Family History Of Coronary Heart Disease Research Articles

Correlation Between Serum microRNA-18a Level and Endothelial Function and Prognosis in Female Coronary Heart Disease Patients.

The aim was to analyze the correlation between serum microRNA (miR)-18a level, endothelial function, and prognosis in female coronary heart disease (CHD) patients. One hundred sixtyfemale patients admitted to our hospital for the first occurrences of chest pain and tightness were divided into CHD and non-CHD groups based on the coronary angiography results. Clinical data, laboratory indexes, serum miR-18a level, and endothelial function [flow-mediated dilation (FMD) function, endothelin 1 (ET-1), and nitric oxide (NO)] were compared. There were no significant differences in clinical data (except CHD family history) between 2 groups. Coronary heart disease group had significantly lower levels of NO and FMD, while significantly higher levels of miR-18a and ET-1 than non-CHD group (P <.05). Pearson correlation showed that serum miR-18a level was positively correlated with ET-1 (r = 0.492, P <.001), and negatively correlated with NO and FMD (r = -0.504, -0.307, P <.001). The receiver operating characteristic) curve showed that the area under the curve of serum miR-18a level in predicting the occurrence of CHD in women was 0.878 (95% CI: 0.828-0.928). Compared with good prognosis group, poor prognosis group had signifi-cantly lower NO, and FMD levels, while higher proportions of acute coronary syndrome, multivessel disease, miR-18a, and ET-1 levels (P <.05). The expression of serum miR-18a in female CHD patients was high, which was related to endothelial function. The increase in serum miR-18a level was a risk factor for the occurrence of MACE in female CHD patients during follow-up, and the serum miR-18a level could effectively predict the occurrence of CHD in female patients.

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.

Self-Reported Cardiovascular Risk Factors among Medical Students

Cardiovascular diseases are the leading cause of death in the world, with smoking, diabetes, high blood pressure, dyslipidemia and a sedentary lifestyle being among the main risk factors. The objective of this study was to evaluate the self knowledge about cardiovascular risk factors among medical students. Methodology: Observational and cross-sectional study on students from the first to the eighth semester of medicine using anonymous questionnaires containing questions about cardiovascular risk factors. Results: A total of 288 students paticipeted. There was a higher percentage of self-declared emotional stress (p&lt;0.001), and high blood pressure (p=0.007), family history of coronary heart disease (CAD) or stroke (0.049) in the female group; The group under 20 years old practiced more physical activity (p=0.023) and reported a balanced diet (p=0.047), the age group between 20 and 29 years old reported a higher percentage of smoking (p=0.001) and alcohol consumption (p=0.048), those older than 30 years old reported a higher knowledge about family history of CAD or stroke.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Dyslipidemia Associated with Hypertension Increases the Risks of CHD among cardiac patients: A Case-Control Study

Background: Coronary Heart Disease (CHD) is one of the largest contributors to mortality and morbidity worldwide. Globally, CHD accounts for 17.5 million deaths in 2012, with over 75% of deaths occurring in developing countries. By 2015, 16% of all female and male deaths were caused by CHD. Dyslipidemia is the most common risk factor of CHD for the excessive level of lipids in blood. Most dyslipidemias are hyperlipidemias in developing countries; that is, an accumulation in blood lipids. CHD was 18 times more likely to grow according to hypertension with dyslipidemia category than with non-dyslipidemias. The aim of this study was to assess the effect of dyslipidemia associated with hypertension for coronary heart disease and identify risk factors for CHD among cardiac patients. Material &amp; Methods: This was a case control study and was conducted in the Department of Medicine, LABAID Specialized Hospital, Dhaka, Bangladesh during the period from May,2022 to March,2023. We included 170 cardiac patients in our study. The patients were divided into two groups – Case group (Patients diagnosed with CHD) &amp; Control group. Results: In total 170 patients from both the groups completed the study. In our study we found most of our patients were male (58%) compared to female (42%). We found the mean age was 46.1±11.3 &amp; 47.1±9.3 years in case &amp; control group respectively. Family history of hypertension was significantly higher in case group (52%). Among all patients, BMI was higher in case group. Cholesterol, systolic &amp; diastolic bp was found significantly higher in case group than control group. HDL was found lower &amp; LDL was found higher in case group. Among 85 cases, majority (68%) had dyslipidemia associated with hypertension. We found dyslipidemia was 55% &amp; 36% in case &amp; control group respectively. Hypertension was also found significantly higher in case group. Age ≥ 60 years, family history of CHD, smoking, diabetes &amp; obesity were also individual risk factors of CHD among cardiac patients. In dyslipidemia with hypertension group 68 patients were diagnosed with CHD which is higher than non-hypertension group. Conclusion: In our study, we found that dyslipidemia, hypertension, age ≥ 60 years, family history of CHD, smoking, diabetes &amp; obesity are individual risk factors of CHD development. Relationship of dyslipidemia with coronary heart disease in hypertension is significant. We also found dyslipidemia with hypertension is an established risk factor of prime importance that increased the risks of CHD among cardiac patients.

Combining family history of coronary heart disease and individual genetic predisposition to predict the risk of major coronary events: Selected Abstract - SITeCS Congress 2022

Background: Inherited predisposition to atherosclerosis leads to higher risk for developing coronary heart disease (CHD). There are mainly two ways to conceptualize inherited risk of CHD: family history and polygenic predisposition. We aimed at assessing the impact of family history of CHD and genetic predisposition in predicting the individual lifetime risk of major coronary events (MCE). Methods: Using adjusted Cox proportional hazard models, we estimated the lifetime risk of MCE associated with parental family history of CHD and individual genetic predisposition (estimated by a polygenic risk score including 350 variants). Results: A total of 445,744 UK-Biobank participants were included in the study (mean age 57 years; 54.3% females). Having one parent with a history of CHD increased the lifetime risk of MCE by 75% (HR 1.75, 95%CI 1.70-1.82). Having both parents with a history of CHD further increased the risk (HR 2.78, 95%CI 2.64-2.92) Similarly, a dose-dependent step-wise increase in MCE risk was observed moving from the lowest to the highest decile of the polygenic score. Compared to subjects without family history of CHD and with average level of the polygenic score, having a parental history of CHD determined an increase in lifetime risk of MCE (HR 1.90, 95%CI 1.82-1.98) comparable to belonging to the highest decile of the polygenic score (HR 1.89, 95%CI 1.76-2.02). However, if subjects present both parents with family history of CHD and a very high polygenic predisposition, the risk was even higher (HR 3.54, 95%CI 3.34-3.75), suggesting an additive contribution to the characterization of the lifetime risk. Conclusions: We described the addictive impact of family history of CHD and individual polygenic predisposition in predicting lifetime risk of MCE. In order to identify subjects at higher risk of having an early event, it is essential to retrieve information about both these hereditary components.

Abstract P449: Life’s Essential 8 and Risk of Coronary Heart Disease: A Prospective Study Among Racially and Geographically Diverse Populations

Introduction: Life’s Essential 8 (LE8) is a new guideline proposed by American Heart Association to improve cardiovascular health, including four health behaviors (i.e., eat better, be more active, quit tobacco, get healthy sleep) and four health factors (i.e., manage weight, control cholesterol, manage blood sugar, manage blood pressure). Hypothesis: Higher adherence to LE8 is associated with reduced risk of coronary heart disease (CHD) among racially and geographically diverse populations. Methods: The current analysis was based on CHD case-control studies nested within the Southern Community Cohort Study (baseline: 2002-2009), Shanghai Women’s Health Study (1996-2000), and Shanghai Men’s Health Study (2002-2006), including 900 incident CHD cases identified through 2018 and 900 age-/sex-/race-matched controls (300 pairs of White Americans, Black Americans, and Chinese adults, respectively). Within each cohort, we constructed the LE8 score (range: 0 to 100) based on DASH diet quality, moderate/vigorous physical activity, tobacco smoking, sleep hours, body mass index, total and non-HDL cholesterol, diabetes status/blood glucose, and hypertension status/blood pressure. We used conditional logistic regression to evaluate odds ratios (ORs) between the LE8 score and incident CHD, adjusting for sociodemographic factors and family history of CHD. Results: The mean ± standard deviation (SD) of LE8 score was 48.1±13.4 among White women, 48.5±14.4 among White men, 48.1±12.3 among Black women, 50.0±13.6 among Black men, 57.2±12.2 among Chinese women, and 50.7±12.5 among Chinese men. Higher LE8 score was associated with significantly reduced risk of CHD: OR for 1-SD increase was 0.58 (95% CI: 0.51-0.65) among all participants, 0.64 (95% CI: 0.53-0.78) among White Americans, 0.57 (95% CI: 0.46-0.69) among Black Americans, 0.52 (95% CI: 0.42-0.65) among Chinese, 0.49 (95% CI: 0.41-0.60) among women, and 0.65 (95% CI: 0.56-0.75) among men; all P &lt;0.001 ( P interaction &gt;0.05 for race and P interaction =0.01 for sex). Similar patterns of beneficial associations were also found in stratified analyses by age group, education level, and history of diabetes, hypertension, or dyslipidemia, with ORs ranging from 0.46 to 0.74. Conclusions: Higher adherence to LE8 is associated with ~35-50% reduced risk of incident CHD across racially and geographically diverse populations, supporting the importance of promoting healthy lifestyles and maintaining metabolic health.

Predictors of Coronary Heart Disease (CHD) among Malaysian Adults: Findings from MyDiet-CHD Study

Introduction: This study aimed to determine the risk factors of CHD among the Malaysian adult population. Methods: Using a cross- sectional observational study design, this study involved 365 adult patients aged between 30-64 years, attending clinics from eight government hospitals and four health clinics in Terengganu, Pahang, Selangor, Putrajaya, Penang, Kedah, Johor and Sabah from February 2018 until September 2020. Sociodemographic characteristics, clinical and dietary data, physical activity and stress level were recorded using a structured questionnaire. Multiple logistic regression was used to analyse CHD risk factors. Results: The overall response rate was 99.2%. The adjusted odds ratio of CHD was greater for age (AOR; [%95 CI]) (1.043;[ 1.009,1.078]); waist circumference (1.033;[1.009, 1.057]); total fat intake (1.035;[1.021, 1.050]); full cream dairy products intake (1.004;[1.001, 1.008]); smokers vs non-smokers (4.691;[2.399, 9.176]); individual with family history of CHD vs without family history (2.705;[ 1.496, 4.891]); married vs single (0.434;[ 0.217,0.867]); and lower for HDL cholesterol (0.185;[0.052, 0.662]); Chinese vs Malays (10.619;[ 2.255, 49.995]); and third lowest income (0.197;[ 0.073, 0.532]) and forth lowest income (0.167;[ 0.056, 0.499]) vs lowest income. Conclusion: Age, race, income, smoking and marital status, family history of CHD, waist circumference, HDL cholesterol, total fat intake, full cream dairy products intake were significantly associated with CHD among this population. This finding is particularly important to the primary health carers to identify at-risk CHD individuals thus appropriate intervention could be provided.

Abstract 10360: Polygenic Risk Score, Rare Monogenic Variants, and Family History Have Independent and Additive Effects on the Risk of Coronary Heart Disease

Introduction. We assessed the effects of a polygenic risk score (PRS), monogenic variants (Mono + ), and family history (FamHx) on the risk of coronary heart disease (CHD) and whether incorporating a PRS into the Pooled Cohort Equations (PCE) improves risk prediction. Method. In 199,997 UK Biobank participants, we calculated a PRS CHD (metaGRS, based on ~1.6 million single nucleotide variants), identified individuals with monogenic etiology (presence of a pathogenic variant in LDLR , APOB , or PCSK9 ), and ascertained family history of CHD (CHD in a first-degree relative). Odds of CHD (myocardial infarction/ coronary revascularization/ cardiovascular death) associated with PRS CHD , Mono + , and FamHx at age 55 were computed using logistic regression analyses adjusted for age, sex, and first 4 principal components of ancestry. We combined PRS CHD and PCE into an integrated score (IS) and assessed net reclassification using an actionable risk threshold of 7.5%. Results. The odds ratio (OR) for CHD in the top 5 th percentile of PRS CHD (PRS P95 ), Mono + , and FamHx were 3.37 (2.98 - 3.81), 2.68 (1.67 - 4.07), and 1.61 (1.47 - 1.76), respectively (all p&lt;0.001). These effects were independent and similar in different subgroups. ( Figure 1-A ) Compared to PRS Q2-4 Mono - (3 middle quintiles of PRS CHD and no monogenic variants), the OR for CHD ranged from 1.73 (0.28 - 5.48, p = 0.446) in PRS Q1 Mono + to 5.10 (2.14 - 10.24, p &lt;0.001) in PRS Q5 Mono + . A similar pattern was seen for other combinations, indicating additive effects ( Figure 1-B ). Incorporating PRS CHD into PCE resulted in a net reclassification improvement of 4.56%. Compared to those with high PCE and low IS, the hazard ratio for CHD in those with low PCE and high IS was 1.48 (1.34 - 1.64, p &lt;0.001). Conclusion. The CHD risk associated with PRS CHD , monogenic variants, and family history is independent and additive. Combining PRS CHD and PCE improved risk prediction, that could improve further by adding monogenic variants and family history.

The burden of severe hypercholesterolemia and familial hypercholesterolemia in a population-based setting in the US

BackgroundContemporary prevalence, awareness, and control of severe hypercholesterolemia (SH) and familial hypercholesterolemia (FH) and the associated atherosclerotic cardiovascular disease risk in the US are unknown. MethodUsing electronic health records, we assessed the burden of SH and FH in Olmsted County, Minnesota, US, between 2004 and 2015. We defined SH as low-density lipoprotein cholesterol (LDL-C) level ≥190 mg/dl without secondary causes of hypercholesterolemia and FH as a Dutch Lipid Clinic Network score ≥6. Controls were age- and sex-matched individuals with LDL-C level <190 mg/dl. ResultsThe age- and sex-adjusted point and period prevalence (age-recursive method) of SH was 4.44% and 8.95%, respectively; 1 in 21 had FH (∼1:233 adults), and 46.2% had a recorded diagnosis. Guideline recommended targets (LDL-C <100 mg/dl and <70 mg/dl in the primary and secondary prevention settings, respectively) were achieved in 33.1% and 21.2% of SH cases, with less women overall achieving the target than men (18.6% vs. 23.7%, p=0.022). After adjustment for conventional risk factors, the hazard ratio for incident coronary heart disease (CHD) in those with SH was 1.21 (1.05-1.39; p=0.010), in those with SH and a family history of CHD was 2.16 (1.57-2.96; p<0.001) and in those with FH was 4.61 (2.66-7.97; p<0.001). The association of SH with CHD was modified by age (p-interaction = 0.015), such that the risk was greater at younger ages. ConclusionsSH was prevalent and an independent risk factor for incident CHD. Awareness and control were low, highlighting a treatment gap (more prominent in women) that needs to be addressed.

Association between a dietary pattern high in saturated fatty acids, dietary energy density, and sodium with coronary heart disease

This study aimed to determine the association between dietary pattern (DP) and coronary heart disease (CHD) among high-risk adults as determined by metabolic syndrome (MetS) criteria in Malaysia. This cross-sectional study involved 365 participants with (CHD = 178; non-CHD = 187) who were recruited from selected health clinics. Dietary intake was measured using a 189-item semi-quantitative foods frequency questionnaire (FFQ) whilst anthropometry and clinical data were measured by trained researcher and biochemical data were obtained from medical records. The reduced rank regression (RRR) method was used to derive DPs scores and binary logistic regression was used to assess the associations between identified DPs and CHD. The main DP found in this study was characterised by “high saturated fatty acid (SFA), high dietary energy density (DED), high sodium”. This DP, which is attributed to high consumption of coconut-based dishes, fast foods and snacks, rice dishes, fat spread, seasoning sauces, salted and processed foods, and low intake of fruits, green leafy vegetables, white rice and other vegetables were associated with CHD (OR:1.32, 95% CI:1.03, 1.69) p value = 0.026 when, adjusted for age, sex, race, education level, household income, family history of CHD, marital status, smoking status, physical activity, stress level and BMI. This study suggests that individuals with a DP of high SFA, high DED, and high sodium have a significantly increased likelihood of having CHD compared to those who do not practice this DP.

Obesity, Fitness and Other Risk Factors in Pacific Islanders Compared with Asian Young Adults

ObjectivesObesity, fitness and other risk factor data for Native Hawaiians and Other Pacific Islanders (NHOPI) are frequently aggregated with Asians, who comprise the largest proportion of the Asian and Pacific Islanders (API) race/ethnic category. However, NHOPI compared with Asians are more at-risk and have higher obesity-related morbidity and mortality outcomes. Aggregated data may not provide accurate NHOPI health outcomes data. Therefore, our objective was to measure differences between fitness, obesity and other risk factors in Pacific Islanders (PIs) compared with Asian young adults.MethodsParticipants completed fitness and obesity assessments, and a health questionnaire from 2006–2015 at a university in Southern California. Participants who self-identified as PIs (n = 191) and Asians (n = 769) were included in the analysis. Independent sample t-tests were conducted to examine differences between PIs and Asians for descriptive statistics, blood pressure, smoking, family history of coronary heart disease (CHD), as well as fitness parameters, including % (%) body fat, relative VO2 max, strength grip, body mass index (BMI) and overall total fitness score (FS). Multiple linear regression was used to investigate the relationship between race/ethnicity (PI vs. Asians) and obesity (dependent variable), adjusting for age, gender, and total FS score.ResultsPacific Islander young adults showed significantly higher BMI (23.55 ± 4.06 vs. 22.89 ± 3.83; p = 0.035), % body fat (20.12 ± 7.23 vs. 18.80 ± 7.49; p = 0.029), and higher family history of CHD (p = 0.007) compared to Asians. When controlling for age, gender, and total FS score, significant (p = 0.035) differences in BMI between PIs and Asian young adults persisted. In addition, when comparing BMI by total FS score, PI young adults had significantly higher BMI compared with Asians for only moderate FS scores.ConclusionsEven at a young age, we observed increased BMI, % body fat and CHD family history for PIs compared with Asians. Obesity differences persisted despite controlling for age, sex and total FS. The findings support the disaggregation of PI and Asian health data, specifically to hone/tailor obesity prevention and physical activity programs in the NHOPI as early as in college-aged populations.Funding SourcesNIH.

Awareness and Knowledge of Coronary Heart Disease among the General Population: A Systematic Review

Introduction: Coronary heart disease (CHD) is one of the cardiovascular diseases that become the leading cause of death (LCOD) in the United States. Knowledge gaps in CHD and its risk factors are significant obstacles to effective prevention and treatment. People's awareness of CHD and their knowledge of its risk factors could provide crucial information for behavior change in the prevention of CHD. Therefore, the purpose of this review was to examine some of the literature on the knowledge and awareness of CHD in the general population.&#x0D; Study Design: Systematic Review.&#x0D; Methodology: Two databases were searched for publications between 2011 and 2021. All studies that were published in English and had components of awareness and knowledge related to CHD were included. A total of 1082 titles and abstracts were screened, 55 full-text articles were assessed and 15 were included for review.&#x0D; Results: This review used data from a total of 4907 respondents and the results were varied. Studies that were conducted in the same countries might have different results. Men and participants with a college education have better knowledge than their counterparts. Meanwhile, another study shows that the elderly have poor knowledge about CHD. Several studies conducted among university employees showed that the majority of participants had poor knowledge of risk factors, while another study showed good knowledge.&#x0D; Conclusion: Our review study showed that most of the study participants had low awareness of CHD and knowledge of its risk factors. Family history of CHD, risk factor profile, and some sociodemographic factors have been reported to be associated with the awareness and knowledge of CHD. Providing health information by healthcare professionals can be the right way to increase people’s awareness and knowledge in order to prevent CHD in the future.

Risk Factors for Coronary Heart Disease Among Lebanese Women: A Case-Control Study.

PurposeWomen are increasingly concerned by coronary heart disease (CHD), with peculiarities of their own, particularly concerning risk factors. The aim of the study was to assess the risk factors for CHD in Lebanese women over forty.Patients and MethodsA case–control study was carried out in 6 hospitals in Beirut and Mount-Lebanon, from December 2018 to December 2019 including 1500 patients (1200 controls and 300 cases). Women were stratified into pre- and post-menopausal groups. Personal and medical data were collected from hospital records and during an interview where validated questionnaires were used. Binary logistic regressions were performed to investigate potential predictors of CHD in the 2 groups.ResultsIn post-menopausal women, dyslipidemia (adjusted odds ratio [aOR], 3.018; 95% confidence interval, 2.102–4.332), hypertension (aOR: 2.449, [1.386–4.327]), a family history of CHD (aOR: 2.724, [1.949–3.808]), cigarette smoking (aOR: 2.317, [1.574–3.410]) and common non-rheumatic joint pain (aOR: 1.457, [1.053–2.016]) were strongly associated with CHD. Conversely, living in Mount Lebanon seemed protective, compared to Beirut (aOR: 0.589, [0.406–0.854]), as well as having a moderate monthly income (aOR: 0.450, [0.220–0.923]), adhering to a Mediterranean diet (aOR: 0.965, [0.936–0.994]), and practicing physical activity [PA] (aOR: 0.396, [0.206–0.759] and 0.725, [0.529–0.992], respectively for high and moderate vs low PA). In pre-menopausal women, dyslipidemia (aOR: 6.938, [1.835–26.224]), hypertension (aOR: 6.195, [1.318–29.119]), family histories of dyslipidemia (aOR: 6.143, [1.560–24.191]) and CHD (aOR: 4.739, [1.336–16.805]) reached statistical significance.ConclusionThe identification of factors associated with CHD in women, some of which are frequent and trivialized in post-menopause, underlines the need to put in place specific and dedicated CHD prevention strategies in women.

Nonlaboratory-based risk assessment model for coronary heart disease screening: Model development and validation

BackgroundIdentifying groups at high risk of coronary heart disease (CHD) is important to reduce mortality due to CHD. Although machine learning methods have been introduced, many require laboratory or imaging parameters, which are not always readily available; thus, their wide applications are limited. ObjectiveThe aim of this study was to develop and validate a simple, efficient, and joint machine learning model for identifying individuals at high risk of CHD using easily obtainable nonlaboratory parameters. MethodsThis prospective study used data from the Henan Rural Cohort Study, which was conducted in rural areas of Henan Province, China, between July 2015 and September 2017. A joint machine learning model was developed by selecting and combining four base machine learning algorithms, including logistic regression (LR), artificial neural network (ANN), random forest (RF), and gradient boosting machine (GBM). We used readily accessible variables, including demographics, medical and family history, lifestyle and dietary factors, and anthropometric data, to inform the model. The model was also externally validated by a cohort of individuals from the Dongfeng-Tongji cohort study. Model discrimination was assessed by using the area under the receiver operating characteristic curve (AUC), and calibration was measured by using the Brier score (BS). ResultsA total of 38 716 participants (mean [SD] age, 55.64[12.19] years; 23449[60.6%] female) from the Henan Rural Cohort Study and 17 958 subjects (mean [SD] age, 62.74 [7.59] years; 10,076 [56.1%] female) from the Dongfeng-Tongji cohort study were included in the analysis. Age, waist circumference, pulse pressure, heart rate, family history of CHD, education level, family history of type 2 diabetes mellitus (T2DM), and family history of dyslipidaemia were strongly associated with the development of CHD. In regard to internal validation, the model we built demonstrated good discrimination (AUC, 0.844 (95% CI 0.828–0.860)) and had acceptable calibration (BS, 0. 066). In regard to external validation, the model performed well with clearly useful discrimination (AUC, 0.792 (95% CI 0.774–0.810)) and robust calibration (BS, 0.069). ConclusionsIn this study, the novel and simple, machine learning-based model comprising readily accessible variables accurately identified individuals at high risk of CHD. This model has the potential to be widely applied for large-scale screening of CHD populations, especially in medical resource-constrained settings.Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register. (Trial registration: ChiCTR-OOC-15006699. Registered 6 July 2015 - Retrospectively registered) http://www.chictr.org.cn/showproj.aspx?proj=11375.

The Predictive Effect of Negative Psychological Emotions of Anxiety and Depression on the Poor Prognosis of CHD Patients with Stent Implantation and the Improvement of Clinical Intervention Measures.

Objective To explore the predictive effect of negative emotions such as anxiety and depression on the poor prognosis of coronary heart disease (CHD) patients with stent implantation and to seek the improvement of clinical intervention measures. Methods A total of 303 patients with CHD and PCI were recruited from February 2019 to April 2021. The risk factors of CHD such as anxiety and depression, age, sex, smoking and drinking, BMI, hypertension, diabetes, dyslipidemia, and family history of CHD were collected. Meanwhile, clinical data such as laboratory examination, angiography, diseased vessels, and stent types were collected. The patients were followed up for 1 year, and the medical records, hospitalization records, or death records were checked by telephone interview once a month. Major adverse cardiovascular events (MACE) such as emergency and causes, readmission times and causes, new nonfatal myocardial infarction, stent restenosis, heart failure, arrhythmia, and death were recorded. The incidence of anxiety and depression in patients after PCI was counted, and Cox regression was applied to analyze the influence and prediction of anxiety and depression on MACE in patients with CHD stent implantation and improve clinical intervention measures. Results Compared with those without MACE, anxiety (56.25% vs 30.63%), depression (62.5% vs 22.88%, P < 0.01), anxiety combined with depression (46.88% vs 15.50%, P < 0.01), and hypertension history (71.8% vs 39.11%, P < 0.01) were more common in patients with MACE. Uncorrected Cox proportional hazard regression found that people with anxiety had a higher risk of developing MACE than those without anxiety (HR 3.181, P < 0.01). Multiple Cox proportional hazard regression analysis of anxiety showed that anxiety was an independent predictor of cumulative MACE (P < 0.01). The risk of developing MACE in patients with anxiety was 3.742 times higher than that in patients without anxiety (P < 0.01). Uncorrected Cox hazard regression analysis showed that people with depression had a higher risk of developing MACE than those without depression (HR 5.434, P < 0.01). Furthermore, the results also uncovered that depression was an independent predictor of cumulative MACE (P < 0.01). The risk of MACE in patients with depression was 3.087 times higher than that in patients without depression (P < 0.01). Cox hazard regression showed that the risk of MACE in patients with anxiety and depression was significantly higher than that in patients without anxiety and depression (HR 4.642, P < 0.01). After screening, it was found that anxiety with depression could predict the occurrence of MACE (P < 0.01). The risk of MACE in patients with anxiety and depression was 3.702 times higher than that in patients without anxiety and depression (P < 0.01). Cox regression analysis showed that the risk of MACE with only anxiety and depression was 2.793 times higher than that without anxiety and depression (95% CI 0.914 8.526), with no statistical significance (P > 0.05), and the risk of MACE with depression without anxiety was significantly higher than that without anxiety and depression (P < 0.01). The risk of MACE in patients with anxiety and depression was 7.303 times higher than that in patients without anxiety and depression (P < 0.01). Conclusion Negative emotions such as anxiety and depression can increase the risk of poor prognosis of patients with CHD. Therefore, in clinical work, in addition to routine treatment and nursing during hospitalization, it is recommended to screen patients with depression in CHD patients. Medical staff should use simple and effective assessment tools in time and take active measures to improve the depression of patients. This trial is registered with ChiCTR2200055645.

Development and Validation of a Predictive Model for Chronic Kidney Disease After Percutaneous Coronary Intervention in Chinese.

AimThere is no model for predicting the outcomes for coronary heart disease (CHD) patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI). To develop and validate a model to predict major adverse cardiovascular events (MACEs) in patients with comorbid CKD and CHD undergoing PCI.MethodsWe enrolled 1714 consecutive CKD patients who underwent PCI from January 1, 2008 to December 31, 2017. In the development cohort, we used least absolute shrinkage and selection operator regression for data dimension reduction and feature selection. We used multivariable logistic regression analysis to develop the prediction model. Finally, we used an independent cohort to validate the model. The performance of the prediction model was evaluated with respect to discrimination, calibration, and clinical usefulness.ResultsThe predictors included a positive family history of CHD, history of revascularization, ST segment changes, anemia, hyponatremia, transradial intervention, the number of diseased vessels, dose of contrast media >200 ml, and coronary collateral circulation. In the validation cohort, the model showed good discrimination (area under the receiver operating characteristic curve, 0.612; 95% confidence interval: 0.560, 0.664) and good calibration (Hosmer-Lemeshow test, P = 0.444). Decision curve analysis demonstrated that the model was clinically useful.ConclusionsWe created a nomogram that predicts MACEs after PCI in CHD patients with CKD and may help improve the screening and treatment outcomes.

Prevalence of Coronary Heart Diseases Risk Factors among Healthcare Male Students in KSAU-HS Riyadh, Saudi Arabia

Background: Coronary heart disease (CHD) is a condition in which plaque builds up on the inner walls of coronary arteries and can lead to blood clot formation. It is the leading cause of death worldwide. Developing coronary heart disease takes long period and its risk factors can be found in young people.&#x0D; Objectives: Study of risk factors that contribute to the pathogenesis of coronary artery disease.&#x0D; Methods: A cross-sectional study was done at King Saud bin Abdul-Aziz University in Riyadh. Non-probability convenience sampling was used to select 151 health care students. The data was collected through questionnaire and physical measurements. The data was entered and analyzed by SPSS.&#x0D; Results: More than half of the students eat fruits one or less time per week which accounts for 53.6%. Moreover, 28.5% of them eat vegetables one time or less per week. Regarding healthy food containing healthy fat such as fish, 76.2% of the students include healthy fat food in their diet more than two times per week. The percentage of those who eat fast food and consume soft drinks is 80.8% and 70.2% more than two times per week respectively. Furthermore, the percentage of the students who are smokers, either currently or occasionally is 49%. Concerning physical activity, 31.3% of the students exercise more than two times weekly, and only 7.3% of the students watch TV more than four hours per day. On the other hand, the majority which accounts for 54.3% of the students use computer, laptop, or tablet more than four hours per day. Regarding premature CAD, 3.3% of the students reported positive and 16.2% of them reported positive for CHD family history. Finally, 1.3% of the found to have DM.

Clusters of the Risk Markers and the Pattern of Premature Coronary Heart Disease: An Application of the Latent Class Analysis

Background: Coronary heart disease (CHD) is the major cause of mortality in the world with a significant impact on the younger population. The aim of this study was to identify prematurity among patients with coronary artery bypass graft surgery (CABG) based on the clustering of CHD risk factors.Methods: Patients were recruited from an existing cohort of candidates for CABG surgery named Tehran Heart Center Coronary Outcome Measurement (THC-COM). A latent class analysis (LCA) model was formed using 11 potential risk factors as binary variables: cigarette smoking, obesity, diabetes, family history of CHD, alcohol use, opium addiction, hypertension, history of stroke, history of myocardial infarction (MI), peripheral vascular disease (PVD), and hyperlipidemia (HLP). We analyzed our data to figure out how the patients are going to be clustered based on their risk factors.Results: For 566 patients who were studied, the mean age (SD) and BMI of patients were 59.1 (8.9) and 27.3 (4.1), respectively. The LCA model fit with two latent classes was statistically significant (G2 = 824.87, df = 21, p < 0.0001). The mean (SD) age of patients for Class I and Class II was 55.66 (8.55) and 60.87 (8.66), respectively. Class I (premature) was characterized by a high probability of smoking, alcohol consumption, opium addiction, and a history of MI (P < 0.05), and class II by a high probability of obesity, diabetes, and hypertension.Conclusion: Latent class analysis calculated two groups of severe CHD with distinct risk markers. The younger group, which is characterized by smoking, addiction, and the history of MI, can be regarded as representative of premature CHD.

Family History is Related to High Risk of Recurrent Events after Ischemic Stroke or Transient Ischemic Attack

ObjectivePrior data suggest paternal or sibling stroke was associated with increased risk of offspring stroke. Whether family history of cardiovascular disease (FHc) predicts risk of stroke recurrence remains unclear, we aim to determine this issue on patients with ischemic stroke (IS) or transient ischemic attack (TIA). Materials and MethodsThis is a post hoc analysis based on the Third China National Stroke Registry III. IS/TIA patients with data of FHc status were included. FHc was defined as family history of coronary heart disease (CHD) or stroke among first-degree relatives (include parents, children, and siblings (same parents)). Cox proportional hazards regression models were performed to assess the association between FHc and recurrent events at 1 year follow-up. ResultsTotally 14,208 patients with verified FHc status were included, 4,454 (31.3%) were female and the median (IQR) age was 62.0 (54.0, 70.0) years. Of these, 294 (2.1%), 726 (5.1%) and 1936 (13.6%) had family history of both CHD and stroke, family history of CHD, and family history of stroke only, respectively. Using multivariable Cox models adjusted for age, sex, and vascular risk factors, we found that patients with FHc experienced higher risk of stroke recurrence (HR=1.151, 95%CI=1.000-1.324) and combined vascular events (HR=1.186, 95%CI=1.036-1.358) at 1 year compared with those without FHc. In sensitivity analysis on patients who received primary secondary prevention treatment of antiplatelet and statins, the association persisted. ConclusionsFHc is associated with increased risk of stroke recurrence even under primary secondary prevention treatment.