Prevalence Of Coronary Heart Disease Research Articles

Abstract 11081: Measures of Food Inadequacy and Cardiovascular Disease Risk in Black Americans: The Jackson Heart Study

Introduction: Food insecurity is common in the U.S. and disproportionately impacts Black Americans, but its association with risk of heart failure (HF) and coronary heart disease (CHD) is unclear. We evaluated the associations of economic food insecurity and proximity to unhealthy food options with risk of incident HF and CHD, and assessed the potential impact of diet quality and stress on these associations. Methods: Among 3,024 Black adult participants in the community-based Jackson Heart Study (JHS) without prevalent HF or CHD who attended visit 1 (2000-2004), the associations of economic food insecurity (receiving food stamps, self-reported ‘not enough money for groceries’) and proximity to unhealthy food stores (>2.5 unfavorable food stores [fast food restaurants, convenience stores] within 1 mile) with incident HF hospitalization and CHD were assessed using multivariable Cox proportional hazard models. Adjustment covariates included age, sex, BMI, hypertension, and diabetes in the initial model and diet quality (Healthy Eating Index) and perceived stress (total Global Perceived Stress score) in the extended model. Results: Mean age was 54±12 years, 34% were men, 630 (21%) were economically food insecure, and 1,512 (50%) had >2.5 unfavorable food stores within 1 mile. In multivariable models, economic food insecurity was associated with a heightened risk of incident HF and of incident CHD, which persisted with minimal attenuation after further adjustment for diet quality and perceived stress (Table). Limited physical food access was not associated with heightened risk of incident HF or CHD after accounting for demographics. Conclusions: Economic food insecurity, but not proximity to unhealthy food options, is associated with HF and CHD risk independent of traditional cardiovascular risk factors. Increased perceived stress and worse diet quality do not appear to account for these associations.

BLOOD GROUP RELATIONSHIP WITH CORONARY HEART DISEASE


 Coronary heart disease is a heart disease caused by narrowing of the coronary arteries, starting from the occurrence of atherosclerosis (arterial stiffness) or the accumulation of fat or plaque (plague) on the walls of the coronary arteries, either accompanied by clinical symptoms or without symptoms.
 Coronary heart disease (CHD) is widely reported in developed countries. The incidence of CHD in European men was recorded by WHO in 1976 as 2-14 per 1000 population and CHD is mostly found in Finland. In developing countries, the prevalence of CHD is generally rare. In South Africa in 1970 the death rate from CHD was 0.05 per 1000 black population and 1.9 per 1000 white population. In Ujung Pandang, the average treatment for CHD is 0.3 per 1000 patients. The type of research used is a quantitative study with a descriptive correlation research design, which is a study or study that describes the relationship between two variables in a situation or group of subjects. This is done to see the relationship between one variable with another variable. This study aims to see the relationship between blood type and the incidence of coronary heart disease in the CVCU room at Haji Adam Malik General Hospital Medan in 2010. The population of this study was 11 people using incidental sampling. From the statistical test using the Chi-Square test analysis, it was found that p (value) = 0.012 where p (value) < 0.05. So the results of these tests found a very close and real relationship between the relationship between blood type and the incidence of coronary heart disease. The results of this study can be used as information and increase knowledge for nursing services in hospitals about the relationship between blood type and the incidence of coronary heart disease.

Associations of Walking Activity With Hypertensive Mediated Organ Damage in Community-Dwelling Elderly Chinese: The Northern Shanghai Study.

Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear.Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin–creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima–media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated.Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease (p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: −0.066, −0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05).Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02368938.

Increased lipoprotein(a) multiplies coronary heart disease risk in patients with familial hypercholesterolemia

Abstract Background Familial hypercholesterolemia (FH) and elevated lipoprotein(a) (Lp[a]) are individually associated with increased coronary heart disease (CHD) risk. Purpose To determine the independent and joint associations of FH and Lp(a) with CHD. Methods This was a cross-sectional study including adult patients with dyslipidemia followed at our University General Hospital, Greece. FH diagnosis was based on the Dutch Clinic Lipid Network Criteria (score ≥5), while elevated Lp(a) levels were defined as &amp;gt;30 mg/dL. Independent and joint associations of FH and Lp(a) with CHD prevalence were determined using binary logistic regression models adjusted for traditional cardiovascular risk factors. Results Among 941 participants (49 years, 47% males, 54% with FH, 36% with increased Lp[a]), the prevalence of CHD was 7.7% (n=72). Compared with subjects without FH and non-elevated Lp(a) (n=296), those with either FH (adjusted OR: 3.21, 95% CI: 1.35–7.62, n=271) or elevated Lp(a) (adjusted OR: 1.89, 95% CI: 0.76–4.69, n=180) were at higher CHD risk. The patients with both FH and elevated Lp(a) had the highest CHD risk (adjusted OR: 7.31; 95% CI: 3.09–17.32, n=195). Among FH patients, increased Lp(a) doubled CHD risk (adjusted OR: 2.22, 95% CI: 1.02–4.83), whereas among patients with elevated Lp(a), FH was associated with a 5-fold increase in CHD risk (adjusted OR: 4.96, 95% CI: 1.83–13.43). Conclusions FH and elevated Lp(a) have independent and additive associations with CHD prevalence. This may have therapeutic implications regarding treatment intensity. Funding Acknowledgement Type of funding sources: None.

Tends in beta-blocker administration and in prevalence of indications for their usage in heart failure with preserved ejection fraction: an analysis of randomized clinical trials

Abstract Background Despite the lack of data supporting their benefits, beta-blockers (BBs) frequently prescribed for heart failure with preserved ejection fraction (HFpEF). This may be due to the other indications (coronary heart disease, atrial fibrillation, etc.) on the one hand and due to clinical inertia with translation evidence from heart failure with reduced ejection fraction to HFpEF on the other. Purpose To assess the trends in BBs administration and prevalence of the possible indications for their usage (hypertension, atrial fibrillation, coronary heart disease, myocardial infarction) in the participants of the randomized clinical trials (RCTs) of HFpEF. Methods A systematic literature search of PubMed database was performed. RCTs of pharmacological treatment of HFpEF carried out between 1993 and 2019 were used. Studies of the effectiveness of BBs usage, or studies performed in specific populations (HFpEF+coronary heart disease or HFpEF+hypertension, etc.) were excluded. Features at enrolment date and data on the frequency of BBs admission and the prevalence of hypertension, atrial fibrillation, coronary heart disease, and myocardial infarction were extracted. The trends over time of enrolment were analyzed using the Mann-Kendall test. Results Of the 718 filtered publications, 14 RCTs met the inclusion and exclusion criteria fully. In the most recent trials, up to 75–80% of patients received BBs. Time trends analysis revealed that between 1993–2019 years the frequency of BBs use among the participants of the RCTs of HFpEF significantly increased (tau=0.51, p=0.014). No such change was observed in the prevalence of coronary heart disease, myocardial infarction, hypertension, and atrial fibrillation (all p&amp;gt;0.05). Prevalence of hypertension and atrial fibrillation showed a tendency toward increasing (tau=0.4, p=0.055 and tau=0.043, p=0.063, respectively) which became statistically significant for atrial fibrilation with the exclusion of the ALDO-DHF study (tau=0.5; p=0.042). The prevalence of myocardial infarction tended to decrease over time (tau=−0.73; p=0.06). Conclusion Over the last 20 years, the proportion of patients who used BB at enrolment in RCTs of HFpEF increased significantly. There was no statistically significant increase in the prevalence of the formal indications for their usage such as atrial fibrillation, hypertension, coronary heart disease or myocardial infarction. This fact requires attention since some retrospective studies have revealed that BBs use in HFpEF patients is associated with an increased risk of hospitalizations. Funding Acknowledgement Type of funding sources: None.

Cardiovascular primary prevention risk factors in a nationwide survey, ABC (atrial fibrillation, high blood pressure and high cholesterol) risk factors in the LIPIDOGRAM2015 study

Abstract Background The National Health Service in England “Long Term Plan” aims to prevent 150,000 strokes and myocardial infarctions over the next 10 years. To achieve this, resources are being allocated to improve early detection of conditions strongly associated with cardiovascular disease. This includes working towards people routinely knowing their “ABC” risk factors (“A”: atrial fibrillation (AF), “B': hypertension and “C”: high cholesterol) (1). Purpose The aims of this study were to: 1) determine the proportion of participants with “A”, “B”, and “C” criteria; and 2) to identify risk factors for patients fulfilling any of these criteria. Methods LIPIDOGRAM2015 was a nationwide cross-sectional survey for adults in Poland. Adults were recruited in 2015 and 2016 by 438 family physicians. For the ABC criteria, “A” was defined as AF identified in the medical records of the participant, “B” was defined as either systolic blood pressure greater than 140mmHg or diastolic blood pressure greater than 90mmHg or both, and “C” was defined as total cholesterol greater than 200mg/dL (5.17mmol/L). The scaled and centred dataset underwent principal component analysis using singular value decomposition to achieve dimensionality reduction. K-means clustering was used to stratify patients with Hartigan's rule being used to identify optimal K number (2–4). The p-value for statistical significance used in this study was p&amp;lt;0.01 unless otherwise specified. Results 13,724 patients were included in the study. 71.0% (n=9,747) of participants fulfilled the criteria for one or more of the “A”, “B” or “C” components (Fig. 1). 26 variables were used in this analysis with Principal Component Analysis showing 7 principal components explaining over 50% of the variance with 20 components explaining over 90%. K-means clustering was also performed, finding 39 separate clusters. Correlations and statistical significance tests showed a high degree of variability between variables. Participants with AF were older (mean (SD) 67.7 (9.5) vs 55.7 (13.7), p&amp;lt;0.0001), with higher prevalence of concomitant coronary heart disease (CHD) (OR 6.73, 95% CL 5.75, 7.87) and ischaemic stroke (OR 13.45, 95% CL 7.66, 23.6). Participants with hypertension were older (mean (SD) 60.1 (SD 12.4) vs 53.8 (14.0), p&amp;lt;0.0001), with a higher BMI (mean (SD) 29.9 (5.1) vs 27.5 (4.8), p&amp;lt;0.0001) and resting heart rate (mean (SD) 75.7 (10.7) vs 72.7 (8.9), p&amp;lt;0.0001), more likely to be male (OR 1.42, 95% CL 1.32, 1.53) and have diabetes (OR 1.61, 95% CL 1.46, 1.78). Participants with high cholesterol showed an inverse correlation with prevalence of both concomitant diabetes (OR 0.85, 95% CL 0.77, 0.94) and CHD (OR 0.85, 95% CL 0.76, 0.94) (Fig. 2). Conclusion Simple demographic and clinical variables could be used to guide targeted screening to increase population awareness of “ABC” status, allowing for a greater proportion of the population to be appropriately managed with cardiovascular prevention strategies. Funding Acknowledgement Type of funding sources: None. “ABC” Venn diagramCorrelogram and significance plot

ECG-AI: electrocardiographic artificial intelligence model for prediction of heart failure.

AimsHeart failure (HF) is a leading cause of death. Early intervention is the key to reduce HF-related morbidity and mortality. This study assesses the utility of electrocardiograms (ECGs) in HF risk prediction.Methods and resultsData from the baseline visits (1987–89) of the Atherosclerosis Risk in Communities (ARIC) study was used. Incident hospitalized HF events were ascertained by ICD codes. Participants with good quality baseline ECGs were included. Participants with prevalent HF were excluded. ECG-artificial intelligence (AI) model to predict HF was created as a deep residual convolutional neural network (CNN) utilizing standard 12-lead ECG. The area under the receiver operating characteristic curve (AUC) was used to evaluate prediction models including (CNN), light gradient boosting machines (LGBM), and Cox proportional hazards regression. A total of 14 613 (45% male, 73% of white, mean age ± standard deviation of 54 ± 5) participants were eligible. A total of 803 (5.5%) participants developed HF within 10 years from baseline. Convolutional neural network utilizing solely ECG achieved an AUC of 0.756 (0.717–0.795) on the hold-out test data. ARIC and Framingham Heart Study (FHS) HF risk calculators yielded AUC of 0.802 (0.750–0.850) and 0.780 (0.740–0.830). The highest AUC of 0.818 (0.778–0.859) was obtained when ECG-AI model output, age, gender, race, body mass index, smoking status, prevalent coronary heart disease, diabetes mellitus, systolic blood pressure, and heart rate were used as predictors of HF within LGBM. The ECG-AI model output was the most important predictor of HF.ConclusionsECG-AI model based solely on information extracted from ECG independently predicts HF with accuracy comparable to existing FHS and ARIC risk calculators.

Assessment of Cardiovascular Risk Factors and Their Interactions in the Risk of Coronary Heart Disease in Patients with Type 2 Diabetes with Different Weight Levels, 2013-2018.

PurposeIn addition to hyperglycemia and hyperlipidemia, obesity and hypertension are important cardiovascular risk factors for coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). This study aims to explore the interaction of these risk factors.Patients and MethodsData of hospitalized patients with T2DM from 2013 to 2018 were collected. A multivariate logistic regression model was established. Patients with normal weight and blood pressure were recruited as controls. The interaction on the risk of CHD was evaluated by relative excess risk due to interaction (RERI).ResultsAmong the 30,693 patients with T2DM, 7202 (23.5%) had CHD. In the low weight group, the prevalence of CHD in patients with hypertension was nearly four times higher than that in patients without hypertension (42.7% vs 11.3%, P < 0.01). The OR value of hypertension alone on CHD increased from 1.29 (95% CI 1.06–1.56) in the body mass index (BMI) 30.0–34.9 kg/m2 group to 1.35 (95% CI 1.11–1.62) in the BMI ≤ 18.5 kg/m2 group. Additive interaction was observed between hypertension and BMI in CHD risk, especially in the low weight group (RERI:2.2, 95% CI 0.9–3.5). BMI and CHD risk showed a smile curve relationship. The attributive proportion in the low weight group was higher than that in the severe obesity group, that is, 0.52 (95% CI 0.35–0.69) vs 0.18 (95% CI −0.59 to 0.95).ConclusionMaintaining normal weight and avoiding low weight are particularly important for patients with co-occurring diabetes and hypertension to prevent the risk of CHD.

Effect of hyperparathyroidism on vascular stiffness in hemodialysis patients

Abstract Background Cardiovascular disease (CVD) is present in &amp;gt; 50% of patients undergoing dialysis and the relative risk of death due to CVD events in HD patients is reported to be 20 times higher than in the general population. In fact, in patients on renal replacement therapy (RRT) the prevalence of coronary heart disease and ventricular hypertrophy has been described to be 40% and 70% respectively, other CVD events include hypertention, arrhythmias, valvular calcification and arterial stiffness. Objective To detect the prevalence of arterial stiffness among end stage renal disease patients on prevalent hemodialysis with hyperparathyroidism. Patients and Methods This observational cross sectional study was conducted on 60 prevalent hemodialysis patients attending at hemodialysis unit of Ain Shams University hospitals, with convenient sampling method. The included patients are clinically stable on thrice weekly hemodialysis sessions for 4 hours per session. Results The Dual Pulse Wave Doppler (DPWD) method we proposed in this study may be considered as a useful and convenient option for clinical local Pulse Wave Velocity (PWV) measurement, this clinical practical and reproducible method had the capability to detect an increased local PWV of LCCA (which reflect arterial stiffness) in the patients with PTH &amp;gt; 300 more than the patients with PTH &amp;lt; 300 as it showed that in Group B (PTH&amp;gt;300), the measured carotid artery local PWV values ranged from 6.22 m/s to 8.84 m/s and the mean value was 7.81 ± 0.72 m/s, which was higher than 6.72 ± 1.06 m/s (ranging from 4.48 m/s to 8.44 m/s) of Group A (PTH&amp;lt;300). Conclusion Our study showed that there is a high prevalence of arterial stiffness in prevalent hemodialysis patients.

WOMEN ARE STILL UNDERREPRESENTED IN CORONARY HEART DISEASE RESEARCH: PERSPECTIVES FROM A SYSTEMATIC REVIEW

<h3>BACKGROUND</h3> For decades, women have been neglected in cardiovascular research. With growing evidence to support a connection between the heart and the brain, we systematically reviewed the status of women included in experimental research assessing the impact of coronary heart disease (CHD) on neuropsychological functions. <h3>METHODS AND RESULTS</h3> We conducted a systematic review and used the PRISMA guidelines to report our findings. We screened a total of 26,843 references, of which 418 remained for full-text screening and only 13 were included in the final analysis. Throughout the screening process, we excluded studies which did not include women or participants with CHD or its subtypes (e.g., myocardial infarction, angina pectoris), or did not perform a neuropsychological – or variant - assessment. During the full-text screening, we excluded studies that did not perform separate statistical analyses for sexes or for conditions (e.g., combining CHD and heart failure participants). Close to half of the studies (161 studies; 46.60%) were excluded during the full-text screening phase because there was no separate analysis for women, exhibiting the underwhelming attention given to sex differences in CHD research. Of the 13 studies kept, 11 had samples composed of 36% or fewer women, and all studies, except one, failed to report the power and effect size of their sample. Furthermore, only one study considered menstrual cycle/menopause status, although it is known to influence performance on cognitive testing and CHD progression. Demographic variables that are commonly acknowledged to be cardiovascular risk factors (e.g. cholesterol, hypertension, smoking, etc.) were often measured but rarely compared between sexes, providing an incomplete picture of the underlying factors which affect the women included in these studies. <h3>CONCLUSION</h3> Our systematic review shows that women are still strikingly underrepresented in CHD research. Based on our findings, we propose the following guidelines: 1) the number of women included in CHD research should be similar to the CHD prevalence in the general population; 2) researchers should calculate the power and effect size of their samples; 3) menstrual cycle or menopausal status should be taken into account; and 4) all demographic variables should be reported separately for men and women. These guidelines aim to improve cardiovascular research in women, so that future research trials can better represent them. <i>Natural Sciences and Engineering Research Council (NSERC)</i>

Epidemiology of Acute Coronary Syndrome in Azadi Teaching Hospital in Kirkuk Governorate

Background: Coronary heart disease (CHD), the principal manifestation of cardiovascular diseases, is the leading cause of morbidity and mortality worldwide. The World Health Organization (WHO) predicts that by 2020, CHD will become the world‘s most important cause of death, disability and premature death. The major factors are an elevated cholesterol level, hypertension, smoking, genetic factors, a sedentary lifestyle, obesity, and diabetes; and the risk increase with age. Adequate control and well awareness of cardiovascular disease risk factors and health habits are important for preventing CHD. Objective: 1- To make a change of morbidity of CHD by education. 2- To evaluate the health-related quality of life in development of ACS. Patients and Methods: A hospital based case-control study was conducted in the Coronary Care Unit (CCU), which is located in Kirkuk (Azadi Teaching Hospital); from March 2017 to September 2017. The study included 180 cases of coronary heart disease and 180 age and sex matched controls. All the participants were interviewed with special questionnaire form. In addition, the weight and height were measured and the fasting lipid profile was sent to the laboratory of same hospital for all participants. Statistical Package for Social Science (SPSS) version 20.0 was used for data analysis. Results: The males accounts two third of cases, 112(62.2%) in comparison to females 68(37.8 %); 63(35 %) of the cases were in the age group (70-79) years. About (54.7%) of all participants were unemployed, (68.3%) had low education and (38.3%) with low income. The study showed a statistical significant association between the following risk factors and educational level: hypertension, diabetes, dyslipidemia, economic level, occupation, and alcohol consumption. Conclusion: Overall there is a significant relation between educational level and risk of developing CHD. The prevalence of CHD was more common in age group (≥ 60) years and the males were more likely to be affected; hypertension is the most prevalent risk and then diabetes mellitus, occupation respectively.

The association of sleep quality and night sleep duration with coronary heart disease in a large-scale rural population

ObjectiveThe purposes of the present study were to explore independent and interactive associations between night sleep duration, night sleep quality and coronary heart disease (CHD) based on a rural population in China. MethodsA total of 27,935 participants (11,177 men and 16,758 women) were investigated from the Henan Rural Cohort. Information about sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between night sleep duration and quality with CHD. ResultAmong the 27,935 participants, 1506 participants with CHD were identified. Compared with participants with scores lower than 3, the odds ratios (ORs) and 95% confidence intervals (95% CIs) of participants with score of 3–5, 6–8, ≥9 were respectively 1.42 (1.24–1.63), 1.99 (1.70–2.33), and 2.56 (2.13–3.08) with full adjustment of covariates. Compared with night sleep duration of 7 h, men and women who slept less than 5 h were 1.55 (1.11–2.17), 1.12 (0.59–2.12) and 1.80 (1.20–2.68), after being adjusted ORs (95% CIs) of the total. Moreover, the ORs and 95% CIs of CHD increased with the shortening of sleep duration at PSQI score above the highlighted levels. ConclusionPoor sleep quality and short night sleep duration were all associated with CHD in Chinese rural areas. Moreover, the association was more obvious in women. In addition, the strongest prevalence of CHD was found in short sleepers with poor sleep quality.

1067Annual changes in job strain and risk of coronary heart disease in Denmark

Abstract Background We examined the association between annual changes in job strain and incident coronary heart disease (CHD) in a population-based cohort study in Denmark. Methods We studied all workers residing in Denmark in 2000, aged 30-59 years with no prevalent CHD (N = 1,660,150). Using a job exposure matrix (JEM) with annual updates, we assessed changes in job strain from 2000-2009. Incident CHD was identified in hospital and death registers from 2001 to 2010. Using Cox regression, we calculated hazard ratios (HR) and 95% confidence intervals (CI) for the association between annual changes in job strain and incident CHD. Results During 16.1 million person-years (mean time of follow-up: 9.7 years), we identified 24,159 CHD cases (15.0 per 10,000 person-years). Compared to persistent no job strain, persistent job strain (HR 1.07, 95% CI 1.03–1.10), onset of job strain (HR 1.20, 95% CI 1.12–1.29) and removal of job strain (HR 1.20, 95% CI 1.12–1.28) were associated with higher CHD incidence. Conclusions Persistent and onset of job strain was associated with a higher risk of CHD. Removal of job strain was also associated with a higher risk, which might be due to health selection. Our results suggest that job strain contributes to risk of CHD in the Danish workforce. Key messages Implementing JEM in a population-based cohort of more than 1.6 million workers enabled us to demonstrate associations between annual changes in job strain and risk of incident CHD.

Socioeconomic position is associated with N-terminal pro-brain natriuretic peptide (NT-proBNP)-Results of the population-based Heinz Nixdorf Recall study.

N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) is a diagnostic marker for heart failure and a prognostic factor for cardiovascular disease (CVD). The aim of this study was to examine the association of socioeconomic position (SEP) with NT-proBNP while assessing sex-differences and the impact of CVD risk factors and prevalent CVD on the association. Baseline data of 4598 participants aged 45-75 years of the Heinz Nixdorf Recall Study were used. Income and education were used as SEP indicators. Age- and sex-adjusted linear regression models were fitted to calculate effect size estimates and 95% confidence intervals (95%-CIs) for the total effect of SEP indicators on NT-proBNP, while potential mediation was assessed by additionally accounting for traditional CVD risk factors (i.e., systolic blood pressure, HDL cholesterol, LDL cholesterol, diabetes, anti-hypertensive medication, lipid-lowering medication, BMI, current smoking). Education and income were included separately in the models. With an age- and sex-adjusted average change in NT-proBNP of -6.47% (95%-CI: -9.91; -2.91) per 1000€, the association between income and NT-proBNP was more pronounced compared to using education as a SEP indicator (-0.80% [95%-CI: -1.92; 0.32] per year of education). Sex-stratified results indicated stronger associations in men (-8.43% [95%-CI: -13.21; -3.38] per 1000€; -1.63% [95%-CI: -3.23; -0.001] per year of education) compared to women (-5.10% [95%-CI: -9.82; -0.01] per 1000€; -1.04% [95%-CI: -2.59; 0.50] per year of education). After adjusting for CVD risk factors some of the observed effect size estimates were attenuated, while the overall association between SEP indicators and NT-proBNP was still indicated. The exclusion of participants with prevalent coronary heart disease or stroke did not lead to a substantial change in the observed associations. In the present study associations of education and income with NT-proBNP were observed in a population-based study sample. Only parts of the association were explained by traditional CVD risk factors, while there were substantial sex-differences in the strength of the observed association. Overt coronary heart disease or stroke did not seem to trigger the associations.

Impact of monocyte to high-density lipoprotein ratio on the identification of prevalent coronary heart disease: insights from a general population

ABSTRACT Background Recent studies have identified monocyte to high-density lipoprotein ratio (MHR) as a simple, practical surrogate of atherosclerosis. Considering atherosclerosis is a major mechanism of coronary heart disease (CHD). The present study aims to evaluate the association between MHR and the prevalence of CHD. Methods and results The present cross-sectional work included 6442 participants (mean age: 59.57 years, 60.2% females), all of them were included from rural areas of northern China between October 2019 to April 2020. MHR was acquired as monocytes count divided by high-density lipoprotein concentration. Prevalent CHD researched 3.14%. After adjustment of sex, age, current drinking and smoking, BMI, WC, diabetes, hypertension, LDL-C, TG, eGFR, lipid-lowering therapy and cerebrovascular disease history, each standard deviation increase of MHR cast a 39.5% additional CHD risk. Furthermore, the top quartile of MHR had an additional 89.0% CHD risk than the bottom quartile. Besides, smooth curve fitting revealed a linear pattern of the association. Additionally, the stratified evaluation showed a robust correlation among the subgroups divided by CHD risk factors. Finally, area under the curve demonstrated an advancement when including MHR into common CHD risk factors (0.744 vs 0.761, p < 0.001). Consistently, reclassification analysis indicated the improvement from MHR (all P = 0.003). Conclusion Our work suggests the robust and linear relationship between MHR and the prevalent CHD in a general population, providing epidemiological evidence for laboratory studies. More importantly, the findings implicate the efficacy of MHR to be a potential indicator to identify the prevalent CHD.

Association of blood pressure and coronary heart disease in women of an open population of a moderately urbanized city of Western Siberia

Objective. The aim of this study was to assess the association between the level of blood pressure (BP) and the prevalence of coronary heart disease (CHD) in women of working age in an open population of a moderately urbanized Siberian city (on the model of Tyumen).Design and methods. We included 1000 women of an open urban population aged 25–64 years, 250 people in each of four decades of life (among persons 25–34, 35–44, 45–54, 55–-64 years old), selected by the method of a random representative sample from the electoral lists of the administrative district of Tyumen, the response was 70,3% (703 participants). In all subjects we measured BP; assessed the presence of coronary artery disease — according to standardized epidemiological methods: based on the extended criteria, “definite” CHD (strict criteria) and “possible” CHD (non-strict criteria) were distinguished. Statistical analysis was performed using STATISTICA 12.0 software, the differences were considered significant at p-level ≤ 0,005.Results. Almost every third woman (25–64 years old) had increased BP (34,7 %), the frequency of increased BP grows with age, reaching 63,3 % in the older group. Low awareness of high BP and low adherence to treatment were found. There was a correlation between the prevalence of CHD and BP level and age. In the presence of increased systolic BP, the chance of developing CHD in women aged 25–64 years in the open population increases by 1,9–2,7 times (p &lt; 0,05), in the presence of increased diastolic BP, the chance of developing CHD according to extended criteria increases by 2,1 times (odds ratio = 2,08, 95 % confidence interval (1,15; 3,74)).Conclusions. Our results can be used for improving the strategy of primary cardiovascular prevention in preventive programs of the Western Siberia region.

Associations of body size and composition with subclinical cardiac dysfunction in older individuals: the cardiovascular health study.

Focused studies in younger to middle-aged populations have demonstrated a relationship between obesity and adverse cardiac mechanics. We examined whether measures of overall and central adiposity are associated with cardiac mechanics, assessed by speckle-tracking echocardiography, in an older population without prevalent coronary heart disease or heart failure. Body composition was measured by anthropometry, bioelectrical impedance, and dual-energy x-ray absorptiometry among participants in the Cardiovascular Health Study, a population-based cohort of adults aged 65 years or older. Systolic and diastolic cardiac mechanics were measured with speckle-tracking analysis of echocardiograms. Multi-variable adjusted linear regression models were used to investigate associations of body composition measures and cardiac mechanics. Mean age for the 3525 included participants was 72.6 years, 39% were male, and 10% were black. Mean body-mass index (BMI) was 26.3 ± 4.4 kg/m2, waist circumference (WC) was 93.2 ± 12.9 cm, and waist-to-hip ratio was 0.92 ± 0.09. In fully adjusted analyses, all adiposity measures were associated with worse LV longitudinal strain, LV early diastolic strain rate, and left atrial reservoir strain; however, associations were strongest for WC and BMI (p < 0.001). When both BMI and WC were included in the same model, only WC remained associated with each cardiac strain measure. In this cross-sectional study of older adults, central obesity was most robustly associated with impaired left ventricular systolic and diastolic strain as well as left atrial strain. The adverse effects of central obesity appear to extend even into older age.

Increased Pericardial Adipose Tissue in Smokers.

Background: Pericardial adipose tissue (PAT), a visceral fat depot directly located to the heart, is associated with atherosclerotic and inflammatory processes. The extent of PAT is related to the prevalence of coronary heart disease and might be used for cardiovascular risk prediction. This study aimed to determine the effect of smoking on the extent of PAT. Methods: We retrospectively examined 1217 asymptomatic patients (490 females, age 58.3 ± 8.3 years, smoker n = 573, non-smoker n = 644) with a multislice CT scanner and determined the PAT volume. Coronary risk factors were determined at inclusion, and a multivariate analysis was performed to evaluate the influence of smoking on PAT independent from accompanying risk factors. Results: The mean PAT volume was 215 ± 107 mL in all patients. The PAT volume in smokers was significantly higher compared to PAT volume in non-smokers (231 ± 104 mL vs. 201 ± 99 mL, p = 0.03). Patients without cardiovascular risk factors showed a significantly lower PAT volume (153 ± 155 mL, p < 0.05) compared to patients with more than 1 risk factor. Odds ratio was 2.92 [2.31, 3.61; p < 0.001] for elevated PAT in smokers. Conclusion: PAT as an individual marker of atherosclerotic activity and inflammatory burden was elevated in smokers. The finding was independent from metabolic risk factors and might therefore illustrate the increased inflammatory activity in smokers in comparison to non-smokers.

Can laboratory tests at the time of admission guide us to the prognosis of patients with COVID-19?

SummaryIntroductionTo enhance the COVID-19 patients’ care and to optimize utilizing medical resources during the pandemic, relevant biomarkers are needed for prediction of the disease’s progression. The current study was aimed to determine the factors that affect the mortality of COVID-19 patients admitted in Baharloo hospital in Iran.Methodsin the current retrospective study, 56 survived patients and 56 patients who were died (a total of 112 cases) because of COVID-19 infection were randomly selected from those who were admitted to Baharloo hospital. Each patient who was diagnosed with COVID-19 and had recovered from it matched with each non-survived patient in the term of age. Laboratory tests of all these patients at the time of admission were recorded and compared. All analyses performed using spss version 22 by considering α = 0.05 as a significant level.ResultsThere was no statistical difference in the age and gender distribution between the two groups (p > 0.05). The prevalence of diabetes among survived patients was 37.5% and among non-survived patients was 26.8% and there was no statistical difference between two groups regarding this comorbidity (p = 0.22). Also, there was no statistical difference in the prevalence of hypertension and coronary heart diseases between two groups (p > 0.05). Lymphocyte percentage, blood oxygen level, and platelet (PLT) count was significantly higher in patients who had recovered (P < 0.05).ConclusionsLDH level, Lymphocyte percentage, PLT count, and blood Oxygen saturation have associations with severe forms of COVID-19 infection and can be used as predictors to assess the patients who are suspected of infection with COVID-19 at the time of admission.

Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome.

Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated.Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients.Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events.Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P < 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P < 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P > 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels.Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.