Onset Of Heart Disease Research Articles

PD-1/PD-L1 and coronary heart disease: a mendelian randomization study.

It has been found that programmed cell death protein-1 (PD-1) or its ligand PD-L1 may play an important role in the onset and progression of coronary heart disease (CHD). Thus, we conducted this mendelian randomization analysis (MR) to estimate the causal relationship between PD-1/PD-L1 and 5 specific CHDs (chronic ischemic heart disease, acute myocardial infarction, angina pectoris, coronary atherosclerosis, and unstable angina pectoris), complemented by gene set enrichment analysis (GSEA) for further validation. Publicly available summary-level data were attained from the UK Biobank with genetic instruments obtained from the largest available, nonoverlapping genome-wide association studies (GWAS). Our analysis involved various approaches including inverse variance-weighted meta-analysis, alternative techniques like weighted median, MR-Egger, MR-multipotency residuals and outliers detection (PRESSO), along with multiple sensitivity assessments such as MR-Egger intercept test, Cochran's Q test, and leave-one-out sensitivity analysis to evaluate and exclude any anomalies. Gene expression profile (GSE71226) was obtained from Gene Expression Omnibus (GEO) database for GSEA. IVW analysis showed a causal association between PD-1 and chronic ischemic heart disease (OR, 0.997; 95%CI, 0.995-0.999; P, 0.009), chronic ischemic heart disease and PD-1 (beta, -3.1; 95%CI, -6.017 to -0.183; P, 0.037), chronic ischemic heart disease and PD-L1 (beta, -3.269; 95%CI, -6.197 to -0.341; P, 0.029). No significant causal relationship was found between PD-1/PD-L1 and other 4 CHDs. The accuracy and robustness of these findings were confirmed by sensitivity tests. GSEA found that the KEGG pathway and related core genes of "PD-L1 expression and PD-1 checkpoint pathway in cancer" pathway were downregulated in CHD. This study provided evidence of a bidirectional causal relationship between PD-1 and chronic ischemic heart disease and a protective association between chronic ischemic heart disease and PD-L1.

Early diagnosis of stroke risk factors in high school students in Makassar, South Sulawesi, Indonesia

The number of stroke patients in Indonesia is ranked as the first country to experience the most strokes in all of Asia. The prevalence of stroke in Indonesia reaches 8.3 out of 1000 population. This prevalence rate increases with increasing age. Indonesian national data shows that stroke is the highest cause of death, at 15.4%, with approximately 750,000 strokes per year in Indonesia and 200,000 recurrent strokes. People who are physically inactive (those who exercise less than three times per week, each for 30 minutes) have an almost 50% increased risk of stroke compared to those who are active. Physical inactivity can lead to weight problems and increased blood pressure and is associated with diabetes, all of which are important risk factors for stroke. Inactivity also contributes to the onset of early atherosclerosis and other cardiovascular diseases, such as heart attacks. This study is an analytical observational study with a cross sectional design to see and observe the risk factors for stroke that exist in school children in Makassar city. Data processing was carried out using computer application programs and SPSS version 22.0 with data analysis methods using the Chi Square Test with the Yate's Correlation formula in SPSS called Continuity Correction and Risk. The number of respondents studied was 896 people. Hypertension is a major risk factor for health problems in society, especially in socioeconomic transition. Hypertension is a primary risk factor for the onset of heart disease and stroke. Doing physical activity will prevent us from various diseases, by doing adequate physical activity we can suppress the increase in blood sugar levels, cholesterol levels, and avoid obesity and strengthen the heart. All of which are risk factors for stroke. So thus by doing adequate physical activity we can avoid stroke. There is a relationship between gender, obesity, hypertension, family history of disease, stress, physical activity, risky diet and smoking on stroke risk factors and there is no relationship between age and knowledge with stroke risk factors.

Relation of Cognitive Reserve Indicator to Heart Disease and Cardiac Structure and Function: A Large Community-Based Longitudinal Study.

High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function. Within the UK Biobank, 349 907 HD-free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow-up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75-0.80) (including 0.68 [0.66-0.71] for coronary HD, 0.91 [0.87-0.95] for cardiac arrhythmia, and 0.63 [0.58-0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37-1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end-diastolic volume (β, 0.13 [95% CI, 0.09-0.17]), left ventricular end-systolic volume (β, 0.05 [95% CI, 0.01-0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12-0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03-0.13]). High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.

Major depression is not associated with higher myocardial infarction rates: insights from a large database.

Background: Depression has been suggested to increase the risk of cardiovascular disease, but many studies assessed depression after heart disease onset. This study evaluated the association between depression and myocardial infarction (MI) using a large inpatient database.Methods: We analyzed patients from the National Inpatient Sample hospitals from 2005 to 2020, selecting those aged >30 with ICD-9 and ICD-10 codes for segment elevation (ST) elevation myocardial infarction (STEMI), non-STelevation myocardial elevation (NSTEMI) and major depression.Results: Our data included 4413,113 STEMI patients (224,430 with depression) and 10,421,346 NSTEMI patients (437,058 with depression). No significant association was found between depression and MI. For STEMI, the 2005 odds ratiowas 0.12(95% CI: 0.10-0.15, p<0.001) and the 2020 odds ratio was 0.71 (95% CI: 0.69-0.73, p<0.001). Similar patterns were observed for NSTEMI.Conclusion: Depression may not independently be a significant risk factor for MI.

A Novel Cerium Oxide/Gold/Carbon Nanocomposite-Based Electrochemical Sensor for Detecting Hydroxyl Radicals

Hydroxyl radicals (•OH), a type of reactive oxygen species (ROS), play a crucial role in maintaining the normal physiological processes of human cells. Nevertheless, an excessive accumulation of these radicals may perturb cellular mechanisms, so triggering the onset of severe diseases, including cancer, neurological disorders, and heart disease. The detection of •OH is thus of utmost importance in the early diagnosis of these disorders. The combination of an electrochemical methodology with a recognition system is considered as a promising approach for the detection of •OH. This is primarily due to its capacity to provide fast and direct readings without the need for any preliminary sample preparation. This study presents the development of a new electrochemical sensor for the detection of •OH. The sensor was developed by modifying a screen-printed carbon electrode (SPCE) with a nanocomposite consisting of cerium oxide nanoclusters (CeOx), gold nanoparticles (AuNPs), and a highly conductive carbon. The synthesis of AuNPs supported by carbon was carried out using a deposition-precipitation process. Subsequently, the meticulous deposition of CeOx nanoclusters onto the AuNPs was achieved by the use of surface organometallic chemistry (SOMC). Energy dispersive X-ray spectroscopy (EDS) and transmission electron microscopy (TEM) were applied to assess the distribution of AuNPs on the carbon substrate and their subsequent embellishment with CeOx nanoclusters. The actual loadings of Ce and Au present in the nanocomposite were measured using inductively coupled plasma optical emission spectroscopy (ICP-OES). Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were employed to analyze the electrochemical responses resulting from the interaction of the CeOx-Au/Carbon nanocomposite with •OH. The CV results demonstrated that the proposed sensor exhibited the capability to effectively identify the presence of •OH in the Fenton reaction, with a notably low limit of detection of 58 µM. The sensor demonstrated a linear correlation between the current response and the concentration of •OH, within the range of 0.05 to 5 mM. Compared to a sensor modified with CeOx/Carbon, the CeOx-Au/Carbon-modified sensor exhibited enhanced electrochemical performance, as demonstrated by an increased current response and a reduced peak potential difference when detecting •OH radicals. Furthermore, the EIS studies showed that the sensor could distinguish •OH from other comparable ROS, such as hydrogen peroxide (H2O2).

Machine Learning-Based Cardiovascular Disease Prediction System to reduce the incidence of occurrence

Health is a paramount factor when considering any nation's sustainable growth and development. The concentration of the larger population of Nigerians is in the rural areas where public health infrastructures are either inadequate or not available. This has affected the larger labor force, leaving society vulnerable to high health. In recent times, one of the major health challenges facing rural and urban dwellers is heart disease occasioned by the non-existence of proper medical diagnosis. This study develops a machine learning model to predict the onset of heart disease to minimize onset cases of occurrence. The health prediction system is integrated with a prediction module to help in providing public healthcare services to rural dwellers. The developed system was comparatively achieved using hybrid machine learning techniques, which include a support vector machine and random forest in the design of the predictive module. The system integrates rural dwellers' health records with the global health database to form part of the Big Data for global access and considerations. The performance evaluation was achieved with the help of Random Forest. The system developed shows an average accuracy of 98% using machine learning algorithms. It also provides a convenient means for rural dwellers to access public health and enables them to receive health predictions to guide against fatal heart disease.

Are there any benefits from prescribing a cardiac cytoprotector to enhance the quality of life in patients with coronary heart disease and chronic heart failure?

Introduction. Type 2 diabetes (T2D) increases the risk of developing cardiovascular diseases, which leads to a high mortality in this category of patients. Issues regarding the prevention of the onset and progression of coronary heart disease (CHD) and chronic heart failure (CHF) in patients with T2D and/or metabolic syndrome (MS) are still not fully understood. The use of metabolic drugs with cardioprotective effects, in particular Mildronate®, is one of the possibilities to improve the effectiveness of combination treatment of CHD and CHF.Aim. To study the effect of Mildronate® on the quality of life (QoL) of patients with CHD and CHF, suffering from T2D and/or MS.Materials and methods. A total of 2.084 patients with co-occurring two (or more) disorders: obesity, type 2 diabetes, angina pectoris, CHT, and CHF were included in the INDICOR observational study conducted in real-life clinical practice settings. Group 1 received therapy with disease-modifying agents prescribed due to CHD and T2D; Group 2 received Mildronate® at a dose of 1000 mg per day in addition to the same therapy. The studied lab test results were assessed at baseline and 42 days of therapy.Results. A 42-day course of therapy in patients receiving Mildronate® at a dose of 1000 mg per day in addition to disease-modifying therapy (DMT) contributed to a percentage increase in the number of patients with CHD, FC (functional class) I angina pectoris (Δ,% + 63%, p &lt; 0.001 ) as compared to the control group with no significant changes (Δ,% + 7%, p &gt; 0.5). A significant increase in the number of patients with FC I CHF was recorded in Group 2 (from 23.5 to 42.1%, Δ,% + 79%) as compared to Group 1, where no significant changes were detected (22.7 to 23.7%, Δ,% + 4%). The QoL in patients with CHF based on data collected using the Minnesota Questionnaire and QoL in patients with CHD based on data collected using the Seattle Questionnaire significantly improved in the groups that received Mildronate® in addition to DMT, as compared with the group of patients who were only on DMT.Conclusion. Results from the Seattle and Minnesota questionnaires showed that the use of Mildronate® as part of combination therapy in patients with CHD and CHF, suffering from T2D and/or MS, contributed to a significant reduction in the frequency of angina attacks and lowering angina FC, CHF FC, and also enhanced the quality of life in this category of patients.

Ayurvedic approach of dietary management of Hrudaya Roga - A Review Article

Diet play an important role in our day to day life for maintenance of our health, energy and various activities. It is now agreed that diet governs many situations favouring the onset of many heart diseases. All disease requires modified diet but diet plays a variable role in their cure. All Disease requires modified diet but diet plays a variable role in their cure. To keep good health we must “eat to live and not live to eat”. The concept of Ahara has been given due importance in various text of Ayurveda. Acharaya Sushruta has stated the important factors of healthy living namely strength, complexion and Ojas are dependent on Ahara. It is presumed that all diseases according to Ayurveda are believed to have their root of origin in improper Ahara and hence it is essential to understand the basic concept of Ahara as elaborated in Ayurveda.

Pulmonary hypertension in congenital heart disease of children

Background: Pulmonary arterial hypertension is the dreaded complication of congenital heart disease with left-right shunt. The aim of this study was to describe the epidemio-clinical aspects of PAH associated with congenital heart disease. Methods: This was a retrospective descriptive multicentre study over a 2-year period (1 January 2020 to 31 December 2021) conducted in three University Hospitals in Antananarivo. Hospitalized children with congenital left-right shunt heart disease were included. Results: A total of 74 cases were recruited. The sex ratio was 0.7. The mean age of the children was 10.9 (SD=18.2) months. The mean age of onset of heart disease was 8 (SD=13.6) months. Heart disease was dominated by ventricular septal defect (51.3%), patent ductus arteriosus (39.2%), and atrioventricular canal (8.1%). PAH was encountered in 49 cases (66.2%). The majority of children with PAH were under 12 months of age (71.4%) and malnourished (70.2%). According to the type of heart disease, PAH was encountered in all complete CAVs, in 76.3% of CIVs and in 55.2% of PCAs. Eseinmenger's syndrome was present in 4% of cases, and the death rate was 20.3%. Conclusions: Improved management of children with congenital heart disease is needed, both in terms of diagnosis and surgical treatment, to prevent the onset of PAH.

Pleiotropic role of GAS6 in cardioprotection against ischemia-reperfusion injury

IntroductionMyocardial ischemia–reperfusion (IR) injury is a common medical issue contributing to the onset and progression of ischemic heart diseases (IHD). Growth arrest-specific gene 6 (GAS6), a vitamin K-dependent secretory protein, promotes cell proliferation and inhibits inflammation and apoptosis through binding with Tyro3, Axl, and Mertk (TAM) receptors. ObjectivesOur study aimed to examine the effect of GAS6 pathways activation as a potential new treatment in myocardial IR injury. MethodsGain- and loss-of-function experiments were utilized to determine the roles of GAS6 in the pathological processes of myocardial IR injury. ResultsOur results revealed down-regulated levels of GAS6, Axl, and SIRT1 in murine hearts subjected to IR injury, and cardiomyocytes challenged with hypoxia reoxygenation (HR) injury. GAS6 overexpression significantly improved cardiac dysfunction in mice subjected to myocardial IR injury, accompanied by reconciled mitochondrial dysfunction, oxidative stress, and apoptosis. In vitro experiments also observed a protective effect of GAS6 in cardiomyocytes. SIRT1 was found to function as a downstream regulator for GAS6/Axl signaling axis. Through screening a natural product library, a polyphenol natural compound catechin was identified to exhibit a protective effect by turning on GAS6/Axl-SIRT1 cascade. ConclusionsTogether, our findings indicate that GAS6 emerges as a potential novel target in the management of myocardial IR injury and other related anomalies.

Food and Cardiovascular Disease: What to Eat and What Not to Eat

In 2019, the Global Burden of Disease study revealed alarming statistics regarding cardiovascular disease (CVD) in Pakistan. The estimated age-standardized incidence and death rates were 918.18 and 357.88 per 100,000 respectively, surpassing global averages.1 Notably, Pakistan faces unique challenges with a high prevalence of Rheumatic heart disease and early onset coronary artery disease.1&#x0D; The World Health Organization's 2021 factsheet underscores four pivotal modifiable behavioral risk factors for CVD and stroke: unhealthy diet, physical inactivity, tobacco use, and harmful alcohol consumption. These behaviors manifest in individuals as elevated blood pressure, glucose, lipids, and adverse body mass index, exacerbating cardiovascular risk.2 In Pakistan, the consumption of unhealthy foods and excessive calories significantly contributes to adverse cardiometabolic profiles, including obesity and dyslipidemia.2&#x0D; Recent research, such as that by Daruish Mozaffain et al. in "Food is Medicine," advocates for food-based interventions tailored to individual health conditions, ranging from medically tailored meals to nutritional and culinary education.3 However, Pakistani patients with CVD face challenges due to the lack of localized guidelines, educational resources, and accessible nutritionists. Shah et al.'s review underscores the importance of providing clear and culturally relevant dietary guidance for the local population.4&#x0D; Addressing these challenges requires the development of high-quality, culturally sensitive educational materials. These resources should be readily understandable, pictorial, and integrated into both inpatient and outpatient care. Local experts, including dietitians and researchers, can play a crucial role in creating tailored educational content. Figures 1 exemplify the efforts of these experts to provide practical guidance to the Pakistani population.4&#x0D; In conclusion, there is an urgent need for comprehensive, easy-to-understand patient education resources catering to the unique nutritional needs of Pakistani individuals with cardiovascular disease. By addressing these gaps, we can empower patients to make informed dietary choices and improve cardiovascular outcomes.&#x0D; References&#x0D; &#x0D; Samad Z, Hanif B. Cardiovascular Diseases in Pakistan: Imagining a Postpandemic, Postconflict Future. Circulation. 2023;147(17):1261-3.&#x0D; Liaquat A, Javed Q. Current trends of cardiovascular risk determinants in Pakistan. Cureus. 2018;10(10):e3409.&#x0D; Mozaffarian D, Aspry KE, Garfield K, Kris-Etherton P, Seligman H, Velarde GP, et al. “Food Is Medicine” Strategies for Nutrition Security and Cardiometabolic Health Equity: JACC State-of-the-Art Review. J Am Coll Cardiol. 2024;83(8):843-64.&#x0D; Shah SU, Waseem T, Afridi T, Shah MI. Nutritional Needs for Cardiovascular Health in Pakistani Population. Pak Heart J. 2022;55(2):101-13.&#x0D; American Heart Association. Lifestyle Changes for Heart Failure. Accessed on March 30, 2024. Available at: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/lifestyle-changes-for-heart-failure&#x0D; American Diabetes Association. What superstar foods are good for diabetes? Accessed on March 30, 2024. Available at: https://diabetes.org/food-nutrition/food-and-blood-sugar/diabetes-superstar-foods&#x0D; American Heart Association. The American Heart Association Diet and Lifestyle Recommendations. Accessed on March 30, 2024. Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations&#x0D; American Heart Association. Managing Blood Pressure with a Heart-Healthy Diet. Accessed on March 30, 2024. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet&#x0D;

Calculated Small Dense Low-Density Lipoprotein Cholesterol Level is A Predominant Predictor for New Onset of Ischemic Heart Disease.

A high level of directly measured small dense low-density lipoprotein cholesterol (sdLDL-C) is a strong risk factor for ischemic heart disease (IHD). However, it remains unclear whether estimated sdLDL-C level is a predictor for IHD. We investigated the associations of new onset of IHD with levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), LDL-C and calculated sdLDL-C by Sampson's equation. After exclusion of subjects with IHD or those with TG ≥ 800 mg/dL, a total of 18,176 subjects (men/women: 11,712/6,464, mean age: 46 years) were recruited among 28,990 Japanese individuals who received annual health checkups. During the 10-year follow-up period, 456 men (3.9%) and 121 women (1.9%) newly developed IHD. Multivariable Cox proportional hazard analyses after adjustment of age, sex, obesity, smoking habit, family history of IHD, estimated glomerular filtration rate, hypertension and diabetes mellitus at baseline showed that the hazard ratio (HR) (1.38 [95% confidence interval: 1.03-1.85]) for new onset of IHD in subjects with the 4th quartile (Q4) of sdLDL-C (≥ 42 mg/dL) was significantly higher than that in subjects with the 1st quartile (Q1) (≤ 24 mg/dL) as the reference, though the adjusted HRs in subjects with Q2-Q4 of TC, HDL-C, non-HDL-C, LDL-C and TG were comparable with those in subjects with Q1 of the respective lipid fractions. The adjusted HR with a restricted cubic spline increased with a higher level of calculated sdLDL-C as a continuous value at baseline. sdLDL-C level calculated by Sampson's equation is a predominant predictor for the development of IHD in a general Japanese population.

The fascinating theory of fetal programming of adult diseases: A review of the fundamentals of the Barker hypothesis.

The theory of fetal programming of adult diseases was first proposed by David J.P. Barker in the eighties of the previous century, to explain the higher susceptibility of some people toward the development of ischemic heart disease. According to his hypothesis, poor maternal living conditions during gestation represent an important risk factor for the onset of atherosclerotic heart disease later in life. The analysis of the early phases of fetal development is a fundamental tool for the risk stratification of children and adults, allowing the identification of susceptible or resistant subjects to multiple diseases later in life. Here, we provide a narrative summary of the most relevant evidence supporting the Barker hypothesis in multiple fields of medicine, including neuropsychiatric disorders, such as Parkinson disease and Alzheimer disease, kidney failure, atherosclerosis, coronary heart disease, stroke, diabetes, cancer onset and progression, metabolic syndrome, and infectious diseases including COVID-19. Given the consensus on the role of body weight at birth as a practical indicator of the fetal nutritional status during gestation, every subject with a low birth weight should be considered an "at risk" subject for the development of multiple diseases later in life. The hypothesis of the "physiological regenerative medicine," able to improve fetal organs' development in the perinatal period is discussed, in the light of recent experimental data indicating Thymosin Beta-4 as a powerful growth promoter when administered to pregnant mothers before birth.

ХАРАКТЕРИСТИКА ЛИПИДНОГО СПЕКТРА У БОЛЬНЫХ СТАБИЛЬНОЙ ИБС С ПОГРАНИЧНЫМ СТЕНОЗОМ КОРОНАРНЫХ АРТЕРИЙ

Introduction. Тherosclerosis is the main cause of cardiovascular diseases, including coronary heart disease (CHD). The presence of borderline coronary artery stenosis (CA) is determined in about 35-45% of cases. Aim. To evaluate the lipid spectrum parameters in patients with stable ischemic heart disease (CHD) with borderline stenosis of the coronary arteries (CA) with different clinical phenotypes. Material and methods. The study involved 201 patients with stable ischemic heart disease, functional class 1-3 angina with borderline (50-70%) coronary artery stenosis. Three groups of patients were identified based on clinical phenotypes: a group with the phenotype of stable ischemic heart disease with borderline coronary artery stenosis without diabetes mellitus (DM) and metabolic adverse obesity phenotype (MAOP), a group with the phenotype of stable ischemic heart disease with borderline coronary artery stenosis with DM, and a group with the phenotype of stable ischemic heart disease with borderline coronary artery stenosis and MAOP. Lipid spectrum parameters (TC, LDL, HDL, TG), APO B, APO A1, and the APO B/APO A1 ratio were assessed in all patients. Coronary angiography was performed. Results. The group of patients with the phenotype of stable ischemic heart disease with borderline stenosis of coronary arteries without DM and MAOP included 71 people, with the phenotype of stable ischemic heart disease with borderline stenosis of coronary arteries with DM – 51 patients, and with the phenotype of stable coronary artery disease with borderline stenosis of coronary arteries and MAOP – 79 patients. The groups of patients with different phenotypes did not differ in age, frequency of hypertension and age of its development, age of onset and duration of ischemic heart disease, as well as the frequency of previous MI. When assessing the lipid spectrum in patients with the phenotype of stable ischemic heart disease and diabetes mellitus, LDL and APO B levels were noted to be significantly lower with more frequent use of statins, and the TG level was significantly higher. In patients with stable ischemic heart disease phenotypes with borderline stenosis of coronary arteries without diabetes and MAOP, the level of protective APO A1 was significantly higher, and the frequency of an increase in the APO B/APO A1 ratio was significantly lower than in patients with other phenotypes. Conclusion. The most favorable lipid indices were determined in the group of patients with the stable IHD phenotype without diabetes mellitus and MAOP, although the patients had a similar duration of IHD and the frequency of MI in the anamnesis to those of patients with diabetes mellitus and MAOP. Patients with the stable IHD and diabetes mellitus phenotype compensated for high levels of proatherogenic lipids by taking statins, but they retained high TG levels, and patients with the stable IHD and MAOP phenotype were characterized by a more frequent decrease in APO A1. The frequency of an increase in the APO B/APO A1 ratio, as a proatherogenic index, was the highest in the IHD with diabetes mellitus and MAOP phenotypes.

Comparative Machine Learning Approaches to Analyzing the Illnesses of the Chronic Renal and Heart Diseases

The considerable increase in the risk of clinical events associated with chronic renal disease makes it a severe global public health issue. Chronic kidney disease (CKD) is a severe global public health issue, increasing the risk of clinical events and being associated with renal failure, cardiovascular disease, and early mortality. An accurate and timely diagnosis is essential. This research paper focuses on the global public health issue of chronic kidney disease (CKD) and its association with cardiovascular disease. It emphasizes the importance of accurate diagnosis and timely intervention for CKD, which poses significant risks to patients’ health. The study proposes a machine learning (ML) approach using deep neural networks and feature selection methods to diagnose CKD and heart attack disease. The ensemble learning algorithms used in this study are decision tree (DT), logistic regression (LR), Naive Bayes (NB), random forest (RF), support vector machine (SVM), and gradient boosted trees (GBT) classifier, as well as one deep learning technique called recurrent neural network (RNN). Feature selection techniques like correlation coefficient methods are used to identify critical characteristics. The evaluation of the proposed approach was conducted using accuracy, precision, recall, and F1 measure metrics. The study employed all features for grid search and testing in each approach.

When radiation meets the heart: Future of stereotactic body radiation therapy for hypertrophic obstructive cardiomyopathy.

Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary cardiac disorder characterized primarily by septal hypertrophy and left ventricular outflow tract obstruction. Traditional therapeutic modalities, such as medications and surgeries, do not yield satisfactory outcomes in a subset of patients. The advancements have been made in novel treatments, including new drugs and percutaneous intramyocardial septal radiofrequency ablation (PIMSRA), still need further observation to obtain long-term efficacy and safety. In recent years, stereotactic body radiation therapy (SBRT) has emerged as an innovative non-invasive approach for treating HOCM. Studies indicate that SBRT allows for precise targeting of the hypertrophied septal region, causing both direct and indirect damage to targeted myocardial cells. This can alleviate left ventricular outflow tract obstruction and myocardial ischemia, fulfilling the therapeutic objective. For those with HOCM who neither respond well to medications nor are surgical candidates, SBRT offers a potential new therapeutic alternative. However, the latent risks of radiation therapy persist, such as the onset of radiation-induced heart disease (RIHD). The preliminary investigations guarantee the safety and feasibility of SBRT in HOCM management, an increased volume of clinical studies and prolonged follow-up data are essential to evaluate its real efficacy and potential hazards. In addition, research regarding the therapeutic mechanisms of SBRT for HOCM, optimal dosages and treatment durations, indications and contraindications, prevention of complications, and enhancing the precision of radiation therapy, still needs to be further exploration, to determine the best therapeutic strategies.

Association Between Onset Age of Coronary Heart Disease and Incident Dementia: A Prospective Cohort Study.

The association of age at coronary heart disease (CHD) onset with incident dementia remains unexplored. This study aimed to examine whether younger onset age of CHD is associated with a higher risk of incident dementia. Data were obtained from the UK Biobank. Information on the diagnosis of CHD and dementia was collected at baseline and follow-ups. Propensity score matching method and Cox proportional hazards models were used to evaluate the association between different ages at CHD onset and incident dementia. A total of 432 667 adults (mean±SD age, 56.9±8.1 years) were included, of whom 11.7% had CHD. Compared with participants without CHD, participants with CHD exhibited higher risks of developing all-cause dementia, Alzheimer's disease, and vascular dementia. More importantly, younger age at CHD onset (per 10-year decrease) was significantly associated with elevated risks of all-cause dementia (hazard ratio [HR], 1.25 [95% CI, 1.20-1.30]; P<0.001), Alzheimer's disease (HR, 1.29 [95% CI, 1.20-1.38]; P<0.001), and vascular dementia (HR, 1.22 [95% CI, 1.13-1.31]; P<0.001). After propensity score matching, patients with CHD had significantly higher risks of all-cause dementia, Alzheimer's disease, and vascular dementia than matched controls among all onset age groups, and the HRs gradually elevated with decreasing age at CHD onset. Younger onset age of CHD is associated with higher risks of incident all-cause dementia, Alzheimer's disease, and vascular dementia, underscoring the necessity to pay attention to the neurocognitive status of individuals diagnosed with CHD at younger age to conduct timely interventions to attenuate subsequent risk of incident dementia.

Association of body mass index with risk of cardiometabolic disease, multimorbidity and mortality: a multi-state analysis based on the Kailuan cohort.

To evaluate the association of body mass index (BMI) with risk of first cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM) and death. 87,512 participants free of CMD were included from the Kailuan cohort, which was established during 2006-2007 and followed up until 2020. BMI was classified as underweight ( < 18.5 kg/m2), healthy weight (18.5-23.9 kg/m2), overweight (24.0-27.9 kg/m2), mildly obese (28.0-31.9 kg/m2), and severely obese ( ≥ 32.0 kg/m2). FCMD was defined as the first onset of diabetes, heart disease, or stroke, and CMM as the coexistence of at least two CMD. The hazard ratio (HR) and 95% confidence interval (95%CI) were estimated with multi-state models. 20,577 participants developed FCMD, 2232 developed CMM afterwards, and 10,191 died. Individuals with higher BMI was more likely to develop FCMD and CMM. Compared with healthy weight, the HR (95%CI) of severe obesity for transition from health to FCMD and from FCMD to CMM was 3.12 (2.91, 3.34) and 1.92 (1.60, 2.31), respectively. On the other hand, underweight was consistently associated with higher mortality risk regardless of initial status, whereas severe obesity was only related to increased risk for transition from health to death (HR: 1.36; 95%CI: 1.17, 1.56) but not for transition from FCMD (HR: 0.70; 95%CI: 0.57, 0.87) or CMM (HR: 0.80; 95%CI: 0.54, 1.19) to death. Our findings highlighted the importance of maintaining healthy weight for primary and secondary prevention of CMD and reflected the demand for more accurate measurement and comprehensive management of obesity for CMD patients.

Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions.

Cardiovascular diseases account for 43% of deaths in Poland. The COVID-19 pandemic increased the number of cardiovascular deaths by as much as 16.7%. Lipid metabolism disorders are observed in about 20 million Poles. Lipid disorders are usually asymptomatic, they cause a significant increase in the risk of cardiovascular diseases. Up to 20% of patients who experience an acute coronary syndrome (ACS) may experience a recurrence of a cardiovascular event within a year, and up to 40% of these patients may be re-hospitalized. Within 5 years after a myocardial infarction, 18% of patients suffer a second ACS and 13% have got a stroke. Lipid-lowering therapy is an extremely important element of comprehensive management, both in primary and secondary prevention, and its main goal is to prevent or extend the time to the onset of heart or vascular disease and reduce the risk of cardiovascular events. A patient with a history of ACS belongs to the group of a very high risk of a cardiovascular event due to atherosclerosis. In this group of patients, low-density lipoprotein cholesterol levels should be aimed below 55 mg/dl (1.4 mmol/l). Many scientific guidelines define the extreme risk group, which includes not only patients with two cardiovascular events within two years, but also patients with a history of ACS and additional clinical factors: peripheral vascular disease, multivessel disease (multilevel atherosclerosis), or multivessel coronary disease, or familial hypercholesterolemia, or diabetes with at least one additional risk factor: elevated Lp(a) >50 mg/dl or hsCRP >3 mg/l, or chronic kidney disease (eGFR <60 ml/min/1.73 m²). In this group of patients, the LDL-C level should be aimed at below 40 mg/dl (1.0 mmol/l). Achieving therapeutic goals in patients after ACS should occur as soon as possible. For this purpose, a high-dose potent statin should be added to the therapy at the time of diagnosis, and ezetimibe should be added if the goal is not achieved after 4-6 weeks. Combination therapy may be considered in selected patients from the beginning. After 4-6 weeks of combination therapy, if the goal is still not achieved, adding a proprotein convertase subtilisin/kexin type 9 protein inhibitor or inclisiran should be considered. In order to increase compliance with the recommendations, Polish Cardiac Society and Polish Lipid Society propose to attach in the patient's discharge letter a statement clearly specifying what drugs should be used and what LDL-C values should be achieved. It is necessary to cooperate between the patient and the doctor, to follow the recommendations and take medicines regularly, to achieve and maintain therapeutic goals.

Development and Evaluation of a Low-Cost Triglyceride Quantification Enzymatic Biosensor Using an Arduino-Based Microfluidic System.

Overweight and obesity promote diabetes and heart disease onset. Triglycerides are key biomarkers for cardiovascular disease, strokes, and other health issues. Scientists have devised methods and instruments for the detection of these molecules in liquid samples. In this study, an enzymatic biosensor was developed using an Arduino-based microfluidic platform, wherein a lipolytic enzyme was immobilized on an ethylene-vinyl acetate polymer through physical adsorption. This low-cost optical biosensor employed a spectrophotometric transducer and was assessed in liquid samples to indirectly detect triglycerides and fatty acids using p-nitrophenol as an indicator. The average triglyceride level detected in the conducted experiments was 47.727 mg/dL. The biosensor exhibited a percentage of recovery of 81.12% and a variation coefficient of 0.791%. Furthermore, the biosensor demonstrated the ability to detect triglyceride levels without the need for sample dilution, ranging from 7.6741 mg/dL to 58.835 mg/dL. This study successfully developed an efficient and affordable enzymatic biosensor prototype for triglyceride and fatty acid detection. The lipolytic enzyme immobilization on the polymer substrate provided a stable and reproducible detection system, rendering this biosensor an exciting option for the detection of these molecules.