Prevalence Of Ischemic Heart Disease Research Articles

Prevalence and associated factors of self-reported ischaemic heart disease and/or stroke: a cross-sectional nationally representative community-based study of adults in Malawi in 2017

ObjectiveThis study aimed to assess the prevalence and associated factors of self-reported ischaemic heart disease (IHD) and/or stroke among adults in Malawi.DesignPopulation-based cross-sectional study.SettingNationally representative sample of general adult population...

Long-term prognosis of patients undergoing radiofrequency catheter ablation for atrial fibrillation: comparison between heart failure subtypes based on left ventricular ejection fraction

Abstract Aims Heart failure (HF) prognosis has been reported similar in patients with preserved vs. reduced left ventricular ejection fraction (LVEF). This study compared the long-term prognosis of HF patients undergoing radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). Methods and results Among 5010 patients undergoing RFCA in Kansai Plus AF registry, 656 patients (13.1%) with a documented history of HF were enrolled in the study before RFCA. The primary endpoint was a composite of all-cause death, HF hospitalization, and stroke or systemic embolism. Patients with reduced (<40%), mid-range (40–49%), and preserved (≥50%) LVEF were 98 (14.9%), 107 (16.3%), and 451 (68.8%) patients, respectively. The prevalence of ischaemic heart disease and cardiomyopathies was higher among patients with reduced as compared with preserved LVEF (27.6% vs. 10.0%, P < 0.05 and 36.7% vs. 15.3%, P < 0.05, respectively). The median follow-up period was 2.9 years. The 3-year cumulative risk for the primary endpoint was higher in patients with reduced LVEF (32.7%) compared to those with mid-range (11.7%) or preserved (11.6%) LVEF (P < 0.001). Reduced LVEF was the most significant independent risk factor for primary endpoint (hazard ratio, 2.83; 95% confidence interval 1.74–4.61, P < 0.001). The 3-year arrhythmia recurrence rate was similar among the groups (48.2%, 42.8%, and 47.3%, respectively, P = 0.75). Conclusion This study raises hypothesis that patients with HFrEF and AF had approximately three times higher risk for a composite of all-cause death, HF hospitalization, and stroke or systemic embolism after AF ablation compared with patients with HFmrEF or HFpEF.

Development of a primary care research network focused on chronic disease: a feasibility study for both practices and research networks

Background: High quality data should be a key resource for research and planning of healthcare, but low quality general practice data has been documented internationally. This study assessed the feasibility of collecting reliable chronic disease data in Irish general practice, using a program of training and feedback to improve the quality of coding for chronic conditions in practice information systems. Methods: Training in chronic disease coding and reporting was provided to a purposive sample of general practices in Ireland. From July to December 2020, practices reported the number of patients receiving free medical care, and the number of patients coded with each of eight chronic conditions: type 2 diabetes mellitus (T2DM), asthma, chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), heart failure (HF), atrial fibrillation (ATF), transient ischaemic attack (TIA) and cerebrovascular accident/stroke (CVA). Calculated prevalences were compared with national and international estimates. Results: We recruited and trained 16 practices with 65.5 full-time equivalent GPs and a study-eligible patient population of 36,327. There was a large degree of variation across practices for all conditions. For example, in July, reported prevalence of IHD ranged from 0.3% to 10.2% (a 34-fold difference), and reported prevalence of HF ranged from 0.2% to 4.0% (a 20-fold difference). No single practice had high or low prevalences across all conditions. Changes over time across all practices were minimal, averaging between 0.1% and 0.3% for all conditions. By December, a large degree of variation across practices remained. Across all conditions, average prevalences were higher than previously published estimates. Conclusions: Although hampered by the COVID-19 pandemic, it was feasible to implement this programme of training and feedback to report on chronic disease data recorded in general practice. Coding quality in Irish general practice is highly varied, and improvement would require a greater degree of intervention, including audit.

Prevalence of ischemic heart disease and its association with socio-economic factors in the population of 25-44 years of Western Siberia

Background and Aims: The aim of the study was to evaluate the prevalence of ischemic heart disease (IHD) according to standardized epidemiological criteria in the population of 25-44 years of Novosibirsk and to identify its associations with risk factors and socio-economic factors.

A hospital based cross sectional study on subclinical hypothyroidism in females over fifty years of age and its relation to hypertension, diabetes mellitus and ischemic heart disease at a tertiary care hospital, Hyderabad

Background: Prevalence of subclinical hypothyroidism is more common in females compared to males and elderly age group. More studies are required to throw light on these aspects especially among elderly women with subclinical hypothyroidism and its association with prevalence of hypertension, diabetes and ischemic heart disease (IHD) among these women. The objective was to study prevalence of subclinical hypothyroidism among elderly females and its relation with the diabetes, hypertension and IHD.Methods: Hospital based cross-sectional study was carried out among 178 women of 50 years and more. Detailed history, clinical examination and routine investigations were carried out. Free T4, free T3 and TSH (thyroid stimulating hormone) levels were measured using electro chemiluminescent method. Presence of hypertension, diabetes mellitus, IHD was noted.Results: Prevalence of subclinical hypothyroidism was 24.7% and more in 61-70 years (38.5%). In 55% of the women the symptoms were absent. The most common symptom was fatigability and constipation. The prevalence of IHD among women with subclinical hypothyroidism was 22.7% compared to only 7.5% in women without subclinical hypothyroidism and this difference was found to be statistically significant (p<0.05). For hypertension and diabetes, it was observed that the prevalence of these two conditions was slightly more in women without subclinical hypothyroidism but the difference was not found to be statistically significant (p>0.05).Conclusions: Prevalence of subclinical hypothyroidism in the elderly women was high. Subclinical hypothyroidism was found to be significantly associated with IHD but not with hypertension and diabetes.

Cross sectional study of familial hypercholesterolemia in dyslipidemia patients receiving lipid-lowering therapy: DYSIS-China subgroup analysis

Objectives: To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China. Methods: Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of "Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version". DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HF, possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gender, lipids levels, drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification. Results: A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) years, 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%), possible FH was 3294 (13.7%), and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups. Conclusion: The detection rate of FH in Chinese patients with dyslipidemia is not low, the blood lipid level is poorly controlled, and the risk of cardiovascular disease is high in Chinses FH patients.

Association between frailty and ischemic heart disease: a systematic review and meta-analysis

BackgroundFrailty is increasingly reported among older adults with cardiovascular diseases and it has been demonstrated to increase negative health outcomes and mortality. To date, no systematic review of the evidence is available regarding the association between frailty and ischemic heart disease (IHD). We performed a systematic review of literature and a meta-analysis to assess the association between frailty and IHD.MethodsWe selected all the studies that provided information on the association between frailty and IHD, regardless of the study setting, study design, or definition of IHD and frailty. PubMed, Web of Science and Embase were searched for relevant papers. Studies that adopted the Fried definition for frailty were included in the meta-analyses. For each measure of interest (proportions and estimates of associations), a meta-analysis was performed if at least three studies used the same definition of frailty. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting.ResultsThirty-seven studies were included. Of these, 22 adopted the Fried criteria to define frailty and provided estimates of prevalence and therefore they were included in meta-analyses. The pooled prevalence of IHD in frail individuals was 17% (95% Confidence Interval [95%CI] 11–23%) and the pooled prevalence of frailty in individuals with IHD was 19% (95% CI 15–24%). The prevalence of frailty among IHD patients ranged from 4 to 61%. Insufficient data were found to assess longitudinal association between frailty and IHD.ConclusionsFrailty is quite common in older persons with IHD. The identification of frailty among older adults with IHD should be considered relevant to provide individualized strategies of cardiovascular prevention and care. Further research should specifically explore the association between frailty and IHD and investigate the potential common biological ground.

Variation in intraabdominal pressure in patients with acute heart failure according to left ventricular ejection fraction. Results of an intraabdominal pressure study

BackgroundThe increase in intraabdominal pressure (IAP) has been correlated with increased creatinine levels in patients with heart failure with severely reduced left ventricular ejection fraction (HFrEF). However, IAP has not been examined in more stable patients or those with heart failure with preserved ejection fraction (HFpEF). Patients and methodWe conducted an observational, prospective descriptive study that measured the IAP of patients hospitalised for decompensated heart failure (HF). The sample was stratified according to left ventricular ejection fraction (LVEF), with a cut-off of 50%. The objective was to analyse the IAP, the baseline characteristics and degree of congestion using clinical ultrasonography and impedance audiometry. ResultsThe study included 56 patients, 22 with HFrEF and 34 with HFpEF. The patients with HFrEF presented a higher prevalence of ischaemic heart disease (11% vs. 6%; p = 0.010) and chronic obstructive pulmonary disease/asthma (6% vs. 2%; p = 0.025). The IAP was higher in the patients with HFrEF (17.2 vs. 13.3 mmHg; p = 0.004), with no differences in renal function at admission according to the LVEF (CKD-EPI creatinine) (HFrEF 55.0 mL/min/1.73 m2 [32.6–83.6] vs. HFpEF 55.0 mL/min/1.73 m2 [44.0–74.9]; p = 0.485). The patients with HFrEF presented a more congestive profile determined through ultrasonography (inferior vena cava collapse [26% vs. 50%; p = 0.001]), impedance audiometry (total body water at admission, 46 L vs. 41 L; p = 0.052; and at 72 h, 50.2 L vs. 39.1 L; p = 0.038) and CA125 concentration (68 U/mL vs. 39 U/mL; p = 0.037). ConclusionsDuring the decompensation episodes, the patients with HFrEF had a greater increase in IAP and a higher degree of systemic congestion.

Cardiopatía isquémica: concepto, clasificación, epidemiología, medidas preventivas y tratamiento no farmacológico

Ischaemic heart disease is a disease process characterised by insufficient blood perfusion to the myocardium to meet required demands. It is usually caused by the formation of atherosclerotic plaque in the epicardial coronary arteries. It is classified as acute coronary syndrome (if there is rupture of an atherosclerotic plaque leading to thrombosis) and chronic coronary syndrome (where the ischaemia is caused by obstruction of the lumen by atherosclerotic plaque without rupture of the plaque). Chronic coronary syndrome includes patients who have suffered an acute coronary syndrome for more than one year. Due to the progressive ageing of the population, the prevalence of ischaemic heart disease is expected to increase in the coming decades; both chronic and acute coronary syndromes. Preventive measures and non-pharmacological treatment have proven at least as important as pharmacological treatment. The primary recommendations are smoking cessation, a body mass index below 25kg/m2, adhering to a Mediterranean diet, and taking 30-60minutes of physical exercise daily.

Changes in body mass index, obesity, and overweight in Southern Africa development countries, 1990 to 2019: Findings from the Global Burden of Disease, Injuries, and Risk Factors Study.

BackgroundHigh body mass index (BMI) is associated with stroke, ischemic heart disease (IHD), and type 2 diabetes mellitus (T2DM). An epidemiological analysis of the prevalence of high BMI, stroke, IHD, and T2DM was conducted for 16 Southern Africa Development Community (SADC) using Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study data.MethodsGBD obtained data from vital registration, verbal autopsy, and ICD codes. Prevalence of high BMI (≥25 kg/m2), stroke, IHD, and T2DM attributed to high BMI were calculated. Cause of Death Ensemble Model and Spatiotemporal Gaussian regression was used to estimate mortality due to stroke, IHD, and T2DM attributable to high BMI.ResultsObesity in adult females increased 1.54‐fold from 12.0% (uncertainty interval [UI]: 11.5–12.4) to 18.5% (17.9–19.0), whereas in adult males, obesity nearly doubled from 4.5 (4.3–4.8) to 8.8 (8.5–9.2). In children, obesity more than doubled in both sexes, and overweight increased by 27.4% in girls and by 37.4% in boys. Mean BMI increased by 0.7 from 22.4 (21.6–23.1) to 23.1 (22.3–24.0) in adult males, and by 1.0 from 23.8 (22.9–24.7) to 24.8 (23.8–25.8) in adult females. South Africa 44.7 (42.5–46.8), Swaziland 33.9 (31.7–36.0) and Lesotho 31.6 (29.8–33.5) had the highest prevalence of obesity in 2019. The corresponding prevalence in males for the three countries were 19.1 (17.5–20.7), 19.3 (17.7–20.8), and 9.2 (8.4–10.1), respectively. The DRC and Madagascar had the least prevalence of adult obesity, from 5.6 (4.8–6.4) and 7.0 (6.1–7.9), respectively in females in 2019, and in males from 4.9 (4.3–5.4) in the DRC to 3.9 (3.4–4.4) in Madagascar.ConclusionsThe prevalence of high BMI is high in SADC. Obesity more than doubled in adults and nearly doubled in children. The 2019 mean BMI for adult females in seven countries exceeded 25 kg/m2. SADC countries are unlikely to meet UN2030 SDG targets. Prevalence of high BMI should be studied locally to help reduce morbidity.

Secular trends of ischaemic heart disease, stroke, and dementia in high-income countries from 1990 to 2017: the Global Burden of Disease Study 2017

BACKGROUND We assessed secular trends in the burden of ischaemic heart disease (IHD), stroke, and dementia in the Organization for Economic Co-operation and Development (OECD) countries. METHODS Using the Global Burden of Disease (GBD) Study 2017, we compared sex-specific and age-standardized rates of disability-adjusted life years (DALY); mortality, incidence, and prevalence of IHD and stroke; and dementia per 100,000 people, in the world, OECD countries, and Canada. RESULTS From 1990 to 2017, the crude incidence number of IHD, stroke, and dementia increased 52%, 76%, and 113%, respectively. Likewise, the prevalence of IHD (75%), stroke (95%), and dementia (119%) increased worldwide. In addition during the study period, the crude global number of deaths of IHD increased 52%, stroke by 41%, and dementia by 146% (9, 6, and 3 million deaths in 2017, respectively). Despite an increase in the crude number of these diseases, the global age-standardized incidence rate of IHD, stroke, and dementia decreased by -27%, - 11%, and - 5%, respectively. Moreover, there was a decline in their age-standardized DALY rates (- 1.17%, - 1.32%, and - 0.23% per year, respectively) and death rates (- 1.29%, - 1.46%, and - 0.17% per year, respectively), with sharper downward trends in Canada and OECD countries. Almost all trends flattened during the last decade. CONCLUSIONS From 1990 to 2017, the age-standardized burden of IHD, stroke, and dementia decreased, more prominently in OECD countries than the world. However, their rising crude numbers mainly due to population growth and ageing require urgent identification of reversible risk and protective factors.

Are women more susceptible to ischemic heart disease compared to men? A literature overview.

Ischemic heart disease (IHD) is known as the leading cause of death in both genders. Moreover, significant sex differences were found in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD. The presence of unique risk factors such as exposure to menarche and pregnancy, more anemia, hypertension, and autoimmune disorders in women have recently received attention. Ischemic symptoms are more indefinite and vague in women compared to men as well as a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented. Without any correct diagnosis, treatment, and prevention, these problems are accumulated and continue up to older age. Accordingly, with the belief of longer life in women and the increased prevalence of IHD with aging, it will become an important public health problem and concern in the future. This narrative review aimed to provide an overview of some of the differences between the two genders in terms of IHD with paying more attention to practical points.

Diagnostic Accuracy in Teleneurological Stroke Consultations

Background: The accuracy of diagnosing acute cerebrovascular disease via a teleneurology service and the characteristics of misdiagnosed patients are insufficiently known. Methods: A random sample (n = 1500) of all teleneurological consultations conducted between July 2015 and December 2017 was screened. Teleneurological diagnosis and hospital discharge diagnosis were compared. Diagnoses were then grouped into two main categories: cerebrovascular disease (CVD) and noncerebrovascular disease. Test characteristics were calculated. Results: Out of 1078 consultations, 52% (n = 561) had a final diagnosis of CVD. Patients with CVD could be accurately identified via teleneurological consultation (sensitivity 95.2%, 95% CI 93.2–96.8), but we observed a tendency towards false-positive diagnosis (specificity 77.4%, 95% CI 73.6–80.8). Characteristics of patients with a false-negative CVD diagnosis were similar to those of patients with a true-positive diagnosis, but patients with a false-negative CVD diagnosis had ischemic heart disease less frequently. In retrospect, one patient would have been considered a candidate for intravenous thrombolysis (0.2%). Conclusions: Teleneurological consultations are accurate for identifying patients with CVD, and there is a very low rate of missed candidates for thrombolysis. Apart from a lower prevalence of ischemic heart disease, characteristics of “stroke chameleons” were similar to those of correctly identified CVD patients.

Comorbidities in patients with chronic hepatitis C and hepatitis B on hemodialysis.

Hemodialysis patients are at increased risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Both HBV and HCV infections lead to risks of end-stage liver diseases and extrahepatic manifestations. This study aimed to investigate hepatic and extrahepatic comorbidities in hemodialysis patients with HBV or HCV infections compared with those without viral hepatitis. A total of 1910 hemodialysis patients, including 159 HCV viremic patients (HCV group), 217 seropositive for HBV surface antigen (HBsAg, HBV group) and 1534 seronegative for both anti-HCV and HBsAg (non-B and non-C [NBNC] group), from 23 hemodialysis centers were enrolled. Comorbidities were classified into 10 categories by the International Classification of Diseases-10th Revision. Among the 1910 patients, the mean age was 64.6years, and 52.7% were male patients. A total of 1834 (96%) patients had at least one comorbidity, and the mean number of comorbidities was 2.9±1.5 per person. The three most common comorbidities were hypertension, diabetes, and ischemic heart diseases. The mean number of comorbidities per person was significantly higher in the HCV group (3.3±1.7) than in the HBV (2.7±1.5, P<0.001) and NBNC groups (2.9±1.5, P=0.004), mainly due to the higher prevalence of ischemic heart disease, respiratory disorders, and mental/behavioral disorders. The HBV and NBNC groups exhibited comparable burdens of comorbidities. Hemodialysis patients had a high prevalence of multiple comorbidities. Hemodialysis patients with HCV exhibited a higher burden of comorbidities, especially ischemic heart diseases, respiratory disorders, and mental/behavioral disorders, than HBV and NBNC patients did.

Sex-based difference in anticoagulated patients with mechanical prosthetic heart valves and long-term mortality risk.

Vitamin K antagonists (VKAs) reduce thromboembolism in patients with mechanical prosthetic heart valves (MPHV). It is unclear whether a sex-based difference in MPHV patients regarding valve site, anticoagulation quality, and mortality risk does exist. We analysed 2111 MPHV patients from the nationwide PLECTRUM study promoted by the Italian Federation of Anticoagulation Clinics (FCSA). We analysed the site of MPHV, anticoagulation quality, as assessed by the time in therapeutic range (TiTR), and mortality risk in women and men. The mean age of the patients was 56.8±12.3years. Women were older with a lower prevalence of ischemic heart disease and smoking habit and a higher prevalence of atrial fibrillation at baseline. Aortic MPHV was more frequent in men (74.7% vs 43.3%, P<.001), whereas mitral (41.1% vs 17.6%, P<.001) and mitro-aortic (15.6% vs 7.7%, P<.001) MPVH in women. The association between female sex and mitral/mitro-aortic site remained at multivariable logistic regression analysis (Odds Ratio 3.623, 95% Confidence Interval [CI] 2.947-4.455, P<.001). Regarding anticoagulation quality, women showed lower mean TiTR (63.0±19.4 vs 57.5±19.2, P<.001), and a higher proportion of TiTR<60% (54.9% vs 43.3%, P<.001). During a mean follow-up of 123months (21665 pt-years), 152 deaths occurred (0.7%/year); 83 in the aortic (0.63%/year) and 69 in the mitral/mitro-aortic (0.81%/year) group. At multivariable Cox proportional hazard regression analysis, female sex was not associated with mortality (HR 0.953, 95%CI 0.678 1.340, P=.783). Female sex is independently associated with mitral/mitro-aortic MPHV. Despite a lower TiTR in women, mortality risk did not differ between the two groups.

Prevalence of ischemic heart disease depending on factors of psychoemotional stress among men of mature age (epidemiological study)

To establish associations of the prevalence of ischemic heart disease (IHD) and factors of psychoemotional stress in men of the open urban population in the age group 4564 years after two decades of life. A cross-sectional epidemiological study using a model of the city of Tyumen was conducted on a representative sample of the population among males of mature age (4564 years). Based on standard epidemiological methods, IHD was established according to strict epidemiological criteria definite IHD. The study of the factors of psycho-emotional stress (depression, hostility, life exhaustion) was carried out according to the algorithms of the World Health Organization program MONICA-psychosocial. When calculating the odds ratio for the development of IHD, a low level of psycho-emotional stress factors was regarded as the absence of a sign, a combination of medium and high levels as a presence. The prevalence of ischemic heart disease in the open population (on the model of Tyumen) according to strict epidemiological criteria in men aged 4554 years was 8.2%, at the age of 5564 years 19.2%, a predominance of painless form of ischemic heart disease was revealed. According to the levels of factors of psychoemotional stress in mature men, mainly the average level of depression and life exhaustion, a high level of hostility were established. In men of an open population (on the model of Tyumen), depending on the psychoemotional stress, a high risk of developing a certain coronary heart disease was established in the age categories 4554 and 5564 years old in the presence of depression, at the age of 5564 years in the presence of hostility or life exhaustion. Consequently, the data obtained indicate the importance of further studying the factors of psychoemotional stress in men of mature age in Siberian populations, their relationships with conventional risk factors for coronary artery disease, as well as the advisability of preventive measures aimed at weakening the influence of not only conventional risk factors, but also factors of psycho-emotional stress. among the Russian population.

Effect of opium consumption on cardiovascular diseases \u2013 a cross- sectional study based on data of Rafsanjan cohort study

BackgroundThere are differences of opinion about the beneficial or detrimental effects of opium consumption on cardiovascular diseases (CVDs). So, we aimed to study the association between opium use and CVDs.MethodsWe used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN), with detailed, validated data on opium consumption and some other exposures. A total of 10,000 adults were enrolled in the study. Logistic regression models were used to assess the possible relationships of opium consumption with the prevalence of ischemic heart diseases (IHD) and myocardial infarction (MI).ResultsIn this study, 9990 participants in the baseline phase of the Rafsanjan adult cohort study were included according to their completed questionnaire. Among all participants, 870 and 296 individuals were found to suffer from IHD and MI, respectively. Opium consumption was found to be relatively high in the RCS participants, especially in men (men = 2150 and women = 228). Opium use was associated with a higher odds of IHD and MI, with the adjusted odds ratios (95% CI) of 1.51 (1.22–1.86) and 1.79 (1.31–2.45), respectively. Also, dose-response increases were observed with the highest odds ratios in the 4th quartile for MI and IHD (p-values for trend < 0.001). Increased odds were observed for the two main methods of opium consumption, i.e. oral and smoking, but oral administration had higher odds ratio.ConclusionsOpium consumption is associated with the increased odds of both IHD and MI diseases.

Ассоциация психосоциальных факторов риска и ишемической болезни сердца в открытой популяции крупного промышленного центра Восточной Сибири

Aim of study. To study gender-based association of high anxiety and depression with ischaemic heart disease exemplified by open population of the city of Krasnoyarsk. Material and methods. A representative sample formed from unoccupied population permanently residing in the city of Krasnoyarsk aged 25-64. Psychometric testing was performed via the Hospital Anxiety and Depression Scale (HADS), the prevalence of ischaemic heart disease was determined based on conventional epidemiological criteria. Results. High values of age-adjusted prevalence of anxiety and depression in the studied sample amounted to 40.1% and 35.0% respectively with no association with the gender. Ischaemic heart disease (IHD) was registered in 10.6% of the patients (15.8% male and 8.6% female subjects, p=0.092). Statistically significant association between IHD and high anxiety (OR=2.39; 95% CI 1.19-4.8; p=0.013) and depression (OR=2.1; 95% CI 1.1-4.1; p=0.031). Gender-discrete analysis has shown analogical associations of IHD with anxiety (OR=4.41; 95% CI 1.57-12.38; р=0.004) and depression (OR=2.91; 95% CI 1.20-7.10; р=0.027) in the female group. Analysis has shown absence of interrelation between the studied risk factors and IHD in the male group of patients. Conclusion. The factor of gender defines association between high anxiety and depression scores according to the HADS in open population of the city of Krasnoyarsk.

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Few epidemiological studies have discussed the gender-specific prevalence of ischemic heart disease (IHD). We aimed to investigate the gender-specific prevalence of IHD among Saudi patients visiting the emergency department and if it is affected by diabetes mellitus and/or hypertension. Three hundred patients were recruited from Prince Sultan Cardiac Center in Al Ahsa, KSA. Hypertension was identified as systolic pressure equal to or more than 140 mmHg and/or diastolic pressure equal to or more than 90 mmHg or by the patient currently being on antihypertensive medication, and coronary artery disease (CAD) was diagnosed by electrocardiogram, cardiac markers, cardiac exercise testing or coronary angiography. Hypertension was found in 80% of males and 72% of females. A significantly higher rate of diabetes was noted in females (62%) compared to males (48%) (p&lt;0.012). Co-existing diabetes and hypertension was found in 70% of females as compared to 38% of males. The occurrence of IHD in males was significantly higher than that in females (p&lt;0.001). However, the incidence of myocardial infarction was greater in females (52%) compared to males (38%) (p&lt;0.035). Co-existing hypertension and diabetes may affect the gender prevalence of myocardial infarction among emergency department patients, with more infarctions being noted among females. This finding helps to guide the treatment strategy for both genders.

Ischemic heart disease among the population of working age in Kyiv region: statistical analysis of the modern epidemiological situation

Annotation. Ischemic heart disease (IHD) is one of the main causes of high mortality, disability and a decrease in the quality of life of the working-age population (WAP) in Ukraine. Aim of the work: to determine the modern features of mortality, disability, prevalence and incidence of ischemic heart disease in the working-age population of the Kyiv region. The analysis of the epidemiology of IHD in the Kyiv region was carried out in dynamics for 2010–2019 and compared to Ukraine. The statistical data of the State Statistics Committee of Ukraine, the Center for Medical Statistics of the Ministry of Health of Ukraine, and the Kyiv Regional Center for Medical Statistics on mortality, disability, prevalence and incidence of IHD in the working-age population of the Kyiv region were analyzed with the medical-statistical method. It has been established that IHD is a significant cause of the loss of labor potential in the Kyiv region. IHD accounts for every fourth (25.0%) death in the working age, and the regional level of working-age population mortality from IHD is the highest in Ukraine. In the Kyiv region working-age population dies from ischemic heart disease 1.5–1.7 times, and from myocardial infarction – 1.7–1.9 times more often than the average in Ukraine. Regional levels of incidence IHD among working-age population exceed similar indicators in Ukraine by 1.2 times, the incidence of myocardial infarction – 1.5 times, the prevalence of ischemic heart disease – 1.7 times. Identified unfavorable dynamic trends in mortality and prevalence of IHD among the working-age population of the Kyiv region. The mortality rate from IHD among working-age population increased in the Kyiv region in 2019 compared to 2010, by 7.9%. The prevalence of IHD increased during 2010–2018 by 14.4%, and the primary incidence of myocardial infarction – by 14.9%. The unfavorable epidemiological situation with IHD among working-age population in the Kyiv region necessitates improving the system for the prevention and the organization of medical care for patients with IHD in this region.