High Prevalence Of Cardiovascular Disease Research Articles

TREATMENT OF CARDIOVASCULAR DISEASES IN PATIENTS WITH PSORIASIS

Highlights Considering the systemic nature of psoriasis and the high prevalence of cardiovascular diseases among this cohort of patients, it is particularly important to focus on the therapy of these conditions in real clinical practice. Thus, the correct choice of pharmacological strategy and timely adjustment of the ongoing therapy play a crucial role in the course of these diseases. AbstractBackground. Currently, psoriasis, as a chronic immune-mediated disease of a multifactorial nature, is one of the most common diseases worldwide. Given the systemic nature of this disease, the level of comorbid pathologies is high, especially those associated with cardiovascular diseases.Aim. To assess the features of the ongoing therapy for psoriasis and CVD in real clinical practice.Methods. The open prospective observational clinical study was conducted. 160 patients diagnosed with mild to severe generalized psoriasis vulgaris constituted the main group, 40 patients were included in the control group. All patients underwent basic clinical and laboratory tests, physical examination with an assessment of body mass index, severity of the disease according to the PASI and DLQI index, psycho-emotional state, and measurement of blood pressure using the Korotkov method. Depending on the age of the patient, the cardiovascular risk (CVR) was assessed using the SCORE2/2OP scale. The therapy used to treat patients with psoriasis and CVD was analyzed.Results. According to the results of the study, patients with high cardiovascular risk (47%) prevail among the patients of the main group, compared with the control group (CG) (30%). There is a high incidence of arterial hypertension (AH) – 34.4% (CG – 22.5%), dyslipidemia – 40% (CG – 5%) (of which only 60% received lipid-lowering therapy), rhythm disturbances – 2% (CG – 1%), CHF – 1% (CG – 1%). Optimal antihypertensive therapy was received by 80% of patients, 20% required hospitalization in the Internal Medicine Department for additional examination and correction of CVD therapy. The use of systemic therapy was quite frequent: 21% received methotrexate, 23% – biological therapy.Conclusion. Thus, in real clinical practice, constant assessment and prevention of CV risk, monitoring of risk factors such as weight, blood pressure, BMI, cholesterol, PASI and DLQI are necessary for a patient-specific, multidisciplinary approach to the treatment of patients with psoriasis and CVD.

Cardiovascular Medication and Health Service Use in Individuals With Cancer: A Retrospective Population‐Based Cohort Study

ABSTRACTBackgroundCancer and cardiovascular disease (CVD) frequently coexist, but little is known about CVD medication use in cancer survivors. The aim of this study was to compare CVD medication and medical service use between individuals with and without cancer.MethodsRetrospective cohort study linking Australian National Health Survey 2020–2021 data from participants aged ≥ 25 years to medication dispensing, medical services, and death registry data via the Multi‐Agency Data Integration Project. Logistic regression was used to compare patterns of CVD medication use between cancer and non‐cancer groups and negative binomial regression to examine patterns of medical service utilisation by cancer and CVD status.ResultsThe analysis included 1828 individuals with a history of cancer (cancer survivors) and 7505 people without cancer. Although cancer survivors had a higher prevalence of CVD (31% vs. 13%) compared to people without cancer, there was no difference in the adjusted use of CVD medications (adjusted odds ratios: 1.15; 95% CI = 1.00–1.33) between these two groups. There was, however, an increased rate of health service use in those with cancer alone (adjusted rate ratios (aRR): 1.39; 95% CI = 1.29–1.50), those with CVD alone (aRR: 1.71; 95% CI = 1.63–1.80), and those with both conditions (aRR: 2.10; 95% CI = 1.97–2.25) compared to people without cancer or CVD.ConclusionsDespite having a higher prevalence of CVD and higher health service utilisation, the overall use of CVD medication did not differ between people with and without cancer. Cancer survivors with CVD had a higher rate of medical services use compared with persons with either condition alone or neither condition. Further research should explore the underlying reasons behind these data to inform strategies to mitigate the detrimental effects of comorbid CVD in cancer.

Machine Learning on Prediagnostic Metabolite Data Identifies Etiologic Endotypes of Exfoliation Glaucoma in United States Health Professionals.

Machine Learning on Prediagnostic Metabolite Data Identifies Etiologic Endotypes of Exfoliation Glaucoma in United States Health Professionals.

Evaluation of the effectiveness of basic cardiopulmonary resuscitation training on willingness to perform CPR among high school students

IntroductionGiven the high prevalence of cardiovascular diseases and sudden cardiac arrest, training in basic cardiopulmonary resuscitation (CPR) skills, especially during adolescence, can play a crucial role in increasing awareness and preparedness in individuals facing emergency situations. The present study aimed to evaluate the effectiveness of basic CPR training on the willingness to perform it among high school students.MethodsThis study is an educational intervention. A simple random sampling method was employed to select 100 individuals in each of the intervention and control groups from four governmental boys’ high schools. The data collection tool was a questionnaire assessing the willingness to learn and perform CPR, which has been validated and shown to be reliable. The educational intervention consisted of three sessions covering the history, practical techniques, and use of AED devices, utilizing diverse educational methods such as PowerPoint presentations, educational videos, and hands-on practice. Data were analyzed using SPSS version 26 and appropriate statistical tests.ResultsThe results indicated that basic CPR training significantly impacted students’ willingness to learn, perform CPR, and related knowledge. The changes in willingness to learn (p = 0.001), willingness to perform CPR (p = 0.001), and knowledge of CPR (p = 0.001) were significantly greater in the intervention group compared to the control group. These findings demonstrate the positive effect of CPR training on increasing willingness to learn, perform, and knowledge of CPR.ConclusionThe results of this study showed that basic CPR training has a positive and significant impact on increasing willingness to learn, willingness to perform CPR, and related knowledge among students. The intervention group displayed significant changes in these variables after receiving training. Therefore, CPR-related education can be considered an effective tool for enhancing awareness and preparedness for performing these life-saving actions.Clinical trial numberN/A.

RISK FACTOR ASSOCIATED WITH CEREBROVASCULAR ACCIDENTS (BRAIN STROKE): DESCRIPTIVE STUDY

Cerebrovascular accidents (CVAs), commonly referred to as strokes, represent a significant global health challenge, accounting for a substantial burden of morbidity and mortality. In addition to these well-established risk factors, emerging research points to the importance of psychological factors in stroke risk. To analyze risk factors associated with cerebrovascular accidents in a cohort of patients admitted to a tertiary care hospital over two years. This study employed a descriptive, cross-sectional design to investigate the demographic characteristics, prevalence of hypertension, diabetes, cardiovascular conditions, and associated psychological factors. Data were collected from clinical records, which provided detailed information on each patient's medical history, including pre-existing conditions, medications, and previous hospitalizations. Data were analyzed using statistical software (SPSS ) to identify associations between various risk factors and the incidence of stroke. A total of 150 patients were included in the study, comprising 85 males and 65 females. The prevalence of angina pectoris (16.5%) and myocardial infarction (7.1%) was higher than that of females, who reported 9.2% and 6.2%, respectively. The study's findings reveal notable gender disparities in health indicators, which align with existing literature and provide insights into the unique health challenges faced by males or females regarding cardiovascular health. Gender disparities are associated with a higher prevalence of cardiovascular diseases, which underscores the need for targeted interventions and further research that explores the underlying mechanisms driving gender disparity in chronic diseases. Moreover, the study highlights the importance of psychological factors and the predominant types of strokes diagnosed in the sample population.

Understanding implementation, adoption, and acceptability of the WHO package of essential noncommunicable (PEN) disease interventions in FIJI: Evidence for scale-up.

The Package of Essential Noncommunicable (PEN) disease interventions in response to the high prevalence of cardiovascular diseases and diabetes was implemented in Fiji commencing in 2012. This study aimed to understand implementation outcomes, and its contextual influences. Semi-structured interviews with health workers and patients across Fiji was conducted. Thematic analysis was mapped to the health system building blocks to understand PEN service delivery. The PEN program was well received by health workers formally trained. The frequency of use of PEN guidelines was influenced at the individual level by motivation, capability and capacity as well as external factors outside of the health workers' control. The key challenges to routine use were lack of essential medicines and equipment for CVD risk screening and management, shortage of health workers, high turnover of staff, limited formal training, and no designated focal person. However, at the country level, the PEN program improved the quality of care by providing patients with regular follow-up visits depending on their CVD risk levels. The patients found care to be comprehensive when they were also seen by dieticians and physiotherapists. In most instances, the barrier to access to care were cost and distance of travel and non-availability of essential medicines. To improve use of PEN program requires strengthening health system components: 1) need for efficient supply chain system for medicines and equipment, 2) improving healthcare workforce retention, 3) establishing accountability mechanisms embedded within the health centres, 4) health information system to track patient level data and 5) multi-level governance structures across the health system.

Cardiac autonomic function in young, healthy adults: Influence of race and sex.

Non-Hispanic Black (BL) adults living in the United States are more likely to develop cardiovascular disease (CVD) compared with their non-Hispanic White (WH) counterparts. Although measures of cardiac autonomic function [i.e., spontaneous cardiac baroreflex sensitivity (BRS) and heart rate variability (HRV)] have a predictive value for CVD, studies investigating racial differences in cardiac autonomic function are limited and have reported conflicting results. Furthermore, sex differences are often not considered despite BL women having a high prevalence of CVD. We hypothesized that young BL men and women would exhibit lower cardiac BRS and HRV compared with their WH counterparts. Heart rate and beat-to-beat blood pressure were continuously recorded during 5 min of supine rest in 145 young (18-33 yr), healthy, BL (37 men, 38 women) and WH (39 men, 31 women) adults to assess cardiac BRS and HRV. Overall cardiac BRS (sequence method) was higher in BL adults compared with WH adults (P < 0.001), which was mainly driven by differences between BL and WH men (BL men: 34 ± 16 vs. WH men: 21 ± 9 ms/mmHg, P < 0.001) compared with women (BL women: 27 ± 12 vs. WH women: 24 ± 11 ms/mmHg; P > 0.05). Likewise, greater HRV in BL adults, indexed by root mean square of successive differences, was primarily driven by BL men (BL men: 109 ± 59 vs. WH men: 64 ± 33 ms; P < 0.001) rather than BL women (P > 0.05). Thus, contrary to our hypothesis, these results support that reduced cardiac autonomic function does not manifest early in life among young BL adults.NEW & NOTEWORTHY Herein, we demonstrated that BL adults do not have lower cardiac autonomic function compared with WH adults. Rather BL men had greater spontaneous cardiac baroreflex sensitivity and heart rate variability compared with WH men while no differences were found among BL and WH women. These findings suggest that reduced cardiac autonomic function, which could increase the risk of cardiovascular disease, does not appear early in life in healthy BL adults.

Clinical and Nonclinical Predictors of Health-Related Quality of Life, One Year After Percutaneous Coronary Intervention (PCI)

Background: According to the high prevalence of cardiovascular diseases and the need to know the factors associated with the important outcome of quality of life after therapeutic interventions, this study was conducted with the aim of determining the factors associated with health-related quality of life (HRQoL), one year after percutaneous coronary intervention (PCI). Methods: This cross-sectional study was conducted on 912 patients undergoing PCI in a referral-educational hospital in Iran. Data collection was done using a HRQoL questionnaire (SF-36) and a checklist containing other study variables by face-to-face interview. To analyze the variables, the descriptive statistics and multivariate linear regression were used. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 16.0 (IBM Corp., Armonk, NY, USA). In this study, the significance level is p < 0.05. Results: The mean ± SD age of the participants was 59.47 ± 9.94 years, and 62.94% of them were male. The mean score of HRQoL in men (69.44 ± 21.18) was significantly higher than women (60.26 ± 21.8) (p < 0.001). In linear regression analysis, the variables of unemployment, age, loss of spouse, comorbidity, re-angioplasty, rehospitalization after PCI were significantly associated with to HRQoL. Conclusions: Better HRQoL after PCI may be linked to a care strategy that takes into account both clinical and nonclinical aspects.

Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults

Cardiovascular health (CVH), defined by the American Heart Association as Life's Simple 7 to promote a healthy lifestyle and manage vascular risk factors, has been associated with a low risk of Alzheimer disease and less vascular dementia. However, the association between CVH and biomarkers of neurodegeneration remains less understood. To investigate the association of CVH with serum biomarkers of neurodegeneration, including neurofilament light chain (NfL) and total tau (t-tau). This cohort study was conducted within the biracial, population-based Chicago Health and Aging Project (CHAP) of adults aged 65 years or older between 1993 and 2012. Participants who had measured serum NfL and t-tau levels and data on all components of the CVH score were included. The statistical analysis was conducted from April 10 to September 26, 2024. The CVH score includes 7 components: a healthy diet; regular exercise; normal body mass index; nonsmoking status; and the absence of dyslipidemia, diabetes, and hypertension. The scores were divided into 3 groups from lowest to highest CVH (0-6 points, 7-9 points, and 10-14 points). The main outcome was the association of CVH score with serum biomarkers of NfL and t-tau as measured using linear regression and mixed-effects models. A total of 1018 CHAP participants were included in the analysis (mean [SD] age, 73.1 [6.1] years; 625 female [61.4%]; 610 Black or African American [59.9%] and 408 White [40.1%]). Participants with a high CVH score (ie, 10-14 points) were predominantly White (151 [64.3%]) and had a higher education (mean [SD], 13.6 [3.7] years). Compared with participants with low CVH scores (ie, 0-6 points), those with CVH scores of 10 to 14 points had significantly lower serum levels of NfL (relative difference, -18.9%; β = -0.091; SE, 0.025). A higher CVH score was associated with a slower annual increase in NfL levels as participants aged (relative difference in rate, -1.7%; β = -0.008; SE, 0.004). Cardiovascular health was not associated with serum levels of t-tau. These findings suggest that promoting CVH in older adults may help alleviate the burden of neurodegenerative diseases, particularly among Black adults, who are known to experience a higher prevalence of cardiovascular disease.

Leptin in very old and long-living patients with coronary artery disease

BACKGROUND. Leptin is involved in the development of some age-related pathological conditions, in particular, metabolic syndrome, obesity, diabetes mellitus and atherosclerosis. Considering the population aging and high prevalence of cardiovascular diseases and related mortality in the older age group, it is quite important to study various risk factors for cardiovascular pathology (including hyperleptinemia) in the very old and long-living population.AIM. To determine the concentration of leptin and to analyze the relationships of this adipokine with obesity and a number of other pathological conditions in very old and long-living patients with coronary artery disease (CAD).MATERIALS AND METHODS. This work was a cross-sectional study. A total of 110 very old patients were enrolled in the study: 90 patients with CAD in the study group and20 patients without CAD in the control group. Mean age of the patients was 88.5 + 4.5 years; 48.2% of patients were ≥ 90 years. The serum leptin concentration was determined by enzyme-linked immunosorbent assay. Normal leptin values were 2.6–11.1 ng/mL for women, and 2.0–5.6 ng/mL for men. The content of adipose tissue in the body was assessed by dual-energy X-ray absorptiometry.RESULTS. Elevated serum leptin concentration was found in 58.2% of patients (decreased in 16.4%, normal in 25.4%). Increased leptin concentration was found in 67.1% of women and in 40.5% of men (p = 0.007). In patients with CAD, mean concentration of leptin reached 16.7 ng/mL; in patients without CAD, 15.3 ng/mL (p = 0.6). In patients with chronic heart failure, the probability of detecting low leptin levels increased by 3.2 times, compared with patients without heart failure (OR = 3.2; 95% CI = 1.1–9.9; p = 0.03). In patients with obesity, the mean leptin concentration was 28.5 ng/mL, while in patients without obesity it comprised 12.2 ng/mL (p = 0.00002). Significant correlation was found between the leptin concentration and body mass index (p &lt; 0.000001). Significant positive correlation was registered between the serum leptin level and the adipose tissue content (p = 0.000001). The leptin concentration positively correlated with the concentration of total cholesterol (p = 0.02) and triglycerides (p = 0.003) in the blood serum. Patients with diabetes mellitus had higher leptin values (26.3 ng/mL vs 13.5 ng/mL in the group of patients without diabetes; p = 0.0003); a significant direct correlation was found between the concentration of leptin and glucose in the blood serum (p = 0.0003). In patients with low leptin concentration, lower bone mineral density was registered (p = 0.0003).CONCLUSIONS: The study results suggest frequent leptin pathology in elderly and long-living patients, both with and without coronary artery disease. Higher leptin levels are associated with various metabolic disorders (obesity, dyslipidemia, and diabetes mellitus). Lower leptin levels are typical for patients with chronic heart failure.

STRUCTURAL NEUROIMAGING UNCOVERS DIFFERENT CARDIOMETABOLIC RISK PROFILES IN DEPRESSION: A DATA-DRIVEN APPROACH ON UK BIOBANK

Abstract Background Major depressive disorder (MDD) is a heterogeneous psychiatric condition associated with a high risk of mortality considering both high rates of suicide [1] and of severe comorbid cardiometabolic dysfunctions [2]. Environmental variables such as adverse childhood experiences (ACEs) can furtherly interact with the disorder’ s prognosis [3-4]. However, not all MDD patients exhibit the same illness trajectories, thus leading to inconsistent findings between clinical outcomes and the underlying neurobiology [5]. Therefore, stratifying MDD based on neurobiological data could prompt the reveal of distinct disorder subtypes and enable personalized treatment approaches. Aims &amp; Objectives We employed an unsupervised machine learning approach to stratify MDD patients into biologically-driven clusters using multimodal structural neuroimaging data, which were then characterized for different cardiometabolic profiles, suicide attempts (SA), and ACEs. Method Cortical thickness, cortical and subcortical grey matter volumes, surface area, and white matter fractional anisotropy (FA) were extracted from 3636 individuals affected by MDD among the UK Biobank cohort. A stability-based relative clustering validation approach [6] was applied to these data to identify neurobiologically homogeneous patients’ subgroups. K-means was implemented for clustering, and support vector machine was trained to predict clusters’ labels through a 2-fold cross-validation iterated 100 times. The best clustering solution among 2 to 5 clusters was identified by minimizing the prediction error. A subsample of 727 individuals (20%) was used to optimize the model’ s hyperparameters through a parallel grid search, while the optimized pipeline was applied on the remaining 2909 (80%). Confounding effects of age, sex, and volumetric scaling factor were controlled in cross-validation. Mann-Whitney U and Chi-squared tests were used to explore differences and associations between the identified clusters and age, sex, structural neuroimaging features, BMI, presence of any cardiovascular disease, diagnosis of diabetes, history of SA, childhood emotional, physical, and sexual abuse, childhood emotional and physical neglect. Results The optimized stability-based clustering pipeline identified 2 clusters (N cluster1=1361, N cluster2=1548) with a normalized stability of 0.084, meaning that the input features could discriminate clusters’ labels with a 91.6% of accuracy. The second cluster was significantly associated with a higher prevalence of cardiovascular diseases (χ2=4.846, p=0.027), comorbid diabetes (χ2=13.245, p&amp;lt;0.001), and childhood physical abuse (χ2=4.101, p=0.043). Remarkably, the same cluster also showed lower cortical thickness (p&amp;lt;0.001), lower cortical and subcortical volumes (p&amp;lt;0.001), and higher surface areas (p&amp;lt;0.001) in most regions of interest, as well as lower FA (p&amp;lt;0.001) in all white matter tracts. No significant associations and differences for SA, age, sex, and BMI were found. Discussion &amp; Conclusion Our data-driven approach revealed that structural neuroimaging can uncover depression subtypes linked to different cardiometabolic risk profiles, which were also associated with a childhood history of physical abuse. These results can hence contribute to the understanding of MDD pathophysiology and possibly help to detect vulnerable individuals which may benefit from tailored treatments in a precision psychiatry framework.

Exploring Cardiovascular Health: The Role of Dyslipidemia and Inflammation.

Cardiovascular diseases (CVDs) are a major global health concern, with their prevalence rising significantly in developing regions like South India. This increase is driven by unique dietary patterns, lifestyle habits, and genetic predispositions contributing to the region's distinct cardiovascular risk profile. However, gaps remain in understanding the biochemical risk factors specific to this population. This study addresses these gaps by focusing on key markers, namely, low-density lipoprotein (LDL), high-density lipoprotein (HDL), high-sensitivity C-reactive protein (hs-CRP), and homocysteine, which are critical in dyslipidemia, inflammation, and endothelial dysfunction. Identifying these markers' prevalence and their role in CVD is essential for developing effective, region-specific preventive strategies. This study employed a cross-sectional design and included 1,200 participants aged between 30 and 70 years from both urban and rural areas in South India, selected through a multistage stratified random sampling approach to ensure demographic representation across socioeconomic groups, gender, and residential settings. Data on demographics, lifestyle choices, and medical histories were collected using structured questionnaires, which were validated through a pilot study involving 50 participants to ensure clarity, cultural relevance, and content validity. Biochemical assessments included lipid profiles, fasting glucose, hs-CRP, and serum homocysteine levels, which were conducted following standardized laboratory protocols. Quality control measures, such as duplicate testing of 10% of samples, ensured reliability. Statistical analyses included logistic regression to identify independent predictors of CVDsand ANOVA to compare mean biochemical parameter values between groups. Results: The study reported that 274 participants (22.83%) were affected by CVDs, with a higher prevalence in urban areas (75 participants (27.37%)) compared to rural regions (48 participants (17.51%)). This disparity is likely attributed to urban-specific risk factors, including sedentary lifestyles, dietary patterns, and environmental stressors. Biochemical analysis revealed significant predictors of CVD, such as elevated LDL cholesterol (498 participants (41.5%), odds ratio (OR) = 2.1, 95% CI: 1.7-2.6), reduced HDL cholesterol (428 participants (35.7%), OR = 1.8, 95% CI: 1.4-2.3), and increased hs-CRP levels (353 participants (29.4%), OR = 1.9, 95% CI: 1.5-2.4), emphasizing the central roles of dyslipidemia and systemic inflammation in CVD pathogenesis. The findings of this study highlight critical implications for public health policies and healthcare systems in South India. The higher prevalence of CVDs in urban areas necessitates targeted interventions such as community-based physical activity programs, dietary counseling, and stress management initiatives. Biochemical management strategies, including early screening and control of dyslipidemia through lipid-lowering agents and addressing elevated hs-CRP levels with anti-inflammatory measures, are essential. Supplementation with folate and vitamin B12 to manage hyperhomocysteinemia should also be considered. However, the cross-sectional nature of the study and its single-center design limit causal inference and generalizability, emphasizing the need for multicenter, longitudinal research to validate these findings and guide comprehensive CVD prevention strategies.

A Decadal Exploration of Cutaneous Adverse Effects of FDA-Approved Cardiovascular Medications: Insights From 2013 to 2023.

Given the high prevalence of cardiovascular disease in the United States, there is a critical need for new medications to improve the outcomes of these diseases. The US Food and Drug Administration has approved numerous medications that are able to effectively do so. While these drugs have significantly beneficial effects, just like any other medication, they can come with a multitude of unwanted side effects. It has been noted that cardiovascular drugs have been associated with a considerable number of dermatologic reactions. This review examines current literature on the various cutaneous manifestations of these adverse reactions. It focuses on these newly Food and Drug Administration-approved cardiovascular medications from 2013 to 2023, detailing both common and rare effects in the past decade. As more medications continue to enter the market, the necessity for awareness of more systemic side effects will continue to grow. This comprehensive review aims to guide clinicians in identifying drug-induced reactions in patients on these therapies.

Identifying predictors of sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide 1 receptor agonist use in hospital among adults with diabetes.

To identify factors associated with use of novel diabetes medications among patients hospitalized under general internal medicine. We conducted a cohort study of patients with type 2 diabetes mellitus (T2DM) hospitalized in Ontario, Canada between 2015 and 2020. We evaluated the patient- and physician-level factors associated with sodium-glucose cotransporter 2 inhibitor (SGLT2) and glucagon-like peptide 1 receptor agonist (GLP1R) use using a multivariable logistic regression model. There were 253,152 hospitalizations and 68,126 involved patients who had T2DM. Prior to discharge, 3.7% (N=2490) of patients with T2DM received an SGLT2 and 0.2% (N=121) received a GLP1R. The strongest predictors for receiving a novel diabetes medication were hemoglobin A1C>9.0% (Odds Ratio (OR)=1.81, 95% Confidence Interval (CI) 1.28, 2.60) and patients aged 40-60 compared with patients <40years old (OR=1.81, 95% CI 1.33, 2.68). The strongest predictors for not receiving a novel diabetes medication were dementia (OR=0.47, 95% CI 0.39, 0.56) and creatinine ≥200μmol/L (OR=0.11, 95% CI 0.08, 0.15). Overall, 46.8% of patients hospitalized with T2DM not receiving a novel diabetes medication would potentially benefit from an SGLT2 inhibitor. Novel diabetes medications were rarely continued or initiated during hospitalization despite a high prevalence of cardiovascular disease, raising the concern for systematic under-utilization after discharge.

A First Diastolic Function Evaluation in the Personalized Exercise Prescription Program for Solid Organs Transplanted Subjects: Is Atrial Strain Useful?

Background/Objectives: Solid organ transplant recipients (OTR) have been recently involved in exercise prescription programs in order to reduce the high prevalence of cardiovascular diseases. The normal systolic and diastolic cardiac function is fundamental to personalizing the prescription. Diastolic dysfunction can be associated to a higher risk of cardiovascular events and left atrial (LA) strain is an emerging parameter in the evaluation of diastolic compromising, especially in subjects with preserved ejection fraction. Left atrial (LA) strain has never been explored in this category. The study aimed to evaluate the contribution of the LA strain in the assessment of diastolic function of OTR and its potential contribution in the exercise program. Methods: 54 solid OTR (liver and kidney transplants) regularly trained for at least 12 months in a home-based, partially supervised model at moderate intensity estimated by cardiopulmonary exercise test, underwent a complete echocardiographic analysis. The measured variables included left ventricle systolic function (ejection fraction, EF), diastolic function (E/A and E/E'), LA indexed volumes, LA peak atrial longitudinal strain (PALS) and LA peak atrial contraction strain (PACS). The data were compared to those of 44 healthy subjects (HS). Results: The OTR showed an overweight condition (BMI: 25.79 ± 2.92 vs. 22.25 ± 2.95; p < 0.01). Both groups showed a preserved systolic function (EF: OTR 63.1 ± 3.5% vs. HS 66.9 ± 6.1; p < 0.001), while diastolic standard parameters were significantly different (E/A, 1.01 ± 0.4 vs. 1.96 ± 0.74; p < 0.001; E/E', 9.2 ± 2.7 vs. 6.9 ± 1.3; p < 0.001, in OTR and HS respectively) despite being normal. LA strain was significantly lower in OTR vs. HS (4C PALS, 33.7 ± 9.7 vs. 45.4 ± 14.19; p < 0.001; 4C PACS, 15.9 ± 6.7 vs. 11.6 ± 7.5; p = 0.006; 2C PALS, 35.3 ± 11.1 vs. 47.6 ± 14.9; p < 0.001; 2C PALS, 17.4 ± 4.9 vs. 13.2 ± 14.97; p = 0.001; in OTR and HS respectively). A specific correlation of two- and four-chamber PACs and PALs with BMI has been observed (R for 4C PALS -0.406 ** and 2C PALS -0.276 *). Conclusions: These findings suggest that the coexistence of increased bodyweight in asymptomatic OTR patients can exacerbate the impairment of LA strains. LA strain detection could be useful in the development of a personalized exercise program for OTRs, especially for asymptomatic subjects and those with elevated cardiovascular risk profile, to potentially manage the exercise program in the long term. Larger studies will confirm the role via an eventual structured clinical score index.

Prevalence and impact of systemic conditions on dental implant therapy: A retrospective study

Abstract Introduction: Dental implant treatment is a widely used approach for replacing missing teeth, but its success can be influenced by the several factors including the patient’s systemic health status. Aims: This retrospective study aims to assess the prevalence and impact of medical conditions in patients presenting for dental implant treatment. Materials and Methods: The medical records of 156 patients evaluated for dental implant treatment between January 2015 and December 2023 were retrospectively analyzed. The inclusion criteria ensured the complete medical records and eligibility for dental implant procedures, while exclusion criteria eliminated incomplete records or cases where treatment was not pursued. Data collection included demographic characteristics, smoking and alcohol use, medical history (e.g., diabetes, cardiovascular diseases, and osteoporosis), and dental implant details such as planned sites and preoperative treatments. Statistical analyses involved descriptive statistics, subgroup comparisons, and logistic regression to assess the association between the medical conditions and implant complications. Interaction effects of combined medical conditions were also evaluated. Results: The study found a high prevalence of cardiovascular diseases (28.8%) and diabetes (22.4%) among patients-seeking dental implant treatment. Osteoporosis was present in 12.8% of patients, with a significant gender disparity (P = 0.01). Logistic regression analysis revealed that diabetes (odds ratio [OR] = 2.1, P = 0.01) and osteoporosis (OR = 2.7, P = 0.01) were significantly associated with higher risks of dental implant complications. Discussion: This retrospective study aimed to assess the prevalence and impact of medical conditions in patients awaiting dental implant treatment. With 156 patients, the study revealed a high prevalence of cardiovascular diseases and diabetes, significant gender differences in osteoporosis prevalence, and notable associations between diabetes and osteoporosis with dental implant complications. Conclusion: The present study evaluates the impact of medical conditions on dental implant complications and was assessed using the logistic regression analysis. Diabetes was associated with higher odds of complications, indicating that diabetic patients have more than twice the risk of experiencing complications compared to nondiabetic patients. Osteoporosis also significantly increased the risk of complications, suggesting a need for enhanced bone health management in these patients. This study highlights the importance of comprehensive preoperative assessments and personalized treatment plans for patients undergoing dental implant therapy. Understanding the prevalence and impact of medical conditions on dental implant outcomes is crucial for optimizing patient care and improving implant treatment success.

Respiratory rate-oxygenation index on the 3rd day is the best predictor of treatment failure in COVID-19 patients.

Predictors of outcomes are essential to identifying severe COVID-19 cases and optimizing treatment and care settings. The respiratory rate-oxygenation (ROX) index, originally introduced for predicting the failure of non-invasive support in acute hypoxemic respiratory failure (AHRF), has not been extensively studied over time during hospitalization. This multicenter prospective observational study analyzed COVID-19-related AHRF patients admitted to eight Italian hospitals during the second pandemic wave. The study assessed the ROX index using receiver operator characteristic curves and areas under the curve with 95% confidence intervals to predict treatment failure, defined as endotracheal intubation (ETI) or death. A total of 227 patients (69.2% males) were enrolled, with a median arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FIO2) ratio at admission of 248 (interquartile range: 170-295). Nearly one-third (29.5%) required ETI or died during hospitalization. Those who experienced treatment failure were older (median age 70 vs. 61 years, p<0.001), more likely to be current or former smokers (8.5% vs. 6.4% and 42.4% vs. 25.5%, p=0.039), had a higher prevalence of cardiovascular diseases (74.6% vs. 46.3%, p<0.001), and had a lower PaO2/FIO2 ratio at presentation (median 229 vs. 254, p=0.014). Gender, body mass index, and other comorbidities showed no significant differences. In patients who failed treatment, the ROX index was higher at presentation and worsened sharply by days 3 and 4. Conversely, in patients who survived without requiring ETI, the ROX index remained stable and reduced after 5-6 days. The ROX index's predictive ability improved notably by day 3 of hospitalization, with the best cut-off value identified at 8.53 (sensitivity 75%, specificity 68%). Kaplan-Meier curves indicated that a ROX index of 8.53 or lower on days 1, 2, or 3 was associated with a higher risk of treatment failure. Thus, a single ROX index assessment on day 3 is more informative than its variability over time, with values of 8.53 or lower predicting non-invasive respiratory support failure in hospitalized COVID-19 patients.

CARDIOVASCULAR RISK FACTORS AND MENTAL HEALTH OUTCOMES AMONG LGB+ OLDER ADULTS

Abstract Emerging evidence highlights that sexual and gender minority (SGM) adults exhibit a higher prevalence of cardiovascular disease (CVD) and its risk factors compared with their non-SGM peers. This increased susceptibility underscores a critical intersection with cognitive health given the link between CVD and cognitive decline and early-onset dementia. Additionally, mental health challenges such as depression and anxiety not only heighten CVD risk but also predict severe cardiovascular complications. Utilizing cross-sectional data from the National Health Interview Survey (NHIS), this study examined these interconnected health issues among older adult LGB+ populations to inform comprehensive interventions aimed at addressing both cardiovascular and cognitive health. This cross-sectional study analyzed data from the 2022 NHIS data to describe cardiovascular and cognitive health characteristics among LGB+ and non-LGB+ older adults using chi-squared tests. The sample was limited to adults who self-reported being age 50 years or older. A CVD risk variable was created based on Framingham criteria. Data from 13,426 participants, including 341 LGB+ individuals, revealed significant differences in demographic characteristics, health, and lifestyle. LGB+ older adults were younger and more frequently formally educated. They exhibited lower rates of CVD risk factors and increased physical activity and preventative health behaviors, yet higher incidence of depression and anxiety and higher rates of smoking and alcohol use. These preliminary findings highlight the unique characteristics of LGB+ older adults in terms of cardiovascular health, offering potential targets for culturally tailored interventions.

Rebamipide: thirty years of experience. A review

The review article describes the 30-year practice of using the cytoprotector rebamipide. The use of the drug in South Korea and Russia in various gastrointestinal disorders, including gastroesophageal reflux disease, functional and organic dyspepsia, chronic gastritis, gastric ulcer, including those associated with H. pylori, inflammatory bowel diseases, irritable bowel syndrome, and as a carcinopreventive agent has been demonstrated. Particular attention is paid to drug-induced conditions, given the uncontrolled use of non-steroidal anti-inflammatory drugs and the high prevalence of cardiovascular diseases, which requires the use of antithrombotic drugs with ulcerogenic action.

Association Between Sleep Duration and Cardiovascular Disease Among Asian Americans.

Cardiovascular disease (CVD) prevalence varies widely among Asian American adults. The American Heart Association added healthy sleep to its metrics to define ideal cardiovascular health. Little is known about the association between sleep and CVD prevalence among Asian subgroups. We aim to examine the association between suboptimal sleep duration and CVD risk prevalence among Asian American subgroups. We used 2012 to 2018 National Health Interview Survey data to examine the association between suboptimal sleep duration and CVD prevalence. We included 6868 self-identifying Asian adults age >40 years (Asian Indian [n=1053], Chinese [n=1415], Filipino [n=1734], and Other Asian [n=2666] adults). Suboptimal sleep was defined as <7 or >9 hours per night. CVD was defined as self-reported stroke, heart attack, coronary artery disease, or angina. Logistic regression was used to calculate odds ratios and 95% CI to estimate the association between suboptimal sleep duration and CVD prevalence. Filipino and Other Asian participants with suboptimal sleep had the highest prevalence of CVD. Aggregated Asian American participants with suboptimal sleep duration had a higher prevalence of CVD (odds ratio [95% CI, 1.35 [1.09-1.68]) compared with those with optimal sleep duration. After stratification by race or ethnicity or both, a significant association persisted for Other Asian participants (1.77 [95% CI, 1.27-2.46]) but not among all other Asian American subgroups. Our study highlights the heterogeneity of CVD prevalence associated with suboptimal sleep duration among Asian American adults. Future studies should consider how different measures of sleep duration and quality affect CVD outcomes among disaggregated Asian American subgroups.