 patients followed in our unit for HFpEF at the Cardiology Department of ERRAZI Hospital, CHU Mohammed VI, Marrakech. Results: Over the past two years, our unit has hosted 87 patients diagnosed with HFpEF. The average age was 68 years and 5 months, with a female predominance. The most common cardiovascular risk factors were hypertension and obesity (BMI &gt; 30). Symptomatic presentations were dominated by exertional dyspnea, observed in 84% of cases, with resting dyspnea and cough affecting about half of the patients. Signs of left heart failure, such as crackling rales, were present in 44% of patients, while signs of right heart failure, such as lower limb edema, were noted in 41%, with jugular distension and hepatojugular reflux in 19%. Echocardiography revealed left ventricular hypertrophy in 57% of patients and left atrial dilatation in 65%. Right ventricular function was markedly impaired, with significant abnormalities in TAPSE (Tricuspid Annular Plane Systolic Excursion), S' wave, and Tei index values, highlighting a marked correlation between the Tei index and the deformation of the right ventricular lateral wall. Rehospitalization for heart failure occurred in 40.2% of the cohort, emphasizing the severe clinical implications of right ventricular dysfunction in this patient population. Discussion and Conclusion: RV strain in HFpEF is an analysis that has not yet revealed all its intricacies. This study demonstrates that there is an alteration in RV strain in patients with HFpEF, which has a prognostic impact on mortality and rehospitalization for cardiac decompensation. This suggests that this parameter should be integrated into routine evaluations of RV systolic function.

Intravenous thrombolysis in young adults with ischemic stroke: A cohort study from the international TRISP collaboration.

Previous observational data indicate that young adults treated with intravenous thrombolysis (IVT) for acute ischemic stroke have more favorable outcomes and less complications when compared to older adults. Given the limited data on this topic, we aimed to provide more evidence on clinical outcomes and safety in such patients, using a large international thrombolysis registry. In this prospective multicenter study, we used data from the Thrombolysis in Ischemic Stroke Patients (TRISP) registry from 1998 to 2020. Patients who received endovascular treatment (EVT), as only treatment or in addition to IVT, were not included in this cohort. Using multivariable regression models, we compared thrombolysed young patients aged 18-49 years with those aged ⩾50 years with regards to the following outcomes: favorable outcome in stroke survivors (modified Rankin Scale ⩽2), symptomatic intracranial hemorrhage (sICH) according to European Cooperative Acute Stroke Study II (ECASS II) criteria, and three-months all-cause death. Of the 16,651 IVT treated patients, 1346 (8.1%) were 18-49 years. Young adults in TRISP were more often male (59.6% vs 54.0%), had a lower median NIHSS score on admission, 7 (4-13) versus 8 (5-15), and had less cardiovascular risk factors except for smoking (42.0% vs 19.0%) when compared to older patients. When compared to thrombolysed patients aged ⩾50 years, a favorable functional outcome was more likely in young adults: 81.9% versus 56.4%, aOR 2.30 (1.80-2.95), whilst sICH 1.6% versus 4.6%, aOR 0.45 (0.23-0.90) and death 2.3% versus 14.2%, aOR 0.21 (0.11-0.39) were less likely. Intravenous thrombolysis in young adults is independently associated with higher rates of favorable outcomes and lower rates of complications.

Sex differences in the intention and decision to use emergency medical services for acute coronary syndrome in Australia: a retrospective study

BackgroundSex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment...

The association of snoring, growth, and metabolic risk factors at the age of two years

Background and aimsThis observational study examined the association of snoring and growth during early childhood and the cardiovascular and metabolic risk factors based on blood samples at the age of two years.Methods and resultsThe sample comprised 78 children from the CHILD-SLEEP birth cohort with full-night polysomnography (PSG) and a questionnaire consisting of parts concerning the child's sleep and environmental factors at 24 months. The growth charts were collected from well-baby clinics. Metabolic blood samples were drawn from 31 children.There were no statistically significant differences in the growth parameters of snoring children compared to controls during the first two years of life. However, in linear regression models, snoring time in PSG significantly predicted lower levels of HDL (β = -0.484, p = 0.007) and ApoA1 (β = -0.451, p = 0.049) and higher levels of hs-CRP (β = 0.410, p = 0.019).ConclusionIn conclusion, in Finnish children the levels of HDL and ApoA1 were inversely related to the snoring time in PSG. In addition, the snoring time in PSG significantly predicted higher levels of hs-CRP. These results suggest that snoring in early childhood could negatively alter the serum metabolic profile, adding to the risk of cardiovascular diseases in adulthood.

Independent Association of Individual Lipid Abnormalities with Cardiovascular All-cause Mortality: A Prospective Cohort Study.

Abnormalities in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are each associated with increased cardiovascular risk, after adjusting for non-lipid risk factors. However, whether and to what extent the association for each lipid measure is confounded by other lipid measures is less understood. This study aims to investigate the association of each lipid measure with cardiovascular and all-cause mortality while precluding the confounding caused by abnormalities in other lipid measures. The study utilized data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and ten cycles of continuous NHANES (1999-2018). The study cohort included 23,761 participants who were 20 years or older, not pregnant, not receiving lipid-lowering treatment, and had complete data on all four lipid measures and mortality status. Participants were categorized into seven subgroups based on their lipid profiles. Kaplan-Meier survival curves and Cox proportional hazards models were used to examine the association between lipid abnormalities and mortality. During a median follow-up of 140 months, 5,003 participants (14.1%) died, with 1,665 deaths (4.2%) attributable to cardiovascular causes. Compared with the reference group in which the four lipid measures were all normal, the subgroups with isolated high TC, two to three lipid abnormalities, and four lipid abnormalities were associated with increased risks for both cardiovascular and all-cause mortality in univariate analysis. However, only those with isolated high TC (for cardiovascular mortality, HR 1.52, 95% CI 1.13-2.06) and four lipid abnormalities (for all-cause mortality, HR 1.34, 95% CI 1.04-1.72) remained statistically significant after adjusting for non-lipid risk factors. Of note, compared with the reference group, the profile of non-lipid risk factors was apparently less favorable in the subgroup with two to three lipid abnormalities but similar (and some factors even more favorable) in the subgroup with isolated high TC. When the lipid measures were analyzed as continuous variables, a U-shaped relationship between HDL-C and mortality risk was observed for both cardiovascular and all-cause mortality, and very low LDL-C level was associated with increased mortality risk. No statistically significant association was found between TG levels and mortality risk. Isolated high TC, very low LDL-C, and concurrent abnormalities in all four lipid measures were associated with increased mortality risk, whereas isolated high TG was not. A U-shaped relationship may exist between HDL-C level and mortality. Overall, these findings underscore the need for integrated management of dyslipidemia that takes all four lipid measures as well as non-lipid cardiovascular risk factors into account, particularly for those with concurrent abnormalities in two or more lipid measures.

Acute Aortic Dissection Complicating Emergency Coronary Intervention for Hyperacute Stent Thrombosis

Introduction: Iatrogenic acute aortic dissection resulting from coronary interventions can have fatal consequences. Although it is an uncommon complication during percutaneous coronary interventions (PCI), it can arise from various factors. Our case report aims to address this rare presentation further, seeking to enhance preprocedural planning which can result in better outcomes. Case Report: We describe an intriguing case of an elderly female patient with multiple cardiovascular risk factors who came to our emergency department presenting with chest pain. Her Electrocardiogram revealed an inferior ST-elevation myocardial infarction (STEMI) for which she underwent successful primary PCI of the right coronary artery (RCA). Four days later, she had an infero-posterior STEMI, which necessitated immediate coronary angiography. Angiography revealed thrombosis of the stent placed earlier in the RCA. On attempting recanalization of the vessel, an acute aortic dissection was identified and was successfully managed by ostial stenting. Follow-up imaging showed no residual dissection, and the patient was found to be comfortable and stable post-procedure. Conclusion: We recommend optimizing blood pressure and performing rapid ostial stenting in these cases, irrespective of the dissection’s origin. This will facilitate effective sealing of the entry site and prevent further progression of the dissection. Our report highlights the favorable results achieved with immediate ostial stenting while discussing the conservative approach to managing such cases.

The Effects of High Protein Intake on Cardiovascular Risk Factors and Weight Loss in Low Caloric Diets in Obese Adults: A Systematic Review

Introduction: This systematic review has been undertaken in order to assess the effects of hypocaloric, high- protein diets on weight loss and cardiovascular risk factors such as serum lipid levels in metabolically healthy obese adults. The primary outcomes measured include changes in pre-and post- diet mean BMI, LDL-C, HDL-C, TAG, and TC levels. Methods: Four databases including: Embase, MEDLINE (via PubMed), Cochrane and Web of Science were searched with no restrictions on language or publication period. Clinicaltrials.gov was also searched in order to identify unpublished or on-going studies. Results: Three of four studies included in this systematic review noted a significantly greater loss in pre- and post- diet mean BMI levels in the hypocaloric, high-protein diet group as compared to hypocaloric, non-high protein diets (control). Whilst pre- and post-diet mean LDL-C, HDL-C, TAG, and TC levels did not differ significantly among hypocaloric, high-protein and control diet groups. Conclusion: Hypocaloric, high-protein diets had an unclear effect on blood-lipid levels as compared to control. Weight loss however was significantly greater in the hypocaloric, high-protein group as compared to other hypocaloric, non-high-protein diet groups.

Pre-interventional renal artery calcification and survival after transcatheter aortic valve implantation.

The prognostic significance of renal artery calcification (RAC) is unknown in patients with severe aortic stenosis (AS) eligible for transcatheter aortic valve implantation (TAVI). RAC can be assessed by computed tomography (CT) performed during pre-interventional planning for TAVI. This study aimed at investigating the utility of RAC for predicting survival after TAVI. In this longitudinal cohort study, RAC volume was measured by CT in 268 consecutive patients with severe AS undergoing TAVI. Association of RAC with mortality was assessed using Cox regression analysis. RAC was evaluated as a binary parameter and in a supplementary analysis as a logarithmically transformed continuous variable. Over a median follow-up time of 9.6 years, 237 (88.4%) patients died, with 174 (73.4%) deaths attributable to a cardiovascular cause. RAC was highly prevalent (N = 150 (86.2%)) among patients suffering cardiovascular death. Competing risk cumulative incidence curves revealed a higher occurrence of cardiovascular death in patients with RAC (P-value = 0.008), while this was not the case for non-cardiovascular death (P-value = 0.71). RAC was independently associated with cardiovascular death (HR 1.61 [95% CI: 1.01-2.57]; P = 0.047) after adjustment for age, sex, cardiovascular risk factors, impaired renal function, and aortic valve calcification. The presence or absence of RAC rather than its volume was important in all the analyses. RAC is a strong and independent predictor of cardiovascular death in patients with severe AS undergoing TAVI. Given its favourable properties for event prediction, RAC may be considered valuable for prognostic assessment of TAVI patients.

Causal association between cardiovascular risk factors and common skin diseases: A multivariate Mendelian randomization study.

Cardiovascular diseases and dermatological conditions are prevalent health issues worldwide. Previous studies have suggested that risk factors for cardiovascular diseases may be associated with the development of dermatological conditions. However, the causal association between these factors remain unclear. This study utilized data from genome-wide association studies and applied Mendelian randomization (MR) to explore the potential causal association between cardiovascular risk factors and common dermatological conditions. Genetic variants significantly associated with low-density lipoprotein cholesterol (LDL-C), serum uric acid, blood glucose, and hypertension were selected as instrumental variables. We employed inverse variance weighted, MR Egger, and weighted mode methods for analysis. Sensitivity analyses, including Cochran Q test, MR-Egger intercept test, MR-PRESSO global test, and leave-one-out analysis, were conducted to ensure the robustness of the results. The MR analysis indicated a positive association between LDL-C levels and the risk of psoriasis (odds ratio [OR] = 1.23, 95% confidence interval [CI]: 1.03-1.47, P = .02). Additionally, hypertension and serum uric acid levels were positively associated with the risk of dermatitis eczema (hypertension: OR = 2.77, 95% CI: 1.23-6.24, P = .01; serum uric acid: OR = 1.09, 95% CI: 1.01-1.06, P = .01). This study provides evidence of a potential causal association between LDL-C levels and psoriasis, as well as between hypertension and serum uric acid levels and dermatitis eczema. These findings highlight the potential importance of cardiovascular health management in the prevention and treatment of common dermatological conditions. Further research is needed to validate these results and explore the underlying biological mechanisms.

Research Progress on the Intervention Effects of Different Exercise Forms on Risk Factors for Obesity-Related Cardiovascular Diseases

Obesity has become a major global health issue and is an independent risk factor for several cardiovascular risks. Exercise, as a therapeutic method, is commonly used to improve cardiovascular health in obese populations. This paper reviews and analyzes the effects of five different exercise forms on risk factors for obesity-related cardiovascular diseases: Moderate-Intensity Continuous Training (MICT), High-Intensity Interval Training (HIIT), Sprint Interval Training (SIT), aerobic combined with resistance training, and Blood Flow Restriction Training (BFR). The aim is to explore the similarities and differences in health benefits among these exercise forms for individuals with obesity. The review finds that MICT is notably effective in reducing cardiovascular disease risk factors and promoting cardiovascular health in obese individuals. In contrast, high-intensity interval exercises such as HIIT and SIT show even more significant improvements in cardiovascular health. This difference may be attributed to varying biological effects caused by different intensity levels and intervals, though the specific mechanisms require further clarification. Since increased skeletal muscle can enhance basal metabolic rate and positively impact the cardiovascular system, resistance training is often recommended in combination with aerobic training for better results. Additionally, BFR can achieve similar training effects under lower exercise loads, providing a safer training option for obese individuals. Future research should focus on the mechanisms by which different exercise forms affect specific cardiovascular disease risk factors and how to optimize exercise programs based on individual differences to enhance personalization and scientific validity of interventions.

Incremental Cardiovascular Risk of Menopause in Women with Psoriasis, Psoriatic Arthritis or Spondyloarthritis?

This narrative review aims to discuss the most recent studies regarding the risk of cardiovascular disease (CVD) in women with psoriasis, psoriatic arthritis (PsA) and spondyloarthritis (SpA). In addition, the potential of menopause to modulate/increase CVD risk in women with these diseases will also be explored. It is of major interest to gain more understanding into this topic because it can have meaningful implications for screening and treatment of CVD risk in these women. Literature shows that psoriasis, PsA, SpA and menopause itself cause higher CVD risks and higher CVD prevalence. This is predominantly explained by the increase of chronic systemic inflammation. No existing literature conclusively demonstrates or studies specifically whether the menopause amplifies this effect caused by psoriasis, PsA, or SpA. Differences in pathophysiology of psoriasis, SpA and PsA versus the menopausal transition could suggest that menopause may increase the risk of CVD. However, the hypothesis that menopause represents an additional CV risk factor in women with psoriasis, PsA and SpA still needs to be thoroughly investigated and more clinical studies are required for further understanding and conclusions.

PSMA - Targeted Clinical Molecular Imaging of Atherosclerosis: Correlation with Cardiovascular Risk Factors.

The early diagnosis of atherosclerotic changes to prevent ischemic events represents a clinical challenge.Prostate-specific membrane antigen (PSMA) as an established diagnostic in the field of prostate cancer also appears to detect neovascularization and inflammation in other diseases. We hypothesized that it might be also suited for detection of inflammation in atherosclerosis. We analyzed data of 78 prostate cancer patients who received a PSMA ligand PET/CT for re-staging. The cardiovascular risk factors (CVRF) of each patient were documented. Target-to-background-ratios (TBR) were calculated from the individual uptake values for three different sections of thoracic aorta [ascending (AA) and descending aorta (AD), aortic arch (AoAC)]. Statistical analyses included a linear regression analysis with the PSMA ligand uptake values of the different arterial segments versus different CVRF as independent variables. The meanTBRmax was measured highest in the AoAC (1.66 ± 0.33) compared to both other vessel sections (AA: 1.46 ± 0.21, p=0.001; AD: 1.59 ± 0.41, p=0.371). There was a correlation between the PSMA ligand uptake in all measured segments of the aorta and BMI, but only a significant correlation in the ascending aorta (r=0.347, p=0.001). This was confirmed in a subgroup analysis, which showed significantly higher uptake values in preadiposity (BMI >25) and obesity (BMI >30) patients in the ascending aorta (p=0.048). PSMA ligand uptake in the ascending aorta was linked to BMI. PET detection of vascular PSMA ligand uptake may be indicative of vessel wall inflammation to some extent. However, PSMA ligands appear to be less suitable than other tracers for this purpose, given their absent correlation with most established CVRFs.

Cardiac Events and Survival in Patients With EGFR-Mutant Non–Small Cell Lung Cancer Treated With Osimertinib

Although it has been reported that osimertinib mesylate provides better survival benefits compared with first- or second-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), it remains unclear whether osimertinib is associated with more cancer therapy-related cardiac events (CTRCEs) compared with other EGFR TKIs, as does the extent of the association these adverse effects may have with overall survival. This issue is particularly critical due to the high prevalence of EGFR variants within Asian populations, including that of Taiwan. To compare CTRCEs and their association with survival in patients treated with osimertinib vs other EGFR TKIs. This cohort study was conducted at the National Cheng Kung University Hospital, a college hospital and tertiary academic referral center in Taiwan. The median follow-up duration was 23.2 (IQR, 15.2-31.5) months. A total of 401 patients with EGFR-mutant non-small cell lung cancer (NSCLC) beginning treatment with EGFR TKIs from September 1, 2019, to July 31, 2022, were retrospectively analyzed. CTRCEs included newly emerging arrhythmias, valvular heart diseases (moderate and more), myocardial infarction, and heart failure and were analyzed after adjusting for age, sex, smoking, alcohol consumption, body mass index, cardiovascular comorbidities, thoracic radiotherapy, and cardiovascular medications. Follow-up was completed January 31, 2024. Osimertinib. The Cox proportional hazards model was used to estimate CTRCEs in patients treated with osimertinib or other EGFR TKIs. Considering that death can lower the incidence of CTRCEs, the competing risk method was used to calculate CTRCEs after adjusting for potential confounders. Multivariable Cox proportional hazard regression analysis for overall survival was used to explore whether CTRCEs were independently associated with overall survival. Among the 401 patients (253 [63.1%] female; mean [SD] age, 69.2 [11.3] years), 195 (48.6%) treated with osimertinib were matched with 206 (51.4%) treated with other EGFR TKIs. Occurrence of CTRCEs in patients receiving osimertinib was significantly higher compared with patients treated with other EGFR TKIs (29 [14.9%] vs 9 [4.4%]; hazard ratio [HR], 3.37; 95% CI, 1.56-7.26; P = .002). After adjustment for relevant cardiovascular risk factors, the HR of CTRCEs was significantly higher in the group treated with osimertinib (adjusted subdistribution HR, 4.00; 95% CI, 1.81-8.85; P < .001). In addition, CTRCEs were independently associated with overall survival (HR, 4.02; 95% CI, 2.44-6.63; P < .001). In this cohort study of patients with EGFR-mutant NSCLC, osimertinib was associated with a higher incidence of CTRCEs compared with other EGFR TKIs; CTRCEs were independently associated with overall survival. These findings highlight the need for ongoing cardiac monitoring in these patients, regardless of preexisting cardiac risk factors.

Understanding Cardiovascular Health and Lifestyle Choices Among Healthcare Professionals in Medically Underserved Regions in Illinois.

This study assesses the prevalence of cardiovascular risk factors, such as diabetes, obesity, high blood pressure, and stress, as related to healthy lifestyle behaviors among healthcare professionals (HCPs), including medical doctors, nurses, pharmacists, laboratory scientists, and radiologists, in medically underserved regions (MURs). Using a cross-sectional study design, an online survey was administered to HCPs in MURs of West Central Illinois. A total of 316 HCPs completed the survey. The study population was predominantly White, female, and aged 55 or older. The findings of this research imply that HCPs in medically underserved regions (MURs) with high cholesterol generally do not engage in physical activity. The study showed a correlation between HCP age, high blood pressure, Type 2 diabetes, and high cholesterol, implying that as HCPs age like every other individual, the likelihood of developing these conditions increases. This study emphasizes the role of time constraints and a lack of motivation in limiting HCPs' participation in physical activity in rural areas. Additionally, the study suggests that inadequate access to nutritious food and exercise facilities in rural regions contributes to lower rates of healthy eating and physical activity. Findings demonstrate how essential it is for healthcare professionals to remain vigilant about cardiovascular disease risk factors.

Incidence and Prevalence of Atherosclerotic Cardiovascular Disease in Cutaneous Lupus Erythematosus

Autoimmune diseases such as systemic lupus erythematosus (SLE) and psoriasis have been previously associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). Whether similar increased ASCVD risk is seen with cutaneous lupus erythematosus (CLE) remains unclear. To evaluate the incidence and prevalence of ASCVD among those with CLE, SLE, and psoriasis compared with a disease-free control group. This retrospective, matched longitudinal cohort study used data from January 2018 to December 2020 in the IBM MarketScan Commercial Claims and Encounters Database. The control population included individuals free of CLE, SLE, and psoriasis, matched 10:1 with the CLE population on age, sex, insurance type, and enrollment duration. Data were analyzed from September 2022 to April 2024. Prevalent ASCVD was defined as coronary artery disease, prior myocardial infarction, or cerebrovascular accident. Incident ASCVD was assessed through the number of hospitalization events through the end of follow-up (up to 3 years) in each group. Multivariable logistic regression and Cox proportional hazards models were performed to compare the prevalence and incidence of ASCVD between exposure groups, adjusting for age, sex, and cardiovascular risk factors. A total of 8138 persons with CLE (median [IQR] age, 49 [40-47] years; 6618 [81%] female), 24 675 with SLE (median [IQR] age, 46 [36-54] years; 22 432 [91%] female), 192 577 persons with psoriasis (median [IQR] age, 48 [36-56] years; 106 631 [55%] female), and 81 380 control individuals (49 [40-57] years; 66 180 [81%] female) were identified. In multivariable analysis, the odds of ASCVD were higher than control for CLE (odds ratio [OR], 1.72 [95% CI, 1.45-2.02]; P < .001) and SLE (OR, 2.41 [95% CI, 2.14-2.70]; P < .001), but not psoriasis (OR, 1.03 [95% CI, 0.95-1.11]; P = .48). At median 3 years follow-up, incidence rates of ASCVD were highest for SLE (24.8 [95% CI, 23.3-26.4] per 1000 person-years), followed by CLE (15.2 [95% CI, 13.1-17.7] per 1000 person-years), psoriasis (14.0 [95% CI, 13.5-14.4] per 1000 person-years), and then controls (10.3 [95% CI, 9.77-10.94] per 1000 person-years). In multivariable Cox proportional regression modeling with the control group as a reference group, the highest risk of incident ASCVD was in those with SLE (hazard ratio [HR], 2.23 [95% CI, 2.05-2.43]; P < .001), followed by CLE (HR, 1.32 [95% CI, 1.13-1.55]; P < .001), and psoriasis (HR, 1.06 [95% CI, 0.99-1.13]; P = .09). In this retrospective matched longitudinal cohort study, CLE was associated with an increased risk for ASCVD, similar to the risk in SLE but higher than the risk in psoriasis. The role of comorbidities that augment ASCVD risk like smoking status should be further investigated. Clinicians treating patients with CLE can consider them at increased ASCVD risk and institute appropriate screening tests.

Oral Health, Inflammation, and Cardiometabolic Factors in the VA Million Veteran Program.

Associations between cardiometabolic comorbidities and self-reported oral health (OH) are often underexplored in large biobank datasets. While these associations are unaffected by dental care access, they could be mediated by immune responses and inflammation. This study assessed the associations between cardiometabolic comorbidities and self-reported OH, periodontitis, and tooth loss using the International Classification of Diseases (ICD) codes in participants from the U.S. Veterans Affairs Million Veteran Program (MVP), adjusting for immune and inflammatory covariates. Data from 154,167 MVP participants were extracted from January 2011 to September 2021, including lifetime cardiometabolic comorbidities, self-reported OH, ICD-coded periodontitis and tooth loss, and laboratory measurements. Multivariate logistic regression analysis was used to calculate the odds ratios of cardiometabolic comorbidities for self-reported OH, periodontitis, and tooth loss, adjusting for demographic, socioeconomic, cardiovascular, and inflammatory (neutrophil and lymphocyte cell counts) risk factors. A separate dataset was used for additional sensitivity analyses, adjusting for serum levels of C-reactive protein and albumin. Complete data were analyzed for 154,167 participants (19%). Most participants (92%) were male and from European ancestry (94%). The mean age was 65.5 y (SD 11.4 y). Ten percent of participants had excellent self-reported OH. Fourteen percent had any periodontitis, and 17% had any tooth loss. Significant associations were found between tooth loss and congestive heart failure (odds ratio [OR], 1.74, P < 0.001) and peripheral vascular diseases (OR, 1.82, P < 0.001). There were also significant associations between congestive heart failure and self-reported OH (excellent versus "poor/fair/good/very good"), with increasing odds as self-reported OH declined (P < 0.001 for trend). These associations remained significant even after sensitivity analyses, albeit with slight attenuation. This study of veterans underscores the important cardiometabolic links of self-reported poor OH and tooth loss, akin to those observed with periodontitis, even after adjusting for potential confounders related to demographics, lifestyle, and inflammation. Exploring cardiometabolic associations with self-reported OH, clinically diagnosed periodontitis, and tooth loss using the ICD in the Veterans Affairs Million Veteran Program, we found significant associations. These associations persisted after adjustment for inflammatory confounders. These findings emphasized the benefit of assessing OH as a vital indicator of overall cardiometabolic health in large-scale biobank studies.

Cardiometabolic risk factors among thyroid cancer survivors

IntroductionThyroid cancer incidence has tripled in the last decades, resulting in a growing population of survivors. In addition to the risks associated with the cancer itself, cardiovascular disease represents a major cause of morbidity and mortality in thyroid cancer survivors. Our study aims to assess the frequency of cardiovascular and metabolic risk factors in thyroid cancer survivors (TCS).MethodsA cross-sectional analysis of thyroid cancer patients at Constantine’s University Hospital, Algeria (January 2021 to July 2022), used the WHO STEPS approach to assess risk factors. Cancer data were extracted from medical records.ResultsA total of 342 patients were included, of whom 88.9% were women. The mean age was 48 years (range 21–85), papillary thyroid cancer accounted for 82% of cases. The mean survival duration was 4 years (6 months to 32 years), and 74.5% of patients responded well to initial treatment. The current smoking rate was 2.6%, 7.5% of patients engaged in vigorous physical activity, and only 7.8% consumed more than 5 fruits or vegetables daily. At the study time, over 80.7% were overweight or obese, and 86% exhibited android obesity. Hypertension (48.8%), diabetes (27.5%), prediabetes (32.5%), dyslipidemia (77.5%), and metabolic syndrome (61.1%) were common. Factors associated with metabolic syndrome included a family history of obesity (OR) of 1.80 (1.08–3.02), age over 40 OR of 2.71 (1.63–4.51), overweight/obesity OR of 5.134 (2.68–9.84), and levothyroxine doses ≥ 125 µg/day OR of 2.480 (1.45–4.23).ConclusionCardiovascular and metabolic risk factors are prevalent in our population of thyroid cancer survivors.

A higher incidence of cardiovascular complications in hyperthyroid patients with Graves’ disease in comparison to hyperthyroid patients with subacute thyroiditis

Background: Hyperthyroidism, as well as systemic inflammation, are associated with a higher incidence and complications of cardiovascular disease. Both in Graves’ disease and subacute thyroiditis, patients are hyperthyroid. However, in Graves’ disease, there is an autoimmune process in the thyroid, and in subacute thyroiditis, hyperthyroidism is accompanied by systemic inflammation. It is not known if the rate of cardiovascular complications is higher in the course of Graves’ disease or subacute thyroiditis.. Methods: We performed a retrospective study of all hyperthyroid patients newly diagnosed with Graves’ disease or subacute thyroiditis between January 1st 2018 and December 31st 2021 at the Department of Nuclear Medicine, University Medical Centre Ljubljana. Cardiovascular complications in the period 3 months before or after diagnosis were registered. Values are expressed as mean (SD).. Results: The sample analysis included 1028 patients (247 with subacute thyroiditis, 781 with Graves’ disease). The two groups did not significantly differ by sex, age, and body mass index. A cardiovascular complication was registered in 78 patients; the incidence was significantly higher in Graves’ disease than in subacute thyroiditis (74 vs. 4, p&lt;0.001). Compared to patients with subacute thyroiditis, patients with Graves’ disease had significantly lower TSH: 0.010 (0.006) vs. 0.024 (0.044) mIU/L (p&lt;0.001), higher free T4: 44.1 (26.6) vs. 37.0 (14.7) pmol/L (p&lt;0.001), higher incidence of diabetes: 4.3 vs. 0.4% (p=0.001), arterial hypertension: 12.2 vs. 5.7% (p=0.004) and smoking: 26.7 vs. 8.7% (p&lt;0.001). In a logistic regression model, a significantly higher likelihood for cardiovascular complications was found in Graves’ disease vs. subacute thyroiditis (odds ratio 5.82, p=0.001), in patients with arterial hypertension (odds ratio 2.83, p=0.002), and in those with higher body mass index (odds ratio 0.92, p=0.043).. Conclusion: We report a higher incidence of cardiovascular complications in hyperthyroid patients with Graves’ disease in comparison to hyperthyroid patients with subacute thyroiditis. Patients with Graves’ disease were more severely hyperthyroid and had more adverse cardiovascular risk factors.

Evaluating Electrochemical Marker for Udavarta (Slow Transit Constipation) and Risk of Cardiovascular Events: A Cross-Sectional Study

Abstract The known risk factors for cardiovascular diseases (CVDs) are diabetes, obesity, unhealthy diet, lack of exercise, smoking, and excessive use of alcohol. The 10-year cardiovascular risk factor prevalence of hypertension, obesity, and diabetes mellitus is 55.8%, 14.4%, and 9.8%, respectively. Besides these known risk factors, other potential but less searched risk factors also need to be explored for better prevention of CVDs. To evaluate the association between Udavarta (STC), changes in lead III of ECG, and heart disease score to demonstrate the earliest pathological changes in the heart. A cross-sectional observational study using a survey method to collect data from November 11, 2021 to January 5, 2022. The Udavarta symptom score (USS) is associated with ECG changes in lead III (P &gt; 0.0098). The USS shows an association with the Hrudroga (heart disease) symptom score: relative risk 1.83 (95% CI: 1.20–3.1), odds ratio 5.65 (95% CI: 1.06–30), and P &gt; 0.0385. Udavarta (slow transit constipation) shows a strong association with heart disease symptom score and lead III ECG changes, and clinically is an equally contributing risk factor for the development of CVDs compared to the other risk factors. This study reports that the minimum duration of constipation for starting the development of heart diseases assessed by ECG is 3 months, and the maximum duration is 25 years. This study emphasizes that slow transit constipation is a risk factor for developing heart disease. Clinical research in this direction is warranted.