Family History Of Heart Disease Research Articles

Rome III Criteria Capture Higher Irritable Bowel Syndrome SNP-Heritability and Highlight a Novel Genetic Link with Cardiovascular Traits

Irritable bowel syndrome (IBS) shows genetic predisposition, and large-scale genome-wide association studies (GWAS) are emerging, based on heterogeneous disease definitions. We aimed at investigating the genetic architecture of IBS defined according to gold-standard Rome Criteria. We conducted GWAS meta-analyses of Rome III IBS and its subtypes in 24,735 IBS cases and 77,149 asymptomatic controls from two independent European cohorts (UK Biobank and Lifelines). SNP-based heritability (h2SNP) and genetic correlations (rg) with other traits were calculated. IBS risk loci were functionally annotated to identify candidate genes. Sensitivity and conditional analyses were conducted to assess impact of confounders. Polygenic risk scores (PRS) were computed and tested in independent datasets. Rome III IBS showed significant SNP-heritability (up to 13%) and similar genetic architecture across subtypes, including those with manifestations at the opposite ends of the symptom spectrum (rg=0.48 between IBS-D and IBS-C). Genetic correlations with other traits highlighted commonalities with family history of heart disease and hypertension, coronary artery disease, and angina pectoris (rg=0.20-0.45), among others. Four independent GWAS signals (p<5×10-8) were detected, including two novel loci for IBS (rs2035380) and IBS-Mixed (rs2048419) that had been previously associated with hypertension and coronary artery disease. Functional annotation of GWAS risk loci revealed genes implicated in circadian rhythm (BMAL1), intestinal barrier (CLDN23), immunomodulation (MFHAS1), and the cAMP pathway (ADCY2). PRS allowed the identification of individuals at increased risk of IBS (OR=1.34, p=1.1×10-3). Rome III Criteria capture higher SNP-heritability than previously estimated for IBS. The identified link between IBS and cardiovascular traits may contribute to the delineation of alternative therapeutic strategies, warranting further investigation.

Diagnosing Peripartum Cardiomyopathy in a Resource-Limited Setting, a Clinical Perspective: Case Report

Peripartum cardiomyopathy is a rare case of heart failure with reduced ejection fraction and is considered a diagnosis of exclusion. The symptoms of heart failure in patients with peripartum cardiomyopathy can mimic the physiologic conditions of normal pregnancy. In an acute decompensated state, PPCM can present with acute severe upper abdominal or epigastric pain. We are presenting a 24-year-old female with no personal or family history of heart disease and no identifiable risk factor for PPCM. Based on her initial presentation in the emergency department, a diagnosis of acute severe pancreatitis was sought, and she was referred to the Intensive Care Unit. After further evaluation of the serological tests and imaging, she was eventually diagnosed as a case of PPCM. We emphasize the rare nature of the disease with a diverse presentation which poses a diagnostic challenge, especially in a resource-limited setting where advanced diagnostic tools may be restricted and socioeconomic condition poses a barrier to further patient evaluation. This case exemplifies the infrequent occurrence and atypical manifestation, presenting a learning opportunity for future clinicians.

The Relationship Between Live Births and CVD Among African American Women in Jackson Heart Study

Background Previous studies have reported mixed results on the relationship between live births and cardiovascular disease among African American females, with few controlling for an inclusive list of major cardiovascular disease (CVD) risk factors and/or including a large population of African American female participants. Methods To help clarify this issue we examined the relationship between live births and cardiovascular events, including major CVD risk factors in a well-studied, exclusively African American cohort. Data was from 3367 African American women, 21 and older, in the Jackson Heart Study. Myocardial Infraction (MI), Self-reported history of cardiac procedures, Coronary Heart Disease Status/History, Self-reported history of Carotid Angioplasty, Cardiovascular Disease history, and Heart Failure History were obtained from 2000 to 2004 interviews. Live births were self-reported. Chi-square test indicated a significant association between live births and the presence of CVD (p =.000). Logistic regression estimated the relationship between live births and cardiovascular events, adjusting for major cardiovascular risk factors. Results After adjusting for hypertension status, current smoking status, cholesterol status, diabetes status, family history of heart diseases (mother), family history of heart disease (father), age, frequency of alcohol use in the past 12 months, and the average number of drinks per week in the past 12 months, there was no longer a significant relationship between live births and the risk of CVD (AOR 1.012, 95% CI, 1.009-1.015, p=.895). Discussion The unadjusted significant relationship between live births and CVD events disappeared after adjusting for major CVD risk factors, which suggests that an association between live births and CVD is indirect and based on the distribution of CVD risk factors. Conclusion Therefore, we propose more research on the use of live births as a CVD indicator in African American/Black women to ensure that African American/Black women obtain optimum cardiovascular health and make informed reproductive decisions.

Knowledge about the Risk of Cardiovascular Disease among Adults with Type 2 Diabetes in Taif City, Saudi Arabia: A Cross sectional study

Background: Diabetes patients are significantly more likely to develop cardiovascular diseases (CVDs). Lack of understanding about the disease’s risk for CVDs would increase morbidity and mortality. Objectives: The purpose of this study was to ascertain the level of awareness among persons with type 2 diabetes in Taif, Saudi Arabia, regarding their risk of CVDs. Methods: A cross-sectional study was carried out on 300 type 2 diabetic patients through an online survey. Results: The mean knowledge of risk of cardiovascular disease among adults in Taif was 15.4 ± 5.4. 26% of the participants had an age range from 50-59 years and 57.1% were females. Most of the participants had an age at diabetes diagnosis more than 30 years and 41.7% had a duration of disease less than 5 years. Regarding knowledge of participants it was reported that, a family history of heart disease 55.8%, old age 66%, smoking 79.5%, high blood pressure 76.9% and bad cholesterol (LDL) 74.4% at higher risk for developing heart disease. 64.4% knew\ they should keep their blood pressure under control and 80.1% knew regular exercise can reduce their risk of developing heart disease. There was a positive relationship between participants education level and knowledge. Conclusion: This study found that adults with type 2 diabetes in Taif have a high level of knowledge about the risk of cardiovascular disease. Education and preventive measures for patients about CVD risk factors and diabetes management can improve health and reduce the risk of CVD. Keywords: knowledge, risk, CVD, DM, adults, Taif

Investigating the Correlation between Obesity Indices and Heart Rate Recovery After Exercise Testing

Background: Heart rate recovery (HRR) after exercise is a specific measure of the functioning of the autonomic nervous system. A rapid HRR immediately after exercise is associated with a lower risk of cardiovascular disease. Besides, there is a correlation between post-exercise HRR and cardiovascular risk factors. Objectives: This study investigated the correlation between obesity indices after exercise testing and HRR to evaluate the autonomic system and the risk of cardiovascular diseases. Methods: In this cross-sectional study, 108 non-random consecutive patients over 18 years old with indications for exercise testing were selected from those referred to Modarres Hospital in Tehran between 2021 - 2022. The patients were subjected to an exercise test, and the decrease in heart rate was recorded in the first and second minutes after the exercise testing. Then, the correlation between obesity indices and risk factors for cardiovascular diseases and the HHR was evaluated. Results: Based on our results, none of the obesity indices such as weight, height, BMI, neck circumference, waist circumference, hip circumference, WHR, ABSI, ABI, or BAI showed a significant correlation with the reduction of the heart rate one and two minutes after the exercise test. However, the heart rate reduction one minute after the exercise test was significantly lower in patients with a family history of heart disease. Also, the heart rate reduction two minutes after the exercise test was significantly lower in diabetic patients, hyperlipidemic patients, and patients with insufficient sleep. Conclusions: Although there was no significant correlation between obesity indices and heart rate reduction after exercise tests due to the harmful effects of obesity and overweight on cardiac function and its increasing prevalence, clinical trial studies will be beneficial in clarifying the effects of obesity indices on cardiac efficiency.

Modifiable risk factors for cardiovascular disease in Iraqi Kurdistan population: a large epidemiological study

Cardiovascular diseases (CVDs) are considered the leading factor of morbidity and mortality across the world. This study aimed to identify the modifiable risk factors of CVDs in the Kurdistan Region. In this retrospective cross-sectional study, the patients who visited and were diagnosed with any type of CVDs and treated in a main private cardiac center in Duhok governorate in Kurdistan Region were included between the years 2018 and 2023. The study found a similar percentage of male and female patients. The percentage of old patients was significantly increased from 18-19 to ≥70. The most preventable modifiable risk factors among cardiac patients were hypertension (86.17%), physical inactivity (60.59%), diabetes (40.15%), and dyslipidemia (56.31%). The less preventable modifiable risk factors were alcohol (4.01%) and cigarette smoking (14.43%). Males had a higher prevalence of cigarette smoking (24.63% vs. 4.38%; P&lt;0.0001) and female patients had a higher prevalence of hypertension (91.25% vs. 81.02%; P&lt;0.000), diabetes (44.43% vs. 35.80 %; P=0.0007) and dyslipidemia (59.15% vs. 53.43%; P=0.0257). In terms of family history of heart disease, the middle age group had a higher prevalence compared to younger and older age groups. Diabetes and cigarette smoking was more prevalent among older age groups, while dyslipidemia was more prevalent among younger and older age groups. Alcohol, physical inactivity, and hypertension were similar among age groups. Hypertension, diabetes, dyslipidemia, and physical inactivity were the most prevalent risk factors for CVDs in this region. The older patients had significantly higher rates of some of these risk factors.

Investigating the Risk Factors of Congenital Heart Diseases in Newborns Admitted to Amir al-Momenin Hospital in Semnan from 2020-2021

Introduction: Congenital heart defects refer to conditions that affect the structure and function of a newborn’s heart. The aim of this study was to investigate the prevalence and risk factors of congenital heart diseases in hospitalized infants in the neonatal intensive care unit of Amiralmomenin Hospital in Semnan. Methods: In this study, 300 medical records of hospitalized infants who underwent echocardiography in the neonatal intensive care unit of Amiralmomenin Hospital in Semnan during 2020-2021 were reviewed. The overall prevalence of congenital heart diseases and their types (ASD/VSD/PDA/TOF) were determined, and the association of study variables (infant gender, gestational age, maternal age, infant weight, parental family history, medication use during pregnancy, and history of heart disease and gestational diabetes) with congenital heart disease was evaluated. Results: The results showed that out of the total 300 hospitalized infants who underwent echocardiography, 132 infants (44%) were diagnosed with congenital heart disease. PDA and VSD were the most common types of congenital heart diseases with a prevalence of 8.56% and 5.23%, respectively. Conclusion: According to the results, there was a significant association between congenital heart disease and diabetes, hypertension, as well as medication use during pregnancy and family history of heart disease , infant gender, gestational age, and weight did not show a significant association. However, there was a significant association between the type of congenital heart disease and gestational age and infant weight, with an increase in gestational age and infant weight leading to a decrease in the prevalence of congenital heart disease

Association between obstructive sleep apnea and heart failure in patients with and without obesity: a population-based cohort study

Abstract Background Obstructive sleep apnea (OSA) is a prevalent disorder characterized by partial or complete airway collapse during sleep, which often leads to sleep disruption and intermittent hypoxia. Previous research has suggested that patients with heart failure (HF) are more likely to have OSA. However, not enough evidence is available for association between new-onset OSA and HF. A recent Danish cohort study found that OSA, without continuous positive airway pressure therapy, is linked to a higher risk of HF across all age groups (1). In addition, the association between OSA and HF in patients with and without obesity has not been extensively studied in a large Asian cohort. Purpose To investigate the association between obstructive sleep apnea (OSA) and heart failure (HF) in a large Asian cohort stratified by obesity, as defined by World Health Organization (WHO) criteria for the Asian population, in both patients with and without obesity. Methods Using a nationally representative cohort of Korean adults over 40 years old who underwent national health screening between 2009 and 2010 with no prior history of HF or cardiovascular disease, we identified OSA using outpatient visit records (ICD-10: G47.3). Participants were tracked from January 1, 2011 to December 31, 2019 for new HF events, death from HF or other causes, or the end of follow-up, whichever occurred first. A Cox proportional hazards model adjusted for sociodemographic factors, health status, health behavior, and family history of heart disease was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Obesity was defined as a body mass index greater than 25.0 kg/m2 based on WHO criteria for the Asian population. Results The final study population included 326,662 participants (32.7% of them were with obesity). Among obese patients, those with OSA had a higher risk of developing HF (HR=1.52; 95% CI: 1.07-2.19) than those without OSA. The association between OSA and HF was less pronounced in non-obese patients (HR=1.07; 95% CI: 0.65-1.78 for HF in patients with OSA compared to those without OSA) with a significant interaction between obesity and OSA-HF association (P-value for interaction&amp;lt;0.001). Conclusions Our findings suggest that OSA is linked to an increased risk of HF, particularly in obese patients. Further research is necessary to examine important clinical subgroups regarding prevention of HF in patients with OSA.

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.

Genetics and Ischemic Heart Disease: Should We Opt for Genetic Testing for Primary Prevention?

Cardiovascular diseases (CVD) are a prevalent health concern within the general population of Pakistan, where the average lifespan is notably lower than the global average, with men typically living to 67 years and women to 69 years. According to the 2019 Global Burden of Disease study, Pakistan had an estimated age-standardized incidence rate of CVD at 918.18 per 100,000 (compared to the global rate of 684.33 per 100,000), along with an age-standardized death rate of 357.88 per 100,000 (globally, this rate is 239.85 per 100,000).1 Coronary heart disease (CHD), as revealed by the Framingham Heart Study focusing on individuals aged 40 to 94 without prior heart disease, displayed a lifetime risk of 49% for men and 32% for women when reaching the age of 40.2 There has been a declining trend in death rates in the United States attributed to CVD, CHD, and stroke since 1975. Data from 2000 to 2008 also indicate a decline in CHD mortality.3 Worryingly, the World Health Organization (WHO) reports a concerning rise in CHD-related fatalities in Pakistan. In 2020, 240,720 individuals died due to CHD, accounting for 16.49% of all deaths. This highlights an escalating trend of CHD-related mortality in Pakistan. It's important to note that most individuals presenting with cardiac events have one or more established or borderline risk factors aside from age and gender.4-6 While some essential risk factors are discernible, others may remain elusive. The screening of these risk factors and the evidence for targeted therapeutic interventions are still emerging and require further exploration.7 The starting point for assessing CVD risk factors is variables used to predict major cardiovascular events. These include age, sex, blood pressure, cholesterol levels, diabetes mellitus, and smoking status. Although risk assessment tools like the Pooled Cohort Equation in 2014 and Astro-CHARM have been developed, they have yet to provide satisfactory assessments for potential new CVD risk factors.8 CHD is recognized as a multifactorial disorder resulting from genetic and environmental factors interplay. Environmental risk factors have been identified in approximately 80% of CHD cases.9 Several risk scores, such as the Framingham Risk Score, PROCAM, Reynolds Risk Score, and QRISK 2, have been proposed to guide the use of statins in high-risk groups.10-14 Yet, these risk scores often lack precision and may either overestimate or underestimate future CHD events.15,16 The variation in disease susceptibility among individuals with similar environmental factors and conventional coronary artery disease risk factors (CRFs) may be attributed to genetic variations.17 Genetic analysis can potentially enhance risk discrimination beyond the consideration of CRFs alone. Family history of heart disease, accounting for more than 40% of risk estimation, has long been considered a part of CRFs.18 Candidate gene studies have been conducted to identify common variants in genes associated with disease pathways.19 Single-nucleotide polymorphisms (SNPs) have been employed as markers of genetic diversity. Among these SNPs, those located on the 9p21 locus have shown the strongest association with CHD risk to date.20,21 However, despite the clear link between these variants and incident CHD, 9p21 locus SNPs have not definitively improved the prediction or classification of CHD risk compared to traditional risk factors.22-24 It is important to note that most genetic studies on CHD have predominantly focused on European/Caucasian populations, and their applicability to the South Asian population, including Pakistan, requires further investigation.25,26 In this context, the Pakistani population, much like other Asian countries, is underrepresented in genetic research on CHD. Shahid SU et al. did some work in this respect,27 showing 21 SNPs risk score for genetic risk analysis in the Pakistani population. In conclusion, while different risk assessment tools have been developed for the Pakistani population aged 40 years and above, there is an urgent need to expand cardiac risk evaluation by identifying genetic markers related to CHD, particularly in the younger population. This will be crucial for advancing our understanding of CHD risk factors and developing more effective prevention and intervention strategies.

Prevalence and factors associated with undiagnosed and uncontrolled heart disease: A study based on self-reported chronic heart disease and symptom-based angina pectoris among middle-aged and older Indian adults.

This study aimed to examine the prevalence of heart diseases and angina pectoris and associated factors among middle-aged and older Indian adults. Additionally, the study examined the prevalence and associated factors of undiagnosed and uncontrolled heart disease among middle-aged and older adults based on self-reported chronic heart disease (CHD) and symptom-based angina pectoris (AP). We used cross-sectional data from the first wave of the Longitudinal Ageing Study of India, 2017-18. The sample consists of 59,854 individuals (27, 769 males and 32,085 females) aged 45 years and above. Maximum likelihood binary logistic regression models were employed to examine the associations between morbidities, other covariates (demographic factors, socio-economic factors and behavioral factors) and heart disease and angina. A proportion of 4.16% older males and 3.55% older females reported the diagnosis of heart diseases. A proportion of 4.69% older males and 7.02% older females had symptom-based angina. The odds of having heart disease were higher among those who were hypertensive and who had family history of heart disease, and it was higher among those whose cholesterol levels were higher. Individuals with hypertension, diabetes, high cholesterol and family history of heart disease were more likely to have angina than their healthy counterparts. The odds of undiagnosed heart disease were lower but the odds of uncontrolled heart disease were higher among those who were hypertensive than non-hypertensive individuals. Those having diabetes were less likely to have undiagnosed heart disease while among the diabetic people the odds of uncontrolled heart disease were higher. Similarly, higher odds were observed among people with high cholesterol, having stroke and also among those who had a history of heart disease than their counterparts. The present study provided a comparative prevalence of heart disease and agina and their associations with chronic diseases among middle-aged and older adults in India. The higher prevalence of undiagnosed and uncontrolled heart disease and their risk factors among middle-aged and older Indians manisfest alarming public health concerns and future health demand.

Dyslipidemia and its associated factors among adult cardiac patients at Ambo university referral hospital, Oromia region, west Ethiopia

BackgroundCardiovascular disease is a cluster of illnesses that affect the heart and blood vessels. Dyslipidemia is the most common risk factor for cardiovascular disease, causing more than 4 million deaths each year worldwide. However, there is very little evidence concerning the prevalence and pattern of dyslipidemia among cardiac patients in Ethiopia.MethodsHospital-based cross-sectional study was conducted from June to September 2022 at Ambo University referral hospital. Data on socio-demographic, clinical and anthropometric features were collected from adults with cardiac diseases using a convenient sampling technique. Lipid profiles and uric acid were measured from overnight fasting blood. The national cholesterol education program adult treatment panel (NCEP-ATP) III criteria was used to define dyslipidemia.ResultsA total of 269 participants were enrolled and the overall 76.6% [95% confidence interval (CI):72.1–81] of patients had at least one dyslipidemia. The prevalence of total cholesterol (TC) ⩾200 mg/dl, triglyceride (TG), LDL-cholesterol and HDL-cholesterol < 40 mg/dl were 38.9%, 44.6%, 29.4%, and 53.5%, respectively. Age > 54 was associated with TC and TG dyslipidemia, adjusted odds ratio (aOR) and (95% CI) were 2.6(1.4–4.8) and 2.4(1.2–4.7), respectively. While, a family history of heart disease, sedentary lifestyle and obesity were associated with TC dyslipidemia, aOR (95%CI) were 1.9(1.1–3.5), 1.4 (1.4–14.6) and 6.7 (1.4–32.5), respectively. In addition, diabetetes mellitus and abdominal obesity were significantly associated with TG dyslipidemia, aOR (95%CI) were 1.9(1.0–3.6) and 2.6(1.16–5.8), respectively. Moreover, uric acid was positively correlated with TC and TG level.ConclusionsThe results indicate that more than 75% of the cardiac patients had at least one dyslipidemia. This reflects the need for regular monitoring of lipid profiles and intensive counseling in this population to mitigate further cardio-metabolic complications.

Current chemoprevention approaches in Lynch syndrome and Familial adenomatous polyposis: a global clinical practice survey.

International chemoprevention preferences and approaches in Lynch syndrome (LS) and APC-associated polyposis, including Familial adenomatous polyposis (FAP) and attenuated FAP (AFAP) have not been previously explored. To describe current chemoprevention strategies for patients with LS or FAP/AFAP (referred to collectively as FAP) practiced by members of four international hereditary cancer societies through administration of a survey. Ninety-six participants across four hereditary gastrointestinal cancer societies responded to the survey. Most respondents (91%, 87/96) completed information regarding their demographics and practice characteristics relating to hereditary gastrointestinal cancer and chemoprevention clinical practices. Sixty-nine percent (60/87) of respondents offer chemoprevention for FAP and/or LS as a part of their practice. Of the 75% (72/96) of survey respondents who were eligible to answer practice-based clinical vignettes based off of their responses to ten barrier questions regarding chemoprevention, 88% (63/72) of those participants completed at least one case vignette question to further characterize chemoprevention practices in FAP and/or LS. In FAP, 51% (32/63) would offer chemoprevention for rectal polyposis, with sulindac - 300 mg (18%, 10/56) and aspirin (16%, 9/56) being the most frequently selected options. In LS, 93% (55/59) of professionals discuss chemoprevention and 59% (35/59) frequently recommend chemoprevention. Close to half of the respondents (47%, 26/55) would recommend beginning aspirin at time of commencement of the patient's first screening colonoscopy (usually at age 25yrs). Ninety-four percent (47/50) of respondents would consider a patient's diagnosis of LS as an influential factor for aspirin use. There was no consensus on the dose of aspirin (≤100 mg, >100 mg - 325 mg or 600 mg) to offer patients with LS and there was no agreement on how other factors, such as BMI, hypertension, family history of colorectal cancer, and family history of heart disease, would affect the recommendation for aspirin use. Possible harm among older patients (>70 years) was identified as the most common reason to discourage aspirin use. Although chemoprevention is widely discussed and offered to patients with FAP and LS by an international group of hereditary gastrointestinal cancer experts, there is significant heterogeneity in how it is applied in clinical practice.

Use of machine learning to identify risk factors for coronary artery disease.

Coronary artery disease (CAD) is the leading cause of death in both developed and developing nations. The objective of this study was to identify risk factors for coronary artery disease through machine-learning and assess this methodology. A retrospective, cross-sectional cohort study using the publicly available National Health and Nutrition Examination Survey (NHANES) was conducted in patients who completed the demographic, dietary, exercise, and mental health questionnaire and had laboratory and physical exam data. Univariate logistic models, with CAD as the outcome, were used to identify covariates that were associated with CAD. Covariates that had a p<0.0001 on univariate analysis were included within the final machine-learning model. The machine learning model XGBoost was used due to its prevalence within the literature as well as its increased predictive accuracy in healthcare prediction. Model covariates were ranked according to the Cover statistic to identify risk factors for CAD. Shapely Additive Explanations (SHAP) explanations were utilized to visualize the relationship between these potential risk factors and CAD. Of the 7,929 patients that met the inclusion criteria in this study, 4,055 (51%) were female, 2,874 (49%) were male. The mean age was 49.2 (SD = 18.4), with 2,885 (36%) White patients, 2,144 (27%) Black patients, 1,639 (21%) Hispanic patients, and 1,261 (16%) patients of other race. A total of 338 (4.5%) of patients had coronary artery disease. These were fitted into the XGBoost model and an AUROC = 0.89, Sensitivity = 0.85, Specificity = 0.87 were observed (Fig 1). The top four highest ranked features by cover, a measure of the percentage contribution of the covariate to the overall model prediction, were age (Cover = 21.1%), Platelet count (Cover = 5.1%), family history of heart disease (Cover = 4.8%), and Total Cholesterol (Cover = 4.1%). Machine learning models can effectively predict coronary artery disease using demographic, laboratory, physical exam, and lifestyle covariates and identify key risk factors.

Genetic and clinical factors underlying a self-reported family history of heart disease.

To estimate how much information conveyed by self-reported family history of heart disease (FHHD) is already explained by clinical and genetic risk factors. Cross-sectional analysis of UK Biobank participants without pre-existing coronary artery disease using a multivariable model with self-reported FHHD as the outcome. Clinical (diabetes, hypertension, smoking, apolipoprotein B-to-apolipoprotein AI ratio, waist-to-hip ratio, high sensitivity C-reactive protein, lipoprotein(a), triglycerides) and genetic risk factors (polygenic risk score for coronary artery disease [PRSCAD], heterozygous familial hypercholesterolemia [HeFH]) were exposures. Models were adjusted for age, sex, and cholesterol-lowering medication use. Multiple logistic regression models were fitted to associate FHHD with risk factors, with continuous variables treated as quintiles. Population attributable risks (PAR) were subsequently calculated from the resultant odds ratios. Among 166 714 individuals, 72 052 (43.2%) participants reported an FHHD. In a multivariable model, genetic risk factors PRSCAD (OR 1.30, CI 1.27-1.33) and HeFH (OR 1.31, 1.11-1.54) were most strongly associated with FHHD. Clinical risk factors followed: hypertension (OR 1.18, CI 1.15-1.21), lipoprotein(a) (OR 1.17, CI 1.14-1.20), apolipoprotein B-to-apolipoprotein AI ratio (OR 1.13, 95% CI 1.10-1.16), and triglycerides (OR 1.07, CI 1.04-1.10). For the PAR analyses: 21.9% (CI 18.19-25.63) of the risk of reporting an FHHD is attributed to clinical factors, 22.2% (CI% 20.44-23.88) is attributed to genetic factors, and 36.0% (CI 33.31-38.68) is attributed to genetic and clinical factors combined. A combined model of clinical and genetic risk factors explains only 36% of the likelihood of FHHD, implying additional value in the family history.

Red flags in patients with hereditary transthyretin amyloidosis at diagnosis in a non-endemic area of Spain.

Hereditary transthyretin (hATTR) amyloidosis with polyneuropathy is a rare multisystemic disease characterised by onset during adulthood and associated with poor prognosis if untreated. A set of signs and symptoms, commonly known as "red flags," have been proposed to assist in early detection of the disease; presence of red flags may suggest underlying hATTR amyloidosis in patients with progressive sensorimotor polyneuropathy. We analysed the frequency of red flags at the time of diagnosis in 30 patients with hATTR amyloidosis in a non-endemic area of Spain; onset was late in the majority of patients. The frequencies of the red flags were as follows: bilateral carpal tunnel syndrome in 15 patients (50%), early autonomic dysfunction in 17 (56%), gastrointestinal problems in 14 (46.6%), unexplained weight loss in 8 (26.6%), heart disease in 12 (40%), asymptomatic cardiac findings in 13 (43.3%), kidney disease in one (3.3%), vitreous opacities in none, family history of neuropathy in 21 (70%), family history of heart disease in 15 (50%), and family history of gastrointestinal problems in 3 (10%). All patients presented at least one red flag at diagnosis, with a median of 4 red flags. Red flags were common at the time of diagnosis, even in patients with late-onset hATTR amyloidosis. Presence of red flags in a patient with symmetrical sensorimotor polyneuropathy should serve as a warning sign, and lead to targeted diagnosis to rule out hATTR amyloidosis, independently of age of onset.

The knowledge of infant CPR among parents visiting Maternity and Children Hospital (MCH) in Al –Ahsa, Saudi Arabia

Background: CPR (cardiopulmonary resuscitation) is a medical procedure that anyone can learn which can help to save a life in the event of a medical emergency. Resuscitation Council UK report that for every minute that a person in cardiac arrest does not receive CPR its survival chance drops by up to 10%. However, an inadequate public awareness and knowledge of infant and pediatric CPR have been documented. Therefore, parents and caregiver should be educated about infant CPR which can help in correctly implementing it and save the life of infant. This study was conducted on the mothers attending the MCH for the baby care is to assess their knowledge on infant CPR skill. Material and methods: This was a Cross sectional study conducted at Maternity and Children Hospital (MCH) in AL- Ahsa. All the parents visiting MCH with their children for the treatment were the study population. The website Raosoft was used to calculate the sample size (n=284). Convenient sampling technique was used to collect the sample. Pretested and predesigned self-reported questionnaire from the previous regional study was distributed to the selected sample participants. The data were entered and analyzed by using the SPSS; version 21. Descriptive statistics were presented using counts, proportions (%), mean ± standard deviation whenever appropriate. Descriptive statistics (e.g. number, percentage) and analytic statistics using Chi Square tests (χ2) to test for the association and/or the difference between two categorical variables were applied. A p-value equal to or less than 0.05 was considered statistically significant. Results: A total of 254 out of 284 subjects responded the questionnaires. The mean age of the participants was 38.65 years ± Std. Dev. 9.90 years .The majority of the participants (61.0%) were graduate Almost sixteen percent (15.7%) of the participants had family history of heart disease. Fifty percent of the participants had attended the CPR course. An overwhelming majority of the participants (87.0%) were willing to take a short course of infant CPR if it is available in MCH. The mean knowledge sore in infant CPR of the participants was 2.42 ± Std.Dev.1.33 (Range 00-6). More than forty one percent of the participants had poor knowledge regarding Infant CPR while 58.7% had good knowledge. As educational qualification increased the percent of good knowledge significantly also increased .The participants who did not have the family history of cardiac disease were having significantly good knowledge about infant(P=0.01).Those participants who had attended infant CPR course had significantly higher knowledge score than those who did not attend the infant CPR course (76.37% vs.40.94%, P=0.000) Those participants who were not willing to take a short course of infant CPR had significantly better knowledge score on infant CPR as compared to those participants who were willing to join the course on infant CPR (69.69% vs.57.01%,P=0.021). Conclusion: The present study has shown a better knowledge among the females regarding infant CPR as compared to other studies conducted in Saudi Arabia. The participants in this study were found very motivated to learn the skills of infant CPR. However there is a need to develop programmers for teaching the infant CPR to the mothers at all level of health care facility attending the MCH, Al Ahsa.

Contemporary aetiology of acute heart failure in a teaching hospital in Ghana

BackgroundHeart failure (HF) is recognized as a global public health disease associated with high morbidity and mortality. It is suggested that the main underlying causes of HF in developing countries differ from those identified in well-resourced countries. This study therefore presents the cardiovascular risk factors and the underlying aetiology of HF among admitted patients in a teaching Hospital in Ghana.MethodThe study prospectively recruited 140 consecutive patients admitted for heart failure at the Medical department of the Korle-Bu Teaching Hospital from March to October, 2014. The study evaluated the cardiovascular risk factors and the aetiologies of heart failure, and compared the risk factors and aetiologies with patient’s age and gender.ResultsThe mean age of the study participants was 51.3 ± 16.8 years. The commonest cardiovascular risk factors observed were hypertension (46.5%), history of previous HF (40.7%), excessive alcohol use (38.6%), and family history of heart disease (29.3%); predominantly hypertension (68.3%). The major underlying aetiology of HF were dilated cardiomyopathy (38.6%), hypertensive heart disease (21.4%), ischaemic heart disease (13.6%) and valvular heart disease (12.9%). These underlying aetiology of HF were more common in patients aged 40 years and above (p = 0.004) and those presenting with multiple risk factors (p = 0.001).ConclusionThe major underlying aetiology of heart failure in adults were dilated cardiomyopathy, hypertensive heart disease, ischaemic heart disease and valvular heart disease, which were significantly high among patients aged 40 years and above and those presenting multiple risk factors. Hypertension, excessive alcohol use, family history of heart disease and personal history of previous heart failure diagnosis are noted as the main cardiovascular risk factors among heart failure patients.

Public Perception of the Risk of Heart Disease and Their Willingness to Pay for Its Diagnosis in Malaysia

In Malaysia, heart disease is a major non-communicable disease and a leading cause of morbidity and mortality. Individuals need to understand the risk factors of heart disease, including health-related behaviors. This study was done to determine the perceived risks of heart disease and to estimate the willingness to pay (WTP) for its diagnosis. One-way analysis of variance was used to determine the significance of mean differences among the other demographic variables, followed by Tukey’s post hoc test to determine the differences between groups. The Spearman Rho test was employed to determine the correlations between participants’ perceived heart disease risk and their WTP for its diagnosis. The Perception of Risk of Heart Disease Scale (PRHDS) mean score of participants with a family history of heart diseases (25.32 ± 2.81; n = 556) was significantly higher than those who did not have such a family history (22.14 ± 3.42; n = 761; p = 0.04). The participants with a family history of heart disease showed a greater WTP for diagnostic tests compared with those without a family history. The participants who were ready to spend within the range of Ringgit Malaysia (RM) 1-RM1000 were willing to pay for diagnostic testing of heart diseases based on their family history and socioeconomic background. This study demonstrated a higher perception of the risk of heart disease in people with a family history of heart disease, who also demonstrated a greater WTP for diagnostic tests. Individuals ready to spend up to RM 1000 were willing to pay for diagnostic testing for heart diseases. The individuals with a family history of heart disease perceived a higher risk of heart disease and were willing to pay to improve life expectancy per year. Hence, the information on family history can be used as a tool for the holistic approach to educate individuals on their risk factors for heart disease and encourage them to do early screening for cardiovascular diseases.

PS-P05-8: CARDIOVASCULAR DISEASES AWARENESS AMONG WOMEN IN NORTHERN JORDAN

Background: Womens awareness of chronic diseases, including cardiovascular diseases, is the cornerstone in promoting womens health. Objectives: To examine the relationship of awareness levels about cardiovascular diseases and their related risk factors with demographic information of Jordanian women. Methods: A cross-sectional study of 18 years and older women. Scores of awareness were computed for each individual and were divided into 4 quartiles. Logistic regression analysis was used to examine the association of demographic information of participants with mean scores of quartiles. ANOVA analysis was used to com-pare between the mean scores of quartiles. Results: A total of 514 women completed the questionnaire, with a mean age of 35.46 (±12.53). Current smokers were 6.2%, and 34.6% had a family history of heart disease. The proportion of diabetes, hypertension, hypercholesterolemia, and overweight/obesity were 15.6%, 19.3%, 14.4%, &amp; 21.6% respectively. The mean score for awareness was 12.87 (+ 3.26). Women who had lower income and who were at younger age were more likely to score low in awareness. Conclusion: Women illustrated a fair level of awareness of CVD and its related risk factors. Increasing women awareness of CVD through educational programs, targeted toward women at risk, assists in disease prevention and help to improve treatment plans.