Infarction In Men Research Articles

Sex-differential effect of waist circumference on new-onset cerebral infarction: a nationwide cohort study.

Excessive abdominal adiposity represents a cardiovascular disease risk factor. Waist circumference (WC) reflects abdominal adiposity and is known as an easy-to-measure indicator of obesity. This study aimed to evaluate the relationship between WC level and the development of cerebral infarction in Koreans. 209,442 Koreans were included among the general population registered in the National Health Information Database. Depending on the degree of WC, the possibility of cerebral infarction was tracked for 4.37 person-years. Identification of patients with cerebral infarction was confirmed through the diagnostic code ICD I63 of inpatient or outpatient. Participants' data were analyzed by sex. The hazard ratios (HRs) and confidence interval (CI) for cerebral infarction were calculated using the Cox proportional hazards model. Between 2009 and 2013, 2,403 cases (1.15%) of cerebral infarction occurred during the follow-up period of 915,223.6 person-years. The HRs (95% CI) for incident cerebral infarction in men was adjusted for multiple covariates, and comparison of WC levels second, third, and fourth quartile with the first quartile showed 1.10 (0.94-1.28), 1.11 (0.95-1.30), and 1.24 (1.07-1.45), respectively (P for trend 0.045). This association was not significant in women (P for trend 0.619). The severity of WC levels in men is significantly associated with the risk of developing cerebral infarction in Koreans. This finding indicates that other measurements for excessive adipose visceral tissue, except abdominal circumference, need to be taken into account to identify the risk of cerebral infarction in women.

The search for new pathogenesis of cardiorenal syndrome: the effect of local Schumann resonance on the occurrence of episodes of kidney disease and myocardial infarction

Background. The pandemic of noncommunicable chronic diseases and the high prevalence of combined damage to the cardiovascular system and kidneys determine the relevance of continuing scientific research to solve these medical problems. Therefore, the aim of this study was to compare the influence of the Earth’s electromagnetic field on the occurrence of episodes of kidney disease and myocardial infarction in order to search for new pathogenetic components of cardiorenal syndrome and deepen fundamental knowledge. According to the Lithuanian magnetometer GCI003, a number of stu­dies in 2014–2018 found that changes in the Earth’s electromagnetic field may play an important role in the pathogenesis of cardiovascular diseases as well as their incidence. Since the functioning of the cardiovascular system and kidneys are closely connected through the metabolic processes of the cardiorenal metabolic axis, this study tested the hypothesis that changes in the Earth’s electromagnetic field may also affect the pathogenesis of kidney disease as the changes of local magnetic field have been shown to influence the functioning of the cardiovascular system. Materials and methods. This was a search retrospective study on the relationship between the influence of local Schumann resonances and the occurrence of hospitalizations in 1340 patients with kidney disease. It also examined the relationship between local Schumann resonances and heart attacks in patients admitted to the University Hospital of the Lithuanian University of Health Sciences (703 patients). Mean power of local magnetic field fluctuations in Lithuania was measured in pT2 s2 in five different frequency ranges, which overlaps the Schumann resonance and electroencephalogram’s frequency ranges: SDelta (0–3.5 Hz), STheta (3.5–7 Hz), SAlpha (7–15 Hz), SBeta (15–32 Hz), SGamma (32–66 Hz). The data of hospitalizations to the Nephrology Department of University Hospital and the dynamics of Schumann resonances were analyzed from January 1, 2021 to December 31, 2021. The data of hospitalizations for myocardial infarction to the Cardiology Department of University Hospital and the dynamics of Schumann resonances were studied from January 1, 2016 to December 31, 2016. Results. It was found that changes in the strength of the Earth’s local magnetic field in 2016 and 2021 were comparable and corresponded to the characteristic annual dynamics of the Earth’s local electromagnetic fields. This made it possible to conduct a comparative analysis of annual correlation graphs and establish general trends in the dynamics of indicators and graphical similarities. It confirmed the pre­sence of a general dependence of reactions to the external electromagnetic field of the Earth in female and male patients both with nephrological pathology and myocardial infarction. In nephrological patients of both sexes, all correlation coefficients in all ranges of Schumann resonances were positive. The only negative correlation coefficient P5 (SGamma) [32; 65] Hz (r = –0.069; p = 0.313) was in the female group. This fact as well as the presence of a significant dynamics of the correlation coefficient P5 (SGamma) [32; 65] Hz (r = 0.009; p = 0.475) in the male group indicate that higher magnetic field strength in this frequency range may be associated with a reduced incidence of kidney disease. We obtained data that a higher magnetic field intensity in the gamma range from 32 to 65 Hz as a pathogenetic component can contribute to the destabilization of the cardiovascular system, but at the same time it is associated with a positive effect on the state of nephrological pathology. Based on this, we can tentatively assume the opposite direction of the Earth’s electromagnetic field influence on the pathogenetic mechanisms of renal and cardiovascular diseases. This is clearly demonstrated by comparing the correlation coefficients between the incidence of kidney disease and the occurrence of myocardial infarction in men and women. The Earth’s stronger magnetic field in the gamma range contributes to an increase in the incidence of myocardial infarction, which is confirmed by the large number of patients during this period. Under these same conditions, a decrease in the incidence of kidney disease has been detected. This opposite direction is observed in both sexes. But in women the reaction is stronger, which is confirmed by a larger difference in correlation coefficients. Conclusions. 1. Changes in the Earth’s electromagnetic field are related to the functional state of the cardiovascular system and the condition of the kidneys. 2. It can be assumed that the effect of the Earth’s electromagnetic field on the pathogenetic mechanisms of kidney disease is in the opposite direction of that on the cardiovascular one. 3. Reliable gender differences in correlations between the influence of changes in the local Schumann resonance on the functional state of the cardiovascular system and kidneys were not found. 4. The connection of the Earth’s local geomagnetic field with kidney function may be another new unexplored pathogenetic mechanism in cardiorenal syndrome and noncommunicable chronic diseases.

Fetuin-A and its genetic association with cardiometabolic disease

Fetuin-A acts as both an inhibitor of calcification and insulin signaling. Previous studies reported conflicting results on the association between fetuin-A and cardiometabolic diseases. We aim to provide further insights into the association between genetically predicted levels of fetuin-A and cardiometabolic diseases using a Mendelian randomization strategy. Genetic variants associated with fetuin-A and their effect sizes were obtained from previous genetic studies. A series of two-sample Mendelian randomization analyses in 412,444 unrelated individuals from the UK Biobank did not show evidence for an association of genetically predicted fetuin-A with any stroke, ischemic stroke, or myocardial infarction. We do find that increased levels of genetically predicted fetuin-A are associated with increased risk of type 2 diabetes (OR = 1.21, 95%CI 1.13–1.30, P = < 0.01). Furthermore, genetically predicted fetuin-A increases the risk of coronary artery disease in individuals with type 2 diabetes, but we did not find evidence for an association between genetically predicted fetuin-A and coronary artery disease in those without type 2 diabetes (P for interaction = 0.03). One SD increase in genetically predicted fetuin-A decreases risk of myocardial infarction in women, but we do not find evidence for an association between genetically predicted fetuin-A and myocardial infarction in men (P for interaction = < 0.01). Genetically predicted fetuin-A is associated with type 2 diabetes. Furthermore, type 2 diabetes status modifies the association of genetically predicted fetuin-A with coronary artery disease, indicating that fetuin-A increases risk in individuals with type 2 diabetes. Finally, higher genetically predicted fetuin-A reduces the risk of myocardial infarction in women, but we do not find evidence for an association between genetically predicted fetuin-A and myocardial infarction in men.

ВАРИАБЕЛЬНОСТЬ ГЕНОВ НАТРИЙУРЕТИЧЕСКИХ ПЕПТИДОВ И АНТИОКСИДАНТНОЙ ЗАЩИТЫ У ПАЦИЕНТОВ С ИНФАРКТОМ МИОКАРДА

Introduction. Cardiovascular diseases (CVD) continue to be the subject of scientific research in relation to molecular genetic predictors of their development. It has been proven that diseases of the cardiovascular continuum have a multifactorial nature with a significant genetic component, including the hereditary risk of myocardial infarction (MI). CVDs are characterized by a complex genetic structure with diverse combinations of single nucleotide polymorphic variants (SNVs). A promising task is to study the relationship of SNV adaptogenesis genes: inflammatory response, myocardial and endothelial dysfunction with developed MI in the Siberian population. Purpose: to reveal the relationship between SNV genes of natriuretic peptides and the antioxidant defense system with the development of myocardial infarction. Materials and methods. The material for the study was genomic DNA isolated from the peripheral blood of patients (n=146, 38 women and 108 men) admitted for treatment at the Kuzbass Clinical Cardiological Dispensary, Kemerovo, with a diagnosis of MI. The control group is represented by a population sample of residents of the city of Kemerovo (n=300, 190 women and 110 men). 20 polymorphic variants of 7 natriuritic peptide genes (NPPA, NPPA-AS1, NPPB, NPPC, NPR1, NPR2, NPR3) and 5 genes of the antioxidant defense system (SOD2, NCF4, CBR1, CBR3, CAT) were selected for the study. Genotyping of selected polymorphic variants was performed by real-time PCR using TaqMan technology. Statistical data analysis was carried out using GraphPad Prism 8 and SNPstats software. Results. Protective associations of allelic variants of the CBR1 rs9024 genes (OR=0.21 (95% CI 0.13-0.34); p=0.0001) and CBR3 (OR=0.44 (95% CI 0.28-0) .69); p=0.001) regardless of gender according to the dominant model of inheritance. When separating patients by gender, it was found that in men, the rs9024 CBR1 allele A (OR=0.20 (95% CI 0.11-0.36); p&lt;0.0001) and the rs1056892 CBR3 allele A (OR=0, 51 (95% CI 0.28-0.91); p=0.022) have a protective effect in the development of MI according to the dominant model of inheritance. Allele T rs2236289 (OR=1.93 (95% CI 1.04-3.58); p=0.035) and allele A rs7034957 (OR=1.88 (95% CI 1.03-3.45); p =0.038) of the NPR2 gene are associated with a risk effect on the development of myocardial infarction in men according to the dominant model of inheritance. In women, rare alleles of the polymorphic loci rs13288085 (OR=0.25 (95% CI 0.08-0.73); p=0.0034) and rs7034957 (OR=0.30 (95% CI 0.11-0, 79); p=0.007) of the NPR2 gene, rs9024 (OR=0.21 (95% CI 0.09-0.47); p=0.00001) of CBR1, as well as rs1056892 (OR=0.31 (95% CI 0.15-0.64); p=0.0014) CBR3 are characterized by a protective effect on the development of MI according to the dominant model of inheritance. Conclusion. It has been shown that polymorphism of genes for natriuretic peptides and antioxidant protection may have a risky and protective effect in relation to predisposition to the development of MI. The obtained preliminary results indicate the need for further studies of the identified SNV genes of adaptogenesis in relation to the severity of MI and the risk of recurrent cardiovascular events in the long-term period after MI.

Fasting blood glucose as a predictor of progressive infarction in men with acute ischemic stroke

ObjectiveBlood glucose is related to early neurological deterioration in acute ischemic stroke, but multiple mechanisms are involved in early neurological deterioration, such as progressive infarction. This study aimed to determine whether fasting blood glucose (FBG) is an independent predictor of progressive infarction.MethodsFrom April 2017 to December 2020, we retrospectively enrolled 477 patients with acute ischemic stroke within 48 hours of onset. Demographic characteristics, clinical information, neuroimaging characteristics, and laboratory data were collected after admission.ResultsWe found that 147 (30.8%) patients had progressive infarction. Multiple regression analysis showed that high FBG concentrations (>7.66 mmol/L) were independently associated with progressive infarction. Sex subgroup analysis showed that high FBG concentrations were an independent predictor of progressive infarction in male patients (odds ratio, 2.559; 95% confidence interval, 1.279–5.121). In a receiver operating characteristic curve analysis, FBG concentrations were a predictor of progressive infarction in all cases, especially in male patients. The cutoff value of FBG in all patients and men was 7.155 mmol/L.ConclusionsFBG is an independent predictor of progressive infarction in patients with acute ischemic stroke within 48 hours of onset, especially in men. Patients with FBG concentrations ≥7.155 mmol/L are more likely to develop progressive infarction.

Isolated posterior ST-elevation myocardial infarction: the necessity of routine 15-lead electrocardiography: a case series

BackgroundTrue isolated posterior myocardial infarction is an uncommon finding of acute coronary syndrome, with an incidence rate of 3–7%. The prevalence rates of isolated posterior myocardial infarction in men and women are 72% and 28%, respectively. This uncommon finding may be attributed to multiple factors, such as unremarkable changes on 12-lead electrocardiography, a lack of awareness or knowledge, and an absence of diagnostic consensus, which leads to reperfusion delay and poor clinical outcomes.Case summaryHerein, we report three cases of acute myocardial infarction presenting as isolated ST-segment elevation in the posterior leads (V7–V9): Asian men aged 57, 62, and 53 years, who presented with ST-segment depression in V1–V3 that resolved gradually. Coronary angiography revealed a total/critical occlusion of the proximal circumflex coronary artery in all three cases. Routine and accurate interpretations of 15-lead electrocardiography (12-lead with additional V7–V9) resulted in a better sensitivity for isolated posterior myocardial infarction diagnoses, followed by a timely and opportune primary percutaneous coronary intervention.ConclusionsIsolated posterior myocardial infarction is a rare but potentially fatal event that is often accompanied by atypical and subtle changes on 12-lead electrocardiography (especially in the V1–V3 precordial leads) and may remain undetected by physicians. Therefore, the comprehensive and routine application of posterior leads is a crucial addition to the standard diagnosis and management of acute coronary syndrome in patients with subtle ST-segment changes who do not fulfill the criteria for ST-elevation myocardial infarction.

Potential crowdedness of mechanical thrombectomy and cerebral infarction mortality in Japan: Application of inverted two-step floating catchment area method

ObjectivesThis study aimed to evaluate a stroke medical delivery system based on population coverage and the potential crowdedness index (PCI) of mechanical thrombectomy and investigate the relationship between PCI and cerebral infarction mortality in Japan. Materials and methodsThis cross-sectional study defined 662 facilities and 1605 neurointerventionalists as supply, population aged 55 years or older as demand, and set the reachable area for demand as 120 min in driving time. Multiple regression analysis adjusted for spatial autocorrelation was used to examine the relationship between PCI and cerebral infarction mortality. ResultsIn the 2020 data, 99% of the population aged 55 years or older had access to mechanical thrombectomy (≤120 min), and the PCI ranged from 5876 to 129838, with a median of 30426. From 2020 to 2035, the PCI is estimated to increase (30426 to 32510), decreasing after 2035 (32510 to 29469). The PCI distribution exhibited geographical heterogeneity. High PCI values emerged in eastern Japan. According to regression analysis, the increase in PCI by 1% led to an increase of 0.13% in standardized mortality ratio of cerebral infarction in men. However, PCI did not significantly correlate with cerebral infarction mortality in women. ConclusionsPCI for hospitals based on supply and demand was geographically heterogeneous in Japan. Optimization of PCI contributes equalization of mechanical thrombectomy provision system and may improve cerebral infarction mortality.

Cardiovascular events and their outcome in diabetes and in people with prediabetes in the Coronary Unit of a Secondary General Hospital

Background: The epidemic proportions that obesity, Diabetes Mellitus, as well as the progressive increase in the average life expectancy and consequently demographic aging are the main factors in the increase in the prevalence of Cardiovascular Diseases. Special reference is made to patients with prediabetes which usually works subclinical without obvious clinical symptoms.Purpose-Methodology-Materials: This is a retrospective study of patients who were admitted with cardiovascular events to the Coronary Unit of a Secondary General Hospital in Greece over a period of three months. A convenience sample of 178 patients (mean age: 67, 7), who were admitted to the Coronary Unit participated in the study. The criteria for the diagnosis of cardiovascular events were based on the guidelines of the European Society of Cardiology.Results: The findings are mostly in line with the literature, according to which the cardiovascular events in diabetics, as well as in people with Prediabetes, as the reason for admission of these people to the Coronary Unit, was Acute Myocardial Infarction in men at a rate of 19.5%, Acute Coronary Syndrome in 15.4% and Atrial Fibrillation in 13.8%, while in women the percentage of Acute Myocardial Infarction was 12.7%, of Acute Coronary Syndrome 10.9%, in contrast to Atrial Fibrillation it touched 23.8% and of Acute Pulmonary Oedema 20.0%. In relation to age, the highest percentage of Acute Myocardial Infarction was in the grouped age of 50-59 years, of Acute Coronary Syndrome at the age of 60-69 years, while of Atrial Fibrillation at the age of 70-79 years and at the same age the highest percentage of Acute Pulmonary Oedema. Regarding the outcome in days of hospitalization, the largest percentage of patients, similar in both sexes, was hospitalized for two days in the Coronary Unit with the largest percentage being transferred to the Cardiology Clinic for the continuation of the treatment process and a large percentage, which touched the 41.8% in total in both sexes, was transferred to an interventional center for further treatment. Death as an outcome was more common in women than in men.Conclusions: People with Diabetes Mellitus have a three to five times greater risk of developing Coronary Heart Disease, even when other risk factors have been treated. It turns out that in addition to the well-known correlation between Diabetes Mellitus and Coronary Artery Disease, prediabetes, which acts subclinically, it is positively correlated with the occurrence of Coronary Artery Disease in patients who are hospitalized in a Coronary Unit. The productive age (50-59 years) is the age group with the highest percentage of Acute Myocardial Infarction, while the elderly (70-79 years) for Atrial Fibrillation. About half of the patients with Acute Myocardial Infarction are further treated with either coronary artery bypass grafting or coronary artery bypass grafting, while the prognosis was worse in women than in men. Early detection of diabetic and pre- diabetic patients and their effective treatment by medical and nursing staff, adherence to monitoring protocols for diabetic patients, a holistic and interdisciplinary approach with the participation of other health professionals, dietitians, and nutritionists are deemed necessary. Education, reinforcement and empowerment for behavior modification, self-care enhancement, as well as strengthening the cooperation of cardiologists and diabetologists in order to reduce cardiovascular events and their complications in the population.

Increased Perceived Age as a Risk Factor for All-cause Mortality and Comorbidities: A Systematic Review

INTRODUCTION: Chronological age has been identified as a major risk factor for a wide variety of pathologies, also serving as a mortality predictor. However, same-aged patients’ diverse health outcomes put its predictor role for reconsideration. Biological age is a measure based on physical, physiological, cellular, and biochemical parameters and might reflect a person’s aging process more accurately. A higher biological age or its isolated components have been associated with a higher risk of developing several chronic diseases and increased mortality risk. Perceived age, defined as how old a person looks to external evaluators, reflects the underlying biological age. Therefore, this review aimed to find whether perceived age is associated with mortality risk or comorbidity outcomes. METHODS: PubMed, EMBASE, and CINAHL were inquired on July 27, 2020. Mesh terms related to perceived age, mortality, and the most prevalent chronic diseases in the United States (including heart disease, cancer, and diabetes) were used. Studies were included if they (1) measured perceived age or isolated facial characteristics of old age, (2) measured mortality risk, mortality rate, or comorbidity outcomes, and (3) were in English. RESULTS: Of the 977 studies, 15 fulfilled the inclusion criteria. Follow-up periods ranged from 2 to 15 years. Same age younger-looking people were used as control groups in all studies. Four studies correlated perceived age with all-cause mortality risk. These studies found that mortality risk increased by 6%–51% in older-looking people (HR 1.06–1.51, P < 0.05) compared with controls. This association was found in women in only one study (HR 1.51, P < 0.05). One study correlated isolated facial characteristics with mortality risk, finding a decreased mortality risk in men with no gray hair (RR 0.81, P < 0.05) and increased mortality risk in women with arcus senilis (RR 1.13, P < 0.05 for half arcus; RR 1.25, P < 0.05 for complete arcus). Two studies measuring mortality rate found deceased patients to look between 1.04 and 1.15 years older than same-aged survivors (P < 0.05). Nine studies correlated perceived age or isolated facial characteristics with different comorbidity parameters. Older-looking people were found to have a higher carotid intima-media thickness (P < 0.01). Breaking down perceived age by facial characteristics, pigmentation showed a significant positive correlation with carotid intima-media thickness (P < 0.05). Younger-looking patients were found to have lower cardiovascular risk (P < 0.01). Additionally, gray hair increased the risk of myocardial infarction in men (RR 1.91, P < 0.01). Older-looking people were also found to have decreased cognitive function and lower bone mineral density (P < 0.01). Lastly, high wrinkle scores were associated with low forced expiratory volume in one second (P < 0.05), the extent of emphysema on computed tomography (P < 0.05), and increased the risk of chronic obstructive pulmonary disease (P < 0.05). CONCLUSIONS: Measurement outcomes differed among included studies and, although perceived age promises to be a useful predictor of mortality and comorbidities, further characterization of its role as a risk factor and its application in general practice is warranted.

Sex differences in the effect of family stress on risk of myocardial infarction and stroke in population 25–64 years: WHO program MONICA-psychosocial

Abstract Purpose To determine the influence of family stress on the risk of cardiovascular diseases (myocardial infarction and stroke) in an open population aged 25–64 years in Russia / Siberia. Methods Within the framework of the III screening of WHO's MONICA-psychosocial program, a random representative sample of the population of both sexes of 25–64 years of Novosibirsk in 1994 (men n=657, mean age 44,3±0,4y, response 82.1%; women: n=689, mean age 45,4±0,4y, response 72.5%) was examined. The screening included: socio-demographic data, the definition of the family stress. New-onset cases of MI and stroke in women - 15 and 35 cases and in men - 30 and 22 cases, respectively detected in the cohort over follow-up period in frame of budgetary theme # AAAA-A17–117112850280–2. Results In the open population aged of 25–64 years the prevalence of high family stress was higher in men (31.5%) than women (20.9%). The risk of myocardial infarction in men and women experiencing stressful situations in the family was 5.9 and 5.58-fold higher, respectively over 16-year period. The most significant risk factors for the development of myocardial infarction were divorce (HR = 3.9) and widowhood (HR = 6.3). The risk of developing a stroke was 3.45-fold higher in men and 3.52-fold higher in women with family stress. The risk of developing stroke was higher among those with high school and elementary education levels, both in men (HR = 3.9 and HR = 6.3) and women (HR = 2.87 and HR = 3.33). Conclusion Stress in the family is more common in men within the working-age population. Family stress increases the risk of developing both myocardial infarction and stroke among men and women. Funding Acknowledgement Type of funding sources: Other. Main funding source(s): This survey was performed within the framework of the budgetary theme NIITPM - branch of the ICG SB RAS Reg. No. AAAA-A17-117112850280-2, Gov.Task No. 0324-2018-0001.

The role of infectious and seasonal factors in the development of myocardial infarction in men under 60 years old

The influence of seasonal and infectious factors on the risk of an unfavorable outcome in the first 56 days of myocardial infarction, a complicated course of the disease, the development of chronic heart failure of the second functional class and higher during this period was studied. The results of examination and treatment of 556 men 1960 years old with verified type I myocardial infarction were evaluated. The analysis of the risks of an unfavorable outcome, a complicated course of the disease, and the development of chronic heart failure was carried out by the method of multivariate analysis of variance. Chronic foci of infections of the abdominal cavity and kidneys, myocardial infarction in winter, spring and autumn have a moderate negative effect on the prognosis of the disease in the examined. Predictors of unfavorable prognosis are heterogeneous across the seasons. Frequent respiratory infections and chronic inflammatory lung diseases reduce the risk of death in those examined in the first months of myocardial infarction, however, they significantly increase the risk of developing chronic heart failure (bibl.: 19 refs).

Adjustment Mechanisms in the Acute Phase of Myocardial Infarction in Men.

Stress and Coping Model and Post-Traumatic Growth Theory indicate adjustment procedures concepts after a crisis. The objective of this study was to assess the relationships between causal attributions, coping strategies and post-traumatic growth in male patients with acute myocardial infarction and variable cardiac function severity. Seventy-eight male patients surviving a myocardial infarction, were divided into two sub-groups based on left ventricular ejection fraction measurements [Group A (left ventricular ejection fraction: <45%, n = 34), Group B (left ventricular ejection fraction: ≥45%, n = 44)] and were interviewed after the acute phase of myocardial infarction, on the last day of their coronary unit stay. Medical data was obtained from their medical records. Causal Attributions' List, Coping Orientation to Problems Experienced and Post-Traumatic Growth Inventory were used. Causal attributions were found to be related to active coping, emotional support, religious coping and self-blame in both groups. Planning, positive reinterpretation and active coping were the strategies associated positively with most of the post-traumatic inventory subscales in total data analyses. Diverse coping strategies were associated with posttraumatic growth factors. It is important to assess adjustment mechanisms in the acute phase of myocardial infarction. A tailored scheme therapy, considering patient's needs, has to be planned.

СОСТОЯНИЕ ЛИПИДНОГО ОБМЕНА У МУЖЧИН МОЛОДОГО И СРЕДНЕГО ВОЗРАСТА С ИНФАРКТОМ МИОКАРДА И РЕЦИДИВИРУЮЩИМИ ЭПИЗОДАМИ ИШЕМИИ

Relevance. Dyslipidemia is considered one of the main risk factors for the development of recurrent myocardial infarction and early postinfarction angina. Aim. To evaluate the features of lipid metabolism in acute and subacute myocardial infarction in men under 60 years old with recurrent episodes of ischemia (recurrent myocardial infarction and/or early postinfarction angina) to search for new approaches to improve prevention measures. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 68 patients; II - control, without it - 427 patients. A comparative assessment of lipid metabolism parameters and their dynamics in selected groups were performed. Results. The study group differed in higher levels of total serum cholesterol (6.17±1.78 mmol/l) from the control group (5.56±1.28 mmol/l; p=0.02) at the end of the third week of disease, its dynamics during the observation period (I: 9.1%; p&lt;0.0001; II: -1.8%; p&lt;0.0001) and the dynamics of the atherogenic coefficient (I: -4.7.1; p=0.02; II: 6.3%; p&lt;0.0001). In both groups, the group showed an increase in lipoproteins of low (I: 33.1; p=0.02; II: 45.5%; p&lt;0.0001) and very low density (I: 275.8; p=0,0004; II: 233.4%; p&lt;0.0001), atherogenic indices, decrease: triglycerides (I: -31.8%; p=0.02; II: -1.7%; p&lt;0.0001) and high-density lipoproteins (I: -0.6%; p=0.02; II: -6.1%; p&lt;0.0001). Conclusions. The group with recurrent ischemia is characterized by more pronounced hypercholesterolemia at the end of the subacute period of myocardial infarction in comparison with the control group due to an increase in the concentrations of atherogenic lipid metabolism fractions. The dynamics of indices and the coefficient of atherogenicity during this period is multidirectional, which requires additional study.

Matters of the Heart: Case-Crossover Analysis of Myocardial Infarction on Valentine's Day

We studied the risk of myocardial infarction on Valentine's Day. We conducted a case-crossover study of 51,450 adults with myocardial infarctions in February, 1989-2019. The exposure was Valentine's Day, and the 2 days before and after Valentine's Day. We estimated odds ratios (OR) to compare days when myocardial infarction occurred with neighboring control days. Compared with other days, Valentine's Day was associated with lower odds of myocardial infarction the following day for men (OR 0.91, 95% confidence interval 0.85-0.98), but not for men and women combined (OR 0.95, 95% confidence interval 0.91-1.01). Risk of myocardial infarction in men is lower the day after Valentine's Day.

Current smoking status as a predictor of cerebral infarction in men: a retrospective cohort study in South Korea

ObjectivesWe examined the relationship between duration (pack-year) of smoking and the risk of developing cerebral infarction in Korean men.DesignRetrospective cohort study.SettingNational Health Insurance Service-National Sample Cohort in Korea.ParticipantsOf 125 743...

Family Stress and The Risk of Cardiovascular Diseases in Working-Age Population 25-64 Years (WHO program MONICA-Psychosocial)

Purpose: To determine the influence of family stress on the risk of cardiovascular diseases (myocardial infarction and stroke) in an open population aged 25–64 years in Russia / Siberia. Methods: Within the framework of the III screening of WHO’s MONICA-psychosocial program, a random representative sample of the population of both sexes of 25-64 years of Novosibirsk in 1994 (men n = 657, mean age 44,3 ± 0,4y, response 82.1%; women: n = 689, mean age 45,4 ± 0,4y, response 72.5%) was examined. The screening included: socio-demographic data, the definition of the family stress. New-onset cases of MI and stroke in women - 15 and 35 cases and in men - 30 and 22 cases, respectively detected in the cohort over follow-up period in frame of budgetary theme № AAAA-A17-117112850280-2. Results: In the open population aged of 25-64 years the prevalence of high family stress was higher in men (31.5%) than women (20.9%). The risk of myocardial infarction in men and women experiencing stressful situations in the family was 5.9 and 5.58-fold higher, respectively over 16-year period. The most significant risk factors for the development of myocardial infarction were divorce (HR = 3.9) and widowhood (HR = 6.3). The risk of developing a stroke was 3.45-fold higher in men and 3.52-fold higher in women with family stress. The risk of developing stroke was higher among those with high school and elementary education levels, both in men (HR = 3.9 and HR = 6.3) and women (HR = 2.87 and HR = 3.33). Conclusion: Stress in the family is more common in men within the working-age population. Family stress increases the risk of developing both myocardial infarction and stroke among men and women.

Influence of Sex on Early Outcomes of Elective Lumbar Fusions: An Updated Propensity-Matched and Subgroup Analysis

Existing data have demonstrated significant differences in morbidity and mortality measures between men and women undergoing various spinal surgeries. However, studies of lumbar fusion surgery have been limited. Thus, we investigated the effects of patient sex on 30-day perioperative outcomes after elective lumbar fusion spine surgery. Patients who had undergone lumbar fusion from 2015 to 2018 were reviewed from the American College of Surgeons National Surgical Quality Improvement Program database. Propensity score matching was used to determine whether the patient's sex had influenced the 30-day perioperative complications. A total of 44,526 cases had met the inclusion criteria and were reviewed. Of the 44,526 patients, 13,715 had undergone posterior lumbar fusion, 21,993 had undergone posterior/transforaminal lumbar interbody fusion, and 8818 had undergone anterior/lateral lumbar interbody fusion. The women were more likely to be older, functionally dependent, and taking steroids for chronic conditions and to have a higher body mass index and lower preoperative hematocrit level. The men were more likely to be white, to smoke, and to have diabetes mellitus, hypertension, and bleeding disorders. In all cohorts, except for a higher incidence of urinary tract infection in the female patients and myocardial infarction in the male patients, no significant differences were found in morbidity and mortality between the sexes. Several differences in demographics and baseline health status were found between men and women undergoing lumbar fusion. When attempting to control for comorbid conditions using propensity score matching, we found that sex was an independent predictor of urinary tract infection in women and myocardial infarction in men across major morbidity and mortality categories in patients undergoing lumbar fusion surgery.

Sex-specific temporal trends in the incidence of atrial fibrillation in a large Norwegian population-based study 1986–2014

Abstract Background Due to population aging, increasing prevalence of obesity and enhanced detection, the prevalence of atrial fibrillation (AF) worldwide is increasing steadily. Considerable sex differences in the epidemiology of AF such as lower prevalence and later onset in women compared to men have been reported. However, little is known about sex-specific temporal trends in AF incidence within the general population. Purpose To explore sex-specific age-adjusted secular trends in the incidence of AF in a general population from Norway between 1986 and 2014. Methods A total of 16,865 men and 15,413 women aged 20 years or older and without AF were enrolled in a longitudinal population study between 1986 and 2008 and followed up for incident AF to the end of 2014. Follow-up was from the date of attendance to the date of AF, emigration or death, whichever came first. All AF cases were validated by an independent endpoint committee using hospital and death records. AF incidence rates were calculated for each calendar year by dividing the number of AF cases per year by the corresponding person-time at risk. To allow for non-linear time trends, calendar year was fitted using fractional polynomials. Poisson regression was used to estimate calendar year-specific AF incidence rates adjusted for age. All analyses were stratified by sex. Results A total of 911 AF events in women and 1,139 AF events in men occurred over 324,090 person-years and 294,531 person-years of follow-up, respectively. During the study period AF incidence rates in men were at least double that in women (Figure). Age-adjusted AF incidence rates in women increased from 1986, peaked at 0.87 per 1000 person-years in 1998 and then decreased slightly towards 2014. In men AF incidence rates increased up to 2.18 per 1000 person-years in 2005 and then steeply decreased. Conclusion(s) AF incidence rates decreased in both women and men towards the end of the study period. The decrease was more profound in men compared to that in women. One possible explanation is more pronounced reduction in incidence and better treatment of myocardial infarction in men compared to women given that the aetiology of AF in men is mainly ischemic heart disease-related. However, further epidemiological analyses should be undertaken to identify explanatory factors. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Hospital of North Norway, Northern Norway Regional Health Authority

CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH RECURRENT ISCHAEMIC DAMAGES DURING MYOCARDIAL INFARCTION

Relevance. Recurrent ischemic damages negatively affect the prognosis of myocardial infarction. Aim. To evaluate the peculiarities of cardiovascular risk factors in men younger than 60 years old with myocardial infarction and recurrent ischemic damages to improve prevention, and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent ischemic damages - 95 patients; II - con-trol, without it - 470 patients. A comparative analysis of the frequency of observation of the main and additional car-diovascular risk factors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hypodynamia (94.7 and 77.7%, respectively; p ˂ 0.05), smoking (86.3 and 72.6%; p ˂ 0.05), myocardial infarction (56.8 and 40.3%; p ˂ 0.05), unstable angina (57.9 and 46.3%; p ˂ 0.05), coronary artery bypass surgery (17.9 and 9, 3%; p ˂ 0.05) in the pa-tient’s medical a history, stress (53.7 and 36.9%; p ˂ 0.05) and changes in meteorological factors (26.4 and 23.0%; p ˂ 0.05) as causes of myocardial infarction , winter (37.9 and 28.1%; p ˂ 0.05) and autumn (28.4 and 18.3%; p ˂ 0.05) periods and impaired renal function (29.2 and 12.1% ; p ˂ 0.05). Conclusions. The use of these factors in prognostic modeling of recurring ischemic damages risk in case of myocardi-al infarction in men under 60 years old, as well as in creating high-risk groups for their development to monitor and conduct preventive measures, will improve the outcome of such patients.

Incidence, survival, and risk of cardiovascular events in adult inflammatory myopathies in South Korea: a nationwide population-based study

Objective Epidemiological studies on inflammatory myopathies (IMs) show widely variable results, and studies on Asians are lacking. Despite emerging interest in the cardiovascular disease (CVD) risk associated with IMs, the prevalence of CVD in IM patients and its impact on mortality remain unclear. We conducted a nationwide, population-based study on the incidence, mortality, and associated major CVD events of IMs in the Republic of Korea over 11 years. Method Using the nationwide, population-based National Health Insurance claims database and the Rare Intractable Disease registration programme, we estimated incidence, mortality, and CVD occurrence. Survival was examined using the Kaplan–Meier method. Mortality rate in IMs with CVD was analysed by Cox proportional hazards regression. Results There were 3014 incident cases, 640 of whom died during the study period. The mean annual incidence was 7.16/106. Dermatomyositis (DM) and polymyositis (PM) had 5 year survival rates of 76.8% and 79.3%, respectively. Cardiovascular events occurred in 155 patients and 40.6% of IM patients with CVD died. Acute myocardial infarction in men had the highest risk of any CVD event in both DM [standardized incidence ratio (SIR) 4.2, 95% confidence interval (95% CI) 2.4–7.2] and PM (SIR 3.5, 95% CI 1.8–7.0). Haemorrhagic stroke had the highest hazard ratio (HR) in both DM (HR 2.31, 95% CI 1.13–4.70) and PM patients (HR 2.10, 95% CI 1.03–4.27) compared with the general population with CVD. Conclusion We found persistently low incidence, poor survival, and high major CVD incidence in IMs, and increased mortality in IMs with CVD.