Coronary Heart Disease Factors Research Articles

The Impact of Periodontal Inflammation on the Severity of Coronary Atherosclerosis.

Introduction Through plausible biological mechanisms, periodontitis causes systemic inflammatory burden and response, thus resulting in damage far beyond the oral cavity. Studies have demonstrated periodontitis to be a significant risk factor for coronary heart disease (CHD) and stroke. The larger the quantum of periodontal inflamed tissue, the greater the chances of periodontitis eliciting bacteremiaand systemic inflammatory responses. Studies have reported that periodontitis and other common oral infections play an important role in the development of atherosclerosis. Therefore, the quantity of inflamed periodontal tissue assumes significance in determining the severity of atherosclerosis. Hence, this study investigates the impact of periodontal inflamed surface area (PISA) on the severity of coronary atherosclerosis. Materials and methods In this cross-sectional study, a total of 160 patients who presented at the department of periodontics of The British University in Egypt (BUE) from 1 January 2023 to 30 September 2023 were enrolled. Patients were only enrolled if they had undergone coronary angiography within the last six months, were less than 60 years of age, shared their previous medical history and coronary angiographic report, and gave informed written consent. Data on classic coronary risk factors and periodontal inflammatory status and angiographic findings were recorded and subjected to appropriate statistical analysis. Results The results revealed that the periodontal inflamed surface area (p = 0.002) apart from age (p < 0.047) and low-density lipoprotein cholesterol(LDL-C) (p < 0.001) is a significant independent predictor of the severity of coronary atherosclerosis. Conclusions The periodontal inflamed surface area is an independent predictor of the severity of coronary atherosclerosis.

Work stress and changes in heart rate variability among employees after first acute coronary syndrome: a hospital-based longitudinal cohort study.

Work stress is considered as a risk factor for coronary heart disease, but its link with heart rate variability (HRV) among heart attack survivors is unknown yet. The aim of this study was to investigate associations between baseline work stress and the changes of HRV over one-year after onset of acute coronary syndrome (ACS). Hundred and twenty-two patients with regular paid work before their first ACS episode were recruited into this hospital-based longitudinal cohort study. During hospitalization (baseline), all patients underwent assessments of work stress by job strain (JS) and effort-reward imbalance (ERI) models, and were assigned into low or high groups; simultaneously, sociodemographic and clinical data, as well depression, anxiety, and job burnout, were collected. Patients were followed up 1, 6, and 12 months after discharge, with HRV measurements at baseline and each follow-up point. Generalized estimating equations were used to analyze the effects of baseline work stress on HRV over the following 1 year. After adjusting for baseline characteristics and clinical data, anxiety, depression, and burnout scores, high JS was not associated with any HRV measures during follow-up (all p > 0.10), whereas high ERI was significantly related to slower recovery of 5 frequency domain HRV measures (TP, HF, LF, VLF, and ULF) (all p < 0.001), and marginally associated with one time domain measure (SDNN) (p = 0.069). When mutually adjusting for both work stress models, results of ERI remained nearly unchanged. Work stress in terms of ERI predicted lower HRV during the one-year period after ACS, especially frequency domain measures.

Abstract P277: Adherence to Time-Restricted Eating, Plasma Metabolomic Signatures, and Risk of Coronary Heart Disease

Introduction: Early time-restricted eating (TRE) has been recently suggested as an effective dietary intervention strategy to improve risk factors of coronary heart disease (CHD), whereas late TRE may be related to poor cardiometabolic health. Metabolomic pathways linking the adherence to habitual TREs depending on the time of the day and CHD risk are unknown. Hypothesis: We tested whether adherence to early or late TRE was related to distinct metabolomic signatures (including those in pathways of energy/purine pyrimidine metabolism, lipids, carbohydrates, and acylcarnitines). We then tested whether TRE-related plasma metabolites were associated with the risk of incident CHD among women without prior CHD. Methods: This study included 674 women without cardiovascular disease who completed 7-day food records and measurements of untargeted plasma metabolomics in a sub-study of the Nurses’ Health Studies (NHS/NHSII). TRE was indicated by 4-12 hours of daily eating window. The adherence to TRE was assessed by summing up the TRE days in a week (0-7 days). We analyzed two TRE habits: early TRE (starting before 9 a.m./ending no later than 9 p.m.) and late TRE (beginning after 9 a.m.). Separately, plasma metabolites were measured in a prospective nested case-control of 762 incident cases of CHD and 762 matched controls identified over 10-14 years of follow-up in the NHS. A metabolomic risk score for predicting adherence to late TRE (MRS-TRE late ) was created based on metabolites selected through the elastic net procedure with a 10-fold cross-validation. Results: Adherence to late TRE was positively associated with greater adiposity, insulin/proinsulin, uric acid, and medium-chain fatty acids/acylcarnitines; the late TRE habit was inversely related to metabolites in the TCA cycle/pyruvate metabolism and specific PC species ( P FDR &lt;0.05). On the other hand, metabolites in lipid pathways (including diglyceride DG 38:5) and glucose were inversely related to the adherence to early TRE. Individual levels of late-TRE-related metabolites in energy/phosphatidylcholine /acylcarnitine pathways were significantly associated with an increased risk of CHD. Every 1 SD increment of MRS-TRE late , based on 21 metabolites in various metabolic pathways, was associated with a relative risk (RR) of 1.24 (95% CI: 1.11, 1.38) for CHD in a model adjusted for matching factors, and a RR of 1.15 (1.02, 1.29) after adjusting for covariates, such as demographic factors, diet quality, alcohol, lifestyle factors, and BMI. Women in the top tertile of MRS-TRE late had a 1.44-fold (1.10, 1.89) increased risk of CHD as compared to those in the lowest tertile after adjusting for the covariates. Conclusions: TRE habit, depending on the timing, was related to distinct metabolomic pathways, and adherence to late TRE may be associated with metabolic reliance linked to the risk of incident CHD among women.

Abstract P105: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Multi-Racial Populations

Background: Blood lipids, such as total cholesterol (TC), LDL-cholesterol (LDL-C), and triglycerides (TG), are well-known risk factors for coronary heart disease (CHD). However, studies that examined the associations of circulating lipids and apolipoproteins carried by different lipoproteins with incident CHD remain limited, particularly among racially diverse populations. Hypothesis: Potential novel lipoprotein biomarkers, other than TC, TG, LDL-C, and HDL-C, are associated with incident CHD in diverse populations. Methods: We conducted nested case-control studies of CHD among White Americans (542 pairs; n =1084), Black Americans (622 pairs; n =1244), and Chinese adults (557 pairs; n =1114) drawn from the Southern Community Cohort Study and Shanghai Women’s and Men’s Health Studies. We examined the associations of 36 plasma lipids, lipoproteins, and apolipoproteins (measured by Bruker IVDr NMR platform) with incident CHD using conditional logistic regression, adjusted for sociodemographics, lifestyle, family history of CHD, and menopausal status (women only). Race-specific odds ratios (ORs) were pooled using fixed-effect meta-analysis. Results: TC, TG, LDL-C, and HDL-C were associated with incident CHD, with pooled ORs being 1.35, 1.31, 1.26, and 0.79 per 1-SD increase. Sixteen lipoprotein biomarkers showed larger effect sizes than those conventional lipids, with pooled ORs per 1-SD ranged from 1.37 to 1.59 and a negative OR of 0.77 ( Figure 1 ); all associations were significant within each race. Significant associations were observed across subpopulations defined by sociodemographics, lifestyle, and status of obesity, diabetes, hypertension, and dyslipidemia, including among individuals with normal levels of TC, TG, LDL-C, and HDL-C. Conclusion: Our study identified several lipoprotein biomarkers (e.g., ApoB/ApoA1 ratio and LDL-TG) associated with incident CHD among multi-racial populations, suggesting potential clinical utility complementing the current lipid panel.

Personality Shaping in the Context of Family Rearing and the Prevention and Treatment of Related Diseases

The abstract cover the following points in order analyzing and resolving epidemics in today’s social from a medical perspective, which is based on the perspectives of palliative care, social medicine, and epidemiology, and focuses on analyzing changes in human health orientation and social adaptability during the process of social development,I have focused on analyzing the occurrence of depression in young children and the mechanisms and potential risks factors of coronary heart disease and hypertension in the elderly population through field investigations. Combining relevant data from clinical practice ,I have evaluated the phenomena and risks, and further pointed out the ways to pay attention to family upbring. Discovering a close correlation between family upbringing and the occurrence and prevention of these diseases. Family upbringing is an important factor in shaping personality, which has far-reaching influence on individual development and health. The purpose of this study was to explore the relationship between personality building and related diseases in the background of family upbringing, and to propose corresponding prevention and treatment strategies. By combing relevant literature and analyzing empirical research data, this paper finds that there is a close correlation between family rearing style and individual personality traits, and there is also a significant relationship between personality traits and related diseases. Based on this finding, this study emphasizes the important role of family education in shaping personality and proposes strategies for cultivating positive and healthy personality in order to prevent and treat the occurrence of related diseases. This paper is of great significance for improving individual physical and mental health and promoting social harmony and stability.

Description of Risk Factors for Coronary Heart Disease at the Family Medical Center Hospital Heart Clinic In 2021

Coronary heart disease (CHD) is a condition of reduced blood and oxygen supply to the heart muscle due to blockage by plaque in the blood vessels, called atherosclerosis. CHD is a health burden in the world because it contributes to high mortality rates, including in Indonesia according to Riskesdas 2018. This research aims to determine the description of risk factors for coronary heart disease at the Family Medical Center Hospital Heart Clinic in 2021. This research uses a descriptive survey method with a cross-sectional approach. The total population was 369 and the sample using the total sampling technique obtained 318 people who met the inclusion criteria. The research results showed that the largest age distribution was in the 60-69 year age range, as many as 111 people (34.9%), the largest gender was female, 165 people (51.9%), 15 people (4.7%) had a family history, hypertension 109 people (34.3%), diabetes mellitus 125 people (39.3%), dyslipidemia 201 people (70.4%), smoking 63 people (19.8%), overweight and obesity 224 people (70.3%). CHD patients at the Family Medical Center Hospital Heart Clinic are mostly aged 60-69 years, female, most have no family history, have dyslipidemia, have a BMI in the overweight and obese categories, most did not have a history of hypertension, did not have Diabetes Mellitus, and most did not smoke.

Longitudinal Lipidomic Signature of Coronary Heart Disease in American IndianPeople.

Dyslipidemia is an independent risk factor for coronary heart disease (CHD). Standard lipid panel cannot capture the complexity of the blood lipidome (ie, all molecular lipids in the blood). To date, very few large-scale epidemiological studies have assessed the full spectrum of the blood lipidome on risk of CHD, especially in a longitudinal setting. Using an untargeted liquid chromatography-mass spectrometry, we repeatedly measured 1542 lipid species from 1835 unique American Indian participants who attended 2 clinical visits (≈5.5 years apart) and followed up to 17.8 years in the Strong Heart Family Study (SHFS). We first identified baseline lipid species associated with risk of CHD, followed by replication in a European population. The model adjusted for age, sex, body mass index, smoking, hypertension, diabetes, low-density lipoprotein cholesterol, estimated glomerular filtration rate, education, and physical activity at baseline. We then examined the longitudinal association between changes in lipid species and changes in cardiovascular risk factors during follow-up. Multiple testing was controlled by the false discovery rate. We found that baseline levels of multiple lipid species (eg, phosphatidylcholines, phosphatidylethanolamines, and ceramides) were associated with the risk of CHD and improved the prediction accuracy over conventional risk factors in American Indian people. Some identified lipids in American Indian peoplewere replicated in European people. Longitudinal changes in multiple lipid species (eg, acylcarnitines, phosphatidylcholines, and triacylglycerols) were associated with changes in cardiovascular risk factors. Baseline plasma lipids and their longitudinal changes over time are associated with risk of CHD. These findings provide novel insights into the role of dyslipidemia in CHD.

Risk Factors of Coronary Heart Disease in North Sulawesi Indonesia

Coronary heart disease (CHD) is caused by multifactorial such as age, gender, blood pressure, blood sugar, and lipid profiles. This study aims to analyze the description of risk factors for CHD at the North Sulawesi, Indonesia. This is a descriptive research conducted at the Cardio Vascular and Brain Center Cardiology Polyclinic, General Hospital Prof. Dr. R. D. Kandou Manado in December 2021 to January 2022. The respondents of this study were CHD patients, totaling 100 people. The variables in this study were age, gender, blood pressure, blood sugar, and lipid profiles. The data was obtained from the patient's medical record data. Data analysis performed univariately. The results showed that the respondents are most distributed in the age group ≥40 years as many as 99 people (99%), and male sex as many as 73 people (73%). Respondents who do not suffer from hypertension are 56 people (56%) more than those who suffer from hypertension, namely 44 people (44%). Respondents with GDP &gt;126 mg/dL were 57 people (57%) more than those with GDP &lt; the same as 126 mg/dL, namely 43 people (43%). Respondents whose total cholesterol level was &lt; equal to 240 mg/dL were more than 60 people (60%) compared to patients with cholesterol levels &gt; 240 mg/dL which were 40 people (40%). It can be concluded that the risk factors for CHD at the North Sulawesi, Indonesia was ≥40 years old, male, more patients with blood pressure &lt;140/90 mmHg, more patients with GDP &gt;126 mg/dL and more patient with total cholesterol level &lt;240 mg/dL

Plasma Lipid Profile and Apolipoproteins in Patients with Coronary Artery Diseases and Healthy Persons, in Sana'a City, Yemen

Background: Cardiovascular disease (CVD) is the primary cause of all disease loads and accounts for almost half of all fatalities. The early detection of coronary artery disease (CAD) has drawn a lot of attention because it is anticipated that the global burden of cardiovascular disease will rise by almost 75% by 2020. They are easily oxidized, which causes an increase in affinity for arterial proteoglycans and a decrease in affinity for LDL receptors. It demonstrates significant CAD importance.&#x0D; Objective: The measurement of plasma lipid profiles and apolipoproteins (ApoA-1, ApoB, and Apo B/A-1 ratio) in healthy individuals and patients suffering from coronary artery disease.&#x0D; Methods: In this cross-sectional comparative study, 90 Yemeni subjects aged 45 to 70 years were divided into three groups: Group I: 30 cases as CAD positive (CAD+). Group II: 30 cases CAD negative (CAD -). Group III: 30 healthy person was as control. A standardized questionnaire was administered to collect demographic and clinical data from participants. Venous blood (10 ml) was collected from each individual and divided into two portions. The first portion was 5 ml in plain tubes, ApoA-1 and Apo B vacuum tubes for freezing at -20°C until analysis. 5ml in a plain tube for measuring fasting blood glucose, and lipid profile.&#x0D; Results: ApoB and Apo B/A ratios were significantly higher in CAD+ and CAD− subjects compared to controls. In addition, ApoB and Apo B/A ratios were significantly higher in CAD+ subjects compared to CAD- subjects. (P. value =0.002). In contrast, Apo A-1 was significant in CAD+ compared to CAD- and controls, and not significantly different between CAD and controls P. value = (0.001, 0.032). Furthermore, FBS and LDL-c were significantly higher in CAD+ compared to CAD subjects (P value = 0.05). In contrast, HDL-c was significantly lower in CAD+ compared to CAD and controls, with no significant difference between CAD and controls (P value=0.038, 0.004, 0.70). However, TG was not substantially different between CAD- and controls, but it was significantly greater in CAD+ compared to controls (P. value =0.002, 0.09, 0.31). Nevertheless, there was no difference in TC between study groups (P. value = 0.08, 0.12, 0.98).&#x0D; Conclusions: The degree of CAD is significantly positively correlated with WHR. More important than overall obesity, abdominal obesity is a risk factor for coronary heart disease (CHD). A significant positive connection has been observed between the Apo B/Apo A ratio and CAD. One thing to think about as a CAD risk factor is Apo B.

Association of GAL-8 promoter methylation levels with coronary plaque inflammation

Background and aimsCoronary heart disease (CHD) is a condition that carries a high risk of mortality and is associated with aging. CHD is characterized by the chronic inflammatory response of the coronary intima. Recent studies have shown that the methylation level of blood mononuclear cell DNA is closely associated with adverse events in CHD, but the roles and mechanisms of DNA methylation in CHD remain elusive. Methods and resultsIn this study, the DNA methylation status within the epigenome of human coronary tissue in the sudden coronary death (SCD) group and control (CON) group of coronary heart disease was analyzed using the Illumina® Infinium Methylation EPIC BeadChip (850 K chip), resulting in the identification of a total of 2553 differentially methylated genes (DMGs). The differentially methylated genes were then subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and significant differential DNA methylation was found. Among the differentially hypomethylated genes were GAL-8, LTF, and RFPL3, while the highly methylated genes were TMEM9B, ANK3, and C6orF48. These genes were mainly enriched in 10 significantly enriched pathways, such as cell adhesion junctions, among which the differentially methylated gene GAL-8 was involved in inflammatory pathway signaling. For functional analysis of GAL-8, we first examined the differences in GAL-8 promoter methylation levels among different subgroups of human coronary tissue in the CON, CHD, and SCD groups using pyrophosphate sequencing. The results revealed reduced GAL-8 promoter methylation levels in the SCD group, while the difference between the CHD and CON groups was not statistically significant (P > 0.05). The reduced GAL-8 promoter methylation level was associated with upregulated GAL-8 expression, which led to increased expression of the inflammatory markers TNF-α, IL-1β, MCP-1, MIP-2, MMP-2, and MMP-9. This enhanced inflammatory response contributed to the accumulation of foam cells, thickening of the intima of human coronary arteries, and increased luminal stenosis, which promoted the occurrence of sudden coronary death. Next, we found that GAL-8 promoter methylation levels in PBMC were consistent with human coronary tissue. The unstable angina group (UAP) had significantly lower GAL-8 promoter methylation levels than stable angina (SAP) and healthy controls (CON) (P < 0.05), and there was a significant correlation between reduced GAL-8 promoter methylation levels and risk factors for coronary heart disease. These findings highlight the association between decreased GAL-8 promoter methylation and the presence of coronary heart disease risk factors. ROC curve analysis suggests that methylation of the GAL 8 promoter region is an independent risk factor for CHD. In conclusion, our study confirmed differential expression of GAL-8, LTF, MUC4D, TMEM9B, MYOM2, and ANK3 genes due to DNA methylation in the SCD group. We also established the consistency of GAL-8 promoter methylation alterations between human coronary tissue and patient peripheral blood monocytes. The decreased methylation level of the GAL-8 promoter may be related to the increased expression of GAL-8 and the coronary risk factors. ConclusionsAccordingly, we hypothesized that reduced levels of GAL-8 promoter methylation may be an independent risk factor for adverse events in coronary heart disease.

Association of 20-Year Longitudinal Depressive Symptoms With Left Ventricular Geometry Outcomes in the Coronary Artery Risk Development in Young Adults Study: A Role for Androgens?

Depression is a risk factor for coronary heart disease and left ventricular hypertrophy (LVH) is a potent predictor of coronary heart disease events. Whether depression is associated with LVH has received limited investigation. This study assessed cross-sectional and 20-year longitudinal associations of depressive symptoms with LVH outcomes after accounting for important known confounders. From 5115 participants enrolled in 1985-1986 in the Coronary Artery Risk Development in Young Adults Study, 2533 had serial measures of depressive symptoms and subsequent echocardiography to measure normal LV geometry, concentric remodeling, and LVH. The primary exposure variable was trajectories of the Center for Epidemiologic Studies Depression (CES-D) scale score from 1990-1991 to 2010-2011. Multivariable polytomous logistic regression was used to assess associations of trajectories with a composite LV geometry outcome created using echocardiogram data measured in 2010-2011 and 2015-2016. Sex-specific conflicting results led to exploratory models that examined potential importance of testosterone and sex hormone-binding globulin. Overall CES-D and Somatic subscale trajectories had significant associations with LVH for female participants only. Odds ratios for the subthreshold (mean CES-D ≈ 14) and stable (mean CES-D ≈ 19) groups were 1.49 (95% confidence interval = 1.05-2.13) and 1.88 (95% confidence interval = 1.16-3.04), respectively. For female participants, sex hormone-binding globulin was inversely associated with LVH, and for male participants, bioavailable testosterone was positively associated with concentric geometry. Findings from cross-sectional and longitudinal regression models for female participants, but not male ones, and particularly for Somatic subscale trajectories suggested a plausible link among depression, androgens, and LVH. The role of androgens to the depression-LVH relation requires additional investigation in future studies.

Lipoprotein(a) Is Markedly More Atherogenic Than LDL: An Apolipoprotein B-Based Genetic Analysis

BackgroundLipoprotein(a) (Lp(a)) is recognized as a causal factor for coronary heart disease (CHD) but its atherogenicity relative to that of low-density lipoprotein (LDL) on a per-particle basis is indeterminate. ObjectivesThe authors addressed this issue in a genetic analysis based on the fact that Lp(a) and LDL both contain 1 apolipoprotein B (apoB) per particle. MethodsGenome-wide association studies using the UK Biobank population identified 2 clusters of single nucleotide polymorphisms: one comprising 107 variants linked to Lp(a) mass concentration, the other with 143 variants linked to LDL concentration. In these Lp(a) and LDL clusters, the relationship of genetically predicted variation in apoB with CHD risk was assessed. ResultsThe Mendelian randomization-derived OR for CHD for a 50 nmol/L higher Lp(a)-apoB was 1.28 (95% CI: 1.24-1.33) compared with 1.04 (95% CI: 1.03-1.05) for the same increment in LDL-apoB. Likewise, use of polygenic scores to rank subjects according to difference in Lp(a)-apoB vs difference in LDL-apoB revealed a greater HR for CHD per 50 nmol/L apoB for the Lp(a) cluster (1.47; 95% CI: 1.36-1.58) compared with the LDL cluster (1.04; 95% CI: 1.02-1.05). From these data, we estimate that the atherogenicity of Lp(a) is approximately 6-fold (point estimate of 6.6; 95% CI: 5.1-8.8) greater than that of LDL on a per-particle basis. ConclusionsWe conclude that the atherogenicity of Lp(a) (CHD risk quotient per unit increase in particle number) is substantially greater than that of LDL. Therefore, Lp(a) represents a key target for drug-based intervention in a significant proportion of the at-risk population.

Smoking as a risk factor for coronary heart disease (CHD): Contemporary insights into treatment strategies

Smoking is a powerful risk factor for coronary heart disease, responsible for numerous deaths each year. This qualitative literature review provides contemporary knowledge regarding the relationship between CHD and smoking as well as an evaluation of current treatment approaches. An electronic search was carried out in databases such as PubMed, Scopus, and Science Direct to examine and assess academic material during the last 5 years. The results indicate that smoking is connected with CHD in patients with type 2 diabetes mellitus, especially in the female population. Also, there is an association with alcohol, body weight, and smokeless tobacco. Gender is also a crucial factor in the frequency of smoking, as heavy smokers need more time to lower the danger of CHD in comparison to current smokers. Modern treatment strategies place a lot of focus on pharmacotherapy and holistic treatments.

Retracted: Analysis of Risk Factors of Coronary Heart Disease and Its Correlation with Inflammatory Factors in Patients with Type 2 Diabetes Mellitus.

[This retracts the article DOI: 10.1155/2022/6818888.].

THE STATE OF THE CORONARY BED IN CORONARY HEART DISEASE IN PATIENTS WITH HYPOTHYROIDISM

Hypothyroidism is a significant aggravating factor for coronary heart disease (CHD). However, there are no practical recommendations for the management of this group to date. The main method of assessing the severity of coronary artery disease is a morphological assessment of the condition of the coronary arteries. The aim. To carry out comparative assessment of clinical parameters, including the state of the coronary bed in patients with coronary artery disease with newly diagnosed (without hormone replacement therapy) and primary manifest hypothyroidism compared with patients with coronary artery disease without hypothyroidism. Materials and methods. Two hundred and forty patients with CHD were examined. The study group included 90 patients with coronary heart disease and hypothyroidism, the comparison group consisted of 150 patients with coronary artery disease without thyroid pathology. A comprehensive examination of patients, including coronary angiography, was performed. The frequency of cases and characteristics of lesions of the coronary bed, the volume of interventions were assessed. The analysis of the obtained data was carried out in Statistica 10.0 (StatSoft Inc., USA). Results. In the study group (CHD and hypothyroidism), a statistically significantly increased level of myoglobin, a change in lipid profile parameters in relation to patients with CHD without hypothyroidism was found. In the group of patients with coronary artery disease and hypothyroidism, a predominance of the frequency of multivessel lesions of the coronary bed was revealed. The volume of surgical interventions between the examined patients did not reveal significant differences. Conclusion. Patients with coronary heart disease and hypothyroidism should be considered as a group of additional cardiovascular risk and require a more careful approach. It is possible to prescribe higher dosages of statins.

Comprehensive Analysis of the Correlation between Estrogen Levels, Homocysteine, and Lipid Profiles in Postmenopausal Women with Coronary Heart Disease

Objective: To investigate the correlation between estrogen levels, blood homocysteine, and blood lipids in postmenopausal female patients with coronary heart disease. Methods: This study selected 50 postmenopausal female patients with coronary heart disease from Northeast Normal University Hospital (observation group). The data collection period extended from June 2021 to June 2023. Simultaneously, 50 healthy patients with no history of coronary heart disease were selected during the same period as the control group. Physical examinations were conducted for all participants. Estrogen levels, blood homocysteine, and blood lipid levels were tested in both groups. Results: Compared to the control group, the observation group exhibited higher levels of follicle-stimulating hormone (FSH), total cholesterol (TC), and homocysteine (Hcy), and lower levels of high-density lipoprotein cholesterol (HDL-C; P &lt; 0.05). Pearson correlation analysis revealed a negative correlation between estradiol (E2) levels and changes in Hcy, TC, and low density lipoprotein cholesterol (LDL-C) levels (P &lt; 0.01). Multivariate analysis indicated that E2 serves as a protective factor against coronary heart disease in postmenopausal women. Decreased E2 levels, LDL-C, and Hcy were identified as independent risk factors for coronary heart disease in women (P &lt; 0.05). Conclusion: A declining trend in estrogen levels among postmenopausal women has implications for their blood lipid levels and is closely associated with the development of chronic complications of menopause.

Is residential exposure to oil refineries a novel contextual risk factor for coronary heart disease?

Despite a multi-decade decrease in cardiovascular disease, geographic disparities have widened, with excess mortality concentrated within the United States (U.S.) South. Petroleum production and refining, a major contributor to climate change, is concentrated within the U.S. South and emits multiple classes of atherogenic pollutants. We investigated whether residential exposure to oil refineries could explain variation in self-reported coronary heart disease (CHD) prevalence among adults in southern states for the year 2018, where the majority of oil refinery activity occurs (Alabama, Mississippi, Louisiana, Arkansas, Texas, New Mexico, and Oklahoma). We examined census tract-level association between oil refineries and CHD prevalence. We used a double matching method to adjust for measured and unmeasured spatial confounders: one-to-n distance matching and one-to-one generalized propensity score matching. Exposure metrics were constructed based on proximity to refineries, activities of refineries, and wind speed/direction. For all census tracts within 10 km of refineries, self-reported CHD prevalence ranged from 1.2% to 17.6%. Compared to census tracts located at ≥5 km and <10 km, one standard deviation increase in the exposure within 5 km of refineries was associated with a 0.33 (95% confidence interval: 0.04, 0.63) percentage point increase in the prevalence. A total of 1119.0 (123.5, 2114.2) prevalent cases or 1.6% (0.2, 3.1) of CHD prevalence in areas within 5 km from refineries were potentially explained by exposure to oil refineries. At the census tract-level, the prevalence of CHD explained by exposure to oil refineries ranged from 0.02% (0.00, 0.05) to 47.4% (5.2, 89.5). Thus, although we cannot rule out potential confounding by other personal risk factors, CHD prevalence was found to be higher in populations living nearer to oil refineries, which may suggest that exposure to oil refineries can increase CHD risk, warranting further investigation.

Evaluating the Role of Fibrinogen as an Independent Risk Factor in Coronary Heart Disease

Evaluating the Role of Fibrinogen as an Independent Risk Factor in Coronary Heart Disease

Multiplicative and additive interactions between risk factors for coronary heart disease

Multiplicative and additive interactions between risk factors for coronary heart disease

Serum lipoprotein(a) and reclassification of coronary heart disease risk; application of prediction in a cross-sectional analysis of an ongoing Iranian cohort

IntroductionRecent studies have introduced elevated lipoprotein(a) (Lp(a)) as a risk factor for coronary heart disease (CHD). This study investigated whether the addition of Lp(a) as a novel biomarker to the Framingham Risk Score (FRS) model improves CHD risk prediction.MethodsThe study included 1101 Iranian subjects (443 non-diabetic and 658 diabetic patients) who were followed for 10 years (2003–2013). Lp(a) levels and CHD events were recorded for each participant.ResultsThe Net Reclassification Index (NRI) after adding Lp(a) to the FRS model was 19.57% and the discrimination slope was improved (0.160 vs. 0.173). The Akaike Information Criterion (AIC), a measure of model complexity, decreased significantly after adding Lp(a) to the FRS model (691.9 vs. 685.4, P value: 0.007).ConclusionsThe study concluded that adding Lp(a) to the FRS model improves CHD risk prediction in an Iranian population without making the model too complex. This could help clinicians to better identify individuals who are at risk of developing CHD and to implement appropriate preventive measures.